When you first meet with a Consultant Gastroenterologist at The Droitwich Spa Hospital
, they will take a medical history and will ask you about your symptoms. They will want to know:
- What symptoms you have
- When these symptoms started
- Whether your symptoms have been getting worse
- Whether any particular foods, drinks or activities make your symptoms worse
- A physical examination may also be carried out.
Additional investigations will sometimes be needed, and these will be arranged by your consultant at the earliest opportunity.
Many potential problems within the GI tract are investigated by endoscopy. An endoscope is a thin, flexible tube with a camera and light at one end. The camera sends a real time video feed to a video screen.
Depending on where you’re experiencing your symptoms, you may need to have a Gastroscopy, a Colonoscopy, a Flexible Sigmoidoscopy or an Endoscopic Retrograde Cholangiopancreatography (ERCP) to investigate. Gastroscopy and Colonoscopy are both offered at the hospital, while ERCP will be arranged for you off-site if required. Endoscopic Ultrasound (EUS) and liver stiffness (fibrosis) assessment with FibroScan can also be arranged and performed by us off-site if needed.
A gastroscopy looks at 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 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 moved along the large intestine and into the small intestine.
A flexible sigmoidoscopy looks only at the lower part of the large bowel (colon). As with a colonoscopy, the endoscope is moved into the large bowel through the rectum.
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 used to investigate possible problems in the liver, pancreas, gall bladder and bile ducts. The endoscope is inserted through the mouth and moved down the oesophagus and into the stomach. A special dye is then injected which shows up on X-ray. If a narrowing or blockage is seen in a bile duct, a stent can be inserted. Should gallstones be found in the bile duct, they can often be removed during your ERCP.
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.
These investigations are not painful, but they can be uncomfortable, so you will be offered sedation. Gas & air (nitrous oxide) can be used if you would prefer. For a gastroscopy or ERCP, a throat spray local anaesthetic will also be used.
Further tests, including blood tests, liver function tests, MRI scan, CT scan and ultrasound are all available on-site at The Droitwich Spa Hospital and are easily arranged when required.
Your Consultant will fully discuss any suitable treatment options with you so that you can make an informed choice about treatment. They will then draw up a personalised treatment plan for you. (It’s important to know that some conditions, such as a diagnosis of bowel cancer, will require referral to another specialist at The Droitwich Spa. If this is needed, your Consultant will arrange this promptly.)