Dysphagia

This condition is treated in the Gastroenterology clinic.

Pre-referral work-up

History

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

History of presenting complaint:

• difficulty or pain on swallowing
• food or liquids are stuck in throat or chest
  • pain or pressure in chest associated with swallowing
  • loss of appetite/food avoidance associated with swallowing difficulty

Tests

Pathology:

FBC

U&E

Iron studies

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.

For more information please see the HealthPathways Tasmania website.

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)

Dysphagia with any of the below also present - please select those that apply:

• suspected GI cancer on clinical examination or abnormal imaging (for optimal care, patient should be seen within 1 week)
• dysphagia with poor oral intake (for optimal care, patient should be seen within 1 week)
• significant dysphagia
• Weight loss, greater than or equal to5% of body weight in previous 6 months
• Persistent vomiting

Ensure urgent box is also ticked for this referral, may also involve clinic contact.

Urgent referrals should be accompanied by a phone call to the Consultant/Registrar to organise urgent review and the referral must be faxed.

We will endeavour to see these patients within four weeks, or sooner if clinically indicated.

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