ATCO.MED.B.020 Digestive system

(a)Oesophageal varices Applicants with oesophageal varices should be assessed as unfit.

(b)Pancreatitis

(1)Applicants with pancreatitis should be assessed as unfit. A fit assessment may be considered if the cause (e.g. gallstone, other obstruction, medication) is removed.

(2)Alcohol may be a cause of dyspepsia and pancreatitis. If considered appropriate, a full evaluation of its use or misuse should be undertaken.

(c)Gallstones

(1)Applicants with a single large gallstone may be assessed as fit after evaluation.

(2)Applicants with multiple gallstones may be assessed as fit while awaiting treatment provided the symptoms are unlikely to interfere with the safe exercise of the privileges of the licence.

(d)Inflammatory bowel disease Applicants with an established diagnosis or history of chronic inflammatory bowel disease may be assessed as fit if the disease is in established stable remission, and only minimal, if any, medication is being taken. Regular follow-up should be required.

(e)Dyspepsia Applicants with recurrent dyspepsia requiring medication should be investigated by internal examination including radiologic or endoscopic examination. Laboratory testing should include haemoglobin assessment and faecal examination. Any demonstrated ulceration or significant inflammation requires evidence of recovery before a fit assessment may be considered.

(f)Digestive tract and abdominal surgery Applicants who have undergone a surgical operation on the digestive tract or its adnexa, including a total or partial excision or a diversion of any of these organs, should be assessed as unfit. A fit assessment may be considered if recovery is complete, the applicant is asymptomatic and the risk of secondary complication or recurrence is minimal.