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Upper gastrointestinal surgery


Minimum Referral Criteria

  • Category 1
    (appointment within 30 calendar days)
    • Upper GI symptoms with anaemia, weight loss, epigastric pain
    • Dysphagia
    • Para-oesophageal hernia with symptoms suggesting recurrent obstruction
    • Abnormal imaging results suggesting oesophageal gastric pathology
  • Category 2
    (appointment within 90 calendar days)
    • Severe volume reflux with episodes suggestive of aspiration and/or severe impairment to quality of life
    • Para-oesophageal hernia
    • Barrett's oesophagus with low grade dysplasia
  • Category 3
    (appointment within 365 calendar days)

1. Reason for request Indicate on the referral

  • To establish a diagnosis
  • For treatment or intervention
  • For advice and management
  • For specialist to take over management
  • Reassurance for GP/second opinion
  • For a specified test/investigation the GP can't order, or the patient can't afford or access
  • Reassurance for the patient/family
  • For other reason (e.g. rapidly accelerating disease progression)
  • Clinical judgement indicates a referral for specialist review is necessary

2. Essential referral information Referral will be returned without this

  • History of the condition including previous treatments tried and efficacy
  • Patients co-morbidities
  • Medications
  • ELFT FBC iron studies results
  • Any abnormal imaging reports and/or endoscopy reports

3. Additional referral information Useful for processing the referral

  • Previous endoscopic procedures (date, report and histology results)

4. Request

Last updated: 13 June 2023