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Gastroenterology and Nutrition, Pediatric   at
Stollery Children's Hospital
Specialty: Pediatric Gastroenterology
Connect Care Department: EDM STO WMC PED GASTRO
Estimated time to routine appointment: Not Available
Alberta Health Services - Edmonton Zone
SERVICE DESCRIPTION
Provides care to children with diseases of the gastrointestinal (GI) tract (esophagus, stomach and bowel) and / or liver.Diagnoses and provides long-term management of gastrointestinal (GI) tract (e.g., esophagus, stomach, bowels) diseases and / or the liver. This includes:
  • gastroesophageal reflux disease (heartburn)
  • eosinophilic gastrointestinal diseases (allergies) and food intolerance
  • peptic ulcer disease (stomach sores)
  • severe functional gastrointestinal diseases (stomach muscles not working correctly)
  • gastrointestinal motility disorders (stomach hurts a lot and may need medicine or different food)
  • inflammatory bowel disease (stomach pain that may need medicine)
  • celiac disease (gluten allergy)
  • children with Intestinal failure - Total Parenteral Nutrition (TPN) dependent (kids who can't eat food by mouth, given food through a tube)
  • chronic diarrhea
  • failure to thrive after pediatric assessment (kids not growing well)
  • liver disease (chronic and acute) (liver problems)
  • liver and multivisceral (small intestine, and other abdominal organs at the same time) transplantation
Provides care to children with diseases of the gastrointestinal (GI) tract (esophagus, stomach and bowel) and / or liver.Diagnoses and provides long-term management of gastrointestinal (GI) tract (e.g., esophagus, stomach, bowels) diseases and / or the liver. This includes:
  • gastroesophageal reflux disease (heartburn)
  • eosinophilic gastrointestinal diseases (allergies) and food intolerance
  • peptic ulcer disease (stomach sores)
  • severe functional gastrointestinal diseases (stomach muscles not working correctly)
  • gastrointestinal motility disorders (stomach hurts a lot and may need medicine or different food)
  • inflammatory bowel disease (stomach pain that may need medicine)
  • celiac disease (gluten allergy)
  • children with Intestinal failure - Total Parenteral Nutrition (TPN) dependent (kids who can't eat food by mouth, given food through a tube)
  • chronic diarrhea
  • failure to thrive after pediatric assessment (kids not growing well)
  • liver disease (chronic and acute) (liver problems)
  • liver and multivisceral (small intestine, and other abdominal organs at the same time) transplantation
ELIGIBILITY REQUIREMENTS
Ages 17 and younger from central and northern Alberta.
Refer to the Pediatric Gastroenterology Referral Quick Reference Pathway
Please review the referral guidelines table before submitting a referral to this service. Incomplete or inadequate referral as per QURE guidelines may be returned or declined.
Ages 17 and younger from central and northern Alberta.
Refer to the Pediatric Gastroenterology Referral Quick Reference Pathway
Please review the referral guidelines table before submitting a referral to this service. Incomplete or inadequate referral as per QURE guidelines may be returned or declined.
Referral instructions for primary care, community care, private
providers etc. who do not send referrals via Connect Care. 
REFERRAL PROCESS - FOR NON-CONNECT CARE USERS
Complete the referral form and fax it to the service using the contact information in this profile.
Non-urgent questions to Paediatric Gastroenterologist can be made through eReferral Advice Request
Complete the referral form and fax it to the service using the contact information in this profile.
Non-urgent questions to Paediatric Gastroenterologist can be made through eReferral Advice Request
REFERRAL PROCESS - FOR CONNECT CARE USERS
Send an Internal Referral using the Ambulatory Referral Order to Pediatric Gastroenterology, type EDM STO WMC PED GASTRO in the “To Department” section and complete order. 
Send an Internal Referral using the Ambulatory Referral Order to Pediatric Gastroenterology, type EDM STO WMC PED GASTRO in the “To Department” section and complete order. 
ADDITIONAL SERVICE DETAILS
To allow for patients to get the most appropriate timely care, please review the recommendations for where to send a referral as some of the reasons for referral should be seen initially by other providers. 
To allow for patients to get the most appropriate timely care, please review the recommendations for where to send a referral as some of the reasons for referral should be seen initially by other providers. 
COMMUNICATION PROCESS
  • Referral receipt to referring source within 7 days.
  • Acceptance via appointment details or wait list status letter to referring source and patient within 14 days.
  • Appointment outcome to referral source within 30 days.
 
