&

You are here:
WBC consultants

Endoscopy

An endoscopy a long, thin, flexible tube used  to look inside your body. The endoscope includes a camera and light source to relay images onto a screen.

There are several different types of endoscopic procedures that are used to diagnose gastrointestinal conditions.

CONTACT US






Colonoscopy

A colonoscopy is used to look at the lining of your large bowel. . Colonoscopies are used to diagnose a range of conditions including Crohn’s disease, ulcerative colitis, diverticular disease and bowel cancer.

A colonoscopy is carried out as a day case, which means you can go home on the same day. You will be given clear instructions about the laxatives you need to take and how to modify your diet in the few days before the colonoscopy. The procedure will normally take half an hour to an hour.

It is standard for the procedure to be performed under ‘conscious sedation’ using a sedative and painkiller to help you relax and feel more comfortable during the procedure.

If you have any concerns regarding conscious sedation we will discuss the role of a full general anaesthetic. For the procedure you will be asked to lie on your left hand side and bend your knees. The colonoscope will be gently inserted into your colon via the anal canal Air will be passed from the scope into the bowel to expand it so that the doctor can get a clearer view, the procedure might feel uncomfortable, usually when the bowel is stretched when navigating angled sections of the colon, the team will usually ask you to change position during the procedure to help reduce any discomfort.

During the procedure the doctor may take a biopsy, which is a small sample of cells, or may remove any polyps, which can become cancerous over time; this is painless. Any biopsies or polyps will be sent to a laboratory for testing, with results usually available after about a week and we will usually discuss the results with you in clinic or can write.

Your bowel needs to be completely empty to provide clear views for the procedure;  you will be given (usually from clinic) strong laxatives to take in the 24hrs before your colonoscopy.

It will give you diarrhoea so make sure you remain close to a loo after taking it.

You will also need to eat a low fibre diet for a few days before the procedure. The day before you should only have clear fluids. If you take iron tablets you should stop these a week before and you should also stop taking medication that affects the way your blood clots (we will give you specific advice for the type of blood thinning medication you are taking).

We will send you a clear protocol to follow for the few days before the colonoscopy.

If you are having a sedative you will be asked not to eat for six hours but can drink clear fluids up to two hours beforehand to ensure there is no risk of stomach contents going into your lungs.

After your scan, you will need to rest until the effects of the sedative have worn off. Your tummy might feel a bit bloated or uncomfortable with colon spasms but this should pass after an hour or so; lying on your right side with your bottom higher than your shoulders often helps to pass wind out. Someone will need to drive you home and stay with you until the sedative has left your system. You should be completely back to normal by the following day.

If you have had a biopsy or polyps removed you may experience bleeding (about a 1 in 500 risk). There is a small risk of tearing or perforating  your bowel from the instruments used during the procedure (about a 1 in 1000 risk). If this occurs you may need surgery to repair it.

Seek urgent help if you develop a fever, abdominal pain or bleeding from your bowel. You can start by contacting the ward you were on after the procedure but if it is out of normal hours or the symptoms are more severe you should attend as a priority your local emergency department.

If the procedure was performed by one of the Windsor Bowel Clinic team and you are safe to walk you can contact and attend the surgical assessment unit at St Peters Hospital, Chertsey on 01932 722932.

Gastroscopy

A colonoscopy is used to look at the lining of your large bowel. Colonoscopies are used to diagnose a range of conditions including Crohn’s disease, ulcerative colitis, diverticular disease and bowel cancer.

A gastroscopy is carried out as a day case, which means you can go home the same day.

It normally takes around 15 minutes although it may be more if it is used to treat a condition.

You will be given a local anaesthetic spray to numb your throat and you will be offered a sedative to help you relax. The endoscope will be guided towards the back of your mouth and you may  be asked to swallow the tube. This can feel unpleasant and you may gag or feel sick but this will pass as the endoscope is moved further down.

Once the gastroscope is inside your stomach, air will be blown down it to inflate the stomach so the endoscopist can clearly see any abnormalities. A biopsy may be taken. This will be painless.

