Table 2.

GI-related diagnoses

Diagnoses	Original tests proposed and retained	Original tests proposed and eliminated	Additional tests proposed and retained	Tests proposed and eliminated
Abdominal bloating	Trial of lactose-free diet	Dietary history Alcohol abstinence Caffeine abstinence Trial off carbonated beverages CBC TSH		Gum-chewing abstinence
Chronic diarrhoea	CBC TSH CMP Stool for giardia IgA TTG		Stool culture Faecal fat Stool O&P Cdiff	Faecal WBC ESR CRP Albumin
Rectal bleeding	Anal exam for fissures/haemorrhoids Trial of fibre CBC		Full colonoscopy if ongoing rectal bleeding
Heartburn	CBC Anti-reflux lifestyle measures 4–8-week trial of proton pump inhibitor (PPI) Careful non-steroidal anti-inflammatory use history Direct EGD if alarm symptoms (unintentional weight loss, anaemia, GI bleed, dysphagia, family history of GI malignancy)		Direct EGD if symptomatic despite BID PPI for at least 4–8 weeks Direct EGD if male, >50 with reflux sx >5 years, additional risk factors (nocturnal reflux, hiatal hernia, elevated BMI, tobacco, central obesity
Iron deficiency anaemia			CBC Iron studies	H. pylori IgG BUN/Cr IgA TTG
Abdominal pain			CBC CMP Amylase Lipase	TSH Iron studies IgA TTG H. pylori IgG
Irritable bowel syndrome			CBC CMP IgA TTG	Iron studies H. pylori IgG Amylase Lipase TSH

BMI, body mass index; CBC, complete blood count; CMP, complete metabolic panel; Cdiff, Clostridium difficile; IgA TTG, IgA tissue transglutaminase; ESR, erythrocyte sedimentation rate; CRP, C-reactive protein; stool O&P, stool ova and parasites; EGD, esophagogastroduodenoscopy; BID, bis in die (two times a day); Cr, Creatinine.