Your child will be assessed by your GP and in most cases referred to a general paediatric specialist before they can be referred to the Paediatric Gastroenterology & Hepatology Service at the Starship Hospital. Many common gastrointestinal problems such as gastro-oesophageal reflux, abdominal pain and constipation can be managed well by general paediatricians and GPs without needing input by the Paediatric Gastroenterology & Hepatology Service. In general, the service only accepts referrals directly from general practitioners under the following circumstances:
- Likely coeliac disease with positive coeliac serology (tTG, EMA or DGP)
- Likely inflammatory bowel disease (IBD) with positive blood-based or faecal inflammatory markers and symptoms suggestive of IBD
- Any form of acute or chronic liver disease
- Hepatitis B or C
- An acute GI bleed with haematemesis or melaena - patient should come directly to the Children's Emergency Department.
If your child has an urgent problem they will be assessed in the Children's Emergency Department at Starship Hospital. There they will be assessed by a senior member of the medical team. Based on your child’s condition they may be admitted to Starship Hospital for ongoing care or follow-up arrangement will be arranged through the outpatient clinics.
Patients from outside of Auckland will be assessed by their local paediatrician and discussion made with the on call paediatric gastroenterologist & hepatologist at Starship. Appropriate arrangements for transfer to Starship can then be made if needed.
If your child has a less urgent problem, a letter of referral is sent to our department. A senior doctor will look at the letter and a decision is made based on the information provided in the letter. We are not able to see all children referred to us and many conditions can be looked after by general paediatricians. Possible outcomes from referral include:
- Outpatient clinic appointment:
An appointment will be offered. For urgent issues this may be within a month: less urgent issues will wait longer than this. However, all children will be seen within 5 months. If your child is getting worse while waiting, please see your General Practitioner or Paediatrician again.
- More investigations are needed:
Sometimes, when we read the referral letter, we feel it would be useful for your child to have more tests, either before we see them, or to decide if we need to see your child. These tests may be blood, urine or faecal (stool, poo) tests or Xrays. In this case, we will write to your referring doctor to arrange these and ask that they let us know when the tests have been done.
For some conditions your child may be booked directly to endoscopy without being seen in clinic first. The reason for this is to decrease delay prior to treatment. Both you and the referring doctor will be sent a letter explaining this. If you have any concerns or questions please contact the team via our Secretary (extension 5471 at Starship Hospital) and we will see you in clinic to discuss things more fully. Endoscopy waiting times are currently around 4 weeks.
- Referral to another service:
Our department receives more referrals than we are capable of seeing. Straightforward cases may be referred back to your referring doctor (as explained above) with written advice or your referral may be passed on to a more suitable service to handle your child’s condition.
Sometimes your child may already be receiving appropriate management from their general practitioner or general paediatrician and we will not need to see them. In this case, an appointment is not made and we write back to the referrer. Should symptoms change, a re-referral to our service can be made.