If you have bleeding stomach ulcers, a probe may be passed through the endoscope and heat or clips used to stop the bleeding. Medication may also be injected to help clotting.

Before you have a gastroscopy, you will be advised whether to stop taking certain medications.

Normally you may be asked to stop taking indigestion/ antacid medication two weeks before the procedure, for example ranitidine or lansoprazole.

You will be asked not to eat for eight hours and to stop drinking clear fluids for two to three hours beforehand to ensure your stomach is empty during the procedure.

Afterwards you will be able to go home once the effects of the sedative have worn off although you will need someone to drive you home.

There is a small risk of internal bleeding or tearing of the lining of the oesophagus, stomach or small intestine.

Seek medical help if you vomit blood or pass black, tarry stool or if you have a fever, pain when swallowing, chest or stomach pain or breathing difficulties. You can start by contacting the ward you were on after the procedure but if it is out of normal hours or the symptoms are more severe you should attend as a priority your local emergency department.

If the procedure was performed by one of the Windsor Bowel Clinic team and you are safe to walk you can contact and attend the surgical assessment unit at St Peters Hospital, Chertsey on 01932 722932.

A gastroscopy allows the doctor to get a good view inside your oesophagus, stomach and small intestine using a thin, flexible tube with a camera and light at one end.

Images are sent to a monitor. Small instruments can also be passed down the tube to carry out minor procedures, such as treating bleeding ulcers.

Sigmoidoscopy

A flexible sigmoidoscopy is used to examine the lining of the lower large bowel. It is used to investigate bright rectal bleeding, to check for bowel cancer, inflammation or polyps.

You will be offered option of a sedative being given intravenously 1 or 2 minutes before the procedure to relax you. The procedure itself is painless although it can feel uncomfortable.

You will be asked to lie on your left side. The sigmoidoscope will be gently passed via the anal canal into the lower end of your large bowel. Air will be passed from the scope into the bowel to expand it so that the doctor can get a clearer view. This may cause mild discomfort but it won’t last long. Sometimes a biopsy may be taken during the examination. This will be painless.

Your bowel will need to be empty for the doctor to be able to get a good look at your bowel.

You will be given an enema in your hospital room before the procedure to help empty your lower bowel. Sometimes you might also be asked to take laxatives beforehand as well. You can eat and drink normally beforehand unless you are having a sedative when you will be asked not to eat for six hours but can drink clear fluids up to two hours beforehand to ensure there is no risk of stomach contents going into your lungs.
If you are taking any medication you will need to bring them with you.

Afterwards you will need to wait an hour for the effects of the sedative to wear off before you go home. Someone else will need to drive you. You may have some trapped wind after the procedure but this will pass by itself. You may experience some bleeding if you have had a biopsy, which should stop after 24 hours. Rarely your bowel may tear during the procedure in which case you will need surgery to repair it.

The sigmoidoscope is a thin, flexible tube with a camera and a light at one end. It is passed into your bottom and up into your bowel. Images are conveyed onto a screen so the doctor can see what is going on inside your bowel.

Capsule Endoscopy

A capsule endoscopy is used to examine your small bowel.

It may be used to investigate a range of symptoms including:

  • Abnormalities found during other scans or barium tests
  • Anaemia
  • Bleeding from an area inaccessible by conventional endoscopy
  • A pre-existing condition such as IBD.

You will be asked to swallow a pill that is capable of transmitting images as it passes through your digestive system.

It will take around 50,000 images as it travels through your small bowel – a process that takes around 8 hours. A special sensor belt, worn around your waist, will send information to a recorder box, which is carried in a bag on your shoulder. You do not have to stay in the hospital for the entire procedure.

Your bowel will need to be empty to give the doctor a clear view. You should avoid eating and drinking the night before the procedure. If you take iron tablets you should stop these a week beforehand.

