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This page contains information for general practitioners on how to refer patients aged 16 years and over to Gastroenterology services at Mater Hospital Brisbane. These services are offered in our specialist outpatient clinics and for eligible patients aged between 16 and 25 years at Mater Young Adult Health Centre Brisbane.
This service includes referrals for:
This service does not include referrals for:
Please see our Pre-Referral Guidelines below for information on when to refer for these conditions, as well as recommendations for conservative management.
Please include all of the minimum referral requirements and:
See Pre-Referral Guidelines below for suggested work-up by condition and information required for appropriate triaging.
Mater Adult Referral Form
Referrals can be faxed to 07 3163 8548.
Available appointments are provided to our patients based on clinical priority.
This should be used as a general guideline only – categorisation will be based on the individual referral
- Strong suspicion of bowel cancer: + FOB or iron deficiency anaemia
- Suspected cancer on imaging: pancreas, bowel, stomach or oesophagus
- Exacerbation Crohn’s and UC
- Acute/sub-acute or chronic liver failure
- Iron deficiency anaemia
- Significant dyspepsia or epigastric pain with red flags
- Hepatitis B and C
- Chronic liver disease with cirrhosis
- New change in bowel habit with no red flags
- Dyspepsia with no red flags
- Constipation with no red flags
- Irritable Bowel Syndrome with no red flags
Mater endeavours to see all priority patients within 30 days from GP referral
Mater endeavours to see all semi urgent patients within 3 months from GP referral
Mater endeavours to see all routine referrals within 12 months from GP referral
Your patient may want to consider a referral to a private specialist.
Mater Health Services offers patients the opportunity to attend bulk billed clinics. To provide your patient with the opportunity to attend a bulk billed specialist clinic, please provide a named referral to one of our specialists listed above.
If you wish to discuss a referral with a medical officer from this specialty, please contact 07 3163 8111 and ask to speak with the gastroenterology registrar or a consultant.
For Hepatology referrals, contact the Clinical Nurse Consultant on 07 3163 6703 or mobile 0434 569 389.
For IBD referrals, contact the Clinical Nurse Consultant on 07 3163 8054 or 0466 777 857.
Alternatively, contact the Clinical Nurse – Referrals and Appointments Management Service on 07 3163 6866.
The following guideline is intended for consideration by the treating GP. It is subject to the assessment of the patient’s clinical circumstances and in no way is intended to replace the clinical assessment and judgment of the GP.
Anti tTG + se IgA
Helicobacter breath test (off PPI for 4 weeks - may require funding by patient and if patient is able to fund)
History of smoking
Before referral and / or endoscopy:
Reduce fatty foods, avoid trigger foods (food diary), weight reduction, smoking cessation, limit alcohol.
Red flags: Weight loss, iron deficiency anaemia, dysphagia, odynophagia, mild haemetemesis, family history of GO malignancy.
Urgent referral to Emergency Department if significant GI bleeding or haemodynamic instability.
GESA Guideline - Gastro-Oesophageal Reflux Disease (2011):
Helicobacter breath test (off PPI for 4 weeks – may require funding by patient and if patient is able to fund)
Symptom triggers e.g. alcohol, caffeine, bending, stress, spicy or fatty foods, smoking
Previous endoscopic procedures (date and report)
If positive Helicobacter breath-test, treat Helicobacter and monitor.
Red flags: weight loss, dysphagia, odynophagia, haematemesis, family history of GO malignancy, iron deficiency anaemia.
PR exam - digital rectal exam
Describe bleeding – distinguish between dark blood coating or mixed with stool; or bright red blood passed after the motion or on the paper
Examination for abdominal and rectal masses
History – of colorectal cancer and previous endoscopic procedures including results and histology
Red flags: weight loss, abdominal mass, iron deficiency anaemia, blood mixed with stool, family or personal history of CRC.
Family or personal history of hereditary cancers
History - of colorectal cancer and previous endoscopic procedures including results and histology
Red flags: weight loss, abdominal mass, iron deficient anaemia, blood mixed with stool, PR bleeding, family or personal history of CRC and polyps.
In the absence of any red flags, the following timeframes are recommended for polyps surveillance:
5 years - If <3 polyps (excluding diminutive rectosigmoid hyperplastic polyps) provided that all polyps are “simple” as defined by dimensions (≤10mm) and histopathology (no high-grade dysplasia or villous change).
3 years - If 3 or more polyps (excluding diminutive rectosigmoid hyperplastic polyps) or if one or more polyps is “advanced” as characterised by dimensions (>10mm) and/or histopathology (presence of high-grade dysplasia or villous change).
Within 12 months – If required, a baseline colonoscopy may need to be repeated in cases of poor bowel preparation (immediate rescheduling), possible incomplete excision of a large polyp (often at 3 months) or the presence of multiple adenomas (>10) to ensure complete clearance.
