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Consult Request Guidelines
for Heartburn in Patients less than 50 years old

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Heartburn in Patients less than 50 years old
Suggested Pre-Referral Evaluation and Management Guidelines
1) Careful NSAID use history
2) Blood Survey, Complete Blood Count (CBC)
3) Anti-reflux lifestyle measures
4) Trial of OTC Prilosec or H2 blocker
Suggested Additional Test/Management Prior to Specialty Visit Assess for alarm symptoms; order EGD if present
Patient Education/Information (includes preps) Gastroesophageal Reflux Disease (GERD)
Appointment Timeframe 1 month
How to Get Results to Consultant UMHS Patients: See MiChart
External Patients: Hand carry non-UM records and MRI films to visit

External patients referral form
Clinic Contact Information Physicians: 800-962-3555
Patients: 734-647-5944
Clinic Location Sites GI Clinic Locations
UM Consulting Physician GI Faculty

Lisa Sylvest, RN - UMHS Patient Liaison will answer provider questions.
Revised on: 01/06/2015

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