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SOP BULLETIN

# 26

23 August 1999

THE FOLLOWING RMA SOPS ARE TO BE GAZETTED ON 8 September 1999

New SOPs

Chronic Gastritis

Revocations & Replacements

Gastro-Oesophageal Reflux Disease (GORD)

Amendments

Nil

IMPORTANT OPERATIONAL FEATURES

Chronic Gastritis

New – 60 & 61 of 1999

This new SOP covers diagnoses of chronic gastritis only, including chronic atrophic gastritis.  It does not cover acute gastritis.

The chronic atrophic gastritis factor in the MN of the Stomach SOP will therefore now propagate to this Chronic Gastritis SOP.

Because chronic gastritis is asymptomatic, the SOP uses the term “before the diagnosis of chronic gastritis” instead of the term “before the clinical onset of chronic gastritis”.  The diagnosis is established by endoscopy alone or by endoscopy together with biopsy.

The only causal factor is “suffering from helicobacter pylori infection (at any time) before the diagnosis of chronic gastritis”.

The Departmental Advisory Note outlining the circumstances under which helicobacter pylori infection may be related to service has not yet been finalised by the Disability Compensation Branch Research & Policy Section.

Gastro-Oesophageal Reflux Disease

Revocation – 62 & 63 of 1999 (replaces 121 & 122 as amended by 123 of 1995)

There has been no change to the definition of the SOP condition.

Significant changes have been made to the smoking factors which previously required evidence of smoking as an “addiction”.  Consumption levels are now specified.

  • For RH it is necessary to be smoking at least five cigarettes per day at the time of clinical onset or worsening and also to have smoked at least one pack year before clinical onset.
  • For BOP it is necessary to be smoking at least ten cigarettes per day at the time of clinical onset or worsening and also to have smoked at least two pack years before clinical onset.

The SOP now refers to the term “alcohol dependence or alcohol abuse”. The factor relating to psychoactive substance abuse has been replaced.

  • For both RH & BOP, it is now necessary to be suffering from alcohol dependence or abuse and also consuming alcohol at the time of clinical onset of GORD.  There are no quantity specifications, however, a diagnosis of alcohol dependence or alcohol abuse (as required by the SOP for that condition) is necessary.

The three causal and aggravating factors relating to raised intra-abdominal pressure, increased gastric pressure, and delayed gastric emptying have been removed.

The factor “being treated with smooth muscle relaxant drug” now requires such treatment be “for a condition for which the drug cannot be ceased or substituted”.  This requirement must now be addressed when investigating this factor and may require medical input.

The “intra-abdominal surgical procedure” factor has been revised in RH with the time limitation reduced from 5 days to 24 hours before clinical onset of GORD (it is now the same as the BOP SOP).

The Zollinger-Ellison syndrome factor has been revised in RH with the time limitation reduced from 5 days to 24 hours before clinical onset of GORD (it is also now the same as the BOP SOP).

Barrett's oesophagitis and ulcerative oesophagitis are still covered by the GORD SOP and those diagnoses should be coded to 530.2.

Remember! If you are having any problems with SOPs, or SOPs in CCPS or if you think a SOP needs to be changed, talk to us !