What does a gastroenterologist do?

A gastroenterologist is a specialist physician who diagnoses and treats conditions affecting the digestive tract, including the oesophagus, stomach, small intestine, large bowel, liver, gallbladder, and pancreas. Dr Jeffrey Tu is a consultant gastroenterologist and hepatologist based in Sydney, consulting at The Mater Hospital (Wollstonecraft), East Sydney Private Hospital, Freshwater Day Hospital, and the Centre for Digestive Diseases (Five Dock).

What conditions does Dr Jeffrey Tu treat?

Dr Tu specialises in irritable bowel syndrome (IBS), inflammatory bowel disease (Crohn's disease and ulcerative colitis), gastro-oesophageal reflux disease (GORD/GERD), small intestinal bacterial overgrowth (SIBO), gut microbiome disorders, faecal microbiota transplantation (FMT), coeliac disease, colonoscopy and gastroscopy, colorectal polyp removal, Barrett's oesophagus, liver disease, and haemorrhoid treatment including infrared coagulation (IRC).

What is Faecal Microbiota Transplantation (FMT) and does Dr Tu perform it?

Faecal Microbiota Transplantation (FMT) is a procedure in which carefully screened donor stool microbiota is transferred into a patient's gastrointestinal tract to restore a healthy gut microbiome. It is most established for recurrent Clostridioides difficile infection and is being investigated for ulcerative colitis, IBS, and metabolic conditions. Dr Jeffrey Tu is a leading FMT practitioner at the Centre for Digestive Diseases (CDD) in Five Dock — Australia's largest FMT programme. FMT can be delivered via colonoscopy, nasojejunal tube, or oral capsules (Restoba).

What is a SIBO breath test and do I need a referral?

A SIBO (Small Intestinal Bacterial Overgrowth) hydrogen breath test measures hydrogen and methane gases produced by bacteria in the small intestine after ingesting a sugar solution. It is used to diagnose SIBO, lactose intolerance, fructose intolerance, and sorbitol intolerance. Dr Tu offers hydrogen breath testing in Sydney. Testing at the associated HydroLab facility in Chatswood does not require a referral, and results are available on the same day.

What is a gastroscopy and what does it involve?

A gastroscopy (also called an upper endoscopy or OGD) is a procedure in which a thin, flexible camera is passed through the mouth into the oesophagus, stomach, and duodenum. It is used to investigate symptoms such as reflux, heartburn, difficulty swallowing, nausea, upper abdominal pain, and unexplained weight loss. The procedure is performed under sedation and typically takes 10-20 minutes. Dr Jeffrey Tu performs gastroscopy at The Mater Hospital (Wollstonecraft), East Sydney Private Hospital, and Freshwater Day Hospital.

What is a colonoscopy and how do I prepare for one?

A colonoscopy is an endoscopic examination of the entire large bowel used to investigate rectal bleeding, altered bowel habits, iron deficiency anaemia, polyp surveillance, and colorectal cancer screening. Preparation involves a low-residue diet the day before, followed by a bowel cleansing preparation (laxative solution). Patients must fast from solid food for at least 6 hours before the procedure and arrange a responsible adult to escort them home. Dr Tu performs colonoscopy at The Mater Hospital, East Sydney Private Hospital, and Freshwater Day Hospital.

What are the fees for a gastroscopy or colonoscopy at Shore Gastroenterology?

Fees vary depending on the procedure, complexity, and your private health insurance cover. As a guide, a diagnostic gastroscopy has a specialist fee of approximately $650, with a Medicare rebate of approximately $239.95. A diagnostic colonoscopy has a specialist fee of approximately $900, with a Medicare rebate of approximately $394.75. Combined gastroscopy and colonoscopy is approximately $1,250 with a Medicare rebate of approximately $577.20. Health fund gap cover may reduce your out-of-pocket costs significantly. Contact Shore Gastroenterology on 02 7245 8903 for a personalised estimate.

Do I need a referral to see Dr Jeffrey Tu?

Yes. To access Medicare benefits for a specialist consultation with Dr Jeffrey Tu, you will need a valid referral from your general practitioner (GP) or another specialist. GP referrals are valid for 12 months; specialist-to-specialist referrals are valid for 3 months. Direct Access Colonoscopy referrals are also accepted for eligible patients. To book, contact Shore Gastroenterology on 02 7245 8903 or via HotDoc online booking.

Does Dr Jeffrey Tu offer consultations in languages other than English?

