Fast assessment and treatment for digestive system concerns
The Gastroenterology Service at Albyn Hospital offers consultations for a wide variety of diseases of the gastrointestinal system. Gastroenterological symptoms and related diseases account for nearly 10% of our general practitioners’ workload, and account for nearly 25% of all cancers. Gastroenterologists are involved in the diagnosis and treatment of these conditions.
The symptoms can be related to the upper GI tract, with common symptoms including abdominal pain, dyspepsia, heartburn and difficulty swallowing.
The symptoms pertaining to the lower GI tract includes abdominal pain, diarrhoea, constipation and rectal bleeding. Symptoms pertaining to the liver and biliary tract are abdominal pain, jaundice and fever with chills. Pancreatic problems often present with abdominal pain and weight loss. Many gastrointestinal conditions may present silently as weight loss, iron deficiency anaemia, abnormal liver function tests or abnormal pancreatic enzymes that are only detected on routine testing.
Some conditions also come to light through screening programmes. The Bowel Screening programme is offered to all individuals over 50 years of age and patients who are found to have evidence of blood in the stools are offered a colonoscopy test.
Gastroenterologists also perform diagnostic and therapeutic endoscopy including:
Luminal gastroenterology focuses on diseases of the gastrointestinal tract and Hepatology focusses on conditions affecting the liver.
There are gastroenterologists with an interest in managing IBD or inflammatory bowel disease comprising ulcerative colitis and Crohn’s disease.
Certain gastroenterologists also have an interest in nutrition.
The bowel screening kit tests for blood in the stool using a Faecal Immunochemical Test (FIT) through the post. This aims to detect bowel abnormalities, such as polyps (which can lead to bowel cancer) and early-stage bowel cancer. This testing facility is available at the Albyn Hospital for all ages.
All those who are FIT-positive are offered a diagnostic test called colonoscopy, which directly visualises the entire colon for abnormalities. Colon cancer is the third most common cancer in Scotland and the screening programme allows detection at an early stage.
Patients who suspect cancer other than screening may notice:
It’s important to remember that having one or more of these symptoms does not automatically mean that you have bowel cancer, but it’s vital that you don’t put off seeing a specialist.
When patients visit the clinic at Albyn with these symptoms, the consultant will discuss their bowel habits in an initial consultation and may conduct a preliminary examination of the back passage.
This is performed using an instrument called a proctoscope, which looks at the anus and rectum. This is followed by the more definitive diagnostic endoscopic test called colonoscopy, which is performed after taking specific laxatives and requires admission as a day-case patient.
During a colonoscopy, if polyps are detected, they can be usually removed by the endoscopist at that time. Rarely, large polyps need a surgical procedure for clearance. If colon cancer is detected on the colonoscopy, biopsies are sent urgently for a definite pathological diagnosis and CT scans are done.
The case is discussed in a multidisciplinary meeting (with surgeons and oncologists) with all the necessary information to decide on the next line of treatment quickly. This can involve respective surgery, chemotherapy or radiotherapy or a combination of these modalities.
If, based on your symptoms, an investigation or other diagnostics are required, you will be booked in a test (or a series of tests), which could include:
Some common conditions seen in clinic include:
This could include investigations such as a CT scan, MRI scan or an ultrasound, to assess a particular organ to see how it is performing.
Gastroscopy is offered to patients with upper gastrointestinal symptoms. Diagnostic biopsies can be taken to rule out conditions like Helicobacter pylori infection and coeliac disease.
Therapeutic interventions like dilatation of strictures and botulinum injections can be performed for a selected group of patients.
Colonoscopy is suggested for those with lower gastrointestinal symptoms primary with change in bowel habits and manifest bleeding in the stools. This is also done for those who are FIT-positive through the bowel screening programme.
Diagnostic biopsies can be taken to rule out inflammatory bowel disease and cancer. Therapeutic interventions like polypectomy and endoscopic mucosal resection can be done if polyps are detected at colonoscopy.
Another sub-speciality available at the Albyn Hospital is Hepatology. Expert opinion regarding a variety of liver conditions including Alcohol related liver disease, Non-alcoholic liver disease (NAFLD), viral hepatitis and autoimmune hepatitis can be obtained from a Hepatology consultation.
*During the period of January to December 2023 Albyn Hospital received 2,170 completed Inpatient/Day Case patient surveys.
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