Neobook — clinical reference

Indications for gastroscopy
Guideline Rx initial pathway for dyspepsia algorithm
Dyspepsia not needing referral algorithm
Cape Metro guidelines for gastroesophageal reflux disease algorithm
Management of gastric ulcer
Cape Metro guidelines for Rx gastric ulcer algorithm
Cape Metro guidelines for duodenal ulcer algorithm

Indications for gastroscopy

Emergency	Two week category/ urgent	Eight week/ elective
Active upper GI bleed	History of recent bleed (melaena stools or haematemeses but currently stable and symptoms resolved Progressive dysphagia Persistent vomiting Progressive unintentional weight loss Epigastric mass	Upper abdominal distress or dyspepsia that persists despite an appropriate trial of therapy or history of NSAIDs or other ulcerogenic drugs (metamphetamine) New-onset dyspepsia in individuals over the age of 45 Chronic iron deficiency anaemia with the clinical exam suggesting an upper GI source Esophageal reflux symptoms that persist or recur despite appropriate therapy

Guideline Rx initial pathway for dyspepsia algorithm

Dyspepsia not needing referral algorithm

Cape Metro guidelines for gastroesophageal reflux disease algorithm

Management of gastric ulcer

Once an ulcer has been identified, samples for histology should be sent. These should only be marked as urgent if the ulcer is suspected to be malignant.

Those patients where, macroscopically a malignancy is suspected should be booked into the Surgical GI Clinic. The appointment should be within two weeks.

The patient with benign gastric ulcers should be managed according to the Gastric Ulcer Guideline.

Patients will be followed up in the medical GI Follow up clinic for repeat endoscopy no sooner than 6 weeks no later than 10 weeks to exclude or confirm a malignancy and confirm ulcer healing by endoscopy and continue management till healing or surgical referral.

These appointments must be specified by the endoscopist on the report and on the front of the folder so that the nurse at the front desk can direct the patient to the booking clerks and an appointment issued before the patient is sent back to the referring ward or unit.

Cape Metro guidelines for Rx gastric ulcer algorithm

Cape Metro guidelines for duodenal ulcer algorithm