The Department will periodically contact patients waiting for an outpatient clinic appointment via SMS, with a link to an electronic form. This is part of routine waitlist auditing to ensure patient details are up to date. If you receive this SMS, please update your details.
North South North West Statewide
All referrals should comply to referral standards and include in particular:
- Family history of gastrointestinal cancers
- Relevant medications
- Medical management to date (document treatments offered and efficacy including failed treatment with moderate dose PPI for dyspepsia)
To refer a patient with this condition, please see the Gastroenterology clinic page for the full referral process and templates.
Recommended pre-referral treatment
Lifestyle Changes:Reduce fatty foods, avoid trigger foods (food diary), weight reduction, smoking cessation, and limit alcohol.
Medical Management:Consider Helicobacter treatment if serology or breath test is positive*: Please note that this may not be covered by Medicare.
* The test-and-treat strategy for H. pylori (i.e. test and treat if positive) is a proven management strategy for patients with uninvestigated dyspepsia who are under the age of 55 years and have no "alarm features" (bleeding, anaemia, early satiety, unexplained weight loss, progressive dysphagia, odynophagia, recurrent vomiting, family history of GI cancer, previous oesophagogastric malignancy).
- Cease any aggravating medications if possible e.g. NSAIDS, aspirin
- A symptom based diagnosis for gastroesophageal reflux can be supplemented by a 2-4 week trial of high dose PPI which has a sensitivity and specificity for reflux disease comparable to oesophageal PH monitoring and superior to endoscopy
- Trial of proton pump inhibitor (PPI) therapy if onset in patients less than 50 years of age and no alarm symptoms as listed in the urgent category
- Proton pump inhibitors should not be necessary long-term for dyspepsia, but may be necessary for severe and /or recurrent GORD, gastric protection for NSAIDs or Barrett's Oesophagus
For more information please see the Tasmanian Health Pathways website.
Potentially life threatening symptoms suggestive of:
- acute upper GI tract bleeding
- acute severe lower GI tract bleeding
- oesophageal foreign bodies/food bolus
- bowel obstruction
- abdominal sepsis
- Acute Severe Colitis - see note
Severe vomiting and/or diarrhoea with dehydration
Acute/fulminant liver failure (to be referred to a centre with dedicated hepatology services
Biliary sepsis (to be referred to a centre with ERCP service)
Note - Acute severe colitis as defined by the Truelove and Witts criteria – all patients with ≥ 6 bloody bowel motions per 24 hours plus at least one of the following:
- temperature at presentation of > 37.8°C,
- pulse rate at presentation of > 90 bpm,
- haemoglobin at presentation of < 105 gm/l, CRP >30mg/dl at presentation (or ESR > 30 mm/hr)
Urgent / category 1
Any patient with significant impact on activities of daily living, unexplained, persistent, or recent-onset symptoms (treatment-resistant) with any of the following concerning features – select those that apply:
- Gastrointestinal bleeding
- Difficulty swallowing
- Persistent and/or recurrent vomiting
- Weight loss ≥5% of body weight in previous 6 months
- Iron deficiency in males and postmenopausal women or unexplained iron deficiency in premenopausal women
Semi-urgent / category 2
Any patient with significant, unexplained, persistent, or recent-onset symptoms (treatment-resistant) without concerning features (as above).
Red flags are clinical indicators of possible serious underlying conditions requiring further medical intervention. They may or may not indicate an emergency.
GESA Guideline: Gastro- Oesophageal Reflux Disease (2011)* The test-and-treat strategy for H. pylori
(i.e. test and treat if positive) is a proven management strategy for patients with un-investigated dyspepsia who are under the age of 55 years and have no "alarm features" (bleeding, anaemia, early satiety, unexplained weight loss, progressive dysphagia, odynophagia, recurrent vomiting, family history of GI cancer, previous oesophageal-gastric malignancy)
Proceed to Emergency Department (ED).
LGH ED Reception – Phone: (03) 6777 6405 Fax: (03) 6777 5201
MCH ED* – Phone: (03) 6478 5120 Fax: (03) 6441 5923
NWRH ED* – Phone: (03) 6493 6351 Fax: (03) 6464 1926
RHH ED Reception – Phone: (03) 6166 6100 Fax: (03) 6173 0489
Advice for medical practitioners can be given by the Medical Officer In Charge (MOIC) - see HealthPathways Tasmania for contact information.
*MCH and NWRH MOICs request GPs call them prior to referring a patient to ensure the patient is being sent appropriately to a safe destination.
We will endeavour to see these patients within four weeks
Urgent referrals should be accompanied by a phone call to the clinic and the relevant doctor for urgent assessment, or patient should be directed immediately to the Emergency Department.
We will endeavour to see these patients within 12 weeks
Next available appointment