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Indications for Endoscopy

Colonoscopy Indications for Referral

  • Rectal bleeding for >4 weeks

  • Positive FOBT result (including National Bowel Cancer Screening Program)

  • Bloody diarrhoea with negative stool MC&S

  • Change in bowel habit >6 weeks with alarm symptoms at any age

  • Change in bowel habit >6 weeks without alarm symptoms in patient aged >60yr

  • Unexplained iron deficiency anaemia in men or non-menstruating women

  • After first episode of proven diverticulitis to exclude neoplasm

  • Abnormal imaging

  • Active inflammatory bowel disease where endoscopy is indicated to progress management

  • Surveillance for past history of bowel cancer, polyps, inflammatory bowel disease

  • Surveillance for significant family history of bowel cancer


Alarm symptoms

  • Persistent rectal bleeding (>4 wks)

  • Unexplained progressive weight loss

  • Severe pain

  • Unexplained iron deficiency anaemia

  • Palpable mass

  • Bloody diarrhoea with negative stool MC&S

Gastroscopy Indications for Referral

  • Unexplained upper GI bleeding (haematemesis, melaena)

  • Unexplained iron deficiency anaemia in men and non-menstruating women

  • Unexplained recent dyspepsia in patients <55yr with alarm symptoms

  • Dysphagia, odynophagia

  • Unexplained upper abdominal pain and weight loss (>10%)

  • Persistent vomiting and weight loss

  • Reflux refractory to medical therapy

  • Upper abdominal mass

  • For duodenal biopsy following positive serology in suspected coeliac disease

  • Surveillance of Barrett’s oesophagus and gastric intestinal metaplasia

Alarm symptoms

  • Unexplained iron deficiency anaemia

  • Overt bleeding (haematemesis, melaena)

  • Dysphagia

  • Unexplained progressive weight loss with upper GI symptoms

  • Severe pain

  • Palpable mass

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