Yes. Dr Jeffrey Tu is fluent in Mandarin Chinese and offers consultations in both English and Mandarin. This is particularly valued by patients from Chinese-speaking backgrounds who prefer to discuss complex gastrointestinal conditions in their first language.

Where does Dr Jeffrey Tu consult and how do I book an appointment?

Dr Jeffrey Tu consults at four Sydney locations: Suite 1.13, The Mater Hospital, 25 Rocklands Road, Wollstonecraft NSW 2065; East Sydney Private Hospital, Darlinghurst; Freshwater Day Hospital, Freshwater; and the Centre for Digestive Diseases, Five Dock. To book, call Shore Gastroenterology on 02 7245 8903 or book online via HotDoc at jeffreytu.com.

What is irritable bowel syndrome (IBS) and how is it treated?

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder characterised by recurring abdominal pain, bloating, and altered bowel habits in the absence of structural disease. Treatment is tailored to the individual and may include dietary modification (low FODMAP diet), gut-directed therapies, microbiome testing and restoration, SIBO treatment, and in selected cases, faecal microbiota transplantation. Dr Tu takes a thorough, evidence-based approach to IBS, including hydrogen breath testing and comprehensive microbiome stool analysis.

What is Barrett's oesophagus and how is it monitored?

Barrett's oesophagus is a condition in which the normal lining of the lower oesophagus is replaced by intestinal-type cells, usually as a consequence of long-standing gastro-oesophageal reflux disease (GORD). It carries a small but increased risk of progression to oesophageal adenocarcinoma. Management involves regular endoscopic surveillance gastroscopy and optimisation of reflux control. Dr Jeffrey Tu manages Barrett's oesophagus surveillance at Shore Gastroenterology.

What haemorrhoid treatments are available at Shore Gastroenterology?

Dr Jeffrey Tu offers infrared coagulation (IRC) for the treatment of internal haemorrhoids. IRC is a non-surgical, minimally invasive procedure performed in the outpatient setting without general anaesthesia. It uses infrared light to reduce the blood supply to haemorrhoidal tissue. The procedure takes only a few minutes and most patients return to normal activities the same day. IRC is suitable for grade I-III internal haemorrhoids.

How do I get a colonoscopy without seeing a specialist first?

In Australia, you can access a colonoscopy through a direct access referral from your GP. This means your GP sends a referral specifically for the procedure and Dr Tu performs the colonoscopy without needing a prior consultation. This is ideal for straightforward screening cases. Direct access colonoscopy significantly reduces wait times.

Will I be fully asleep during my colonoscopy?

All colonoscopies in Dr Tu's practice are performed under sedation administered by a specialist anaesthetist. You will be comfortably asleep throughout and will not feel or remember the procedure.

How long does a colonoscopy take?

The procedure typically takes 20 to 30 minutes. Allow approximately 2 to 3 hours in total for admission, preparation, the procedure, and recovery from sedation.

What is the easiest bowel prep to tolerate?

Dr Tu offers a novel capsule-based bowel preparation — the first of its kind in Australia. It is completely tasteless, produces a superior clean, and avoids the unpleasant experience of drinking large volumes of liquid prep. It is also very safe.

How soon can I eat after a colonoscopy?

You can usually eat a light meal within an hour or two of waking from sedation. Starting with something gentle such as toast, soup, or crackers is advised, returning to a normal diet by the next day.

Why am I bloated every day even when I eat well?

Daily bloating despite a healthy diet can be caused by IBS, SIBO, food intolerances, motility issues, disruption of the gut microbiome, or intestinal parasites such as Blastocystis hominis and Dientamoeba fragilis — organisms that are frequently overlooked but can cause persistent bloating, fatigue, and diarrhoea. Persistent bloating almost always has a treatable underlying cause.

Is blood in my stool an emergency?

A small amount of bright red blood is commonly from haemorrhoids, but should never be assumed without proper investigation. Dark or black stools, blood mixed through the stool, or bleeding with weight loss or change in bowel habit warrant urgent assessment. Any new rectal bleeding deserves a conversation with your doctor.

What does it mean if my reflux is not responding to PPIs?

If reflux symptoms persist despite proton pump inhibitors, conditions like functional dyspepsia, eosinophilic oesophagitis, or bile reflux may be the cause — these mimic acid reflux but do not respond to acid suppression alone. Further investigation such as gastroscopy is warranted.

Should I be worried about loose stools that will not go away?

Persistent loose stools lasting more than a few weeks should be investigated. Chronic diarrhoea can signal inflammatory bowel disease, coeliac disease, microscopic colitis, or parasitic infections such as Blastocystis and Dientamoeba fragilis. Blood tests, stool tests, and sometimes colonoscopy can identify or exclude serious causes.

