Criteria for referral to public hospital service

• Hiatus hernia identified on chest x-ray or gastroscopy
• Suspected hiatus hernia with volume reflux or obstructive symptoms
• Severe heartburn unresponsive to maximum medical management.

Information to be included in the referral

Information that must be provided

• Onset, characteristics and duration of symptoms, particularly volume or obstructive symptoms
• If severe heartburn, details of previous medical management including the course of treatment and outcome of treatment
• Current and complete medication history (including non-prescription medicines, herbs and supplements)
• Statement about the patient’s interest in having surgical treatment if that is a possible intervention.

Provide if available

• Gastroscopy results, including when and where the procedure was performed
• Chest x-ray
• Abdominal and chest CT scan
• Any relevant previous biopsy results.

Additional comments

The Summary and referral information lists the information that should be included in a referral request.

Referrals for Gastroesophageal reflux should be directed to gastroenterology service provided by the health service.

Where appropriate and available the referral may be directed to an alternative specialist clinic or service.

Referral to a public hospital is not appropriate for

• Incidental findings found on imaging without symptoms or clinical significance
• Patients with controlled symptoms.