CLICK + TO VIEW REFERRAL GUIDELINES
Routine Reason for Referral
Access Targets convey the clinically appropriate timeframe patients should be seen within, by reason for referral and priority level.
Access Target
Required Information/Investigations
Investigation Timing
Additional Details
Abdominal pain
Growth chart (or at least current height/weight) *BMI should be calculated and plotted for children ages 2-17 years
 
Within 1 month

ALT, GGT Bilirubin
 
Within 3-6 Months

Albumin
 
Within 3-6 Months

CBC, ESR/CRP
 
Within 3-6 Months

Celiac Screen on Gluten
 
Within 3-6 Months

Description of Symptoms (if relevant)
 
Within 1 month

Pediatric Consult
 
Within 3-6 Months
Abdominal Pain (chronic or recurrent)
1. Refer to pediatrician.
2. Referral from pediatrician to pediatric gastroenterology must include the indicated information/investigations.

Red flags include;
*weight loss
*diarrhea +/- blood
*vomiting
*nocturnal waking
*fever
*fatigue
*age <3 years old

Autoantibody screening for celiac disease positive
Growth chart (or at least current height/weight) *BMI should be calculated and plotted for children ages 2-17 years
 
Within 1 month

Celiac Screen on Gluten
 
Within 3-6 Months

Complete blood count
 
Within 3-6 Months

Ferritin
 
Within 3-6 Months
Celiac Screen: positive finding

Chronic diarrhea
Growth chart (or at least current height/weight) *BMI should be calculated and plotted for children ages 2-17 years
 
Within 1 month

C Diff Toxin (age >1 year)
 
Within 1 month

CBC, ESR/CRP
 
Within 1 month

Celiac Screen on Gluten
 
Within 1 month

Description of Symptoms (if relevant)
 
Within 1 month

Electrolytes, TCO2
 
Within 1 month

Iron Studies
 
Within 1 month

Stool O&P, culture
 
Within 1 month

Total Protein / Albumin
 
Within 1 month
Chronic diarrhea = duration >4 weeks
1. Refer to pediatrician.
2. Referral from pediatrician to pediatric gastroenterology must include the indicated information/investigations.
Red flag;
*>5% weight loss

Chronic liver disease
Growth chart (or at least current height/weight) *BMI should be calculated and plotted for children ages 2-17 years
 
Within 1 month
Liver disease (chronic)/Portal Hypertension

Conjugated hyperbilirubinemia
Growth chart (or at least current height/weight) *BMI should be calculated and plotted for children ages 2-17 years
 
Within 1 month

ALT, AST, GGT
 
Within 3-6 Months

Abdominal U/s
 
Within 3-6 Months

Bili T/D
 
Within 3-6 Months

INR
 
Within 3-6 Months

Stool Color
 
Within 3-6 Months

Constipation
Growth chart (or at least current height/weight) *BMI should be calculated and plotted for children ages 2-17 years
 
Within 1 month

Calcium
 
Within 3-6 Months

Celiac screen on Gluten
 
Within 3-6 Months

Description of Stool
 
Within 3-6 Months

Electrolytes, TCO2
 
Within 3-6 Months

Pediatric Consult
 
Within 3-6 Months

TSH
 
Within 3-6 Months

Treatment (dose, duration, results)
 
Within 3-6 Months
1. Refer to pediatrician.
2. Referral from pediatrician to pediatric gastroenterology must include the required information/investigations.
Note: Simple constipation is triaged initially to constipation teaching sessions. Four sessions are currently offered per year.