Can stress really cause gut symptoms?

The gut-brain connection is real — stress genuinely alters gut motility, sensitivity, and the microbiome. However, stress should not be used as a label before the right investigations have been done. A thorough approach addresses both stress and lifestyle factors while ensuring nothing organic has been missed.

Can intestinal parasites cause IBS-like symptoms?

Parasites such as Blastocystis hominis and Dientamoeba fragilis are frequently overlooked and can cause persistent bloating, fatigue, and diarrhoea that closely mimics IBS. Dr Tu offers transcolonic antibiotic infusion for these infections — a targeted treatment delivering antibiotics directly to the site of infection — achieving a success rate of approximately 98%. Many patients treated for parasitic infections have been previously told they simply have IBS.

What is faecal microbiota transplantation (FMT) and how does it work?

FMT involves transferring processed stool from carefully screened healthy donors into a patient's gastrointestinal tract to restore a healthy microbiome. Dr Tu performs FMT at the Centre for Digestive Diseases in Five Dock, which runs Australia's largest and longest-established FMT programme. Multi-donor preparations are GMP-certified and TGA-approved. Treatment can be delivered via colonoscopy, enema, or oral capsules depending on the clinical scenario.

Who is a candidate for FMT in Australia?

The strongest evidence for FMT is in recurrent Clostridioides difficile infection, where cure rates exceed 85 percent. Beyond C. diff, FMT is also used in selected cases of ulcerative colitis using specialised antibiotic-FMT combination protocols. Each case is assessed individually.

How many FMT treatments will I need?

For recurrent C. diff, a single colonoscopic FMT is often sufficient, though some patients benefit from a follow-up course. For ulcerative colitis, the protocol is more intensive — typically involving antibiotics and multiple FMT infusions over several weeks.

Is FMT safe and what are the risks?

FMT has an excellent safety profile when performed within a regulated programme with rigorously screened donors. The programme at the Centre for Digestive Diseases uses multi-donor preparations with very stringent donor selection. There has been no recorded infection transmission since inception. The most common side effects are mild and transient — bloating, cramping, or a temporary change in bowel habit.

Can FMT help conditions beyond C. diff infection?

Beyond C. diff, there is growing evidence for FMT in ulcerative colitis using antibiotic-FMT combination protocols. Research is also exploring FMT's role in IBS, metabolic syndrome, and other conditions linked to microbiome disruption.

Can I get FMT if I have another condition like depression or chronic fatigue?

Having a co-existing condition such as depression, a neurological condition, autoimmune disease, or chronic fatigue syndrome does not automatically exclude you from FMT. Many of these conditions have emerging links to gut microbiome disruption. Each case is assessed individually taking into account the full medical history and current treatments.

What is the difference between FMT capsules, enema, and colonoscopic FMT?

Colonoscopic FMT delivers donor material directly into the colon allowing for the largest volume and most targeted delivery. Enema-based FMT can be administered at home in some cases. Oral capsules are the least invasive and are often used for maintenance therapy. Many treatment plans use a combination — colonoscopic FMT as the initial treatment followed by capsules or enema for ongoing support.

How do I know if my gut microbiome is damaged?

Symptoms such as persistent diarrhoea, bloating, or recurrent infections after antibiotic use can suggest microbiome disruption. A history of repeated or prolonged antibiotic courses is one of the strongest risk factors for significant microbiome damage. Assessment includes stool analysis and clinical evaluation.

Can FMT reverse antibiotic damage to the gut?

In many cases yes. Antibiotics — especially broad-spectrum courses — can significantly reduce the diversity and balance of gut bacteria. FMT is one of the most effective ways to restore that diversity by reintroducing a complete healthy microbial ecosystem.

How do I know if I have IBS or something more serious?

IBS should be a diagnosis of exclusion. Conditions like inflammatory bowel disease, coeliac disease, colorectal cancer, and parasitic infections such as Blastocystis and Dientamoeba fragilis must be ruled out first, especially if red flag symptoms are present such as bleeding, weight loss, anaemia, or onset after age 50.

I have tried everything for my IBS — what else can I do?

For patients who have exhausted conventional IBS treatments, a combined approach targeting the gut-brain axis from multiple angles is recommended: microbiome modulation including FMT where appropriate, tailored dietary intervention to change the gut food environment, and gut-directed hypnotherapy to recalibrate central nervous system signalling. When you change the food, change the microbiome, and change the brain's response, you get the best outcomes.

What is the difference between IBS and IBD?

