Suggested Pre-Referral Evaluation and Management Guidelines
Patients should be assessed and treated by a gastroenterologist prior to surgical referral. Referral is indicated when colon transit time is delayed and patient has failed conservative treatment measures which include optimization of bowel regimen and completion of pelvic floor physical therapy for those patients with demonstrated dysynergia. Recommended studies include:
-Colon transit study with sitz markers
-Small bowel follow-through
-Gastric emptying study
*Smart pill test can be done in lieu of the above 3 diagnostic tests.
-Anal manometry with balloon expulsion test
Patients who have not had a complete workup as above may be referred to the multidisciplinary Michigan Bowel Control Program, which includes surgeons, gastroenterologists, and others.
Reports of any testing performed outside of the UMHS system and radiologic images on CD should be available for review at or before the time of the clinic visit. Receiving these before the clinic visit is preferable.
Suggested Additional Test/Management Prior to Specialty Visit
UMHS Patients: See MiChart
Reports and/or medical records can be faxed to 734-232-6189
CDs can be hand-carried to the appointment
Reports, medical records, CDs, and pathology slides can be mailed to:
Division of Colorectal Surgery
Attention: Jain Carver
1500 East Medical Center Drive, SPC 5343
Ann Arbor, MI 48109-5343