Diet / texture progression difficulty
Growth chart (or at least current height/weight) *BMI should be calculated and plotted for children ages 2-17 years
 
Within 1 month

Diet / texture progression difficulty
 
Within 1 month
1. Refer to pediatrician.
2. Consider referral to Nutrition Services if one or more food groups are missing from diet or very low food variety with suspected nutritional deficiency.
3. For feeding issues; refer to Feeding and Swallowing Services

Dysphagia
Growth chart (or at least current height/weight) *BMI should be calculated and plotted for children ages 2-17 years
 
Within 1 month

Description of Symptoms
 
Within 1 month
Dysphagia or Odynphagia

Failure to thrive
Growth chart (or at least current height/weight) *BMI should be calculated and plotted for children ages 2-17 years
 
Within 1 month

CBC, ESR/CRP
 
Within 1-3 months

Ca, Phos, ALT
 
Within 1-3 months

Celiac screen on Gluten
 
Within 1-3 months

Electrolytes, BUN, Creat.
 
Within 1-3 months

Pediatric and/or Nutrition Services consult
 
Within 1-3 months

Total protein/albumin
 
Within 1-3 months
1. Consider referral to both pediatrician and Nutrition Services.
2. Refer to Feeding and Swallowing Services when there is difficulty eating due to an anatomical or developmental concern or when there is a swallowing difficulty.
3. For case with suspected GI causes, refer to pediatric gastroenterology.

Fatty liver with elevated BMI
Growth chart (or at least current height/weight) *BMI should be calculated and plotted for children ages 2-17 years
 
Within 1 month

AST, ALT, GGT, ALP
 
Within 3-6 Months

Abdominal U/S
 
Within 3-6 Months

Bil, ALB
 
Within 3-6 Months

Lipid Profile
 
Within 3-6 Months
Fatty Liver with elevated BMI (BMI 85th percentile or greater for age)
1. Refer to pediatrician.
2. Refer to Provincial Pediatric Weight Management Services - Central Access Service.
3. Referral from pediatrician to pediatric gastroenterology must include required information/investigations.

Fatty liver without elevated BMI
Growth chart (or at least current height/weight) *BMI should be calculated and plotted for children ages 2-17 years
 
Within 1 month

AST, ALT, GGT, ALP
 
Within 3-6 Months

Abdominal U/S
 
Within 3-6 Months

Bil, ALB
 
Within 3-6 Months

Lipid Profile
 
Within 3-6 Months
Fatty Liver without elevated BMI (BMI 85th percentile or less)

Feeding difficulty with suspected aspiration
Growth chart (or at least current height/weight) *BMI should be calculated and plotted for children ages 2-17 years
 
Within 1 month
1. Refer to Feeding and Swallowing Services
2. May require a prior referral to pediatrician and/or Nutrition Services for a clinical assessment.

Feeding difficulty without failure to thrive
Growth chart (or at least current height/weight) *BMI should be calculated and plotted for children ages 2-17 years
 
Within 1 month
1. Refer to pediatrician.
2. Consider referral to Nutrition Services if one or more food groups are missing from diet or very low food variety with suspected nutrient deficiency.
3. If child is not able to eat anatomically/developmentally, refer to Feeding and Swallowing Services
4. For suspected eating disorder refer to Eating Disorder Program

Food allergy
Growth chart (or at least current height/weight) *BMI should be calculated and plotted for children ages 2-17 years
 
Within 1 month

History and type of allergy
 
Within 1 month
1. Refer to pediatrician.
2. Pediatrician may consider referral to Nutrition Services for overall assessment and/or to pediatric allergist for allergy confirmation.

Gastroesophageal reflux disease
Growth chart (or at least current height/weight) *BMI should be calculated and plotted for children ages 2-17 years
 
Within 1 month

Pediatric Consult
 
Within 1 month
1. Refer to pediatrician.
2. Persistent complicated (FTT, hematemesis, respiratory symptoms) or medication-dependent GE reflux may be referred to pediatric gastroenterology for long term management.

