• Suspected strangulated/incarcerated or obstruction of any hernia
• Acute, severe abdominal pain with or without associated sepsis
• New onset of obstructive jaundice
• Acute painful perianal conditions
• Acute cholecystitis
• Acute pancreatitis
• Bowel obstruction
• Severe per rectum bleeding
• Acute abscess at any site
• Acute testicular pain Gallstones with symptoms of cholangitis

• Appearance medicine

Essential information (Referral will be declined without this)

• General referral information
• Specific family history of gastrointestinal malignancy, polyposis or IBD
• Previous gastroenterologist investigations and results (date, report and histology results) e.g. last 2-3 clinic letters
• History of weight loss and/or ascites
• History of bowel function:
• altered bowel habit
• rectal tenesmus
• incomplete rectal emptying
• PR blood, pus or mucus
• flatus
• mass
• Co-morbid conditions and other risk factors
• FBC ELFT U&E
• CEA results if diagnosis of cancer suspected

Additional referral information (useful for processing the referral)

• Relevant imaging report/s
• CT of chest, abdomen and pelvis results
• Virtual CT report
• Any positive DRE findings and perianal condition
• Previous colonoscopy and polypectomy results
• Biopsy results
• FOBT results

Other useful information for management (not an exhaustive list)

• Refer to local Healthpathways or local guidelines
• Lifestyle modification (increased activity, dietary, weight, smoking, alcohol)
• Correct iron deficiency and anaemia if possible
• Routine follow-up of patients on treatments for IBD
• Change in symptoms should initiate reassessment of previous results

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Essential information (Referral will be declined without this)

• General referral information
• Management to date including timeline, medication and lifestyle
• History of previous drainage operation

Additional referral information (useful for processing the referral)

• Previous gastroenterologist investigations and results (date, report and histology results) e.g. last 2-3 clinic letters

OASIS

• Assess sphincter function and integrity and endoanal USS results.

Other useful information for management (not an exhaustive list)

• Refer to local Healthpathways or local guidelines
• Local application of cold packs and oral anti-inflammatory medications
• Referral to pelvic floor physiotherapist
• Education about pelvic floor care and specific techniques for defecation
• Oral antibiotics such as Augmentin®, or clindamycin where penicillin allergy is a factor, should be considered.
• Sexual counselling for the couple
• Counselling for subsequent pregnancy management
• Importance of follow-up six weeks and three months postpartum
• Postpartum management: avoid constipation, use of aperients, dietary advice

Fistula

• Persisting fistula discharge/infections Glyceryl trinitrate 0.2% ointment (Rectogesic®): TDS for four-six weeks (NS)
• Lifestyle modification (increased activity, dietary, weight, smoking, alcohol)

Pilonidal Sinus

• Lifestyle modification (increased activity, dietary, weight, smoking, alcohol)
• Advice on hygiene, sweating activity, activity associated with sitting and buttock friction

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Essential information (Referral will be declined without this)

• General Referral Information
• Relevant condition information
• Relevant pathology and imaging reports

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.