Patient questions, answered

Yes. To claim a Medicare rebate on a specialist consultation you need a current referral from your GP or another specialist. Without one you can still be seen, but the consultation will not attract a rebate. Bring the referral with you or ask your GP to send it to the rooms ahead of your appointment.

Iron tablets stop about a week before, because they darken the lining and make it harder to see. Fibre supplements stop a couple of days before. Blood thinners need a plan agreed with the endoscopist beforehand rather than a general rule, and low-dose aspirin is usually the one that continues. Never stop a blood thinner on your own. A diabetes medicine ending in flozin, such as Forxiga, Jardiance or Steglatro, or a combination tablet such as Xigduo, Jardiamet, Segluromet, Glyxambi, Qtern or Steglujan, stops three days before. Those brands are examples rather than a full list, because taken through a bowel preparation it can cause ketoacidosis even when the blood sugar reading looks normal. A GLP-1 medicine such as Ozempic, Wegovy, Rybelsus, Trulicity, Victoza, Saxenda or Mounjaro is not stopped: current Australian guidance asks for a full clear fluid day followed by the standard fast instead, which the bowel preparation already provides. Tell the rooms about everything you take, including anything bought over the counter. There is more detail on the colonoscopy page, which lists the guidelines this follows.

A GP referral to a specialist is generally valid for 12 months from the date of your first appointment, not from the date it was written. A referral from another specialist usually lasts three months. For ongoing conditions such as Crohn's disease or ulcerative colitis, your GP can write an indefinite referral so you are not chasing paperwork every year. The rules are set out by Services Australia.

It depends on the location and the urgency. Suspected new inflammatory bowel disease, a significant flare, significant rectal bleeding and positive bowel screening tests are prioritised. Ask your GP to mark the referral urgent and phone the rooms. Routine appointments are booked in the order received.

A/Prof Kariyawasam will go through your symptoms, medical history and medications in detail, examine you and agree on a plan with you. That may involve blood tests, stool tests including faecal calprotectin, imaging or booking a colonoscopy or gastroscopy. Bring your referral, your medication list and copies of any previous test results, endoscopy reports or scans.

Fees depend on the consultation or procedure and on the facility. The rooms will explain the fee and the expected Medicare rebate when you book, and you will receive written informed financial consent before any procedure. For procedures in a private hospital, check your level of cover with your health fund. If cost is a concern, please raise it when you book, as there are usually options, including the public hospital clinics.

Yes. A/Prof Kariyawasam holds an appointment with the IBD Service at Concord Repatriation General Hospital. Public appointments are arranged through the hospital clinic rather than the private rooms, so your GP should send the referral directly to the hospital department.

A/Prof Kariyawasam consults at Complete Health Australia in Norwest and Rouse Hill, at Pennant Hills Gastroenterology and at Macquarie GI at Macquarie University. Procedures are performed at Norwest Private Hospital, Macquarie University Hospital and Pennant Hills Day Surgery. Full addresses and phone numbers are on the locations page.

Irritable bowel syndrome (IBS) is a disorder of gut-brain interaction: the bowel is sensitive and its motility is disturbed, but it is not damaged or inflamed. Inflammatory bowel disease (IBD), meaning Crohn's disease and ulcerative colitis, is genuine inflammation that injures the bowel wall and can cause complications such as strictures, fistulas and an increased risk of bowel cancer. The two can feel similar, and blood tests, faecal calprotectin and endoscopy are what tell them apart. That is why persistent symptoms are worth investigating.

Modern IBD treatment aims to heal the bowel lining rather than settle symptoms alone. Depending on the type, extent and severity of your disease, that may mean topical or oral therapies, immunosuppressants or biologic and small-molecule therapies. Treatment is monitored objectively with blood tests, faecal calprotectin, drug levels and periodic endoscopy or imaging, so that it can be adjusted early. Diet, smoking, vaccinations, bone health and planning around pregnancy are part of the same conversation.

Rectal bleeding, black or tarry stools, unintentional weight loss, persistent change in bowel habit, difficulty swallowing, iron deficiency anaemia or a family history of bowel cancer all warrant assessment rather than watchful waiting. Severe abdominal pain, heavy bleeding or vomiting blood are emergencies. Go to an emergency department or call 000.

You will need to fast, generally no food for six hours and no fluids for two hours before the procedure, though you will be given exact times. As with colonoscopy, sedation means you will need someone to take you home. Tell the rooms about blood thinners and diabetes medications in advance.