It will take around an hour for the test to be set up. You should wear loose clothing. You will be asked to lie down while sensors are attached to your chest and abdomen. Before you swallow the capsule you will be given medication to disperse any air bubbles in your small bowel. Once you have taken it you will be able to go home. You will be given a time to return the data recorder to the unit.

Rarely the capsule may not pass out of your system naturally, which could require surgery to remove it. Sometimes the images captured may not be adequate for a definitive diagnosis.

The capsule contains a battery that enables it to transmit images to the sensor belt as it passes through your digestive system.

These are captured by the data recorder for analysis by your doctor. The capsule will pass naturally out of your system after a day or so.

WBC consultants

Imaging

There are several different types of image tests that are used to diagnose gastrointestinal conditions.

CONTACT US






CT Scan

CT stands for computerised tomography.

CT scans use X-rays to build up a detailed picture of the inside of your body, taken from different angles, including your bones, internal organs and blood vessels. These are then put together to create a 2D image.

CT colonography, also known as a virtual colonoscopy, is used to create a 3D image of your large bowel and rectum. These are used to:

  • Diagnose bowel cancer
  • Identify abnormal areas in the bowel for people who are unsuitable for colonoscopy.

A CT scan enables the doctor to identify if you have bowel cancer, what stage it is at. You might hear the acronym TNM. This stands for:

  • Tumour – what size it is
  • Nearby lymph nodes – whether the cancer has spread to these
  • Metastasis – whether the cancer has spread to other parts of your body.

There are four stages of bowel cancer:

  • Stage 1 – it is contained within your bowel or rectum
  • Stage 2 – it has spread beyond the bowel muscle and may have penetrated the surface of your bowel or nearby organs
  • Stage 3 – it has spread into nearby lymph nodes
  • Stage 4 – it has spread to other parts of your body.

A CT scan cannot take a biopsy like a colonoscopy so you may still need a colonoscopy or flexible sigmoidoscopy to biopsy or remove abnormal areas.

If you are having a CT colonography a thin, flexible tube is inserted into your bottom and gas is used to inflate your bowel. CT scans are then taken from several different angles.

The CT scanner is shaped like a donut. You lie on a bed and a ring rotates around a section of your body as you pass through the scanner. You need to lie still so the images don’t become blurred. The radiographer sits in the next room and you can communicate via an intercom. The scan normally lasts no longer than 20-30 minutes.

Your bowel needs to be empty for the scan to work so you may be asked to follow a special diet for a few days beforehand and you will be given a laxative to empty your bowels.

You will nearly always be given a contrast medium to show up areas of your bowel during the scan. This may be swallowed and/ or injected.

You will need to remove any metal items that could interfere with the equipment.

Afterwards you will need to wait until the effects of the sedative or any contrast dye have worn off.

You will be able to eat and drink as normal. Rarely some people can have an allergic reaction to the contrast dye.

CT scans produce multiple X-rays by rotating around your body. This enables the radiographer to see your body in slices. These can be combined to create a detailed 3D image.

MRI Scan

MRI stands for magnetic resonance imaging.

MRI scans use powerful magnetic fields and radio waves to produce images of the inside of your body, particularly your soft tissues. MRI scans are used to diagnose:

  • Abnormalities in the small bowel and rectum
  • Inflammatory bowel disease
  • Rectal cancer.

During an MRI scan, your whole body will enter the scanner while you lie on a bed.

Some people can find this claustrophobic so you may be offered a sedative to help you relax. The scan is painless but you will need to lie completely still which can be uncomfortable. Once you are in the right position the radiographer will leave the room. You will be able to communicate via an intercom.

The couch will move slowly through the scanner, which takes pictures as you pass through it. You will hear a very loud clanging sound during the scan. You will be given headphones to protect your hearing and can listen to music if you want to.

It is important that you don’t have any metal on your body as you enter the scanner so you will be asked to remove jewellery and empty your pockets.

If you have metal inside your body, such as a pacemaker or surgical clips or plates, tell the radiographer as they can be affected by the magnetism.

