Gastroenterology in Greenwich

Gastroenterology is the field of medicine involved in investigating, diagnosing and treating diseases and dysfunctions of the digestive system. A doctor who specialises in this field is known as a Consultant Gastroenterologist.

Your digestive system is incredibly complex, comprising many different parts and functions. As a whole, it is responsible for breaking food down into smaller parts so that they can be absorbed into the body and used by it. It is also responsible for then ensuring the removal of waste products that cannot be broken down and used by the body by expelling them as faeces.

If disease or dysfunction occurs in any part of the digestive system, it can affect your overall health and may cause a variety of symptoms such as abdominal pain, heartburn or rectal bleeding.

The Consultant Gastroenterologists at The Blackheath Hospital cover the spectrum of digestive system conditions and symptoms, providing expert assessment, diagnosis and treatment for people in and around London. They would be delighted to help you too.

Your digestive tract, also known as the gastrointestinal (GI) tract, stretches from mouth to anus and comprises:

Upper GI –the mouth, oesophagus, stomach and first part of the small intestine

Lower GI (Colorectal) - the small intestine, large intestine, anus and rectum

HBP (Hepato Pancreato Biliary) – liver, pancreas and gallbladder

Common symptoms caused by a problem in any one of these parts of the digestive system are:

• Abdominal pain
• Bloating
• Indigestion
• Heartburn
• Nausea and/or vomiting
• Blood in vomit
• Diarrhoea
• Constipation
• Altered bowel habits
• Rectal bleeding – normally can’t be seen by the eye (this is known as occult blood)
• Acid reflux – stomach acid passes up the throat and causes heartburn
• Jaundice (yellow discolouration of skin)

If you have any of these symptoms, it is advisable to consult a doctor for advice. The Gastroenterology team at The Blackheath are experts in this area and can investigate any of these symptoms thoroughly to determine the cause and to ensure you receive the best treatment for your specific condition as soon as possible.

Due to the complexity of the digestive system, many conditions that affect it can have very similar symptoms, which sometimes makes diagnosis more challenging. Some of the more common conditions that can affect the digestive system include:

• Cancer - oesophageal, bowel, liver, bile duct or pancreatic
• IBD (Inflammatory Bowel Disease) – this includes both Crohn’s Disease and ulcerative colitis
• Dyspepsia (Indigestion)
• Diverticulitis – a small pocket (diverticula) formed in the lining of the intestine becomes inflamed
• Polyps - small fleshy raised areas. These may become cancerous over a number of years
• Gallstones – formation of small stones in the gall bladder
• Liver abscess
• GERD/GORD (Gastroesophageal Reflux Disease)
• Fatty liver disease

Early diagnosis of any of these conditions means that you’ll be able to receive any necessary treatment sooner. Many of these conditions are best treated when they’re at the earliest possible stage, making assessment and diagnosis vital. At The Blackheath, we can provide you with comprehensive investigation from an expert without delay.

When you first meet with you Consultant Gastroenterologist in London at The Blackheath, they will take a medical history and will ask you to talk to them 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 any particular foods, drinks or activities make your symptoms worse

A physical examination may also be carried out.

It may be that at this consultation it is found that your symptoms are not a cause for concern. In other cases, additional investigation may be needed to properly assess things. Many potential 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 is attached to a 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 Blackheath at the earliest opportunity.

• A gastroscopy looks at the upper part of the GI tract. The endoscope is introduced into the body through the mouth and slowly moved down the oesophagus, into the stomach and then to 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.

For either investigation, your Consultant is able to carefully examine the inside of the GI tract, checking for any abnormalities or areas of possible concern.

• An ERCP is a special type of endoscopy used to investigate problems in the bile ducts, gall bladder and pancreas. It is mainly used to treat conditions that cause a blockage within the bile ducts. This is most commonly due to a stone which can be removed after 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.

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 are occasionally uncomfortable. A spray is used to reduce coughing and gagging during a gastroscopy (endoscopy to examine the stomach). Some patients find this is sufficient, but many prefer to have a sedative injection also. For a colonoscopy, an injection of a sedative and a pain-killing medication is often used, but others may prefer to have the procedure without sedation or opt to have 'gas and air' (nitrous oxide). Your gastroenterologist will explain these options to you prior to the procedure.

Additional tests, including blood tests, liver function tests, MRI scan, CT scan and ultrasound, are all available on-site at The Blackheath, so are easily arranged if needed.

Once the results of any investigations are back, your Consultant will draw up a personalised treatment plan for your condition. If referral to another specialist is needed (for example, if bowel cancer is discovered or surgery is needed to manage the symptoms of Crohn’s disease), this will be done without delay.

Your Consultant will fully discuss any suitable 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 be very happy to talk these through with you.

Many people are referred to a Consultant Gastroenterologist at The Blackheath Hospital by their GP, another healthcare professional or their private medical insurance provider. Others choose to self-refer in order to get clarity about what’s causing their symptoms sooner than would be possible elsewhere.

We treat patients with private medical insurance and those using one of our self-pay options.

While many of our patients live in London, excellent road and public transport makes it easy to visit us from further afield as well.

When you choose to visit a Consultant Gastroenterologist at The Blackheath Hospital in London, you will benefit from:

• Fast access to expert assessment – Many GI symptoms can be worrying to experience, and you’ll want to get help as soon as possible. Our team of experienced Gastroenterologists can see you without delay, so that your symptoms can be investigated, diagnosed and treated sooner.
• Personalised care – Given the complexity of the digestive system, any investigations and treatments need to be carefully tailored to your specific symptoms and whatever may be best for you. Your Consultant will oversee every aspect of your care.
• Appointments to suit you – With appointments available throughout the week, it is easy to book an appointment with an experienced Consultant Gastroenterologist at a time that suits your schedule.
• A whole team approach – While your Consultant is highly experienced in diseases and disorders of the digestive system, they work closely with specialists in other areas such as General Surgery, Radiology, Anaesthetics and Oncology. This multidisciplinary team approach ensures you will receive support and treatment from the most appropriate specialist throughout your time with us.
• Recommended by our patients – In an independent survey, 97.9% of patients said they were likely or highly likely to recommend us to family and friends.

Whether you’ve been experiencing new symptoms that are causing you concern or you have a pre-existing condition (like Crohn’s disease or ulcerative colitis) that you would like us to help better manage, we would be delighted to help you.

For peace of mind and known expert care, book your appointment online now.

We look forward to welcoming you to The Blackheath Hospital soon.