When you meet your Consultant Gastroenterologist at The Saxon Clinic, they will take a medical history and talk with you in detail about the symptoms you have. They will want to know things like:
- What symptoms do you have?
- When did these symptoms first start?
- Have your symptoms been getting more noticeable/severe?
- Do any specific foods, drinks or activities make your symptoms worse?
- Have you received any treatment already?
- How is your general health? Do you have any underlying health conditions?
They may carry out a physical examination.
For many GI symptoms and conditions, further investigations may be needed to confirm a diagnosis. These may include blood tests, liver function tests, MRI, X-ray, or ultrasound (CT can be provided off-site), but the most common way of investigating the GI tract is with endoscopy.
An endoscope is a thin, flexible tube with a camera and light at one end. The camera provides a real time image to an external screen. When moved along the GI tract, your consultant can carefully examine it, checking for any abnormalities, blockages, or narrowed areas.
Depending on your symptoms, your consultant may want to look at the upper part of the GI tract, the lower part, or the bile ducts and gall bladder.
- A gastroscopy is used to examine the upper part of the GI tract. The endoscope is moved into your mouth and down your throat, into the oesophagus, stomach, and duodenum (first part of the small intestine).
- A colonoscopy is used to examine the lower part of the GI tract. The endoscope is inserted into the rectum, moved through the large intestine and into the small intestine.
- An ERCP is used to investigate the bile ducts, gall bladder and pancreas. It can also be used to treat blockages within the bile ducts. These blockages are usually caused by a small stone. By making a small cut at the lower end of the duct, the stone will often be freed. For other blockages, a small stent (a thin tube) may be placed within the duct to help open it up and allow it to drain.
If any of these are required, they will be arranged for you at the earliest opportunity. All these investigations can also be used to take a small sample of tissue (biopsy) if needed, which is then sent away for examination under a microscope.
For gastroscopy, a throat spray can help to reduce discomfort and coughing, although some people choose to have an injection of a sedative.
For a colonoscopy, an injection of a sedative and a pain-killing medication is often used. If you have a sedative, there are certain restrictions (such as not being able to drive yourself home and not being alone in your house for a certain time). For this reason, some people opt to have nitrous oxide ('gas and air') instead. Your gastroenterologist will explain these options to you beforehand so that you can make the choice that’s right for you.
Your consultant will usually be able to talk with you about what the endoscopy showed soon afterwards, once the effects of any sedative have worn off. If a biopsy was taken, they will let you know the results as soon as they are back.
It may be that referral to another specialist is needed (for example, if it is determined that you would benefit from surgery to manage the symptoms caused by Crohn’s disease), this will be arranged for you quickly.
If you have any questions or concerns, your consultant will be very happy to discuss them with you.