Oesophago-gastric and bariatric (OGB) surgery referral

Eligibility

At least one must be met for the patient to be eligible for referral.

Patients who are being treated for the same condition at another Victorian public hospital

Children under 18 years of age

Gastro-oesophageal reflux in pregnancy

Loss of weight

Anaemia

Progressive Dysphagia

Liquids Vs solids Provide If available: May include history or findings of:

Foreign body ingestion

Gastro-oesophageal motility disorder

Neoplasm

Nocturnal choking or coughing attacks

Scleroderma Diagnostic studies may include (depending on history):

Gastroscopy

Barium swallow/meal or videofluoroscopy Additional comments:

Medication is required for 6 weeks or more, or

Symptoms of weight loss, anaemia or dysphagia are evident

Progressively worsening oropharyngeal or throat dysphagia

Inability to swallow with drooling or pooling of saliva

Unresolved food bolus obstruction

Hiatus hernia identified on chest x-ray or gastroscopy

Suspected hiatus hernia with volume reflux or obstructive symptoms

Severe heartburn unresponsive to maximum medical management

If inadequate response to treatment after two months, refer for endoscopy

Pain with weight loss or pain with anaemia

Post-prandial vomiting: refer for endoscopy

If specialist follow up required after endoscopy refer to OesophagoGastric/Bariatric Surgery

Suspected oesophageal rupture or oesophageal bleeding

Shortness of breath or chest pain, syncope or pre-syncope with iron deficiency (ferritin below the lower limit of normal.)

Known or suspected upper gastrointestinal malignancy

Iron deficient anaemia that persists despite correction of potential causative factors

Red flags

Indicate urgent (Category 1) referral or emergency assessment.

Routine referral criteria

Determine Category 2 or 3 urgency.

Initial primary-care work-up complete (history, examination, baseline investigations per Alfred guideline)

Symptoms persist or progress despite primary-care management

Usually managed in primary care

Patients who are being treated for the same condition at another Victorian public hospital
Children under 18 years of age
Gastro-oesophageal reflux in pregnancy Referral to Victorian public hospitals is not appropriate for:
Incidental findings found on imaging without symptoms or clinical significance
Patients with controlled symptoms
Fax the referral and completed assessment forms to 9076 0113. What happens if the referral is accepted?
Patients will be required to complete a Bariatric Health questionnaire which will be sent on acceptance of referral
Patients are required to actively participate in a 16-week online Health Improvement and Weight Management program. On completion of these requirements, patients will then receive an appointment to attend the multidisciplinary Bariatric Surgery clinic and discuss the options for management
Refer to the full Alfred Health PDF guideline for complete inclusion / exclusion criteria, required investigations and triage categories.