Gastroenterology and Hepatology
Refer a Patient
How to Refer a Patient
Updated December 2019
We are accepting new referrals.
The Gastroenterology and Hepatology Program is currently experiencing longer-than-normal wait times. Our referral backlog includes more than 1,000 patients with conditions considered not urgent and typically manageable in the primary care setting, for whom we have no appointment slots available. We are in the process of notifying these patients and their providers that we are temporarily unable to see them and are also putting a hold on taking new referrals for these conditions.
To improve access for patients, we are:
- Temporarily redirecting patients with the following diagnoses to primary care unless they have alarm symptoms or red flags*:
- Functional constipation
- Functional abdominal pain
- Physiological gastroesophageal reflux
* For information about red flags/alarm signs, visit Resources for Providers below and view the protocol and algorithm for functional constipation and two algorithms for GERD (one for infants, one for noninfants).
- Reviewing referrals daily. Our internal triage process identifies those patients who need to see a specialist most urgently.
- Actively recruiting and hiring new providers. We hope to have them in place and resume seeing all referrals by fall 2020.
If you are unsure whether to refer your patient, please call our Clinical Intake Nurses at 206-987-2080, option 1.
We ask that providers submit a referral that is complete. A complete referral helps us schedule an appointment for your patient in a timely manner and match them with the right specialist and clinic location. It ensures a productive and smooth first appointment for your patient. It also helps us assess the needs of our community and plan to have the capacity to meet those needs.
We may not schedule patients until a complete referral is received.
Please submit all relevant documentation and chart notes with your referral, including:
- Growth curves/charts
- Results from any relevant labs and stool tests
- Relevant imaging results
- If you are referring a patient for functional constipation, functional abdominal pain or physiological gastroesophageal reflux (GERD), please provide full clinical details including alarm signs/red flags and your prior treatment plan and timeline.
- Patients who have not been seen by our department in the last 18 months will need a new referral.
- We will see new patients through age 17 only. If your patient is 18 or older, we ask that you refer them to an adult gastroenterology/hepatology provider.
Submit a referral
Please follow the standard referral procedures below:
- After we receive your referral, we will triage it and then call the family when we have an appointment available.
- Patients are prioritized based on their current condition and acuity and the availability of a specialist to see them.
- We will notify you when an appointment is made.
- Your patient will be seen by the provider who is the best match for managing the current problem.
We’re committed to partnering with you
If we evaluate your patient and determine they do not have a condition that requires ongoing evaluation and management in a specialty setting, we will return them to primary care with an appropriate plan of care for the primary care provider.
We are creating tools to support referring providers in caring for patients who have conditions that can be evaluated and treated in primary care. Learn more in Resources for Providers below.
We are always available to answer questions and support your care of your patients.
- Diagnosis and treatment options: call 206-987-7777 (Provider-to-Provider Line).
- Referring or transporting a patient to our Emergency Department or Urgent Care: call 206-987-8899 or, toll-free, 866-987-8899 (Emergency Department Communications Center).
- Questions about scheduling and referrals, including locating or expediting a referral: call 206-987-2080 (Clinical Intake Nurses).
Learn more about managing your patients at Seattle Children's, including viewing your patient’s records.
What Your Patients Can Expect
- Once we receive your referral, your patient will be in our queue to review and schedule. Many services have a long wait.
- We review openings and the patient referral queue daily.
- As openings become available, we call families to schedule based on provider availability and the patient’s condition and acuity.
Even if we do not have openings right away, there are many resources through Seattle Children’s and in the community that can help.
- Gastroenterology – The Healthy Endoscopy Research Study
- IBS – iSTEP Study for Mothers with IBS
- PREDICT Trial: Precision Diagnostics in Inflammatory Bowel Disease, Cellular Therapy and Transplantation
Resources for Providers
- The Functional Constipation Clinical Protocol (PDF), developed by Seattle Children’s specialists in collaboration with community providers, can help you determine whether your patient should be referred to a specialist or treated in primary care.
- Algorithm for Functional Constipation (p. 12 in document above)
- Guideline for families, including education materials to help understand and manage their child’s constipation
- Parent booklet about constipation from St. Louis Children’s
- Dosage Tables
- Please review the Functional Constipation Clinical Protocol, including the algorithm on page 12.
- Consider the following screening tests: CBC, ESR, CRP, albumin, BUN/Cr, ALT, TTG IgA, total IgA, TSH and stool Helicobacter pylori.
- Consider abdominal imaging with ultrasound, upper gastrointestinal series or other if concerning symptoms for gallbladder pathology, abnormal GI anatomy or extraintestinal sources of symptoms.
- Education materials to help families understand and manage their child’s abdominal pain:
- Seattle Children’s article: “Abdominal Pain in Kids – Anxiety-Related or Something More?”
- Free mobile app for teenagers experiencing pain
- Pain associated with chronic vomiting, chronic diarrhea, bleeding, weight loss, or significant lab abnormalities is considered an urgent referral. Please include these details in the referral or contact our GI providers.
- Algorithm for GERD in infants(<12 months)
- Algorithm for GERD in children ages 1+
- A guideline for families that includes education materials to help understand and manage their child’s reflux: “Reflux (Spitting Up)”
- Seattle Children’s handout, “Gastroesophageal Reflux: Helping Your Baby.”
- Gastroesophageal Reflux Disease (GERD): Parent’s Take-Home Guide from GI Kids (Spanish)
- Consider recommending a food and emotion diary to correlate reflux symptoms with certain foods and stressors.
- Consider trial of acid suppression for two to four weeks.
- Chronic vomiting, vomiting with weight loss and dysphagia are considered a more urgent referral. Please include these details in the referral or contact our GI providers.
To suggest additional resources from Seattle Children’s that would be useful to primary care providers, please email us.