RMS GP Sifter Information
| Information for RMS GP sifters for GI services at RCHT |
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| Upper GI | |
| Reflux / heartburn | OGD* or reject if primary care management incomplete. Consider upper GI medical or upper GI surgery OPA if OGD already done |
| Dysphagia | OGD* ?2ww or urgent |
| Dyspepsia | OGD* (?2ww or urgent) or reject if primary care management incomplete |
| Vomiting | OGD* ?2ww or urgent |
| Suspected coeliac disease | OGD* for duodenal biopsy |
| Confirmed coeliac disease | OP medical |
| Anaemia | OP medical if confirmed IDA, reject if not |
| Symptoms associated with previous surgery | OP surgical |
| Confirmed gallstones | OP surgical |
| Any type of hernia | OP surgical |
| Malaena | OGD* ?2ww or urgent |
| Hepatology | |
| Asymptomatic abnormal LFTs | routine or reject if criteria not met |
| Signs or symptoms of compensated liver disease | routine |
| Signs or symptoms of decompensated liver disease | urgent |
| Jaundice | jaundice hotline |
| Lower GI | ||
| Diarrhoea or change in bowel habit +/- pain | Age < 45 | OP medical or reject if IBS and primary care management incomplete |
| Age >= 45 | OP colorectal or lower GI medical unless 2ww | |
| Rectal bleeding | Colorectal OPA unless 2ww. NO direct to test now | |
| Constipation | OP medical | |
| Anaemia | OP medical if confirmed IDA, reject if not | |
| Abdominal pain | OP medical or surgical depending on likely diagnosis | |
| IBS | OP medical or reject if primary care management incomplete | |
| IBD | OP medical | |
| Family history of colon cancer | OP medical or surgical or reject if doesn't fit criteria | |
| Fecal incontinence | OP surgical | |
| Haemorrhoids | OP surgical | |
| Anal fissure | OP surgical | |
| Pruritus ani | OP surgical | |
| Diverticular disease | OP surgical | |
| Symptoms associated with previous surgery | OP surgical | |
| Any type of hernia | OP surgical | |
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* = direct to endoscopy |
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