Your
Consultant will take a detailed account of your medical history and ask about the symptoms you have been experiencing. They will want to know:
- What your symptoms are;
- How long you have had these symptoms;
- Have your symptoms become progressively worse;
- Whether your symptoms are causing you any concern, worry or embarrassment, and
- Whether they are affecting your daily activities in any way.
They will also perform a physical examination and may refer you for further investigations.
If you have been experiencing rectal bleeding, or a change in bowel habits, your Consultant will usually want to carry out an endoscopic procedure to investigate more fully. An endoscope is a thin, flexible tube with a light and camera on one end. It transmits a live feed to an external monitor.
The two types of endoscopic tests normally used for diagnosing a colorectal problem are:
- Colonoscopy, and
- Flexible Sigmoidoscopy.
A colonoscopy is a way of thoroughly examining the whole of your bowel. The endoscope is introduced through the anus and moved through the bowel. While this is not a painful procedure, it can be uncomfortable, so you will usually be offered sedation or gas. If you have sedation, you will need somebody to take you home and then stay with you until the effects of the sedation have fully worn off. Before a colonoscopy, the bowel needs to be fully emptied. This is done with a strong laxative. This will be fully explained to you in your consultation before the procedure.
Flexible sigmoidoscopy is a slightly simpler investigation that only looks at the left side of the bowel. It is commonly performed when somebody has been experiencing rectal bleeding. Similar to a colonoscopy, the endoscope is introduced through the anus to give your consultant a video of the lower part of your bowel. This can be a helpful way of also looking at haemorrhoids or piles. Often, these can be treated at the same time by your consultant.
With either a colonoscopy or flexible sigmoidoscopy, your Consultant will be able to look very carefully for any abnormalities, damage or areas of interest. A biopsy may be taken during the endoscopy and then sent for analysis. While they may both help with locating the source and cause of your symptoms, they can also often rule out concerns such as bowel cancer.
After either procedure, your Consultant will talk you through the results and explain the next steps in terms of treatment options or further investigations.