IBS (irritable bowel syndrome) is a functional disorder — the gut looks structurally normal but does not function well. IBD (inflammatory bowel disease), which includes Crohn's disease and ulcerative colitis, involves actual inflammation and damage to the bowel visible on colonoscopy and biopsy. The treatments are very different.

Why does my H. pylori keep coming back after treatment?

Recurrent H. pylori is often due to antibiotic resistance — standard triple therapy regimens fail more frequently due to increasing resistance patterns. Dr Tu uses vonoprazan-based combination therapy, a novel treatment offering far superior eradication rates compared to traditional PPI-based regimens, guided by sensitivity testing.

What is SIBO and why is it so hard to treat?

SIBO — small intestinal bacterial overgrowth — occurs when bacteria that normally reside in the colon proliferate in the small intestine. Hydrogen-dominant SIBO tends to cause diarrhoea while methane-dominant overgrowth causes bloating and constipation. It is difficult to manage because antibiotics can temporarily clear the overgrowth but without addressing the underlying cause such as motility issues or structural factors it tends to recur.

Can ulcerative colitis go into long-term remission?

Yes. With the right treatment strategy, many patients with ulcerative colitis achieve sustained remission. Treatment options include conventional medications, biologics, and antibiotic-FMT combination protocols.

Why do I keep getting C. diff infections after antibiotics?

Recurrent C. diff is a vicious cycle — antibiotics used to treat the infection further damage the gut microbiome, which is what normally keeps C. diff in check. FMT breaks this cycle by restoring a healthy microbiome in a way that antibiotics alone cannot. Two or more recurrences is a strong indication for FMT.

Is there a test that can tell me exactly what is wrong with my gut?

There is no single test that provides all the answers, but the right combination of investigations can be very revealing. Depending on symptoms this may include blood tests, stool studies, breath testing, colonoscopy, gastroscopy, or advanced techniques like confocal laser endomicroscopy (Cellvizio), which allows examination of the gut lining at a cellular level in real time during the procedure.

Can coeliac disease develop later in life?

Yes. While coeliac disease has a genetic basis it can present at any age. It is worth considering with persistent diarrhoea, iron deficiency, unexplained weight loss, or a family history of coeliac disease. A blood test for coeliac antibodies followed by gastroscopy with duodenal biopsies is the standard diagnostic pathway.

What causes microscopic colitis and how is it diagnosed?

Microscopic colitis causes chronic watery diarrhoea, often in patients over 50. The colon looks completely normal on colonoscopy — diagnosis is only made by taking biopsies, which is why it is called microscopic. Certain medications, autoimmune conditions, and smoking are known risk factors. It responds very well to treatment once diagnosed.

What bowel preparation is required for a colonoscopy at The Mater Hospital?

Purchase PrepKit Orange and Hydralyte tablets from any pharmacy without a prescription. Two to three days before: low residue diet, avoid nuts and grains. Day before: light breakfast then clear fluids only. At 4pm take one Picoprep sachet in 250ml water then two glasses of clear fluid. At 6pm take one Glycoprep sachet in one litre of water. At 8pm take a second Picoprep sachet. On procedure day: take regular medications with a sip of water but no blood thinners. Nothing by mouth 6 hours before admission. Arrange transport home. If you take Insulin, Warfarin, or Clopidogrel discuss with your GP or Dr Tu 2 weeks before. Cease iron tablets 1 week prior. Contact: The Mater Hospital (02) 9900 7300.

What bowel preparation is required for a colonoscopy at East Sydney Private Hospital?

Purchase PrepKit Orange and Hydralyte tablets from any pharmacy without a prescription. Follow the same preparation protocol as for The Mater Hospital. Procedure day is Monday with preparation on Sunday. Contact East Sydney Private Hospital on (02) 9001 2000.

What bowel preparation is required for a colonoscopy at Freshwater Day Hospital?

Purchase PrepKit Orange and Hydralyte tablets from any pharmacy without a prescription. Follow the same preparation protocol as for The Mater Hospital. Procedure day is Thursday with preparation on Wednesday. A nurse will contact you 2 days prior. Contact Freshwater Day Hospital on (02) 9063 7585 or admin@freshwaterdaysurgery.com.au.

What are the consultation fees at Shore Gastroenterology?

At The Mater Hospital (Wollstonecraft): Initial consultation $320 with Medicare rebate of $148.35. Follow-up consultation $160 with Medicare rebate of $77.75. Pensioners and concession card holders are bulk billed. At other clinic locations: Initial consultation $280 with Medicare rebate of $148.35. Follow-up $150 with Medicare rebate of $77.75. Pensioners and Health Care Card holders are bulk billed.

