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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

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