CONSULT REQUEST GUIDELINES                                                                         Print

GERD/Heartburn in patients younger than 50 years

Suggested Pre-Referral Evaluation and Management Guidelines

1)

Complete blood count (CBC)

2)

Anti-reflux lifestyle measures:
Avoid irritant foods (chocolate, alcohol, peppermints, coffee, onions, fatty foods, citrus, tomato-based foods)
Avoid large meals. Try not to eat within 2-4 hours of sleeping.
Raise the head of the bed at least 6 inches
Stop smoking
Lose weight if overweight or obese

3)

Trial of OTC proton pump inhibitor or H2 blocker

Suggested Additional Test/Management Prior to Specialty Visit

Assess for alarm symptoms:
Unexplained weight loss
Early satiety
Dysphagia or odynophagia
Chest pain
Blood in the stools
Vomiting

If alarm symptoms are present, order EGD
Direct Access Endoscopy Referral form
Patient Education/Information (includes preps) Gastroesophageal Reflux Disease (GERD) Clinical Care Guideline
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 CT /MRI films to visit; outside physician offices fax records

Outpatient Consult Request Form
Clinic Contact Information Physicians: 800-962-3555
Patients: 734-647-5944 or 800-229-7408
Clinic Location Sites GI Clinic Locations
UM Consulting Physician GI Faculty

Suzanne Taylor, RN - UMHS Patient Liaison will answer provider questions. 734-232-9424
Revised on: 06/15/2018
 
 

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