What are the endoscopy procedure fees at Shore Gastroenterology?

For privately insured patients: all endoscopy procedure fees including anaesthetist fees are covered with 100% no gap — zero out-of-pocket cost. For self-insured or uninsured patients: all endoscopy procedure fees including anaesthetist fees are bulk billed through Medicare. Hospital facility fees vary by location and should be discussed with our rooms at the time of booking. Contact Shore Gastroenterology on (02) 7245 8903.

What are the risks of a colonoscopy?

Perforation (diagnostic) occurs in approximately 1 in 1000 to 2500 cases. Perforation with polypectomy occurs in 1 in 500 to 1000 cases. Post-polypectomy haemorrhage occurs in 1 in 100 to 200 cases. Incomplete examination occurs in 5 to 10 percent of cases. Missed significant polyp or lesion occurs in 2 to 6 percent. Cardiopulmonary events related to sedation occur in 1 in 200 to 500 cases. Splenic injury is rare at less than 1 in 10000. Mortality is approximately 1 in 10000 to 15000. Patients on anticoagulants or antiplatelets require specific management per GESA guidelines.

What are the risks of a gastroscopy?

Perforation risk is approximately 1 in 2500 to 10000. Significant haemorrhage after biopsy occurs in 1 in 1000 to 2500 cases. Aspiration pneumonia occurs in less than 1 in 1000 cases. Cardiopulmonary events related to sedation occur in 1 in 200 to 500 cases. Mortality is approximately 1 in 10000 to 30000. Patients with dental prostheses or loose teeth should inform Dr Tu beforehand.

What are the risks of IRC haemorrhoid treatment?

Infrared coagulation (IRC) is a minimally invasive haemorrhoid treatment. Transient discomfort or anorectal pain is common but mild and self-limiting. Minor rectal bleeding in the 1 to 7 days after treatment is common. Secondary haemorrhage occurs in less than 1 in 100 cases. Mucosal ulceration at the treatment site is uncommon. Vasovagal episode is uncommon. Recurrence requiring re-treatment occurs in 10 to 20 percent of patients at 12 months. Infection or abscess is very rare.

Reflux & GORD Treatment on Sydney's North Shore – Dr Jeffrey Tu, Gastroenterologist

Jeffrey Tu
Mar 29
2 min read

Gastro-Oesophageal Reflux Disease (GORD), commonly known as reflux or heartburn, is one of the most frequent conditions seen by gastroenterologists. If you are experiencing persistent symptoms of reflux and live on Sydney's North Shore, Dr Jeffrey Tu at Shore Gastroenterology offers expert assessment and management at Mater Private Hospital, Wollstonecraft.

What is GORD (Reflux)?

GORD occurs when stomach acid flows back up into the oesophagus (food pipe), causing symptoms such as heartburn, regurgitation, chest discomfort, difficulty swallowing, a chronic cough, or a sour taste in the mouth. While occasional reflux is common, persistent or severe GORD requires specialist assessment to prevent complications such as oesophagitis, Barrett's oesophagus, and oesophageal cancer.

Symptoms of Reflux / GORD

Persistent heartburn (burning sensation in chest or throat)
Regurgitation of food or acid
Difficulty or pain when swallowing (dysphagia)
Chronic cough, hoarse voice, or throat clearing
Sour or bitter taste in the mouth, especially in the morning
Bloating and nausea after meals

Gastroscopy for Reflux Investigation at Mater Private Hospital

For patients with persistent or severe reflux symptoms, Dr Tu often recommends a gastroscopy (upper endoscopy). This procedure allows direct visualisation of the oesophagus, stomach and upper small bowel to assess for oesophagitis, Barrett's oesophagus, hiatus hernia, or ulcers. Gastroscopies are performed at Mater Private Hospital in Wollstonecraft under light sedation, as a day procedure.

Serving North Shore Patients – Roseville, Chatswood, Lindfield & Beyond

Shore Gastroenterology at Mater Private Hospital is conveniently located for patients across Sydney's upper and lower North Shore, including Roseville, Killara, Lindfield, Gordon, Pymble, Turramurra, Chatswood, St Leonards, Artarmon, Crows Nest, Neutral Bay, and Mosman. The practice is easily accessible via the Pacific Highway.

Book a Reflux Consultation

If you have persistent reflux symptoms, please see your GP for a referral and contact Shore Gastroenterology on (02) 7245 8903. Early assessment and treatment can prevent serious complications. Visit jeffreytu.com for more information.