When you first meet with you Consultant Gastroenterologist at The Meriden in Coventry, they will take a detailed medical history and ask you to describe your symptoms. They will want to know things like:
- The symptoms you have
- How long you’ve had these symptoms
- Whether your symptoms have been getting worse
- Whether any particular foods, drinks or activities make your symptoms worse
- Any ways your symptoms are impacting on your quality of life
- Whether you have any specific concerns about any of your symptoms (for example, are you worried that a recent change in bowel habits mean you have bowel cancer?)
A clinical examination may be carried out during your consultation.
It may 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. Alternatively, it may be determined that your symptoms are being caused by something that does not need treatment.
However, for many conditions and symptoms, further investigations may be needed for specific areas or functions of the digestive system.
One of the best ways to investigate GI symptoms is with an endoscopy. An endoscope is a thin, flexible tube with a camera and light at one end. The camera transmits a live feed to a video screen.
Depending on your specific symptoms, you may need a Gastroscopy, a Colonoscopy, a Flexible Sigmoidoscopy or an Endoscopic Retrograde Cholangiopancreatography (ERCP). If required, these are all easily and quickly arranged for you at The Meriden and will be carried out by your Consultant Gastroenterologist.
- A gastroscopy is used to look at 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 looks at the lower part of the GI tract. The endoscope is inserted into the rectum and then moved up and around the large intestine and into the lower part of the small intestine.
- Aflexible sigmoidoscopy is commonly used when somebody has been experiencing rectal bleeding. It looks only at the left side of the bowel. The endoscope is introduced through the anus to allow your consultant to examine the lower part of your bowel. This can also be a helpful way of looking at haemorrhoids (piles).
- An ERCP is used to investigate the liver, pancreas, gall bladder and bile ducts. Similar to a gastroscopy, the endoscope is put in through the mouth and then moved down into the stomach. A special dye that shows up on X-ray is then injected to show the function of the bile ducts and pancreatic duct. As well as being helpful for diagnostic purposes, an ERCP can be used to treat some conditions (this is known as a therapeutic investigation). For example, a blocked or narrowed bile duct can have a stent inserted to allow bile to drain. Gallstones in the bile duct can often be removed.
During any of these endoscopic investigations, your Consultant will be looking carefully for possible areas of concern, such as small lumps or a narrowing anywhere within the GI tract. A biopsy (small sample of tissue) may be taken and sent away for further analysis.
Although these investigations are not painful, they can be uncomfortable. You will be offered sedation) to help make things more comfortable for you, and gas & air (nitrous oxide) may be offered if you would prefer not have sedation.
Additional tests can also be helpful. These may include blood tests (including liver function tests), MRI scan, CT scan and ultrasound, all of which are available on-site at The Meriden and easily arranged if required.
Once the results of any further investigations are back, your Consultant will talk about treatment options with you, explaining the expected benefits as well as possible risks and complications, so that you can make an informed choice.
You will probably have some questions at this stage, and your Consultant will be very happy to discuss these with you, as well as any concerns you have.
Some conditions will require referral to a specialist in another field of medicine. (For example, if bowel cancer is discovered you will need to be referred to the Oncology team.) With fast access to leading experts in the different areas of medicine on-site, this is easily arranged at The Meriden.