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Gastroenterology Referral

Our Gastroenterology clinic is accepting urgent referrals only at this time.

Patients with non-urgent issues, including constipation and/or abdominal pain without additional GI red flags (see below) are not eligible for referral. This allows us to prioritize specialist clinical resources for patients who have urgent GI concerns that require care.

Urgent cases

Please find below GI red flags. Patients must have one or more symptoms, along with abdominal pain or constipation, to be eligible for referral.

Abdominal pain red flags include one or several symptoms including: 

  • involuntary weight loss 
  • slowed linear growth or delayed puberty 
  • difficulty swallowing/dysphagia 
  • significant vomiting (bilious, protracted) 
  • pain away from the umbilicus 
  • nocturnal waking 
  • blood in stool or GI blood loss 
  • severe diarrhea (including nocturnal) 
  • unexplained fever 
  • joint pain or swelling  
  • family history of Crohn’s disease or colitis 
  • hepatosplenomegaly 
  • perianal abnormalities or abnormal blood markers including anemia, increased CRP, increased tissue transglutaminase, or elevated fecal calprotectin. 
Constipation red flags include one or several symptoms including: 

  • bilious emesis
  • bloody diarrhea
  • poor feeding/weight gain/weight loss
  • anal stenosis
  • lumbosacral abnormality 
  • tight/empty rectum 
  • perianal abscess/fistula 
  • toe walking
  • loss of bladder continence.  

In addition to making a referral, urgent concerns can be discussed 24/7 with the BC Children’s Hospital GI physician on-call who can be contacted through the switchboard: 

1-888-300-3088 or 604-875-2345. 

This service is applicable for the following patients: 

  • Attending an emergency department and when acute management needs to be discussed
  • In-patients
  • Patients who may need transport to a higher level of care.
We recognize you may have questions and require specialist guidance in treating non-urgent GI concerns. 

Since May 2023, there is a new platform referred as eCASE that can support clinicians who require specialist consultation. eCASE is meant for clinician and specialist use only. Learn more about the platform.

Clinicians who require specialist consultation can submit patient details and clinical background, and a GI specialist will provide a written response within approximately seven days. In most cases, this approach results in improved clinical outcomes and significantly reduces a delay in care. 

If you are not registered on eCASE, contact eCASE at:

Referrals form

GI does not have a standard referral form. See Feeding & Swallowing Referral for the Complex Feeding and Nutrition referral form.

Referrals process

The referrals process is for urgent cases.

  1. All new patients require a referral. The Gl clinic does not have a standard referral form.
  2. For general referrals (not Complex Feeding and Nutrition), write your own referral letter and fax it to us. Please include relevant investigations and growth curves.
  3. If you are stating that the referral is "urgent", please specify why.
  4. You can suggest if you prefer that the patient be seen via Videoconference (particularly for remote / outlying communities), or in Outreach clinic (presently in Prince George, Nanaimo, Victoria, and Kelowna). Not all requests can be honoured.
  5. A division member will triage the referral and a cover letter will sent back to the referring office. Please take this as a receipt of referral and unless specified, no action is required. Our booking secretary will contact the families directly with the appointment, usually one month prior to the appointment.
  6. If there is a change in clinical status or new information, feel free to send an update and then we can review whether this will change the original triaging status.

G tube referral

Referrals for G-tubes (gastrostomy tubes) should continue to go to General Surgery (G-tube referral form) or if appropriate Interventional Radiology. A referral to GI may be appropriate if there is a family or doctor requesting a review regarding the necessity of the G-tube. 

Celiac referrals

Patients who have two readings of tTG > 10 ULN (spaced by 1 month) are considered to meet non-biopsy diagnosis criteria for celiac disease with an accuracy of > 95% . Referred patients will be reviewed by our dietitians and teachings related to gluten free diet will take place.

Patients with tTG > 2 ULN and < 10 ULN should still go on to have upper endoscopy and biopsies (after consultation). It is important these patients remain on a gluten containing diet. 

Patients with tTG readings < 2 ULN should should be followed with serial readings and should not implement a gluten free diet. Readings at this level are non-specific and may not be accepted for review.‎

SOURCE: Gastroenterology Referral ( )
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