Hematemesis
Growth chart (or at least current height/weight) *BMI should be calculated and plotted for children ages 2-17 years
 
Within 1 month

Complete blood count
 
Within 1 month

Hepatitis
Growth chart (or at least current height/weight) *BMI should be calculated and plotted for children ages 2-17 years
 
Within 1 month

ALT, AST, GGT
 
<1 Week

Bili, T/D
 
<1 Week

Complete Blood Count
 
<1 Week

INR
 
<1 Week
Hepatitis: Acute (ALT >10x normal, normal INR)

Hepatitis B and hepatitis C
Growth chart (or at least current height/weight) *BMI should be calculated and plotted for children ages 2-17 years
 
Within 1 month
Hepatitis B, C - serology positive

Imaging of abdomen abnormal
Growth chart (or at least current height/weight) *BMI should be calculated and plotted for children ages 2-17 years
 
Within 1 month

Imaging Report
 
Within 1 month
Consider contacting pediatric gastroenterology service directly to determine the optimal approach

Inflammatory bowel disease
Growth chart (or at least current height/weight) *BMI should be calculated and plotted for children ages 2-17 years
 
Within 1 month

ALT, GGT, lipase
 
Within 1 month

Albumin
 
Within 1 month

C. difficile toxin
 
Within 1 month

Complete blood count
 
Within 1 month

Description of symptoms (if active send abnormal labs, if suspected send normal labs)
 
Within 1 month

ESR/CRP
 
Within 1 month

Ferritin/Iron studies
 
Within 1 month

Stool C&S, O&P
 
Within 1 month
Active/suspected/inactive

Iron deficiency anemia
Growth chart (or at least current height/weight) *BMI should be calculated and plotted for children ages 2-17 years
 
Within 1 month

Celiac screen on Gluten
 
Within 1 month

Complete blood count
 
Within 1 month

ESR/CRP
 
Within 1 month

Iron studies
 
Within 1 month

Potential reason for deficiency
 
Within 1 month
1. Refer to pediatrician.
2. For anemia with suspected GI cause, refer to pediatric gastroenterology.
3. Refer to Nutrition Services if one or more food groups are missing from diet or very low food variety with suspected nutritional deficiency.

Liver enzymes abnormal
Growth chart (or at least current height/weight) *BMI should be calculated and plotted for children ages 2-17 years
 
Within 1 month

ALT, GGT, Bili T/D
 
Within 1 month

Abnormal ultrasound
 
Within 1 month

Albumin
 
Within 1 month

CK
 
Within 1 month

Complete blood count
 
Within 1 month

INR
 
Within 1 month

IgG
 
Within 1 month

Viral hepatitis screen (B&C)
 
Within 1 month
Abnormal on 2 occasions over 3-6 months

Nutritional deficiency
Growth chart (or at least current height/weight) *BMI should be calculated and plotted for children ages 2-17 years
 
Within 1 month
Nutrition/Nutrient Deficiency
1. Consider referral to both pediatrician and Nutrition Services.

Pancreatitis
Growth chart (or at least current height/weight) *BMI should be calculated and plotted for children ages 2-17 years
 
Within 1 month

Abdominal U/S
 
Within 1 month

Lipase
 
Within 1 month
Chronic/recurrent

Persistent vomiting
Growth chart (or at least current height/weight) *BMI should be calculated and plotted for children ages 2-17 years
 
Within 1 month

Abdominal U/S
 
Within 3-6 Months

Barium Swallow
 
Within 3-6 Months

Complete blood count
 
Within 3-6 Months

Electrolyte
 
Within 3-6 Months
Persistent vomiting/nausea
1. Pediatric gastroenterologists may refer to surgery for confirmed malrotation.

Red flag;

*bilious vomiting (emergency)

Polyposis
Growth chart (or at least current height/weight) *BMI should be calculated and plotted for children ages 2-17 years
 
Within 1 month

Family history (mutation and/or names of polyps if available)
 
Within 1 month

Previous screening/colonoscopy if available
 
Optional
Polyposis, family history
1. May require referral to medical genetics.

