General surgery

The digestive tract is a long, hollow tube running from mouth to the anus. Consisting of a series of organs joined together, it is responsible for breaking the food we eat down into smaller parts so that the body can absorb it and removing leftover waste products from the body as faeces.

It is a hugely complex system, with many different parts, functions and processes. If anything causes part of it to stop working properly – whether disease, damage or dysfunction - it can have a big impact on health and quality of life.

Problems also tend to cause certain symptoms, many of which can be quite worrying to experience such as pain in the abdomen, change in bowel habit or blood in the stools.

If you have any symptoms that are concerning you, it is often sensible to get expert assessment and advice.

At The Manor Hospital, our Consultant General Surgeons provide assessment, diagnosis and treatment for a range of conditions in the abdomen and the entire digestive tract. They would be delighted to help you.

• Upper GI – mouth, oesophagus, stomach and first part of the small intestine
• Lower GI (Colorectal) – small intestine, large intestine, anus and rectum
• HBP (Hepato Pancreato Biliary) – liver, pancreas and gallbladder

We have surgeons who subspecialise in conditions in the upper GI tract (Upper GI Surgeon), and in the lower GI tract (Colorectal Surgeon), ensuring that you get the most appropriate and specialised advice relating to your specific symptoms.

General Surgery also investigates and treats hernias and unexplained ‘lumps and bumps’ in the abdomen. A private consultation can help avoid delay in getting the most appropriate treatment for these problems.

People usually book an appointment with a Consultant General Surgeon at The Manor Hospital because they have certain symptoms and would like expert assessment. Common symptoms are:

• Acid reflux
• Bloating or swelling (distention) in the abdomen
• Blood in vomit
• Blood in your stool – may be visible or not visible to the naked eye (occult)
• Change in bowel habit
• Loss of appetite
• Unexpected / unexplained weight loss
• Pain in the upper or lower abdomen
• Unexplained lump or bump in the abdomen – may be painful
• Jaundice - yellow discolouration of skin If you have any of these symptoms, it is always sensible to get things looked at by somebody who is experienced in diagnosing problems in this area. Many of the problems that affect the abdomen and GI tract have very similar symptoms, so it’s important to get the right diagnosis.

Some of the common conditions your Consultant will want to rule out are:

• Cancer - oesophageal, bowel, liver, bile duct or pancreatic
• IBD (Inflammatory Bowel Disease) – Crohn’s Disease and Ulcerative Colitis
• Indigestion (Dyspepsia)
• Diverticulitis – inflammation of a small pocket (known as a diverticula) in the lining of the intestine
• Polyps - small fleshy raised areas. May develop into cancer if left untreated for many years
• Gallstones – small stones that can form in the gall bladder
• Liver abscess – a pus-filled mass inside the liver
• GERD/GORD (Gastroesophageal Reflux Disease) – causes stomach acid to leak back into the oesophagus
• Hernia – these may cause bowel obstruction
• Haemorrhoids (piles)
• Anal fissures and fistulas
• Pilonidal disease
• Rectal prolapse

• What your symptoms are and when they first appeared
• If your symptoms have been getting worse
• Whether any particular things like food, drink or activity, trigger your symptoms or cause them to flare up
• If you have received any treatment already, such as medications prescribed by your GP / pharmacist

Hernias are usually straightforward to diagnose, as a visible lump can often be seen. However, they may need imaging to confirm.

Many conditions affecting the GI tract are best investigated using endoscopy. An endoscope is a thin, flexible tube with a camera and light at the end. The camera transmits a real time video to an external screen.

A gastroscopy is used to examine the upper part of the GI tract. The endoscope is introduced into the body through the mouth and moved down the oesophagus, then into the stomach and the first part of the small intestine (known as the duodenum).

A colonoscopy or sigmoidoscopy is used to examine the lower part of the GI tract. The endoscope is inserted via the rectum and moved along the large bowel.

During either investigation, your Consultant will look for any abnormalities such as a swelling, lump or narrowing in the GI tract. If anything unusual is seen, a biopsy may be done. This involves taking a small sample of tissue, which is then sent away to be analysed under a microscope. If polyps are seen they may be removed immediately or they may need a further specialist procedure to remove.

While neither a Gastroscopy or a Colonoscopy are painful, they may be uncomfortable, and you will normally be offered some sedation to make things more comfortable. If you’d prefer not to have any sedation, gas & air (nitrous oxide) can also be used.

Further investigations may also be carried out, including blood tests, MRI scan, CT scan or ultrasound. These can all be arranged for you by your Consultant when required. Please note that some investigations (such as MRI/CT/endoscopy) will be done off-site.

Once a diagnosis has been confirmed, your Consultant will discuss treatment options with you. Treatments for GI tract conditions fall into one of three categories:

• Watchful waiting / surveillance
• Medication
• Surgery – may be open or laparoscopic (keyhole)

Treatment will always be tailored to your specific requirements to provide you with the best result possible. If you have any questions or concerns at any time, your Consultant will be very happy to talk these through with you to make sure you are happy with your treatment plan.

Most people are referred to our Consultants General Surgeons by their GP, another healthcare professional or their private medical insurance provider. With many people finding it quite difficult to get a GP appointment nowadays, you may choose to self-refer to avoid delay.

We treat private medical insurance and self-pay patients.

When you choose The Manor for your General Surgery consultation, you will benefit from:

• Rapid assessment from an expert – We can quickly book you an appointment with a highly experienced Consultant General Surgeon. A prompt assessment means you’ll be able to enjoy the benefits of any treatment sooner.
• Tailored treatment– We believe in a bespoke approach to treatment, and your Consultant will formulate your treatment plan to best fit your condition and needs.
• An experienced team – Our multidisciplinary team offers fast access to experts in areas such as dermatology, oncology, plastic surgery, radiology, dieticians physiotherapy and anaesthetics when needed. You will always see the most appropriate specialist for your condition.
• Appointments to fit your schedule – With General Surgery appointments available throughout the week, you will be able to arrange an appointment at a time that fits with your availability.
• Remote consultations – General Surgery consultations are usually done in person at The Manor Hospital, but we can offer remote consultations by telephone or video call where required (and when clinically appropriate).
• Recommended by patients – We believe in listening to what our patients say about us. In an independent survey, a staggering 99.1% of patients said they were likely or highly likely to recommend us to family and friends.
• Free Parking – Our 47-space car park is free of charge to patients and visitors

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

We look forward to welcoming you to The Manor Hospital and helping you return to better health sooner.