Source: GESA Guideline - Bowel Cancer - Early Detection, Screening and Surveillance (2011) http://www.gesa.org.au/professional.asp?cid=9&id=52
Bowel Cancer - Early Detection, Screening and Surveillance (2011):
History of bleeding from any orifice, including menstrual history
If dietary, modify diet and / or refer to dietician
Establish and treat the cause e.g. Menorrhagia, dietary.
Treatment with oral iron prior to referral:
Red flags: Urgent referral to Emergency Department if unwell due to blood loss (Hb < 80 g/L), haemodynamic compromise or cardiorespiratory compromise.
GESA Guideline - Iron Deficiency (2008):
History – Frequency, consistency, presence of alternating diarrhoea
Helicobacter breath test (may require funding by patient and if patient is able to fund)
Consider Faecal Calprotectin for patient <40yo (may require funding by patient and if patient is able to fund)
Increase dietary fibre if lacking and fluid intake. Rapid response to urge to defaecate. Regular exercise.
Red flags: Progressive and unintentional weight loss, iron deficiency anaemia and vomiting, family history bowel or ovarian cancer, new onset age >50.
NICE guidelines – Quick Reference Guide : Irritable bowel syndrome in adults:
Dietary Advice for IBS – Irritable Bowel Syndrome and Diet – The British Dietetic Association:
Guidelines for Use of Prucalopride – NICE Prucalopride for the treatment of chronic constipation in women:
History – Frequency, detail period of monitoring prior to referral
Stool MCS x3
C.difficile testing of stool if recent antibiotics
Consider Faecal Calprotectin for patient <40yo and / or pancreatic elastase stool test (may require funding by patient and if patient is able to fund)
Red flags: Acute severe diarrhoea, weight loss.
Urgent referral to Emergency Department if bloody diarrhoea.
Serology must be run while patient is on a diet containing gluten (e.g. four pieces of bread per day for four weeks).
Following diagnosis of Coeliac’s disease, a strict life-long gluten free diet must be maintained for life.
Post Diagnosis Management:
Coeliac Disease (2007)
Asymptomatic bowel cancer screening through the National Bowel Cancer Screening Program (NBCSP) is currently not provided by Mater Hospital.
Patients with positive FOBT results outside of the National Bowel Cancer Screening program can be referred to the Mater, and will be given a priority.
NBCSP is conducted at other hospitals and community clinics, with more information available at http://www.health.qld.gov.au/metrosouth/specialty/bowel.asp.
For general information on FOBT and the National Bowel Cancer Screening Program go to www.cancerscreening.gov.au or see the GESA Guideline - Bowel Cancer - Early Detection, Screening and Surveillance (2011) - http://www.gesa.org.au/professional.asp?cid=9&id=52.
Other asymptomatic bowel cancer screening will be considered based on familial colorectal cancer risk with High Risk Patients as per GESA Guideline - Bowel Cancer - Early Detection, Screening and Surveillance (2011) (Table 2 category 3) receiving priority.
ESR & CRP
Faecal specimen for M,C & S
Where and when diagnosed
Histology if available
Consider Faecal Calprotectin if unsure of diagnosis (may require funding by patient and if patient is able to fund)
Red flags: PR bleeding, significant weight loss, anaemia, obstructive symptoms.
Hepatitis serology – Hep A IgM, Hep B sAb, Hep B cAb, HCV Ab
Auto antibodies (ANA, SMA, AMA)
Copper and caeruloplasmin
Upper abdomen ultrasound
Alcohol and drug history
Record of last normal liver function test (if available)
For fatty liver: Dietary and exercise review and education, alcohol abstinence.
Red flags: Suspected cirrhosis with decompensation, acute hepatitis with decompensation.
(HBsAg, aHBs, aHBc, HBeAg, HBeAb), HBVDNA quant, HIV Antibody Screen, Hep A (IgG, IgM), Hep C, HDVIgG, FBC, Coags, Fe Studies, TFT, α fetoprotein, ELFT's.
Red flags: family history of Hepatocellular cancer, Presence of advanced liver disease and cirrhosis, co-infection with HCV, HDV or HIV, longer duration of infection.
GESA- Australian and New Zealand Chronic Hepatitis B Recommendations:
ASHM (Australasian Society for HIV Medicine):
HCV Screening Bloods: HIV Antibody Screen, Hep A (IgG, IgM) & Hep B (HBsAg, aHBs, aHBc) Screen, FBC, Coags, Copper, Ceruloplasmin, α-1-antitrypsin, Fe Studies, TFT, ANA, α fetoprotein, AMA, SMA, HCV PCR Quantitative, ELFT's, HCV genotyping, Abdominal Ultrasound.
Red flags: Presence of advanced liver disease and cirrhosis, co-infection with HCV, HDV or HIV, longer duration of infection.
UQ School of Medicine:
Hepatitis Queensland Patient Resources:
Content reviewed 23/12/15
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