CONSULT REQUEST GUIDELINES                                                                         Print

Gastroesophageal Reflux Disease

Suggested Pre-Referral Evaluation and Management Guidelines
  • H2 blockers
  • PPI
  • Prokinetic
  • Should see Dietary 1st
  • Change feeding to small volume more frequent offering
  • Avoidance of trigger foods
  • Signs of dysphagia
Suggested Additional Test/Management Prior to Specialty Visit 1) UGI
2) Ph probe (if clinically indicated)
Patient Education/Information (includes preps) 1) Nissen fundoplication
2) Prep: Prep for Pediatric Upper GI
3) Prep: ph probe
Appointment Timeframe Next Available Appointment. Please complete Outpatient Consult Request Form and fax to 734-936-9784
How to Get Results to Consultant UMHS Patients: See MiChart
External Patients: Hand carry or fax records to 734-936-9784
Clinic Contact Information Physician: 800-962-3555
Patients: 734-764-4151
Clinic Location Sites C.S. Mott Children's Hospital
UM Consulting Physician Pediatric Surgery Faculty
Revised on: 01/15/2016



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