When you first meet with your consultant, they will talk with you about your symptoms. They will want to know:
- What symptoms do you have?
- When did your first notice these symptoms?
- Have your symptoms become any worse?
- Does anything (food, movement, stress, tiredness etc.) make your symptoms worse?
- Do you have any particular concerns about your symptoms (for example, are you worried you may have bowel cancer?)
- Do you have any concerns about weight loss?
Hernias are usually quite straightforward to diagnose, as your consultant will be able to see a visible lump where the hernia is. An ultrasound or a CT scan can be used if the diagnosis is not clear.
Many GI tract symptoms are best investigated with endoscopy. An endoscope is a thin, flexible tube with a camera and light at the end. It is used to examine the inside of the GI tract, checking for any abnormalities or areas of possible concern.
Depending on where you are experiencing your symptoms, you may need to have a Gastroscopy, a Colonoscopy or a Flexible Sigmoidoscopy. All endoscopy investigations are now performed at a hospital within the Circle Group (Clementine Churchill Hospital).
- A gastroscopy is used to investigate symptoms in the upper part of the GI tract. The endoscope is introduced into the body through the mouth and passed down the oesophagus, into the stomach and then to the duodenum (the first part of the small intestine).
- A colonoscopy investigates symptoms at the lower part of the GI tract. The endoscope is inserted into the rectum and passed along the large intestine and into the terminal end of the small intestine.
- A flexible sigmoidoscopy looks only at the lower part of the large bowel (rectum and distal colon). As with a colonoscopy, the endoscope is moved into the large bowel through the rectum.
Whichever of these investigations you have, a biopsy may be taken for further analysis. This involves carefully removing a tiny sample of tissue from the area in question, which is then sent away for analysis under a microscope.
Further tests, including blood tests, liver function tests, MRI scan and ultrasound are all available on-site and can be easily arranged when required.
Once the results of any investigations are back, your consultant will meet with you to discuss them with you and to explore treatment options. Treatment may involve:
- Watchful waiting
- Medication
- Surgery
If surgery is required, whether minor or more involved, this will be arranged for you at the earliest opportunity.
Many problems within the GI tract or abdomen can be treated by laparoscopy (keyhole surgery). Also known as minimally invasive surgery, small incisions are made in the abdomen and a thin tube with a camera and light at one end (laparoscope) inserted. Small surgical instruments can be used to carry out a range of operations, including bowel resection, gall bladder removal, a full range of hernia repair or removal of an inflamed appendix.
Laparoscopic surgery has a number of benefits over traditional open surgery, including:
- Less pain
- Less bleeding
- Reduced scarring
- Promote faster recovery & return to work
For other conditions, open surgery may be required.