Gastroenterology Consult 🤢
Guide for gastroenterology consultation and referral. Key information to provide, common indications, and referral scripts for NCHDs.
📋 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
🔎 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
📞 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.
📝 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