Skip to the content

Endoscopy

The endoscopy service is based across two sites: Royal Stoke University Hospital and County Hospital.  Our endoscopy service cares for patients throughout Staffordshire and the surrounding areas.

Royal Stoke University Hospital has a state-of-the-art JAG accredited endoscopy unit comprising six endoscopy rooms and a GI Physiology service. It delivers the full range of diagnostic and therapeutic procedures which include ERCP, EUS, EMR, Double-Balloon Enteroscopy (DBE), ESD, POEM, surveillance, colonoscopy, OGD, Trans-nasal Endoscopy, Cyptosponge, Bowel Cancer Screening Programme, PEG, GI Physiology and a bronchoscopy service.   We are also providers of specialised training and education for medical and nursing staff.

Message from our Unit Manager, Mrs V Jomon: 

"Our dedicated, fully trained team of multi-diverse specialist nurses and health care workers work together with our Endoscopists to provide you with the best standards of care during your time with us. 

Certain procedures include a pre-assessment service where you can ask any questions regarding your endoscopy, and all our tests have detailed information booklets (please see the patient information section to view these).  Every patient can expect to undertake a full booking in process on arrival, where a member of the nursing team will go through details of your procedure."

Getting Here

Royal Stoke Hospital, Newcastle Road, Stoke-on-Trent, ST4 6QG

Royal stoke map

royal stoke road map

Please note, car parking charges apply.

There is a shuttle bus service running between Royal Stoke and County Hospital. Please call 01782 824232 to arrange a place on the bus.

The Endoscopy Unit at County Hospital was opened in 2014. It has four rooms and offers diagnostic services including flexiblesigmoidoscopy, colonoscopy, OGD, capsule endoscopy and hydrogen breath tests.

The department comprises ​a committed team of Endoscopists, Nurses, Healthcare Assistants and admin teams, who collaborate to assist you on your journey through our department.  

County Hospital is very proud to have achieved JAG accreditation in 2016. Our services continue to expand, the bowel cancer screening service was also introduced in September 2017.

Getting Here

County Hospital (formerly Stafford Hospital), Weston Road, Stafford, ST16 3SA

County hospital map

County hospital road map

Please note, car parking charges will apply.

There is a shuttle bus service running between Royal Stoke and County Hospital. Please call 01782 824232 to arrange a place on the bus.

​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​At UHNM, we have hundreds of dedicated staff caring for our patients. Click on the links below to find out about your consultant in Endoscopy, or keep scrolling down to meet our nurse endoscopists
Consultants

Our Team

Current list of Scopists:

POSTION

NAME

Consultant Gastroenterologists

Ashraf, Sohail

Brind, Alison

Desai, Rajeev

Farmer, Adam

Glass, Robert

Gohar, Farhan

Hebbar, Srisha

Jamal, Shahid

Kurup, Arun

Lau, Kar

Nkhoma, Alick

Rajkumar, Sarveson

Sen, Sandip

Sringeri, Rakesh

Tahir, Faraz

Upper GI Surgical Consultant

Balaji, Nagammapudur

Beardsmore, Duncan

Bouras, George

Cheruvu, Chandra

Durkin, Damian

Marimuthu, Kanagaraj

Priest, Oliver

Rao, Vittal

Sharples, Alistair

Lower GI Surgical Consultant

Bullen, Tim

Dawson, Robin

Farmer, Martin

Garimella, Veera

Goussous, Ghaleb

Roy, Sudipta

Varghese, Phillip

Yeomans, Neil

CNS

Hoole, Sarah

Marshall, Paul

Prince, Rachel

Rajan, Sunitha

Sombach, Charmain

Thomas, Prince

 

Houghton, Lucy (new NME)

Please note, no registrar’s or medical/surgical trainees or locums are included in this list

​​Nurse Endoscopists

Sarah Hoole

Sarah Hoole

Prince Thomas

Prince Thomas

Rachel Prince

Rachel Prince

Sunitha Rajan

Sunitha Rajan

Contact information

For more information about the team or advice on how to obtain your screening kit, contact:

Bowel Cancer Screening Centre Office: 01782 676643 (answer machine) or 01782 676642 (screening nurses) or 01782 676641 (Lead Nurse​).

Email: bcsp@uhnm.nhs.uk

Screening Hub Free telephone helpline: 0800 707 60 60

The Bowel Cancer Screening Centre is open Monday to Friday between 8.00am and 4.30pm.

For further information: www.bowelcancer.uk, www.cancerresearchuk.org

 

About the condition

Symptoms

  • Blood in the poo
  • Going to the toilet more often
  • A change in your normal bowel habit
  • Lost weight and you don't know why
  • Lump in the tummy

 

After the treatment

Most patients receive a normal result, but about two percent receive a positive or abnormal result. Patients with a positive result will be invited to see a specialist nurse and may be referred for a colonoscopy, an examination of the lining of the large bowel (colon) using a tiny camera on the end of a flexible tube.

  • About 5 in 10 people who have a colonoscopy will have a normal result.
  • 4 in 10 people who have a colonoscopy will be found to have a 'polyp'.
  • About 1 in 10 people who have a colonoscopy will have cancer detected.

 

Clinics

Nurse-led clinics are run at Royal Stoke University Hospital and County Hospital. Full details and clinic times are sent to patients with their invitation. Colonoscopy investigations take place in the endoscopy unit at the Royal Stoke University Hospital and County Hospital. 

 

Bowel cancer screening team

The bowel cancer screening team are working hard to increase awareness and eventually improve outcomes for patients with bowel cancer in Stoke on Trent and Staffordshire.

The NHS Bowel Cancer Screening Programme (BCSP) offers screening every two years to all men and women. Its aim is to identify people who appear healthy but are at an increased risk of developing bowel cancer. Over the next four years or so the screening programme is 'Age Expanding'; it will include people aged 50 – 58 and our screening centre has now commenced with screening for 56-year-olds. Anyone above the age of 74 can opt into the programme by telephoning the free phone hub on 0800 707 60 60. From April 2022 58-year-olds will be invited. People aged 60-74 will continue to be invited when they are due to be screened.

Age Expansion is very exciting for the screening programmes across England.

The team are regularly out in the local area speaking to the public about the importance of bowel cancer screening and explaining the importance of early detection and diagnosis. Bowel cancer affects around 42,000 people in the UK every year and is the second most common cause of cancer death, with 1 in 20 people developing bowel cancer during their lifetime. Each year around 16,000 people die from bowel cancer. The work that the team are carrying out is aimed at improving the diagnosis and eventual prognosis for patients with bowel cancer.

The service has received excellent feedback from patients and highlights the importance of patient engagement to help improve and develop the programme.​

UHNM's team has 14 members. The team will continue to carry out health promotion activities in 2022.

 

The wider team

  • Dr Sandip Sen, Consultant Gastroenterologist: BCS Clinical Director and Accredited Screening Colonoscopist
  • Dr Srisha Hebbar, Consultant Gastroenterologist: Accredited Screening Colonoscopist
  • Dr Alison Brind, Consultant Gastroenterologist: Accredited Screening Colonoscopist
  • Dr Sarveson Rajkumar, Consultant Gastroenterologist: Accredited Screening Colonoscopist
  • Dr Arun Kurup, Consultant Gastroenterologist: Accredited Screening Colonoscopist
  • Dr Rajeev Desai, Consultant Gastroenterologist: Accredited Screening Colonoscopist
  • Prince Thomas, Endoscopist: Accredited Screening Nurse
  • Dr Daniel Brett, Lead Pathologist
  • Dr Ingrid Britton, Lead Radiologist
  • Carol Beeston, Service Lead Specialist Screening Nurse
  • Gloria Garlick, Screening Nurse
  • Adrian Black, Screening Nurse
  • Deborah Maccioni, Screening Nurse
  • Rachel Owen, Screening Nurse
  • Edna Beaty, Screening Nurse
  • Carol Wheatley, Screening Nurse
  • Amanda Baggaley, Screening Nurse
  • Wendy Walchester, Screening Nurse
  • Angela Power, Bowel Cancer Screening Programme Manager
  • Karen Davies, Lead Administrator
  • Louise Booth, Co-ordinator
  • Kathleen Pointon, Administrator

Further information and support

The Macmillan Cancer Support and Information Centre

At the centre, staff will:

  • Listen to how cancer is affecting your life
  • Provide a wide range of free booklets and other written information
  • Put you in touch with other sources of support such as local counselling services, benefits advisers and support groups

The address is: 

