Buying health services for local people

If you have recently travelled from Wuhan, China or are looking for information on the coronavirus outbreak please go to our page on coronavirus or the information on GOV.UK

en English
en English

Gastro Oesophageal Reflux Disease – Information for GPs

Referral criteria / commissioning position

Refer to secondary care for:

  • weight loss (unintentional)
  • iron deficiency anaemia
  • vomiting – persistent
  • dysphagia
  • evidence of GI bleeding (blood loss from upper GI tract is a prokinetic agent so may be reflected in change in bowel habit and/or stool colour change
  • epigastric mass
  • patients aged over 55 with unexplained, persistent and recent onset dyspepsia
  1. unexplained: no obvious reason found in the history of dyspepsia
  2. persistent: continuation of symptoms/signs beyond that would normally be associated with self-limiting problems (usually regarded as 4-6 weeks)
  3. recent: new onset and not recurrent symptoms

Risk factors for cancers: in addition to the red flags above, a lower threshold for referral is suggested in those with a history of Barrett’s oesophagus, pernicious anaemia, intestinal dysplasia, peptic ulcer surgery or a family history of upper GI cancer.

Investigations prior to referral

  • FBC, U&E, LFTs
  • USS if history suggestive of biliary/pancreatic involvement

Information to include in referral letter

  • Treatments and interventions tried including the results
  • Drug history (prescribed and non-prescribed)
  • Relevant past medical/surgical history
  • Current regular medication
  • BMI
  • Smoking status
  • Alcohol consumption

Patient information leaflets

To view the Dyspepsia Non-Ulcer Patient Information leaflet, please click here

To view the Indigestion Patient Information leaflet, please click here

To view the Helicobacter Pylori and Stomach Pain, please click here

en English
X