Suggested Pre-Referral Evaluation and Management Guidelines
Red Flags: involuntary weight loss, bloody diarrhea, fevers, joint pains, persistent vomiting, hematemesis, elevated sedimentation rate or c-reactive protein, anemia, family history of inflammatory bowel disease, pain waking the child at night, pain farther away from the umbilicus, or presence of more than one symptom
Most common causes of abdominal pain:
Constipation (periumbilical abdominal pain or left lower quadrant) - treat with Miralax at a dose to have soft, pudding-consistency stools; can do an abdominal x-ray to assess for the presence of fecal loading
Gastroesophageal Reflux/Dyspepsia/Nausea (epigastric abdominal pain) - treat with a proton-pump inhibitor 20-30 minutes prior to breakfast
Suggested Additional Test/Management Prior to Specialty Visit
Blood work: CBC with differential and platelets, comprehensive metabolic panel, sedimentation rate, c-reactive protein
No radiographic imaging is necessary prior to appointment, unless clinically indicated.
Patient Education/Information (includes preps)
3 months, sooner for Nurse Practitioners (typically 1-2 months)
How to Get Results to Consultant
UMHS Patients: See MiChart
External Patients: Fax records to 734-763-7359 prior to appointment.
A referral from the primary care physician is required prior to the appointment. Consult for a second opinion requires approval by a staff Pediatric Gastroenterologist. The covering staff physician may be reached by M-line.
It is important for us to receive records of the following in order to prepare for an optimal visit with the patient:
the child's growth record (obtained from their primary care clinician)
any prior laboratory studies
any prior x-rays
prior endoscopy reports
other test results, or hospitalizations
Clinic Contact Information
Physicians: 734-763-9650 or M-Line 734-936-3856