Rectal bleeding age 1 year or older
Growth chart (or at least current height/weight) *BMI should be calculated and plotted for children ages 2-17 years
 
Within 1 month

Albumin
 
Within 1 month

Complete blood count
 
Within 1 month

ESR/CRP
 
Within 1 month
Age >1 year without constipation

Rectal bleeding age < 12 months
Growth chart (or at least current height/weight) *BMI should be calculated and plotted for children ages 2-17 years
 
Within 1 month

Albumin
 
Within 1 month

Complete blood count
 
Within 1 month

ESR/CRP
 
Within 1 month

Pediatric Consult
 
Within 1 month
Age <12 months without constipation
1. Refer to pediatrician.
2. Referral from pediatrician to pediatric gastroenterology must include the indicated information/investigations

Unconjugated hyperbilirubinemia
Growth chart (or at least current height/weight) *BMI should be calculated and plotted for children ages 2-17 years
 
Within 1 month

Bili, T/D
 
Within 1 month

Complete Blood count
 
Within 1 month

Pediatric Consult
 
Within 1 month
1. Refer to a pediatrician.
2. Referral from pediatrician to pediatric gastroenterology must include the indicated information/investigations.
Emergent Reason for Referral
Additional Details
+-
Acute gastrointestinal hemorrhage
Acute significant gastrointestinal bleeding/melena Please refer directly to the Emergency Department or Contact RAAPID North at 1-800-282-9911 or 780-735-0811.

+-
Acute pancreatitis
Acute pancreatitis Please refer directly to the Emergency Department or Contact RAAPID North at 1-800-282-9911 or 780-735-0811.

+-
Caustic injury gastritis
Caustic Ingestion Please refer directly to the Emergency Department or Contact RAAPID North at 1-800-282-9911 or 780-735-0811.

+-
Dehydration
Acute Diarrhea with dehydration Please refer directly to the Emergency Department or Contact RAAPID North at 1-800-282-9911 or 780-735-0811.

+-
Foreign body
Esophageal foreign body/food impaction  Please refer directly to the Emergency Department or Contact RAAPID North at 1-800-282-9911 or 780-735-0811.

+-
Liver failure
Acute liver failure (INR>1.5) Please refer directly to the Emergency Department or Contact RAAPID North at 1-800-282-9911 or 780-735-0811.
PATIENT APPOINTMENT INFORMATION
 
MISSED APPOINTMENT GUIDELINES
Missing or cancelling two (2) scheduled appointments associated with the same consult request may result in cancellation and return of the referral to the referring provider; a new referral to the program would be required if specialist consultation is still desired.
Missing or cancelling two (2) scheduled appointments associated with the same consult request may result in cancellation and return of the referral to the referring provider; a new referral to the program would be required if specialist consultation is still desired.
 
HOURS OF OPERATION
Monday: 7:45 am - 4:30 pm
Tuesday: 7:45 am - 4:30 pm
Wednesday: 7:45 am - 4:30 pm
Thursday: 7:45 am - 4:30 pm
Friday: 7:45 am - 4:00 pm
   
 
ADDRESS
2E Pediatric Oilers Ambulatory Clinic
8440 112 Street
Edmonton Alberta
T6G 2B7
PATIENT APPOINTMENT INSTRUCTIONS
  • Bring your Alberta health care card and a piece of government issued photo ID to be presented at the front desk when checking in for an appointment.
  • Check in at reception 15 minutes prior to your scheduled appointment time.
  • Interpreter services are available upon request. Notify the Central booking prior to your appointment if an interpreter is needed.
  • Parent or guardian is strongly encouraged to attend the appointment.
  • Bring your Alberta health care card and a piece of government issued photo ID to be presented at the front desk when checking in for an appointment.
  • Check in at reception 15 minutes prior to your scheduled appointment time.
  • Interpreter services are available upon request. Notify the Central booking prior to your appointment if an interpreter is needed.
  • Parent or guardian is strongly encouraged to attend the appointment.
 
