Gastroenterology Consult 🀒

πŸ“‹ Key Info to Have Ready

  • Patient identifiers: full name, date of birth, location and MRN; note that admission may not be for a gastro reason
  • Reason for consult (e.g. GI bleed, abnormal LFTs, jaundice, IBD flare, dysphagia)
  • Past Medical History: liver disease, alcohol use, GI diagnoses (e.g. IBD, coeliac), prior endoscopies
  • Medications: anticoagulants, PPIs, immunosuppressants, recent antibiotics
  • Observations: vitals, evidence of bleeding, jaundice, encephalopathy
  • Bloods: LFTs, coagulation profile, FBC, U&E, CRP, amylase/lipase if pancreatitis suspected
  • Imaging: recent abdominal ultrasound or CT scan
  • Stool results if diarrhoea or infectious query

πŸ”Ž Investigations to Know

  • LFTs – trends are key (ALT/AST, ALP, bilirubin, GGT)
  • INR and coagulation profile
  • Amylase/lipase – if ?pancreatitis
  • Imaging – any abdominal US/CT done
  • Endoscopy history if applicable
  • Stool cultures or C. diff testing if relevant

πŸ“ž Example Script

  • Hi, this is [Your Name], the intern from the [Team Name]. I'm calling to request a gastroenterology consult for a [Age] year-old [M/F] patient, admitted for [reason for admission], but with a gastro concern of [e.g. upper GI bleed, abnormal LFTs].
  • They have a background of [e.g. cirrhosis, alcohol use disorder, Crohn's]. They are currently [e.g. haemodynamically stable], with labs showing [e.g. ALT 300, INR 1.8, bili 70].
  • We’re hoping for your input regarding [e.g. need for endoscopy, management of liver dysfunction]. Let me know if any further tests would be helpful beforehand.

πŸ“ Tips

  • Be clear if urgent (e.g. GI bleed) or routine (e.g. LFT derangement)
  • Hold anticoagulation if appropriate before endoscopy
  • Know the patient's alcohol history and prior liver function
  • Review any prior scopes or hepatology input