When you first meet your Consultant Gastroenterologist at BMI The Cavell Hospital, they will take a medical history and talk with you in detail about your symptoms. They will want to know things like:
- The symptoms you have
- When these symptoms first appeared
- Whether your symptoms have been getting more noticeable/severe
- Whether specific foods, drinks or activities make your symptoms worse
A physical examination may also be carried out.
It may be found that your symptoms are not being caused by anything worrying, and no treatment is needed.
In other cases, further investigation may be required to aid diagnosis. Many conditions and symptoms affecting the GI tract are most easily investigated using a special instrument known as an endoscope, a thin, flexible tube with a camera and light at one end. The camera is attached to an external video screen and provides a real time image.
Depending on where you’re experiencing your symptoms, you may need to have a Gastroscopy, a Colonoscopy or an Endoscopic Retrograde Cholangiopancreatography (ERCP) to investigate. If any of these are required, they will be arranged for you at the earliest opportunity.
- A gastroscopy is used to examine the upper part of the GI tract. The endoscope is moved through the mouth and down the oesophagus, into the stomach and the duodenum (the first part of the small intestine).
- A colonoscopy looks at the lower part of the GI tract. The endoscope is inserted into the rectum and slowly moved along the large intestine and into the small intestine.
During either investigation, your Consultant will be carefully examining the inside of the GI tract, checking for any abnormalities or areas of possible concern.
- An ERCP* is used to investigate problems in the bile ducts, gall bladder and pancreas, and to treat blockages within the bile ducts. These blockages are usually caused by a small stone, which is removed by making a small cut at the lower end of the duct. Occasionally the problem is caused by a tumour, in which case the obstruction can be relieved by placing a thin tube ('stent') within the duct.
(* Please note that ERCPs are carried out at an external venue. This will be arranged for you by your Consultant.)
Whichever of these investigations you have, a biopsy may be taken for further analysis. This involves carefully removing a small sample of tissue from the area in question.
Endoscopic procedures are generally well tolerated, but they may be a bit uncomfortable. Some people find a throat spray is helpful to reduce discomfort and coughing during a gastroscopy, while others prefer to also have a sedative injection. For a colonoscopy, an injection of a sedative and a pain-killing medication is often used, although some people choose to have nitrous oxide ('gas and air'). Your gastroenterologist will explain these options to you prior to the procedure.
Additional tests may include blood tests, liver function tests, MRI scan, CT scan and ultrasound, all of which are available on-site at BMI The Cavell Hospital.
A Fibroscan can be helpful in measuring scarring (fibrosis) of the liver.
Hydrogen breath testing can be carried out at our sister site, BMI The Kings Oak Hospital, and is useful for diagnosing several conditions that can cause gastrointestinal symptoms.
Once any tests results are back, your Consultant will meet with you to discuss them with you and to talk through treatment options. If referral to another specialist is needed (for example, if surgery is needed to manage the symptoms of Crohn’s disease), this will be arranged for you.
If you have any questions or concerns, they will be very happy to talk these through with you in your private appointment.