When to Refer to a Gastroenterologist
[ also see (Table 12) ]
Suspected gastric outlet or small bowel obstruction
Suspected pancreatitis or cholangitis
Unexplained nausea and vomiting
Swallowing symptoms (dysphagia, odynophagia)
Evidence of GI bleeding (anemic, hematemesis, melena)
Recent caustic ingestion
Acetaminophen overdose
Suspected inflammatory bowel disease
Abnormal liver enzymes or jaundice
When to Refer to Other Specialists

Obstetrician

Persistent nausea and vomiting at any time during pregnancy



Nausea and vomiting in 3rd trimester of pregnancy
Otolaryngologist
Refractory Méniére's disease


Suspected vestibular neuronitis
Cardiologist Suspected cardiac ischemia
Surgeon Small bowel obstruction