PATIENT ELIGIBILITY CRITERIA

Colonoscopy and Gastroscopy may be scheduled for patients with specific accepted indications.

EXCLUSION CRITERIA for direct access endoscopy

Unsuitable Patients:
  • Not fit for day-case procedure
  • Not fit for at home bowel prep
  • Age < 16 years
  • Significant co-morbidities (eg. uncontrolled CCF, severe renal disease)

 Please discuss your patient with one of our gastroenterologists if any of the following apply:
  • Age > 85 years
  • BMI > 35 
  • Pregnancy
  • Patient unable to give consent
  • Severe aortic stenosis
  • Artificial heart valve
  • Chronic obstructive pulmonary disease (COPD) (forced expiratory volume (FEV) 1 < 1.0)
  • Myocardial infarction/angina/severe congestive heart failure within 6 months
  • Anemia with Hb < 65
  • Coagulopathy / hereditary hemorrhagic disorders / anticoagulation test (INR > 1.5, platelets < 75,000)
  • Exception to exclusion: Warfarin is not an exclusion to direct access - our office will manage bridging clexane if required

The summary below is intended as a guide only. If you are uncertain about the role of endoscopy,
please contact one of our gastroenterologists to discuss your patient's case.

COLONOSCOPY indications include:

1. Colon cancer screening/polyp surveillance
For a detailed protocol please visit the Australian Cancer Council website.

Screening
- Positive faecal occult blood test
- Family history of colon cancer or polyps:
  • 2 or more 1st degree relatives or one 1st degree relative affected at age younger than 60 years (every 5 years starting at age 40 or 10 years earlier than youngest diagnosis in family, whichever is first)
  • 1st degree relative at age younger than 60 years (average risk screening but beginning at age 40 years)
  • HNPCC or FAP (genetic counseling & special screening)

Polyp (adenoma) surveillance
2. Bleeding
  • Unexplained iron deficiency
  • Positive faecal occult blood test
  • Rectal bleeding

3. Unexplained chronic diarrhea (longer than 3 weeks duration)

4. Inflammatory bowel disease (patient should have GI follow-up)
  • Ulcerative pancolitis or Crohn's colitis for longer than 8 years, or left-sided ulcerative colitis for longer than 15 years (repeat every 1 to 2 years)

5. Unexplained weight loss

6. Altered bowel habit

GASTROSCOPY indications include:

  • Persistent symptoms of gastroesophageal reflux disease (GORD)
  • Persistent dyspepsia
  • Dysphagia
  • Nausea/vomiting
  • Iron deficiency anemia