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Crohn's and Colitis Support
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Lower GI Referral, Please help

Hi,

ive just collected the paperwork for my first gastroenterology referral. I tried to book appointment but got the message that there was nothing available for me.

I have two questions:

1. What exactly 'Lower GI-Medical Gastroenterology stands for?

2. How do the referrals work? Will I get a kind of general appointment first or is it possible to get the colonoscopy or whatever they intend to do on the first go?

Thank you in advance. Any help would be highly appreciated.

19 Replies
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Hello, Gastroenterology is the department I believe. A referral from a 'family doctor' or 'Primary Care Physician' will generally send you to a specific Gastroenterologist, that specialist will take the initial information from the PCP, ask you why you are there and what you are experiencing and do a physical exam. They may do some blood tests and stool tests and depending on your situation and test results, then schedule you for a colonoscopy or some other diagnostic. Sometimes appointments can take awhile to get, my first one was a two month long wait, and I was considered 'urgent' My wait for colonoscopy was another three months wait. I am from Canada. I understand the UK and other places may have a different protocol.

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hi, its lower gastro-intestinal medicine, so involves a specialist who is experienced in the bowels and liver. An upper GI is specialised in oesophagus (throat) stomach and duodenum (first part of small bowel)

Waiting times depend on your hospital trust. As a rule it is 18 weeks. your first appointment will be with a consultant, he will then refer you for a colonoscopy. The time for this will be determined on whether he ticks the urgent or routine box. urgent being within 12 weeks and routine up to 6 months.

The consultant will also likely order other tests such as specific blood tests and stool tests. As Hobbits said, it is dependant on your symptoms.

Good luck and keep us posted x

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Thank you both guys.

Last night I saw on NICE website that with suspected IBD note I should get an appointment within 4 weeks. I want to believe it’s the reason why I don’t see any slots to book. I have had various blood and stool tests done for the past two months They excluded many potential conditions so hopefully they won’t repeat the tests. I struggle to eat as almost anything causes immediate sickness. I can’t go anywhere in the afternoon because of my guts. I’m pretty sure you know how it is too well but I can't imagine waiting 18 weeks for appointment to repeat the tests.

I wonder if calling the clinic I was referred to and asking for their waiting time make sense. What you think?

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you are well within your patient right to ask and get this information. Hopefully it will be soon

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Hi Joanna,

I am knowledgeable in IBD as I was diagnosed earlier this year and I'm also knowledgeable in the referral process as I am a Medical Secretary working in a GP Surgery. The reason there are no slots on E-referral is because there are no clinic appointments allocated yet to be booked into, you will go onto the waiting list of the Hospital that you select. I do not know what area you live in but I deal with Lincolnshire and Nottinghamshire and there are approximately 4 month waits for a Gastro appointments. You will not get a colonoscopy at your first appointment with a Gastroenterologist because that is a seperate referral onto Endoscopy (GP's can't refer there directly). Your Gastroenterologist will decide if you need a colonoscopy, or it may be a sigmoidoscopy. If you can afford to pay you could go the private route to be seen much sooner. Alternatively you can go back to your GP if your symptoms are worsening and he/she may decide to write to the Hospital to see if your appointment can be brought forward (this is with an 'expedite' letter) but this is not always a guarantee because not all GP's will do it and even if they do, the Consultant will have graded your initial referral based on your symptoms and sometimes the next GP letter will not alter it from a routine to an urgent. It is worth a try if you become more ill though. As a sufferer of IBD I can relate to the waiting times frustrations, I was graded an urgent and it still took 3 months to get my diagnosis and start treatment and by that time I was really poorly. I hope this may help you and wish you best of luck 'getting through the system'!

Claire

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Hi Claire, your response is very helpful but bad news.

I cannot select the hospital unfortunately. I live in Nottingham. As I mentioned above, I had a number of blood and stool tests done and received the referral with a Suspected IBD note. I read last night on NICE website that such referrals ought to be seen within 4 weeks of the date on referral but it doesnt sound like that from what you say so thats probably bullshit to pretend good standards...

My symptoms are worsening all the time since mid-August. I don't know how much longer I could go without any actual help.

How do I know if I have urgent or routine?

How do you feel now? x

Thank you for your message x

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Hi Joanna,

I'm really sorry but I don't understand the basis on which you've been referred - what is a suspected IBD note? This could be a Nottinghamshire system because this is not familiar to the Lincolnshire way of referring. I went to my GP & got a referral to Colorectal initially (because my GP had wrongly diagnosed piles) until the Colorectal Team did the colonoscopy and I needed to be transferred to Gastroenterology because they saw the IBD on the colonoscopy. Even though they said it was 'severe and significant' I still faced a long wait as an Urgent transfer to Gastro. This was at Grantham Hospital and they are especially poor for waiting times. I then requested my GP for a transfer to Nottingham Woodthorpe Hospital because (as a Secretary I can access Hospital waiting times) I knew Dr Shonde's waiting list there was short and I only had to wait 2 weeks to see him. Woodthorpe is a private Hospital but has an NHS Gastro Clinic that you can go to - are you able to go and see your GP and ask for a referral there? Once I saw Dr Shonde there he prescribed me my medication and then I was moved over to his team at Kingsmill Hospital near Mansfield, which is an NHS one. I now see him at Kingsmill. Let me know if I can offer any more advice,

Claire

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it was on the paper i received from my gp and needed to hand over at reception and then they prepared the paperwork for collection next day afternoon. ive never been referred anywhere before so thats all pretty new for me.

i googled local hospitals and hoped woodthorpe would be on my list as their av. waiting time is only 7 days. i wasnt also sure if private with nhs services would enable me to go there but thanks to you its now clear for me. im going to call the hospital i was referred to on monday morning and if they say their waiting times exceed a month, ill try to go back to gp and ask for adding woodthorpe to my list.

i really appreciate your information. that helps me a lot xx

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You're welcome, you are entitled to request a specific Hospital so ensure you do if you need to. I had to refer a patient to Gastro very recently and she told me I could send her to any Hospital within 50 miles of Grantham to get the shortest wait time and it was still Woodthorpe. Let me know how you get on xx

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hi, i phoned the clinic in the morning and they said no chance for app until january or february so i went to my practice and asked at reception to ask my gp to change my referral as shes away today.

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Great, try the Woodthorpe they're best for wait times at the moment x

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looks like i have an appointment with them on friday.

thank you for motivating me to come back and request the clinic change xx

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No problem, glad to help because I know what it's like. Which Consultant do you have, do you know? Coincidentally I saw Dr Shonde at Kingsmill this morning, that's where you go to see him after your first appointment at Woodthorpe, he's very nice if you get him.

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i dont know yet. i dont mind travelling to mansfield if thats required. im just really happy there is a chance to move forward in 3 days.

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Let us know how you get on

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Hi, I saw Dr Shonde too. It was a quick appointment and I have a colonoscopy at the end of next week.

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Great, you'll get some answers pretty quickly then, I did think this first appointment would be very quick - it's all about the colonoscopy!!

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hi, my apt was cancelled when i already started drinking that tasty liquid. having an amazing evening with my bowels playing even louder than usual.

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Oh what a disappointment! Let's hope they re-book you soon xxx

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