Gastroenterological presentations out of scope

​​Public outpatient services in NSW are generally not provided to patients presenting with these conditions.​

• Abdominal pain – second opinions for conditions already seen by the same specialty
• Hepatocellular cancer surveillance, when indicated to be conducted in a primary care setting
  (see Cancer Council guidelines for more information)​
  
• ​​Completed colonoscopy with adequate bowel preparation in the last 2 years for the same symptoms
  Note: Colonoscopy is not required if already performed in the last 2 years and findings were normal (i.e. no polyps) so long as there are no new symptoms or other indication for more frequent colonoscopy>
• ​​Haemorrhoid surgery or banding (if medical therapy fails)
  ​Note: referral to colorectal surgery is indicated
• ​Fissure surgery (if medical therapy fails)
  Note: referral to colorectal surgery is indicated
• Persistent but unchanged gastrointestinal symptoms previously investigated
• Normochromic, normocytic anaemia with normal iron studies or isolated low serum iron
  Note: Clinical monitoring within primary care for anaemia secondary to gynaecological, haematological or other causes. Consider faecal occult blood test. Refer to outpatient services if anaemia is progressive, faecal occult blood test is positive or if gastrointestinal symptoms emerge.
• Fatty liver with normal liver function tests and Fibrosis-4 (FIB 4) score below 1.3 (meaning no significant fibrosis evident)
• Belching
• Halitosis​