DIRECTIONS
Bus stops are located on 112 and 114 Streets NW, and an LRT station is located just west across 114 Street NW.
Bus stops are located on 112 and 114 Streets NW, and an LRT station is located just west across 114 Street NW.
 
PHONE
780-248-5555 (Central Booking)
780-248-5420 (Administration)
VIRTUAL APPOINTMENT INFORMATION
 
 
WHEELCHAIR ACCESSIBILITY
Yes

The primary purpose of the All Locations list is to let the user easily access any location of a healthcare service without going back to the main search screen.

The locations listed have 3 background colors:
  • Green means the healthcare service@location has referral information attached to it.
  • Brown means the healthcare service@location never had referral information attached to it, or it has unpublished referral information.
  • Red means
    • IA changed the healthcare service@location's status to something other than Current
    • It was deleted if it is an ARD healthcare service@location.
Green  and Brown are always at the top of the list. These are the Healthcare Service@Locations with the status of Current.
The Red list at the bottom consists of non-current Healthcare Service@locations that once had Published referral information in the ARD.
If the referral information was never published in ARD the Healthcare Service@location will not show in the Red list.

The secondary purpose of the All Locations list is to allow ARD Administrators to recover (copy) referral information from the non-current Healthcare Service@Locations to ones that are current.

Common Scenario:
A Healthcare Service moves from one location to another. In this case the IA Healthcare Service@Location record will be made defunct (non-current) and a new Healthcare Service@Location record will be created with a current status. In this scenario the captured referral guidelines in ARD can become "orphaned" as they are not attached to any current IA healthcare service.

Categories of non-current or orphaned referral guidelines: INDIVIDUAL and COMMON.
The REFERRAL GUIDELINES section of the profile has the prefix INDIVIDUAL or COMMON to help you choose the method below when transferring referral guidelines from a non-current Healthcare Service@Location to a current healthcare service@location.

Individual referral process
  1. Click on a non-current (Red) Healthcare Service@Location at the bottom of the All Locations list.
  2. The non-current referral info is displayed with the link Copy this Referral Process to another Healthcare Service@Location link on the upper right hand corner. Click on the copy link.
  3. Choose a current location (Green or Brown) from the All Locations list. This will be the Healthcare Service@Location you are pasting the referral info into.
  4. The system will display the Edit Referral Info screen populated with the referral info from the non-current Healthcare Service@Location you viewed in the first step.
  5. Click Save and the referral info is transferred from the non-current Healthcare Service@Location to the current one.
  6. Repeat these steps for each Healthcare Service@Location that needs attention.

Common referral process - 2 sub cases.
Case 1: At least 1 current Healthcare Service@Location with common referral info is with current status for this healthcare service; One or more Healthcare Healthcare Service@Locations where replaced by new one.
  1. Click on any current Healthcare Service@Location whether it has referral info (Green) or not (Brown).
  2. The healthcare service location opens in the Edit Referral Info screen populated with the current common referral info.
  3. Save it. 
  4. All locations will be updated with the common referral information, including all the locations that don't have referral info yet (Brown). The non-current referrals (Red) will also be updated.
Case 2:  All Healthcare Healthcare Service@Locations for a healthcare service are set to a non-current status and replaced by new ones. In this case there is no current additional referral info to copy from, so the only alternative is to pick up the non-current common referral process (Red). Follow the steps described in the section Individual Referral Process above to copy/paste the non-current common referral info to the current healthcare service locations.
Generally we want to replicate current common referral info to new or replaced healthcare service locations. We only resort to copying non-current common referral info if there is no other option.

Remember: Some fields can be location specific with the common referral process:
Parking Instructions, Directions, Parking Map, Wait Time, Referral Phone or Referral Fax.
To update these items you have to edit each Healthcare Service@Location separately.

ADDITONAL NOTES:
  • The info icon after the All Locations drop down will be visible to ARD Administrators.
  • The system doesn't allow you to copy referral information from one non-current Healthcare Service@Location to another.

 

V6.5