When you first meet with you Consultant Gastroenterologist at The Highfield Hospital, they will take your medical history and will ask you to describe your symptoms. They will want to know things like:
- The symptoms you have
- When these symptoms first appeared
- Whether your symptoms have been getting worse
- Whether any particular foods, drinks or activities make your symptoms worse
- Whatever you are currently taking any medication
A physical examination may also be carried out.
This may be all that is needed to determine that your symptoms are not being caused by anything worrying or dangerous. However, many people will be referred for further investigations.
A lot of possible problems within the GI tract are most easily investigated using a special instrument known as an endoscope. This is a thin, flexible tube with a camera and light at one end. The camera transmits a real time feed to an external screen.
Depending on your symptoms, you may have a Gastroscopy, a Colonoscopy or an Endoscopic Retrograde Cholangiopancreatography (ERCP). All can be easily arranged for you at The Highfield Hospital.
- A gastroscopy examines the upper part of the GI tract. The endoscope is introduced into the body through the mouth and moved down the oesophagus, into the stomach and then into the duodenum (the first part of the small intestine).
- A colonoscopy examines the lower part of the GI tract. The endoscope is inserted into the rectum and moved along the large intestine, into the small intestine.
Both investigations allow your Consultant to thoroughly examine the relevant part of the GI tract, and they will look carefully for anything unusual or of possible concern, such as bulges, lumps or a narrowing.
In both procedures, a biopsy can be taken. This involves removing a small sample of tissue from the area in question, which is then sent for examination under a microscope.
- An ERCP is an endoscopy to investigate problems in the bile ducts, gall bladder and pancreas. It is primarily used to treat conditions that are causing a blockage within the bile ducts. These blockages are usually caused by a stone, which is removed by making a small cut at the lower end of the duct. Occasionally, a blockage will be caused by a tumour. In this case, a thin tube ('stent') can be inserted into the duct to allow it to drain once more.
Endoscopic procedures are normally well tolerated, but they can occasionally be uncomfortable. A spray will be used to help reduce coughing and gagging during a gastroscopy, but some choose to also have a sedative injection. During a colonoscopy, an injection of a sedative and a pain-killing medication is often used, but some people chose to have no sedation or to use 'gas and air' (nitrous oxide) instead. Your Consultant will explain the different options available to you before the endoscopy.
Other tests, including blood tests, liver function tests, MRI scan and ultrasound, may be required and these are available on-site at The Highfield, and simply arranged.
Once results are back, your Consultant will draw up a personalised treatment plan for you. There may be occasions that referral to another specialist is required (for example, if surgery will be needed for severe Crohn’s disease), and this is easily done.
Your Consultant will always discuss treatment options with you so that you can make an informed choice about treatment. If you have any questions or concerns at any time, they will always be very happy to talk through them with you.