| CONSULT REQUEST GUIDELINES
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Non-specific Colitis
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| Suggested Pre-Referral Evaluation and Management Guidelines |
Patients should be evaluated and treated by a gastroenterologist prior to referral. Referral is indicated if the patient has:
- symptomatic disease refractory to medical management
- stricture with recurring symptoms of partial small bowel obstruction
- enterocutaneous, enteroenteric, enterovaginal, or enterovesical fistula
- intra-abdominal abscess
- persistent and significant bleeding (anemia)
- extensive perineal or perianal fistulas
- high grade dysplasia on biopsy
If patient has been managed external to the UMHS system, fax colonoscopy report and pathology report confirming the diagnosis of Non-specific Colitis, operative reports from any procedures performed on the bowel, and a list of all disease related drugs
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| Suggested Additional Test/Management Prior to Specialty Visit |
- CT scan of the abdomen and pelvis with oral and IV contrast
- Serum studies to include comprehensive metabolic panel and complete blood count
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| Patient Education/Information (includes preps) |
www.fascrs.org/ |
| Appointment Timeframe |
2-4 weeks
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| How to Get Results to Consultant |
UMHS Patients: See MiChart
External Patients:
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
2124 Taubman
1500 East Medical Center Drive, SPC 5343
Ann Arbor, MI 48109-5343 |
| Clinic Contact Information |
Physicians: 800-962-3555
Patients: 734-615-7565 |
| Clinic Location Sites |
Colorectal Surgery Clinic |
| UM Consulting Physician |
Karin M Hardiman, MD
Arden Marie Morris, MD
Scott E Regenbogen, MD
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| Revised on: |
09/19/2012 |
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