Abdominal Pain, Discomfort or Bloating

This condition is treated in the Gastroenterology clinic.

Pre-referral work-up

History

All referrals should comply to the referral standards and include in particular:

Patient and family history of gastrointestinal cancer including relationship to patient, age of cancer diagnosis and type of cancer

Previous endoscopic procedures (date, report and histology)

Tests

Pathology:

LFT

FBC

U&E

Iron studies (if indicated / performed)

Imaging:

Any relevant

Investigations:

Nil

Interim/GP management

To refer a patient with this condition, please see the Gastroenterology clinic page for the full referral process and templates.

Refer to the recommended pre-referral treatment for reflux/heartburn/dyspepsia.

For more information please see the HealthPathways Tasmania website.

GESA Guideline: Gastro- Oesophageal Reflux Disease (2011)

Clinic appointments

? Red location flags are clinical indicators of possible serious underlying conditions requiring further medical intervention. They may or may not indicate an emergency.

Emergency

?Potentially life-threatening symptoms suggestive of:

• acute upper GI tract bleeding
• acute severe lower GI tract bleeding
• oesophageal foreign bodies/food bolus
• bowel obstruction
• abdominal sepsis
• Acute Severe Colitis - see note

? Severe vomiting and/or diarrhoea with dehydration
? Acute/fulminant liver failure (to be referred to a centre with dedicated hepatology services
? Biliary sepsis (to be referred to a centre with ERCP service)

Note- Acute severe colitis as defined by the Truelove and Witts criteria - all patients with greater than or equal to 6 bloody bowel motions per 24 hours plus at least one of the following:

• temperature at presentation of over 37.8°C,
• pulse rate at presentation of over 90 bpm,
• haemoglobin at presentation of under 105 gm/l, CRP over 30mg/dl at presentation (or ESR over 30 mm/hr)

If you, or someone else, are experiencing a serious and life-threatening injury or illness call triple zero (000) immediately or go to the nearest Emergency Department.

Learn more about when to access emergency care and non-emergency care options if the injury or illness is not serious or life-threatening.

Urgent (Category 1)

Severe abdominal pain with significant impacts on activities of daily living or with any of the following concerning features (also select those applicable):

• weight loss greater than or equal to5% of body weight in previous 6 months
• past history Barrett's/polyps/cancer
• Family history of Barrett's, oesophageal or gastric or bowel cancer
• iron deficiency in males and postmenopausal women or unexplained iron deficiency in premenopausal women
• abdominal mass on clinical examination or abnormal imaging
• nocturnal symptoms

We will endeavour to see these patients within four weeks

Urgent referrals should be accompanied by a phone call to the clinic and the relevant doctor for urgent assessment, or patient should be directed immediately to the Emergency Department.

Semi-urgent (Category 2)

Abdominal pain for over 6 weeks without concerning features (see above) and not affecting activities of daily living

Routine (Category 3)

For all other presentations of abdominal pain

Next available appointment

Availability

North

Launceston General Hospital
Level 3 - Specialist Clinics

Phone: 1300 977 694
Fax: 03 6777 5227

North West

All North West referrals are managed via Mersey Community Hospital
Phone: 03 6478 5222
Fax: 03 6441 5942

South

Wellington Clinics (Level 10)
Phone: 03 6166 0000
Fax: 03 6234 3982