| Reason for referral |
Mandatory information on consult |
Timeframe of investigations |
Other information |
| Chronic abdominal pain (>3 month) |
- Description of symptoms/physical exam
- Summary of treatment history
- Pertinent past medical history
- Medication list
- Growth charts
- Blood work (CBC, ESR, CRP, ALT, GGT, lipase, albumin, celiac screen while on gluten)
|
Within 3 months
|
- Community Pediatrics consult
- All consults should include the mandatory information
- Red flags:
- bloody diarrhea
- weight loss (5-10%)
- persistent vomiting
- fever
- age <3 years old
|
| Positive celiac antibody |
- Medical history
- Family history
- Current diet
- Growth chart
- Tissue transglutaminase, CBC, ferritin
|
Within 3 months |
|
| Chronic diarrhea (>2-4 weeks) |
- Description of symptoms/physical exam
- Summary of treatment history
- Pertinent past medical history
- Blood work (CBC, ESR, CRP, albumin, celiac screen on gluten)
- Stool testing (O&P, culture, viral gastroenteritis panel, C. diff)
|
Within 1 month |
- Community Pediatrics consult.
- All consultations should include mandatory information.
- Red flags:
- Weight loss (5-10%)
- Bloody stools
- Associated extra intestinal manifestations
|
| Constipation |
- Description of symptoms, stool type (Bristol stool chart)
- Past medical history (e.g., passage of meconium)
- Growth chart
- Summary of medications tried (dose, frequency, duration, response)
- CBC, celiac screen while on gluten, Ca, TSH
|
Within 1 month |
- Community Pediatrics consult
|
| Dysphagia |
- Description of symptoms (e.g. texture of food tolerated, choking, food sticking etc.)
- Past medical history and family history (e.g., achalasia, EoE)
- Barium swallow
- Medications/interventions tried
|
Within 1 month |
Food bolus impaction should be directed to the Emergency department |
| Failure to Thrive |
- Description of GI symptoms (if any)
- Paste medical history
- Growth chart
- Current medications and medications tried
- CBC, ESR, CRP, ferritin, Ca, albumin, celiac screen while on gluten, stool tests (this is all age dependent)
- Nutritional history/Dietitian’s assessment
|
Within 1 month |
- Community Pediatrics consult
- Community Dietitian consult
- Feeding difficulty, oral aversion-consider Feeding team
|
| Gastroesophageal Reflux |
- Description of symptoms (bilious, hematemesis)
- Presence of complications (aspiration/respiratory, hematemesis, FTT)
- Past medical history
- Growth chart
- Medications and dietary interventions tried (dose, duration)
|
|
Community Pediatrics consult |
| Inflammatory bowel disease (suspected) |
- Description of symptoms (e.g. diarrhea, blood in stools, abdominal pain, weight loss, perianal disease)
- Past medical history
- Family history of IBD/autoimmune conditions
- Growth chart
- CBC, ESR, CRP, albumin, ALT, ferritin, stool tests (O&P, stool culture, C. difficile)
|
Within 1 month |
|
| Iron deficiency anemia |
- Description of GI symptoms (if any)
- Past medical history
- CBC, ferritin, iron studies, celiac screen while on gluten, ESR, CRP, H pylori stool antigen
- Medications tried (dose, duration, response)
|
Within 1 month |
Community Pediatrics consult |
| Rectal bleeding |
Description of symptoms (stool type on Bristol chart, frequency, pain with defecation etc.)
Physical exam (e.g. fissures)
CBC, ferritin, ESR, CRP, albumin
|
Within 1 month |
Community Pediatrics consult |