If you have cancer of the rectum, the doctor may insert an endo anal coil into your bottom, which is a small magnetic coil that gives a very clear picture of your rectum. It can feel a bit uncomfortable.

After the test you will stay in the department until the staff are certain that you feel OK. If you have had a sedative you will need to wait for this to wear off. You should be able to resume your normal activities straight away and eat and drink. Some people have side-effects from the contrast dye, including:

  • Sickness
  • Dizziness
  • Headache
  • Rash.

Within the human body there are water molecules, consisting of hydrogen and oxygen.

At the centre of each hydrogen atom is a tiny particle called a proton. Protons act like tiny magnets and are very sensitive to magnetic fields. When they are subjected to radio waves, the protons get knocked out of alignment. When the radio waves are turned off, the protons realign themselves, sending out radio signals that are picked up by the scanner. This provides information about where the protons are located. Protons in different tissues of the body realign at different speeds and give off different signals. These signals help to create detailed images of the inside of your body.

Ultrasound Scan

Ultrasound scans use sound waves and their echoes to build up detailed, moving images of the inside of your body.

It can show up changes including abnormal growths. This type of scan is normally used to assess solid organs, it is not used to diagnose bowel abnormalities because the accuracy is poor in gas filled structures.

You may be given:

  • Abdominal ultrasound to look for abnormalities  in your liver, kidneys, ovaries, gallbladder and some other areas but not the small or large bowel (colon)
  • Endorectal ultrasound to assess the anal sphincter muscles and occasionally for early rectal cancer
  • Endoscopic ultrasound to assess areas in the stomach, pancreas and bile duct.

Ultrasound scans are painless. You will have a cold lubricating gel spread over your abdomen.

A handheld probe is held against your skin and moved around. It may sometimes be pressed against your tummy.

In endorectal ultrasound a special kind of transducer is inserted into your bottom to give a detailed picture of your rectum. In intraoperative ultrasound, the procedure is carried out while you are under general anaesthetic. The transducer is placed directly against the surface of your liver.

Before an ultrasound you will be asked to put on a hospital gown and lie on a bed. Cold lubricating gel will be spread on your tummy.

If you are having an endorectal ultrasound you will be asked to lie on your left side while the probe is gently inserted into your bottom using a lubricant and protective sheath.

Afterwards you should be able to return to your normal activities and eat and drink. There are not normally any side-effects from an ultrasound scan.

An instrument called a transducer gives off sound waves and picks up the echoes as they bounce off your internal organs. These echoes are converted into images on a screen, giving the radiographer a detailed picture of the internal organs.

Proctogram

This is an x-ray examination, which produces a series of images that shows how your rectum and pelvic floor function during emptying of your bowels.

The purpose is to try to find the cause of your symptoms of difficulty in emptying your bowels/passing stool or incontinence. The procedure is very low risk, a small tear in the lining of the bowel is a very rare complication (1 in 2000), the procedure will only be recommended if it is in your best interest to diagnose and potentially treat your symptoms.

The procedure takes about 2 hours and is not painful. You will be asked to drink a quantity of dye for about an hour before the procedure.

You will be directed to a cubicle and asked to change into a hospital gown. A specialist radiographer or doctor will guide you through the procedure.

Some barium paste will be passed into your back passage using a soft tube. You will be taken into the x-ray room where you will be asked to sit on a specially designed commode (toilet) surrounded by a modesty curtain.

Once you feel comfortable low dose x-rays will be taken in three stages. First an image is taken at rest, then we will ask you to squeeze hold of the barium in your bottom, finally we will ask you to empty your bowels

We fully appreciate this procedure requires privacy, the team are experienced in what is quite a commonly performed investigation, we will make every effort to make you feel comfortable and relaxed.

No special preparation is required.

After the procedure it is advisable to drink plenty of fluids to flush out the barium paste, which will make you stool whitish and can constipate you for a few days.

The radiologist will examine the pictures and a report of the findings will be sent to your doctor.

Giving your health the priority it deserves

Contact us now or ask Windsor Bowel Clinic a question: