The Gastroenterology Outpatients Clinic sees patients with general gastroenterological and liver conditions.
Referrals
Specific Clinic referral information :
- Clinical details and reason for referral
- Onset, characteristics and duration of symptoms
- Relevant medical history
- Dietary history
- Results of all recent and relevant investigations
- Medications(including non-prescription)
- Alcohol use and injectable drug use
- Allergies
- Please include copies of any relevant test results to enable appropriate triaging
(e.g. / Faecal occult blood test – National Bowel Cancer Screening Program). - Referrals with incomplete / insufficient information to enable triaging may be
rejected until this information has been received.
Please see statewide criteria link below:
Categories for appointment
Click to expand categories
| Clinical Description | Timeframe | |
|---|---|---|
| Emergency | – Acute gastrointestinal tract haemorrhage (haematemesis and/or melaena and/or haematochezia – Bloody diarrhoea with signs of dehydration – Suspected acute, severe or fulminant hepatic failure – Severe hepatitis with jaundice – Symptomatic marked ascites or new onset of ascites – Suspected cholangitis – Moderate / severe pancreatitis | Go to Emergency Department |
| Category 1 Urgent | – Strong suspicion of cancer – Obstructive or unexplained cholestatic jaundice – Chronic GI bleeding o Iron deficiency anaemia o Occult GI bleeding (including positive FOBT) o Unexplained rectal bleeding – Severe inflammatory bowel disease – Suspected malabsorption, unexplained weight loss – Progressive or obstructive dysphagia – Decompensating liver disease, suspected chronic liver disease or moderate to severe abnormal LFTs Gastrointestinal symptoms (e.g. altered bowel habits, dyspepsia) with alarm/ red flag symptoms | < 30 Days |
| Category 2 Semi-Urgent | – Diarrhoea without alarm symptoms and normal investigations – Hepatitis B and C (active or untreated) – Haemochromatosis (untreated) New onset dyspepsia or reflux with no alarm symptoms (age ≥55) – Moderately elevated liver function tests – Stable inflammatory bowel disease – Previous polyps with high risk features (polyposis syndrome, previous endoscopic mucosal resection – Known Barrett’s oesophagus with dysplasia | > 3 months |
| Category 3 Routine | – Constipation – Abdominal Pain – Fatty liver with elevated liver function tests – Mild liver function test derangement – Family history of colon cancer (meeting NHMRC guidelines for screening) – Previous history of colonic polyps or Barrett’s oesophagus for surveillance – IBS management | Waitlist >12 -18 months |
Eligibility criteria
All adult residents within Peninsula Health geographical area.
Exclusions
Patients outside the geographically catchment area for Peninsula Health Children (<16 years old)
Indications for referral not meeting the state-wide referral criteria.
- Fatty liver with normal LFTs
- Constipation without alarm symptoms
- Positive coeliac gene test with normal coeliac serology
- Diarrhoea < 4 weeks without alarm symptoms (e.g. bleeding)
- Belching
- Halitosis
- Reflux (<55) where there are no alarm symptoms
- Non-iron deficiency in pre- menopausal women when menorrhagia
has been treated first - Isolated low serum iron
- PR bleed known to be coming from haemorrhoids or untreated anal
fissure
Alternative referral options
There can be a significant wait for new non-urgent patients to be seen in the clinic.
Please consider if the patient can be referred to the private rooms of specialists affiliated with Frankston Hospital (see Specialist Directory).
Make a referral
The following information is required for referral to this clinic.
- Abnormal LFT, suspected or follow up of cirrhosis.
Pathology Tests: LFT, FBE, INR, UEC, HBV serology, HCV serology
Imaging: Upper abdominal U/S, Hep B & C virus serology test, Fe studies.
Clinical History: Current medications, alcohol intake, injectable drug use. - Hepatitis B.
Pathology Tests: Hep B virus serology results (sAg/ Ab, eAg/ Ab, cAg/Ab), Hep B RNA PCR results, Hep C and HIV serology, LFT , FBE, previous liver biopsy results.
Imaging: Upper abdominal U/S.
Clinical History: Current medications. - Hepatitis C.
Pathology Tests: Hep C virus serology, HCV genotype and HVC RNA results, LFT, FBE, UEC, previous liver biopsy results.
Imaging: Upper abdominal U/S, liver fibrosis assessment (fibroscan or shearwave elastography).
Clinical History: current medications, alcohol history. - Persistent Iron deficiency +/-anaemia.
Pathology Results: FBE, iron studies (within one month of referral), coeliac serology, FOBT, faecal calprotectin.
Clinical History: Dietary history, mensural history, family history of GI diseases (IBD, cancers), current medications. - Rectal Bleeding.
Pathology Results: FBE, Iron studies, UEC.
Clinical History: Duration of symptoms, clinical characteristics (e.g. mixed with stool,
in toilet, on paper, pain), history of previous haemorrhoid treatment, family history
of gastrointestinal diseases and colorectal cancer, previous colonoscopy reports. - Unexplained weight loss or other sentinel symptoms (chronic nausea
and vomiting).
Pathology Results: FBE, EUC, LFT, ESR, CRP, fasting glucose, faecal calprotectin, FOBT results.
Imaging Results: Abdominal ultrasound, CT abdomen/ pelvis.
Clinical History: Duration of weight loss, amount of weight loss, associated symptoms, current medications. - Dysphagia.
Imaging: Barium swallow.(Please provide if available)
Clinical History: previous gastroscopy results. - Coeliac disease.
Pathology Results: Coeliac serology, FBE, Fe studies, Vitamin D, previous duodenal Biopsy Results if available. - Suspected Inflammatory Bowel disease.
Pathology Results: FBE, Iron Studies, CRP, faecal calprotectin, stool M/C/S + PCR, C
diff toxin.
Imaging Results: results of any abdominal imaging.
Clinical History: Duration of symptoms, bowel frequency, blood in stools, current medications, colonoscopy and histology results. - Chronic Diarrhoea.
Pathology Tests: FBE, UEC, CRP, EST, Fe studies, Faecal calprotectin, stool M/C/S and PCR. Stool Clostridium difficile toxin.
Clinical History: Frequency of bowel actions, duration of symptoms, current medications, previous colonoscopy results. - Irritable Bowel syndrome/ abdominal pain.
Pathology Results: FBE, UEC, LFT, CRP, coeliac serology, faecal calprotectin, stool M/C/S + PCR.
Imaging Results: plain abdominal x-ray.
Clinical History: Characteristics and durations of symptoms, dietary history, current medications. - Constipation.
Pathology Tests: FBE, Fe studies, UEC, calcium, TSH, Faecal occult blood test.
Clinical History: Duration of symptoms, current medications, documentation of failure to trials of standard laxatives. - Gastroesophageal reflux/ Epigastric pain, Dyspepsia.
Pathology Results: Helicobacter breath test, FBE, Iron studies.
Clinical History: response to trial of reflux medications, response to Helicobacter eradication (if breath test is positive), associated symptoms (dysphagia, weight changes), current medications, previous gastroscopy reports. - Surveillance of colorectal polyps, colorectal cancer or Barrett’s oesophagus.
Clinical History: Previous endoscopy report and histology (if not performed at Peninsula Health), any relevant gastrointestinal symptoms, current medications.
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