When you first meet with your Consultant Gastroenterologist, they will take a detailed medical history and ask you to describe your symptoms. A clinical examination may be carried out.
It could be that your medical history, symptoms and the results of the physical examination are all that is needed to make a diagnosis at this point. Similarly, it may be determined that your symptoms are being caused by something that is not dangerous and does not need treatment.
Some GI conditions and symptoms will need further investigation, and these will be arranged for you at the earliest possible date.
A Consultant Gastroenterologist is highly experienced in endoscopy. An endoscope is a thin, flexible tube with a camera and light at one end. The camera transmits a live feed to a larger screen.
Depending on your specific symptoms, you may need a Gastroscopy, a Colonoscopy or an Endoscopic Retrograde Cholangiopancreatography (ERCP).
- A gastroscopy is used to investigate symptoms in the upper part of the GI tract. Introduced into the body through the mouth, the endoscope is moved down the oesophagus, into the stomach and then into the first part of the small intestine (the duodenum).
- A colonoscopy is used to investigate symptoms in the lower part of the GI tract. The endoscope is inserted into the rectum and then moved through the large intestine and into the lower part of the small intestine.
- An ERCP is used to investigate the liver, pancreas, gall bladder and bile ducts.
With any of these investigations, as the endoscope is moved through the GI tract your consultant will be looking for anything unusual or of possible concern, such as a narrowing, swelling or small lump. If anything is seen that needs looking at more carefully, a biopsy (small sample of tissue) can be taken and sent away for analysis under a microscope.
Endoscopic procedures are generally well tolerated, but they can be uncomfortable. A spray is used to reduce coughing and gagging during a gastroscopy. Some patients find this is sufficient, but others prefer to have a sedative injection as well. For a colonoscopy, an injection of a sedative and a pain-killing medication is often used, but some people choose to have it without sedation. You may also choose to have 'gas and air' (nitrous oxide) to ease discomfort. Your gastroenterologist will explain these options to you prior to the procedure, so that you can choose your preference.
Other investigations can also be helpful for, including blood tests, liver function tests, MRI or CT scan and ultrasound. All of these can easily be arranged for you at Chaucer Hospital if required.
Once any results are back, your consultant will discuss them with you and talk about any suitable treatment options. If you have any questions or concerns, your consultant will be happy to talk these through with you.