Gastroenterology


 * General guidelines on Colon Cancer Screening
 * Diagnostic evaluation of rectal bleeding
 * Hepatology- Hepatitis B, C, fatty liver, cirrhosis, etc,
 * Hepatitis B


 * Flexible sigmoidoscopy (Flex Sig)** referrals (per email from Chris Farnitano January 2010)
 * Prescribe the bowel prep medicines at the time of the referral. In RxM, to select the standard bowel prep prefilled with proper sig and quantity, type "FLEX".
 * The patient should receive the instruction sheet at the time of the referral. This form will be in clinic, but you can also print it with this link: [[file:ccrmc/A88 sigmoidoscopy standard bowel prep instructions.pdf|Flexible sigmoidoscopy standard bowel prep instructions (A88).pdf]] . Spanish instructions are on page 2.
 * For patients with renal insufficiency, i.e. Cr > 2.5, magnesium citrate is contraindicated, so use this [[file:ccrmc/A89 sigmoidoscopy PEG metoclopramide alternative bowel prep instructions.pdf|A89 sigmoidoscopy PEG metoclopramide alternative bowel prep instructions.pdf]] instead. You must prescribe alternative medicines. Spanish instructions are on page 2.
 * A new "Flex Sig" waiting list (distinct from the "Gastro Consult Only" waiting list) is now in Epic. Patients should be placed on this "Flex Sig" waiting list only if there are no available appointments at the time of referral.
 * All patients are supposed to be contacted by the staff of the sigmoidoscopy clinic 1-2 weeks before the appointment to ensure they received the bowel prep meds and instructions, answer questions about the prep, and confirm the patient intends to keep the appointment
 * For more details, here is the Standard Workflow for scheduling Sigmoidoscopy