The Macmillan Cancer Support and Information Centre
University Hospitals of North Midlands
Ground Floor
Main Building
Newcastle Road
Stoke on Trent
ST4 6QG

Contact: 01782 676333 or e-mail: macmillancentre@uhnm.nhs.uk

Opening hours are Monday to Friday between 9.00am and 5.00pm

Please note, we are not related to the local Douglas Macmillan Hospice, despite the word Macmillan being in both our namesIf you are making a special journey, please ring to make an appointment so you are not kept waiting.​

University Hospital North Midlands (UHNM) Endoscopy Unit is a Joint Advisory Group (JAG) accredited training centre which sits within UHNM as a teaching hospital.   The JAG encompasses national best practice standards for endoscopy.  Hospitals have to go through a rigorous assessment process to become an accredited Trust, and are then subject to annual compliance reviews.  Only those hospitals that are awarded this accolade are able to apply to become a training centre.  More information on JAG can be found here https://www.thejag.org.uk

Through our national training programmes we run courses that:

  • Allow medical and nursing professionals training in the specialism of endoscopy, to gain learning opportunities from our knowledgeable, accredited trainers here at UHNM. Our trainers have undertaken JAG endorsed training courses themselves, to enable them to train others.
  • Assess these professionals against the national standards to allow them to be signed off for independent practice (as a qualified Endoscopist in their area of training).
  • Train the future generations of Endoscopist
  • Train and assess qualified Endoscopy colleagues to become trainers themselves and thus contribute to train Endoscopists in their own hospitals.
  • Share good practice between medical professionals to provide a better quality of care for not only our patients, but patients from around the country.

 

We offer the following JAG accredited courses from our County and Royal Stoke Endoscopy units:

  • Basic Skills in Upper Gastrointestinal  (UGI) Endoscopy
  • Basic Skills in Colonoscopy
  • ERCP Skills Training
  • Training the ERCP Trainer (TERCPT)
  • Training the Colonoscopy Trainer (TCT)

We are looking to get our ERCP Sharing Good Practice course accredited in 2022 and are hoping to add some additional courses to our training portfolio within the next 12 months.  We are also proud to host our international ERCP EUS Symposium from Royal Stoke Hospital.

If you are a trainee and would like further information on any of our courses please follow the link below, or email our Training Centre Manager: Emily.Meakin@uhnm.nhs.uk
https://www.jets.nhs.uk/RoyalStoke

Follow us:

Twitter: @UHNMEndoscopyTC

Linkedin: UHNM Endoscopy Training Centre

Bronchoscopy procedures are performed five days-a-week across both the Royal Stoke and County Hospital sites. 

Royal Stoke site, Stoke on Trent

Monday (AM), Tuesday (AM), Wednesday (PM), Thursday (AM), Friday (AM).

County Hospital site, Stafford

Tuesday (AM), Wednesday (PM)

The bronchoscopy department comprises a dedicated team including Bronchoscopists, Nurses, Healthcare Assistants and reception and appointment clerks, who all work together to give you a good experience in our department.   

Bronchoscopy procedures performed at UHNM include:

Diagnostic flexible bronchoscopy

This helps us to visualise the breathing passages of the lungs (called 'airways'). It is done to see inside the airways of your lungs, or to get samples of mucus or tissue from the lungs.

Endoscopic inspection vocal cords to investigate dysfunctional breathing

We inspect the movement of the voice box (vocal cords) in relation to breathing.

EBUS (Endobronchial Ultrasound) and transbronchial needle aspiration

This procedure allows us to visualise the breathing tubes (similar to a bronchoscopy) and take sampling from enlarged glands (lymph glands) within the chest. This is done by using the aid of an ultrasound scan which is present at the end of a telescope and taking samples from the glands which lie outside the normal breathing tubes (bronchi).

Autofluoresence bronchoscopy and narrow band imaging​

This helps us to visualise early abnormalities on the surface of the lung airways.​​

Bronchoscopy/EBUS under propofol sedation

This is the same as procedures for a bronchoscopy and EBUS but it is done with deeper sedation​.

Rigid bronchoscopy under general anaesthesia

This is carried out in combination with a flexible bronchoscopy for diagnostic and therapeutic purposes, which include central airway obstruction management, argon plasma coagulation, stenting and balloon dilation.

Endoscopic management of emphysema​

In addition to these procedures, the unit performs:

  • Local anaesthetic thoracoscopy (LAT)
  • Visualisation of the inner lining of the chest cavity and sampling of abnormal lesions
  • Tunnelled chest tube to drain fluid collection in the chest at home

The service at Royal Stoke has been running for five years, with the Local Anaesthetic Thoracoscopy (LAT) service introduced two years ago. It is one of the largest services of its kind in the UK and the service will shortly be expanding to include a radial ultrasound mini-probe and cryobiopsy service. 

The service is also accessed by surrounding hospitals investigating and treating patients from Walsall, Telford and Shrewsbury.

The Respiratory Consultant team comprises:

Dr M Haris
Dr S Khan
Dr N Maddekar
Dr S Bikmalla
Dr I Hussain
Dr E Idris
Dr M Iqbal
Dr M Ganaie
Dr K Asa'ari (interventional bronchoscopy and pleural fellow)​

The gastrointestinal physiology unit is located within the Endoscopy department on LG1 at Royal Stoke University Hospital.  The unit is led by an independent practitioner who uses the most up-to-date, highly technical equipment to provide a range of diagnostic procedures on the upper and lower intestinal tract. We also offer a biofeedback service for people with bowel disorders.  

We see in excess of 1000 patients each year, who may be referred because they suffer from any of the following conditions:

  • Difficulty swallowing (dysphagia)
  • Unexplained chest pain
  • Heartburn, indigestion (gastro oesophageal reflux disease)
  • Cough
  • Excessive belching or burping
  • Malabsorption due to small bowel bacterial overgrowth or lactose intolerance
  • Faecal incontinence
  • Constipation
  • Feeling of incomplete rectal emptying
  • Rectal prolapse

The physiology team work as part of a multidisciplinary team which includes Gastroenterologists, Upper GI and Colorectal Surgeons, Radiographers and other healthcare professional,s all of whom discuss patient test results and the care pathway.

Gastrointestinal tests include:

  • Oesophageal high resolution manometry
  • 24 hr ambulatory pH and Impedance monitoring
  • Anorectal high resolution manometry
  • Biofeedback therapy
  • Breath tests to detect for small bowel bacterial overgrowths and lactose intolerance

We have a well-established service for capsule endoscopy that has now been running for 11 years at County Hospital. We offer patency capsule, small and large bowel capsules. A capsule endoscopy is where a special capsule containing a small camera is swallowed, allowing images of the small bowel to be recorded as it travels through the gut. The images are recorded onto a monitor worn by the patient. The capsule is excreted and simply flushed away and the recorder returned to the hospital for analysis of the images. The small bowel capsules are used to investigate a part of the bowel that is not as easily visualised by conventional methods. Colon capsules may be used as an alternate to colonoscopy in some cases. Capsule endoscopy is a less invasive, radiation-free day-case procedure.

The service was set up and is managed by Sister Faye Baldwin, with Dr Kurup as the lead for the service. Susan Thompson and Claire Johnson complete the team as capsule specialist nurses.

 

Video Capsule Endoscopy (Pill Cam)

Read the patient information leaflet

 

Patency capsule

Read the patient information leaflet

 

Small bowel endoscopy

Read the patient information leaflet

Our service

University Hospitals of North Midlands offers an IBD service cross both Royal Stoke and County Hospital. Along with gastroenterology consultants, we have clinical nurse specialists who offer nurse-led clinics and a telephone helpline for those patients needing advice/support in between clinic appointments and expedition of clinic appointments, as required. 

If you have a confirmed diagnosis of IBD and require support, the helpline number is 01782 675360 for Royal Stoke and County Hospital. The helpline is available Monday-Friday (excluding bank holidays) between the hours of 08:00-16:00. This number is also available for GPs to contact us on for advice.

Alongside nurse-led clinics and the telephone helpline, our nurse specialists also coordinate and administer biological treatments across both hospital sites, along with blood monitoring of those patients on both biologics and immunosuppressant medications. ​

County Hospital:  Monday – Friday, 8am – 6pm, closed Bank Holidays

Royal Stoke:  Monday – Saturday, 8am – 6pm, closed Bank Holidays

We very often receive lovely comments from our patients following their care at UHNM.

Here is just a snapshot of the type of feedback we get. We hope that reading it will help to bolster your confidence in the knowledge and skill of our amazing team: 

 

“Kept informed and at ease throughout the procedure”

“Everybody was kind and looked after me extremely well”

“The department is very efficient and friendly”

“Staff very kind and compassionate despite being very busy. Everything was explained at each step clearly”

“Everything during endoscopy was very good, very good support throughout”

“I was made to feel very comfortable; staff very friendly explained everything in detail”

“Really well, all staff were really pleasant polite and made my visit very comfortable, could not have asked for a better service”

 “The whole team were excellent I arrived extremely stressed. From entering the surroundings everyone was very supportive through the entire procedure. Even held my hand. Thank you to everyone”

 

NHS Choices

You can share your experience of our services on NHS Choices. NHS Choices is a national website similar to the trip advisor you see on holiday and hotel websites.

Visit the NHS Choices website and type in which hospital you visited.

Your comments can also help us to improve things for future patients.

What is a Gastroscopy?

A gastroscopy (or simple endoscopy) is a test which allows the Endoscopist to look directly at the lining of the oesophagus (gullet), the stomach, and the first part of the small intestine (duodenum). In order to do this, a thin flexible tube called a gastro scope that transmits live video images to a TV monitor is passed through your mouth into your stomach.

Why am I having a Gastroscopy?

Your doctor wants to find out if there is a reason for the symptoms you are having so that they can suggest treatment. The Endoscopist will get a clear internal view and find the cause of your symptoms. Importantly, this is the only test that allows biopsies to be taken for analysis.

Are there any alternatives to the test?

Yes, a barium swallow or meal are x-ray test which will show larger abnormalities of the musoca (lining) but biopsies cannot be taken.

What are the risks?

A gastroscopy is a safe test – serious complications are uncommon. Occasionally the gastroscope can damage the lining of the oesophagus, stomach or instetine.

This can cause:

• Bleeding
• Infection
• Rarely, a tear in the oesophagus or stomach

Before admission:

Please remember no food for 6 hours before the test and clear fluids only until 2 hours before the test. This is very important as we cannot do the test if you have eaten.

What should I expect?

• On arrival, report to the Reception desk in Endoscopy Unit. Your details will be checked and you will be asked to take a seat.
• A nurse will collect you and take a brief medical history from you, including a discussion of your current medication, discharge arrangements and the test itself.

Please inform the nurse of any allergies. Please ask questions if you have any.

• You may be asked to wait a short while until you have the test.
• A Nurse or Endoscopist will ask you to sign the consent form making sure you understand the test.
• You do not need to get undressed, but you will need to take off your coat.
• The ward is a single sex area.

Is the procedure painful?

The test is not painful however you may experience some retching as the tube touches the back of your throat. You may feel bloated and burp because air is put into your stomach to ensure good views. The test usually lasts between five and fifteen minutes.

These feelings are not pleasant but do not last long.

There are two ways you can have the test:

1. You can have local anaesthetic spray to the back of the throat which numbs the area and makes it easier to the pass the tube. It also reduces retching.
2. You can have a mild sedative which will help you feel more relaxed about the test. It does not put you to sleep.

If you do not wish to have any of these options, please inform the nurse.

During the test

  • You will be taken into the procedure room. In the room will be the Endoscopist and two nurses who will stay with you during the test
  • Your throat will be sprayed with local anaesthetic or you will be given the sedative injection if you have requested it.
  • You will be made comfortable on your left side. A pad will be placed under your chin.
  • A plastic mouth guard will be placed gently in your mouth.
  • The endoscope will be passed across the top of your tongue to the back of your throat. Try to breathe steadily and remain calm.
  • It will then be passed down the gullet, into the stomach and the small intestine.You may feel bloated as air is used to inflate your stomach to get good views.
  • Biopsies can be taken and this is painless.
  • Photographs may be taken of normal and abnormal mucosa.
  • If you get a lot of saliva in your mouth, the nurse will clear it using a suction tube.
  • The endoscope is removed slowly taking some air out at the same time.
  • The mouth guard will be removed and a tissue provided to wipe your mouth.
  • You will be made comfortable
  • You will be taken out to the ward area to recover.

When can I go home?

If you have had local anaesthetic you can go home as soon as you feel well enough. You need to wait 30 minutes before having a drink to ensure the spray has worn off. If you had a sedative then you will need to rest in the department for as long as necessary. We will only discharge you when you are safe to go home and you feel happy to do so.

If you have had sedation- FOR 24 HRS YOU MUST NOT:

  • Drive
  • Operate machinery
  • Drink alcohol
  • Sign legal documents

How will I feel afterwards?

  • Your throat may feel sore but will settle without treatment.
  • You may feel bloated because air remains in your stomach, again it will settle without treatment.
  • You should be able to eat and drink as normal once the effects of the throat spray have worn off.

When will I know the results?

  • If you have throat spray, you will be told what has been seen and done after the test.
  • If you have been sedated, when you are fully awake, you will be told the information. If you would like a family member or friend to be present as you may forget what you have been told, please inform the nurses.
  • You will be given a discharge leaflet which includes aftercare, useful telephone numbers and information about your test.
  • The hospital Consultant responsible for your procedure will receive any biopsy results and will write to you or see you in Out-patients. A copy of the report will also be sent to your GP.

Giving my consent (permission):

We want to involve you in decisions about your care and treatment. If you decide to go ahead, you will be asked to sign a Consent form​​​. This states that you agree to have the treatment and you understand what it involves. Please read the Consent Form and bring it with you to your appointment.

What if I decide not to have the test?

If you read this information and decided not to go ahead with the test, please ring the department, using the telephone number on your appointment letter, to let us know. You should also discuss your decision with your GP or hospital Consultant.

 

Colonoscopy

 

 

 

Contents

Introduction

Your appointment

What is a colonoscopy?

What are the benefits and risks?

What preparation will I need for my colonoscopy?

Preparation instructions.

What about my medication?

Your colonoscopy procedure

Procedure options

During your procedure

After your procedure

Going home

Your medication after the procedure

When will I know the results?

Concerns or questions

Sources of information and support

Free Bus Service

How to find us

 

Introduction

Your specialist has recommended that you have a colonoscopy to investigate your symptoms.  

You will be asked to attend either Royal Stoke Hospital Endoscopy Unit or County Hospital Endoscopy Unit.

Your appointment

  • Please check your appointment letter before attending to make sure you attend the correct site.
  • If you request sedation, your procedure will be cancelled if you do not have an escort with you to take you home. The escort will also need to stay with you for 12 hours once you return home.
  • As you will need to see the Nurse first, the time you are given to attend is not the time of your colonoscopy.
  • The time is approximate due to different procedures taking different time periods.
  • Emergency procedures will take priority.
  • Expect to be in the unit for up to 3 hours approximately.

 

If you call to cancel your appointment, you will need to provide:

  • Your full name.
  • Date of birth.
  • Date of your procedure.
  • Contact telephone number.

You are advised to discuss with your Doctor the implications of not having this procedure.

 

What is a colonoscopy?

A colonoscopy is a test which allows the Doctor/Nurse Specialist (Endoscopist) to look directly at the lining of your large bowel (colon).

A long flexible telescope (colonoscope), about the thickness of your index finger, with a bright light at its tip is carefully passed through the bottom (anus) to the caecum and the end of your small intestine.

Diagram to show the procedure

 

  • A digital video camera on the colonoscope transmits pictures of the inside of your colon to a monitor. This enables the Endoscopist to be able to look for any abnormalities.
  • A biopsy (small piece of tissue) may be taken using tiny biopsy forceps. This does not cause any pain.
  • If polyps (projections of tissue, rather like mushrooms) are found, it is possible to remove them or a biopsy taken to be sent for further tests.
  • Sometimes polyps can bleed.

 

 

What are the benefits and risks?

The procedure helps to investigate symptoms and be able to treat them. 

A colonoscopy does have its risks but major and serious complications are rare.   These risks will be discussed with you before you sign the consent form.

These can include: 

  • Bleeding can happen. Slight spotting of blood on the toilet paper or small drops in the toilet bowl should be expected however, this should stop quickly within a few days.
  • Significant bleed can happen if a polyp is removed, however the risk of this is less than 1 in 200. It is advisable not to travel overseas for 2 weeks following removal of polyps because bleeding can happen at any time up to 2 weeks later.
  • A perforation (tear in the bowel). The risk of perforation is less than 1 in 1000.  If a significant bleed or perforation were to happen, further treatment may be required such as a blood transfusion or surgery.
  • Reaction to medication for example, sedation and painkillers.
  • Missed pathology. This is where a diagnosis was not noticed.

What preparation will I need for my colonoscopy?

Your bowel must be completely empty of waste material (faeces) for the Endoscopist to have a clear view.  

The procedure may have to be repeated at a later date if your bowel is not empty.

 

Preparation instructions

 

Five Days before your colonoscopy

 

It is important that you follow the dietary and medication instructions provided in the information leaflet:  ‘Taking Moviprep Oral Bowel Cleansing Agents Safely and Effectively for Colonoscopy/Flexible Sigmoidoscopy’.

Day of colonoscopy

 

Unless you are told otherwise, please stop drinking clear fluids TWO HOURS before your appointment at the hospital.

What should I bring on the day?

 

·      If you are diabetic please bring

your insulin or tablets.

·      Your prescription medication.

·      Your reading glasses so that you can read the consent form.

·      You are welcome to bring your own dressing gown and slippers.

When you arrive

Only one escort/relative will be able to accompany you due to limited space.  If you need someone to support you, please call the unit to arrange.

Please report to the Endoscopy Reception.  You will be greeted by a Nurse and then:

·      You will be asked several questions about your health and current medication. 

·      Your blood pressure and pulse will be taken.

·      You may be asked to sign a consent form.

·      You will be asked to undress and change in to a theatre gown or if you have brought them, your own dressing gown and slippers. This will be a private single sex area.

·      A cannula (small needle) will be inserted so intravenous medication can be given.

·      Please talk to us about any worries or concerns that you may have.

 

What about my medication?

  • If you are taking any blood thinning medication for example, Warfarin, Clopidogrel, Apixiban, Rivaroxaban,etc., please contact the Endoscopy Unit Tel: 01782 676010 or 01782 675713.
  • There is no need to stop low dose aspirin, for example, 75mg/day.
  • If you are diabetic, please contact the Diabetic Nurse Specialist for advice Tel: 01782 679770 or 01782 715444.
  • If you take Iron tablets, please stop them 5 days before the test.
  • If you have a stoma, please contact your Specialist Nurse for advice.
  • If you have any other concerns about your medication, please seek advice from your GP.

Your colonoscopy procedure

The procedure will take place in the Endoscopy theatre.

  • You will be kept as comfortable as possible.
  • You will need to lie on your left side.
  • A Nurse will stay with you throughout the procedure.
  • Each stage of the procedure will be explained to you as it happens.
  • Your oxygen levels and pulse will be monitored as well as your level of comfort.
  • You may be given oxygen during the test, through little prongs that fit just inside your nostrils.

Procedure options

  • Gas and air’ (entonox). Some patients prefer this as they want to try to have the procedure carried out without any sedation.  This can sometimes make them feel more comfortable and relaxed and wears off in half an hour.
  • Sedative and painkiller. This method will help you to relax but it is not a general anaesthetic. This is given through a small needle placed in a vein on the back of your hand.

 

 

During your procedure

  • The Endoscopist will carefully pass the colonoscope through your bottom (anus) into your rectum and on into your colon.
  • Some abdominal cramping and pressure is felt from the air which is introduced into your colon which is normal and will pass quickly.
  • You may get the sensation of wanting to go to the toilet, but as the bowel is empty, there is no danger of this happening.
  • You may feel you need to pass wind and, although this may be embarrassing, remember the staff do understand what is causing it.
  • If you need to change position during the procedure, a Nurse will help you.
  • The Nurse may need to press on your abdomen for a few moments during the procedure to help the colonoscope around awkward bends in your bowel. You will be warned before any pressure is applied.
  • The Endoscopist may take tissue samples (biopsies), photographs or a video of your bowel, even if it all looks normal.
  • At the end of the examination, the colonoscope is removed quickly and easily.
  • The procedure usually takes between 10 and 45 minutes.

After your procedure

  • You may feel bloated because air remains in your bowel. This will settle as you pass wind.
  • Your blood pressure and pulse will be monitored.
  • If you have been given intravenous sedation you will need to rest in the recovery area until you are fully awake (usually one hour).
  • If you have used gas and air (entonox), you should be able to leave after 30 minutes as the sedative effects wear off quickly.

 

 

Going home

If you have received intravenous sedation:

This impairs your reflexes and judgment so it is important that a responsible adult escorts you home and stays with you for 12 hours.  Please note that your procedure will be cancelled if you do not have an escort.  We cannot escort you home.

For 24 hours after the procedure you must not:

  • Operate machinery.
  • Drink alcohol.
  • Sign legal documents.
  • Breast feed.

If you have received entonox (gas and air):

  • It wears off within 30 minutes and you should be able to drive home.
  • You do not require an escort home.

You will be given any written information that you need when you leave the hospital.

Your medication after the procedure

We will talk to you about your medication after the procedure and before you go home in case changes to your medication are needed.

When will I know the results?

You will be told about the results when you are ready to be discharged and provided with a copy of the colonoscopy report.  A copy will also be sent to your GP or whoever referred you.

It is suggested that when you receive your results, you have your escort or relative with you in case you forget any information due to the sedation you have received.   

 

 

Concerns or questions

For further advice please contact the Endoscopy Unit between 8am and 5pm Monday to Friday:

Endoscopy Unit Tel: 01782 676010 or 01782 675713.

Please leave your contact number, full name, date of birth and date of your procedure as this is a voicemail facility.  We will return your call as soon as possible.

Sources of information and support

For further information (including videos of what to expect during your appointment), please visit our website:

www.uhnm.nhs.uk/our-services/endoscopy/

Free Bus Service

There is a free shuttle bus service between Royal Stoke and County sites.

Members of the public who wish to use this service are required to pre-book their journey in advance:

Shuttle Bus booking line Tel: 01782 824232

How to find us:

County Hospital

(formerly Stafford Hospital),

Weston Road,

Stafford, ST16 3SA.

Tel: 01785 257731

 

Endoscopy Unit is on the ground floor.

Royal Stoke Hospital,

Newcastle Road,

Stoke-on-Trent,

ST4 6QG.

Tel: 01782 715444

 

Endoscopy Unit is on lower ground floor 1.

Please note car parking charges will apply.

What is a Flexible Sigmoidoscopy?

A flexible sigmoidoscopy is a test which allows the Endoscopist to look directly at the lining of the left side of the large bowel (colon). This is done using an endoscope which has a thin flexible tube that transmits live video images to a TV monitor. This is passed into your anus (back passage) and around your bowel.

The test allows the Endoscopist to painlessly take tiny pieces of tissue (biopsies) for analysis to assess the lining of the bowel. If a polyp (an overgrowth of tissue) is found this can often be removed painlessly during the procedure and again sent for analysis.

Why am I having a Flexible Sigmoidoscopy?

Your doctor wants to find out if there is a reason for the symptoms you are having so that he can suggest treatment. The Endoscopist will get a clear internal view and find the cause of your symptoms. Importantly, this is the only test that allows biopsies or polyps to be taken for analysis.

Are there any alternatives to the test?

Yes, a Computed tomographic colonography (virtual colonoscopy) which will show larger abnormalities of the mucosa (lining) however biopsies cannot be taken and polyps cannot be removed.

Are there any risks to the test?

The procedure is considered safe. Complications are rare but possible:

• If a biopsy is taken or a polyp removed it can lead to bleeding or a perforation (tear) of the bowel. Bleeding usually settles on its own. A perforation often requires surgery but the risk of this complication is small. The overall complication rate including perforation and bleeding is estimated to be less than 1 in 1000 cases.
• Complications of sedation
• You are likely to feel bloated and have some abdominal discomfort after the test.

Before admission

Please refrain from having any food or drinks for 2 hours before this appointment. Please bring a list of your medication with you.

What should I expect?

• On arrival, report to the Reception desk in Endoscopy Unit. Your details will be checked and you will be asked to take a seat.
• A nurse will collect you and take a brief medical history from you, including a discussion of your current medication, discharge arrangements and the test itself.

Please inform the nurse of any allergies. Please ask questions if you have any.

• You may be asked to wait a short while until you have the test.
• A Nurse or Endoscopist will ask you to sign the consent form making sure you understand the test.
• You will be asked to change into a theatre gown and remove your underwear.
• You will be given an enema, which is inserted into the back passage. The large bowel, which normally contains faeces, must be clean to ensure safe, clear views. You will have a private room with its own toilet facilities.
• The ward is a single sex area.

Is the procedure painful?

The procedure can be uncomfortable so you will be offered Entonox which is a short acting pain relief in the form of gas you breathe in. This does not remain in your system so you would not need any special aftercare requirements if you choose this option or you will be offered a sedative and a painkilling injection which is given through a plastic tube (cannula) inserted into the back of your hand or arm. This will make you more comfortable but it does not put you to sleep, however you may forget the procedure afterwards, and there are special aftercare requirements for 24 hours after the procedure.

If you do not wish to have any of these options, please inform the nurse

During the test

• You will be taken into the procedure room. In the room will be the Endoscopist and two nurses who will stay with you during the test
• You will normally be given Entonox or a sedative injection unless you have requested otherwise.
• You will be made comfortable on your left side with your knees bent
• A pad will be placed under your bottom
• The Endoscopist will lubricate your back passage with a gloved finger and lubricating jelly.
• They will then pass the instrument into your back passage and manoeuvre it carefully around the bowel
• Biopsies can be taken or polyps removed.
• Photographs may be taken of normal and abnormal mucosa
• You may be asked to change positions and the nurses will help you do this
• The nurse may press on your abdomen to assist the manoeuvring of the
instrument
• The endoscope is removed slowly to ensure good views
• You will be covered and made comfortable
• You will be taken out to the ward area to recover.

When can I go home?

If you have had Entonox then you would be allowed to leave the department when the effects have worn off normally no longer than 30 minutes. If you had a sedative then you will need to rest in the department for as long as necessary. We will only discharge you when you are safe to go home and you feel happy to do so.

If you have had sedation: FOR 24 HRS YOU MUST NOT:

• Drive
• Operate machinery
• Drink alcohol
• Sign legal documents

How will I feel afterwards?

• You may feel bloated because air remains in your bowel; it will settle as you pass wind
• If you have been sedated, you may feel tired and lethargic for the next 24 hrs so you should rest
• You should be able to eat and drink as normal

When will I know the results?

You will be told what has been seen and done after the test. If you have been sedated, when you are fully awake, you will be told about the test and anything that has been done. We prefer a family member or friend to be present as you may forget what you have been told because of the medication you have had. If you object to a family member being present, please inform the nurses. You will be given a discharge leaflet which includes aftercare, useful telephone numbers and information about your test.

The hospital Consultant responsible for your procedure will receive any biopsy results and will write to you or see you in Out- patients. A copy of the report will also be sent to your GP.

The consent form

You will find a Consent form​​​ with this information. This gives the Endoscopist a formal indication that you are agreeing to undergo the procedure as described. You keep a portion of the form as your record.
Please read the consent form and bring it with you to the appointment.

What if I decide not to have the test?

If you read this information and decided not to go ahead with the test, please ring the department, using the telephone number on your appointment letter, to let us know. You should also discuss your decision with your GP or hospital Consultant.

What is a Gastroscopy?

A gastroscopy (or simple endoscopy) is a test which allows the Endoscopist to look directly at the lining of the oesophagus (gullet), the stomach, and the first part of the small intestine (duodenum). In order to do this, a thin flexible tube called a gastroscope that transmits live video images to a TV monitor is passed through your mouth into your stomach.

Why am I having a Gastroscopy?

Your doctor wants to find out if there is a reason for the symptoms you are having so that they can suggest treatment. The Endoscopist will get a clear internal view and find the cause of your symptoms. Importantly, this is the only test that allows biopsies to be taken for analysis.

What is a Flexible Sigmoidoscopy?

A flexible sigmoidoscopy is a test which allows the Endoscopist to look directly at the lining of the left side of the large bowel (colon). This is done using an endoscope which has a thin flexible tube that transmits live video images to a TV monitor. This is passed into your anus (back passage) and around your bowel. The test allows the Endoscopist to painlessly take tiny pieces of tissue (biopsies) for analysis to assess the lining of the bowel.
If a polyp (an overgrowth of tissue) is found this can often be removed painlessly during the procedure and again sent for analysis.

Why am I having a Flexible Sigmoidoscopy?

Your doctor wants to find out if there is a reason for the symptoms you are having so that they can suggest treatment. The Endoscopist will get a clear internal view and find the cause of your symptoms. Importantly, this is the only test that allows biopsies or polyps to be taken for analysis.

Are there any alternatives to the test?

Yes, a barium swallow, barium meal or a Computed tomographic colonography (virtual colonoscopy) which will show larger abnormalities of the mucosa (lining) however biopsies cannot be taken and polyps cannot be removed.

Are there any risks to the test?

The procedure is considered safe. Complications are rare but possible:

• If a biopsy is taken or a polyp removed it can lead to bleeding or a perforation (tear) of the bowel. Bleeding usually settles on its own. A perforation often requires surgery but the risk of this complication is small. The overall complication rate including perforation and bleeding is estimated to be less than 1 in 1000 cases.
• Complications of sedation.
• Damage to teeth, crowns or bridges.
• Aspiration.
• You are likely to feel bloated and have some abdominal discomfort after the test.
• You may also have a mild sore throat.

Before admission

Do not eat or drink anything for 2 hours before the test. Please bring a list of your medication with you and your dressing gown and slippers.

What should I expect?

• On arrival, report to the Reception desk in Endoscopy Unit. Your details will be checked and you will be asked to take a seat.
• A nurse will collect you and take a brief medical history from you, including a discussion of your current medication, discharge arrangements and the test itself.

Please inform the nurse of any allergies. Please ask questions if you have any.

• You may be asked to wait a short while until you have the test.
• A Nurse or Endoscopist will ask you to sign the consent form making sure you understand the test.
• You will be asked to change into a theatre gown and remove your underwear.
• You will be given an enema, which is inserted into the back passage. The large bowel, which normally contains faeces, must be clean to ensure safe, clear views. You will have a private room with its own toilet facilities.
• The ward is a single sex area.

Is the procedure painful?

The procedure can be uncomfortable so you will be offered Entonox which is a short acting pain relief in the form of gas you breathe in. This does not remain in your system so you would not need any special aftercare requirements if you choose this option or you will be offered a sedative and a painkilling injection which is given through a plastic tube (cannula) inserted into the back of your hand or arm. This will make you more
comfortable but it does not put you to sleep, however you may forget the procedure afterwards, and there are special aftercare requirements for 24 hours after the procedure. During the gastroscopy you may experience some retching as the tube touches the back of your throat. You may feel bloated and burp because air is put into your stomach to ensure good views. The test usually lasts between five and fifteen minutes. These feelings are not pleasant but do not last long.

There are two ways you can have the Gastroscopy:

1. You can have local anaesthetic spray to the back of the throat which numbs the area and makes it easier to the pass the tube. It also reduces retching.
2. You can have a mild sedative which will help you feel more relaxed about the test. It does not put you to sleep.

If you do not wish to have any of these options, please inform the nurse.

During the test

• You will be taken into the procedure room. In the room will be the Endoscopist and two nurses who will stay with you during the test
• You will normally be given Entonox or a sedative injection unless you have requested otherwise.
• You will be made comfortable on your left side with your knees bent
• A pad will be placed under your chin and one under your bottom.
• A plastic mouth guard will be placed gently in your mouth.
• The endoscope will be passed across the top of your tongue to the back of your throat. Try to breathe steadily and remain calm.
• It will then be passed down the gullet, into the stomach and the small intestine.

You may feel bloated as air is used to inflate your stomach to get good views.

• Biopsies can be taken and this is painless.
• Photographs may be taken of normal and abnormal mucosa.
• If you get a lot of saliva in your mouth, the nurse will clear it using a suction tube.
• The endoscope is removed slowly taking some air out at the same time.
• The mouth guard will be removed and a tissue provided to wipe your mouth.
• The trolley you are lying on will be turned around.
• The Endoscopist will lubricate your back passage with a gloved finger and lubricating jelly.
• They will then pass the instrument into your back passage and manoeuvre it carefully around the bowel
• Biopsies can be taken or polyps removed.
• Photographs may be taken of normal and abnormal mucosa
• You may be asked to change positions and the nurses will help you do this
• The nurse may press on your abdomen to assist the manoeuvring of the
instrument
• The endoscope is removed slowly to ensure good views
• You will be covered and made comfortable
• You will be taken out to the ward area to recover.

When can I go home?

If you have had Entonox and/or throat spray then you would be allowed to leave the department when the effects have worn off normally no longer than 30 minutes. If you had a sedative then you will need to rest in the department for as long as necessary.

We will only discharge you when you are safe to go home and you feel happy to do so.

If you have had sedation: FOR 24 HRS YOU MUST NOT:

• Drive
• Operate machinery
• Drink alcohol
• Sign legal documents

How will I feel afterwards?

• Your throat may feel sore but will settle without treatment.
• You may feel bloated because air remains in your bowel; it will settle as you pass wind
• If you have been sedated, you may feel tired and lethargic for the next 24 hrs so you should rest
• You should be able to eat and drink as normal

When will I know the results?

When you are fully awake, you will be told about the test and anything that has been done. We prefer a family member or friend to be present as you may forget what you have been told because of the medication you have had. If you object to a family member being present, please inform the nurses. You will be given a discharge leaflet which includes aftercare, useful telephone numbers and information about your test. The hospital Consultant responsible for your procedure will receive any biopsy results and will write to you or see you in Out- patients. A copy of the report will also be sent to your GP.

The consent form

You will find a Consent form​ with this information. This gives the Endoscopist a formal indication that you are agreeing to undergo the procedure as described. You keep a portion of the form as your record. Please read the consent form and bring it with you to the appointment.

What if I decide not to have the test?

If you read this information and decided not to go ahead with the test, please ring the department, using the telephone number on your appointment letter, to let us know. You should also discuss your decision with your GP or hospital Consultant.

What is a Gastroscopy?

A gastroscopy (or simple endoscopy) is a test which allows the Endoscopist to look directly at the lining of the oesophagus (gullet), the stomach, and the first part of the small intestine (duodenum). In order to do this, a thin flexible tube called a gastroscope that transmits live video images to a TV monitor is passed through your mouth into your stomach.

Why am I having a Gastroscopy?

Your doctor wants to find out if there is a reason for the symptoms you are having so that he can suggest treatment. The Endoscopist will get a clear internal view and find the cause of your symptoms. Importantly, this is the only test that allows biopsies to be taken for analysis.

What is a Colonoscopy?

A colonoscopy is a test which allows the Endoscopist to look directly at the lining of the large bowel (colon). This is done using an endoscope which has a thin flexible tube that transmits live video images to a TV monitor. This is passed into your anus (back passage) and around your bowel.
The test allows the Endoscopist to painlessly take tiny pieces of tissue (biopsies) for analysis to assess the lining of the bowel.

If a polyp (an overgrowth of tissue) is found this can often be removed painlessly during the procedure and again sent for analysis.

Why am I having a Colonoscopy?

Your doctor wants to find out if there is a reason for the symptoms you are having so that he can suggest treatment. The Endoscopist will get a clear internal view and find the cause of your symptoms. Importantly, this is the only test that allows biopsies or polyps to be taken for analysis.

Are there any alternatives to the test?

Yes, a barium swallow, barium meal or a Computed tomographic colonography (virtual colonoscopy) which will show larger abnormalities of the mucosa (lining) however biopsies cannot be taken and polyps cannot be removed.

Are there any risks to the test?

The procedure is considered safe. Complications are rare but possible:

• If a biopsy is taken or a polyp removed it can lead to bleeding or a perforation (tear) of the bowel. Bleeding usually settles on its own. A perforation often requires surgery but the risk of this complication is small. The overall complication rate including perforation and bleeding is estimated to be less than 1 in 1000 cases.
• Complications of sedation.
• Damage to teeth, crowns or bridges.
• Aspiration.
• You are likely to feel bloated and have some abdominal discomfort after the test.
• You may also have a mild sore throat.

Before admission

Bowel preparation is included with this letter together with specific diet instructions for you to follow. It is essential that you follow these instructions exactly as the bowel needs to be clear for the test to be successful. Do not drink anything for 2 hours before the test. Please bring a list of your medication with you and your dressing gown and slippers.

What should I expect?

• On arrival, report to the Reception desk in Endoscopy Unit. Your details will be checked and you will be asked to take a seat.
• A nurse will collect you and take a brief medical history from you, including a discussion of your current medication, discharge arrangements and the test itself. Please inform the nurse of any allergies. Please ask questions if you have any.
• You may be asked to wait a short while until you have the test.
• A Nurse or Endoscopist will ask you to sign the consent form making sure you understand the test.
• You will be asked to change into a theatre gown with your dressing gown and slippers on. Please remove your underwear.
• The ward is a single sex area.

Is the procedure painful?

The procedure can be uncomfortable so you will be offered Entonox which is a short acting pain relief in the form of gas you breathe in. This does not remain in your system so you would not need any special aftercare requirements if you choose this option or you will be offered a sedative and a painkilling injection which is given through a plastic tube (cannula) inserted into the back of your hand or arm. This will make you more
comfortable but it does not put you to sleep, however you may forget the procedure afterwards, and there are special aftercare requirements for 24 hours after the procedure. The colonoscopy makes you feel bloated and as if you need to go to the toilet. These sensations settle after the tests. During the gastroscopy you may experience some retching as the tube touches the back of your throat. You may feel bloated and burp because air is put into your stomach to ensure good views. The test usually lasts between five and fifteen minutes. These feelings are not pleasant but do not last long.

There are two ways you can have the Gastroscopy:

1. You can have local anaesthetic spray to the back of the throat which numbs the area and makes it easier to the pass the tube. It also reduces retching.
2. You can have a mild sedative which will help you feel more relaxed about the test.

It does not put you to sleep. If you do not wish to have any of these options, please inform the nurse.

During the test

• You will be taken into the procedure room. In the room will be the Endoscopist and two nurses who will stay with you during the test
• You will normally be given Entonox or a sedative injection unless you have requested otherwise.
• You will be made comfortable on your left side with your knees bent
• A pad will be placed under your chin and one under your bottom.
• A plastic mouth guard will be placed gently in your mouth.
• The endoscope will be passed across the top of your tongue to the back of your throat. Try to breathe steadily and remain calm.
• It will then be passed down the gullet, into the stomach and the small intestine.You may feel bloated as air is used to inflate your stomach to get good views.
• Biopsies can be taken and this is painless.
• Photographs may be taken of normal and abnormal mucosa.
• If you get a lot of saliva in your mouth, the nurse will clear it using a suction tube.
• The endoscope is removed slowly taking some air out at the same time.
• The mouth guard will be removed and a tissue provided to wipe your mouth.
• The trolley you are lying on will be turned around.
• The Endoscopist will lubricate your back passage with a gloved finger and lubricating jelly.
• They will then pass the instrument into your back passage and manoeuvre it carefully around the bowel
• Biopsies can be taken or polyps removed.
• Photographs may be taken of normal and abnormal mucosa
• You may be asked to change positions and the nurses will help you do this
• The nurse may press on your abdomen to assist the manoeuvring of the
instrument
• The endoscope is removed slowly to ensure good views
• You will be covered and made comfortable
• You will be taken out to the ward area to recover.

When can I go home?

If you have had Entonox and/or throat spray then you would be allowed to leave the department when the effects have worn off normally no longer than 30 minutes. If you had a sedative then you will need to rest in the department for as long as necessary. We will only discharge you when you are safe to go home and you feel happy to do so.

If you have had sedation:FOR 24 HRS YOU MUST NOT:

• Drive
• Operate machinery
• Drink alcohol
• Sign legal documents

How will I feel afterwards?

• Your throat may feel sore but will settle without treatment.
• You may feel bloated because air remains in your bowel; it will settle as you pass wind
• If you have been sedated, you may feel tired and lethargic for the next 24 hrs so you should rest
• You should be able to eat and drink as normal

When will I know the results?

When you are fully awake, you will be told about the test and anything that has been done. We prefer a family member or friend to be present as you may forget what you have been told because of the medication you have had. If you object to a family member being present, please inform the nurses. You will be given a discharge leaflet which includes aftercare, useful telephone numbers and information about your test. The hospital Consultant responsible for your procedure will receive any biopsy results
and will write to you or see you in Out- patients. A copy of the report will also be sent to your GP.

The consent form

You will find a Consent form​​ with this information. This gives the Endoscopist a formal indication that you are agreeing to undergo the procedure as described. You keep a portion of the form as your record.
Please read the consent form and bring it with you to the appointment.

What if I decide not to have the test?

If you read this letter and decide not to have the test, then please ring the department to tell us and you should also discuss your decision with your GP or hospital Consultant.

What is an EUS?

An Endoscopic Ultrasound (EUS) is a procedure which allows the Endoscopist to examine the lining and layers of the upper gastrointestinal tract, which includes the oesophagus (gullet), stomach, duodenum (first part of the small intestine that is connected to the stomach) and the surrounding areas and organs such as the pancreas and gallbladder.
It involves passing the endoscope (a long thin tube with an ultrasound probe at the tip) through your mouth, down the oesophagus and into your stomach and duodenum.

The procedure is the same as for an upper gastrointestinal endoscopy which you may have already had, in EUS this is combined with high frequency sound waves, transmitted from the ultrasound probe at the tip of the endoscope. This allows a scan of the surrounding organs.

Why am I having an EUS?

Your doctor wants to find out if there is a reason for the symptoms you are having so that they can suggest treatment.

It can be used to diagnose and treat:
• The size and nature of abnormal areas or lesions
• Gallstones
• Glands
• Biopsies (tissue samples)
• Whether further surgery is required

Are there any alternatives to the test?

Yes, a Computed Tomography (CT) scan but the investigation is less sensitive and small lesions/glands (less than 1cm) can be missed.

Are there any risks to the test?

The procedure is considered safe.

Complications are rare but possible:
• Allergic reaction to the equipment, materials or medications. The Endoscopy team is trained to detect such reactions but it is important to tell them if you have any allergies or if you have reacted to any tests or drugs in the past.
• Bleeding can occur from a biopsy site. This usually stops on its own. Let the endoscopist know if you are on warfarin or other blood-thinning drugs. If you are on warfarin, then it is unlikely that a dilatation will be performed or a biopsy taken.
• Perforation, a tear in the intestinal wall (oesophagus, stomach, duodenum-small intestine). This can be made during the procedure and the risk is slightly raised if an abnormality such as narrowing or growth is encountered. If therapeutic treatment is performed such as stretching the narrowing, the possibility can be up to 1 in 10 procedures.

If a hole is made, you will need to be admitted to hospital for further treatment which may include surgery. If you develop severe chest pain while at home, tell your doctor straight away.

• Complications of sedation.
• Damage to teeth, crowns or bridges.
• Aspiration.
• You may also have a mild sore throat.

Before admission

Please remember no food for 6 hours before the test and clear fluids only until hours before the test. This is very important as we cannot do the test if you have eaten.

What should I expect?

• On arrival, report to the Reception desk in Endoscopy Unit. Your details will be checked and you will be asked to take a seat.
• A nurse will collect you and take a brief medical history from you, including a discussion of your current medication, discharge arrangements and the test itself. Please inform the nurse of any allergies. Please ask questions if you have any.
• You may be asked to wait a short while until you have the test.
• A Nurse or Endoscopist will ask you to sign the consent form making sure you understand the test.
• You do not need to get undressed, but you will need to take off your coat.
• The ward is a single sex area.

Is the procedure painful?

The procedure can be uncomfortable so you will be offered a sedative and a painkilling injection which is given through a plastic tube (cannula) inserted into the back of your hand or arm. This will make you more comfortable but it does not put you to sleep, however you may forget the procedure afterwards, and there are special aftercare requirements for 24hours after the procedure.

If you do not wish to have any of this option, please inform the nurse.

During the test

• You will be taken into the procedure room. In the room will be the Endoscopist and two nurses who will stay with you during the test.
• You will be made comfortable on your left side with your arm behind your back as you may be turned onto your stomach during the test.
• Oxygen will be given through a tube placed in your nostril and a probe placed on your finger will monitor your pulse and oxygen levels.
• A pad will be placed under your chin.
• A plastic mouth guard will be placed gently in your mouth.
• You will be given the sedative injection via a cannula normally in the back of the hand. This will make you feel relaxed and comfortable.
• The endoscope will be passed across the top of your tongue to the back of your throat. Try to breathe steadily and remain calm.
• Tissue samples can be taken and this is painless.
• If you get a lot of saliva in your mouth, the nurse will clear it using a suction tube.
• The endoscope is removed slowly taking some air out at the same time.
• The mouth guard will be removed and a tissue provided to wipe your mouth.
• You will be made comfortable
• You will be taken out to the ward area to recover.

When can I go home?

As you will be having a sedative, you will need to rest in the department for as long as necessary. We will only discharge you when you are safe to go home and you feel happy to do so.

If you have had sedation:FOR 24 HRS YOU MUST NOT:

• Drive
• Operate machinery
• Drink alcohol
• Sign legal documents

How will I feel afterwards?

• Your throat may feel sore but will settle without treatment.
• You have been sedated so may feel tired and lethargic for the 24 hours so you should rest.
• You should be able to eat and drink as normal once the effects of the throat spray have worn off.

When will I know the results?

When you are fully awake, you will be told about the test and anything that has been done. We prefer a family member or friend to be present as you may forget what you have been told because of the medication you have had. If you object to a family member being present, please inform the nurses. You will be given a discharge leaflet which includes aftercare, useful telephone numbers and information about your test.

The hospital Consultant responsible for your procedure will receive any biopsy results and will write to you or see you in Out- patients. A copy of the report will also be sent to your GP.

The consent form

You will find a Consent form​​​​​ with this information. This gives the Endoscopist a formal indication that you are agreeing to undergo the procedure as described. You keep a portion of the form as your record. Please read the consent form and bring it with you to the appointment.

What if I decide not to have the test?

If you read this letter and decide not to have the test, then please ring the department to tell us and you should also discuss your decision with your GP or hospital Consultant.

ERCP Procedure Information

Giving my consent (permission):

We want to involve you in decisions about your care and treatment. If you decide to go ahead, you will be asked to sign a Consent form​​​​​​​​​. This states that you agree to have the treatment and you understand what it involves. Please read the Consent Form and bring it with you to your appointment.

What if I decide not to have the test?

If you read this information and decided not to go ahead with the test, please ring the department, using the telephone number on your appointment letter, to let us know. You should also discuss your decision with your GP or hospital Consultant.

Oesophageal Manometry

Please speak to a member of staff if you need this leaflet in large print, braille, audio or another language

 

Contents

Introduction. 3

Your appointment 3

What is an oesophageal manometry test?. 4

What are the benefits and risks to oesophageal manometry?. 4

Preparation instructions. 5

What about my medication?. 6

During your test 6

After your test 7

When will I know the results?. 7

Concerns or questions. 7

Free Bus Service. 7

How to find us. 7

Introduction

Your Specialist has recommended that you have an oesophageal manometry test to investigate your symptoms.  

You will be asked to attend Royal Stoke Hospital Endoscopy Unit.

Your appointment

Expect to be in the unit for up to 1 hour approximately.

If you call to cancel your appointment, you will need to provide:

  • Your full name.
  • Date of birth.
  • Date of your test.
  • Contact telephone number.

You are advised to discuss with your Doctor the implications of not having this procedure.

 

What is an oesophageal manometry test?

Oesophageal manometry is a test which measures the pressure in the oesophagus and how the sphincters (ring like muscles which open and close at either end of the oesophagus) are working.

This is done by passing a multi-channel probe which has sensors situated at 1cm intervals via the nose. 

You do not need to be sedated for this procedure.

What are the benefits and risks to oesophageal manometry?

The test helps to investigate symptoms and be able to treat them. 

The test does have its risks but major and serious complications are rare.

This test will be discussed with you and any risks identified before you sign the consent form.

These can include: 

  • A sore throat.
  • A nose bleed or a runny nose, however this is rare.
  • Occasionally the tube may enter the larynx (voice box) and cause you to cough. When this happens the tube will be gently pulled back a few centimeters.

 

Preparation instructions

Three Days before your test.

 

Stop taking:

·     Alverine citrate (Spasmonal).

·     Buscopan.

·     Baclofen.

·     Domperidone (Motilium).

·     Mebeverine (Colofac).

·     Metoclopramide (Maxolon).

Day of the test

 

·    Do not have anything to eat (including sweets and chewing gum) FOUR HOURS before the test.

·    Unless you are told otherwise, please stop drinking clear fluids TWO HOURS before your appointment at the hospital.

·    If you are diabetic, continue with your normal diet.

·    Wear loose fitting clothes if possible.

·    Do not apply face cream or wear make-up.

What should I bring on the day?

 

·    If you are diabetic please bring your insulin or tablets.

·    Your prescription medication.

·    Your reading glasses so that you can read the consent form.

When you arrive

 

Please report to the Endoscopy Reception. You will be greeted by a Physiologist and then:

·    You will be asked several questions about your health and current medication. 

·    You may be asked to sign a consent form.

·    Please talk to us about any worries or concerns that you may have.

 

 

What about my medication?

  • If you are taking any medication for your heart, breathing problems or hormone therapy, please continue to take them as usual.
  • If you are diabetic, please contact the Diabetic Nurse Specialist for advice Tel: 01782 679770 or 01782 715444 and ask if you should change your morning dose.
  • Oral hypoglycaemic medicines are usually not taken that morning until completion of the test and you start eating again.
  • If you have any other concerns about your medication, please seek advice from your GP.

During your test

  • You will be asked to sit upright on a couch.
  • A probe (tube) will be passed via your nostril down the back of your throat and into your stomach. You will be given some water to drink to ease the passage of the tube.
  • Once in position it will taped to your nose to hold it in place for the duration of the study.
  • Each stage of the procedure will be explained to you as it happens.
  • Your level of comfort will be monitored.
  • The process of placing the tube and undertaking the study is around 20 -30 minutes.
  • You will be asked to try not to swallow for the first 30 seconds this allows for a baseline measurement to be taken.
  • You will be given 5ml of water to swallow approximately ten times in the upright position.
  • You will then be given five 2ml water swallows and a 200ml glass of water to drink.
  • Following this, a further five 5ml water swallows will be given to you in the lying down position.
  • Further to this you may be asked to swallow solid foods such as bread or rice (if this is required you may be asked to bring some in with you).
  • The tube will then be removed.

After your test

  • You will be free to leave straight away and resume your daily activities.
  • You may restart taking you medication again after your test is completed.

When will I know the results?

The results will be sent within 5 working days of the completion of your test to your Consultant in charge of your care.  A copy will also be sent to your GP. 

The Consultant will then decide the most appropriate treatment for you and you will receive a clinic appointment.

If you do not hear anything from the hospital within 6 weeks, please contact your Consultant’s secretary via the hospital switchboard on 01782 715444. 

Concerns or questions

For further advice please contact the Endoscopy Unit between 8am and 5pm Monday to Thursday:

Endoscopy Unit Tel: 01782 676009.

Please leave your contact number, full name, date of birth and date of your procedure as this is a voicemail facility.  We will return your call as soon as possible.

Free Bus Service

There is a free shuttle bus service between Royal Stoke and County sites.

Members of the public who wish to use this service are required to pre-book their journey in advance:

Shuttle Bus booking line Tel: 01782 824232

How to find us

County Hospital

(formerly Stafford Hospital),

Weston Road,

Stafford, ST16 3SA.

Tel: 01785 257731

Endoscopy Unit is on the ground floor.

Royal Stoke Hospital,

Newcastle Road,

Stoke-on-Trent,

ST4 6QG.

Tel: 01782 715444

Endoscopy Unit is on lower ground floor 1.

Please note, car parking charges apply.

Anorectal

Manometry

 

Please speak to a member of staff if you need this leaflet in large print, braille, audio or another language

 

Contents

Introduction. 3

Your appointment 3

What is an anorectal manometry test?. 3

What are the benefits and risks to an anorectal manometry test?. 4

What about my medication?. 4

Your anorectal manometry test 4

During your test 5

After your test 5

When will I know the results?. 5

Concerns or questions. 6

Sources of information and support 6

Free Bus Service. 6

How to find us. 6

Introduction

Your Specialist has recommended that you have an anorectal manometry test to investigate your symptoms.  

You will be asked to attend Royal Stoke Hospital Endoscopy Unit.

Your appointment

Expect to be in the unit for up to 1 hour approximately.

If you call to cancel your appointment, you will need to provide:

  • Your full name.
  • Date of birth.
  • Date of your test,
  • Contact telephone number.

You are advised to discuss with your Doctor the implications of not having this procedure.

What is an anorectal manometry test?

An anorectal manometry test measures the pressures in the back passage (rectum) by using a fine tube (catheter).

The test will show how good the muscle function is in controlling bowel motions and wind.

Please be assured that we will make every effort to ensure your privacy and dignity is maintained during the test.

You do not need to be sedated for this test.

 

What are the benefits and risks to an anorectal manometry test?

The test helps to investigate symptoms and be able to treat them.  The test does have its risks but major and serious complications are rare.

This test will be discussed with you and any risks identified before you sign the consent form.

These can include some bleeding but this should resolve quickly and is rare.

Preparation instructions

Day of the test.

·        No special preparation is necessary. You should, if possible, have a bowel movement before coming for the test

What should I bring on the day?

·        If you are diabetic please bring your insulin or tablets.

·        Your prescription medication.

·        Your reading glasses so that you can read the consent form.

When you arrive

 

Please report to the Endoscopy Reception. You will be greeted by a Physiologist and then:

·      You will be asked several questions about your health and current medication. 

·      You may be asked to sign a consent form.

·      Please talk to us about any worries or concerns that you may have.

What about my medication?

You may continue to take your prescribed medication as usual.

Your anorectal manometry test

The test will take place in a clinical room.

  • You will be asked to undress from the waist down and you will be provided with a sheet to cover yourself. Please be assured that we will make every effort to ensure your privacy and dignity is maintained during the test.
  • You will need to lie on your left side.
  • Each stage of the procedure will be explained to you as it happens.
  • Your level of comfort will be monitored.

During your test

  • A small tube (catheter) will be placed into your rectum.
  • You will be asked to squeeze in tight with the muscles around your bottom and hold for 5 seconds. This will be done 3 times with 30 seconds between each maneuver.
  • You will then be asked to do one long squeeze.
  • This will be followed by 2 strong single coughs.
  • Next you will be asked to bear down 3 times for 15 seconds each time.
  • A balloon is fixed to the catheter this will be inflated with a small amount of air. This is to look for a reflex.
  • The rectal sensation test will be carried out you will be asked when you first feel the balloon inflate, when you feel the urge to empty your bowels and the 3rd sensation is the maximum you can tolerate before you have urgency. The balloon will be deflated.
  • The catheter will be removed.
  • Another catheter with a balloon fixed to it will be inserted into the rectum and filled with 50ml of water. You will then be asked in the sitting position to push the balloon out. You will do this behind a screen in private.

After your test

You should be able to drive home or work immediately afterwards.

When will I know the results?

The results will be sent your Consultant in charge of your care.  A copy will also be sent to your GP. 

The Consultant will give you a diagnosis and discuss any further treatment if required at a future appointment.

Concerns or questions

For further advice please contact the Endoscopy Unit between 8am and 5pm Monday to Thursday:

Endoscopy Unit Tel: 01782 676009.

Please leave your contact number, full name, date of birth and date of your procedure as this is a voicemail facility.  We will return your call as soon as possible.

Sources of information and support

Bladder and Bowel Foundation

Email: info@bladderandbowelfoundation.org

Website: www.bladderand bowelfoundation.org

Website : www.bowel-control.co.uk

Free Bus Service

There is a free shuttle bus service between Royal Stoke and County sites.

Members of the public who wish to use this service are required to pre-book their journey in advance:

Shuttle Bus booking line Tel: 01782 824232

How to find us

County Hospital

(formerly Stafford Hospital),

Weston Road,

Stafford, ST16 3SA.

Tel: 01785 257731

Endoscopy Unit is on the ground floor.

Royal Stoke Hospital,

Newcastle Road,

Stoke-on-Trent,

ST4 6QG.

Tel: 01782 715444

Endoscopy Unit is on lower ground floor 1.

Please note, car parking charges apply.

Biofeedback

Therapy

Please speak to a member of staff if you need this leaflet in large print, braille, audio or another language.

 

Contents

Introduction. 3

Your appointment 3

What is biofeedback therapy?. 4

What are the benefits and risks to biofeedback therapy?. 4

Preparation Instructions. 4

What about my medication?. 5

Your biofeedback therapy. 5

During your therapy. 5

After your therapy. 5

Follow up appointments?. 5

Concerns or questions. 6

Additional sources of information and support 6

Free Bus Service. 6

How to find us. 6

 

Introduction

Your Specialist has recommended that you have a course of biofeedback therapy.  This is a form of therapy that uses exercises and life style changes to try and improve your bowel symptoms.

You will be asked to attend Royal Stoke Hospital Endoscopy Unit.

Your appointment

Expect to be in the unit for up to 1 hour approximately.

If you call to cancel your appointment, you will need to provide:

  • Your full name.
  • Date of birth.
  • Date of your therapy.
  • Contact telephone number.

You are advised to discuss with your Doctor the implications of not having this procedure.

 

What is biofeedback therapy?

Biofeedback therapy is a technique used for selected patients suffering from either faecal incontinence, constipation or both.

Biofeedback involves either retraining the muscles to relax or strengthen muscle tone in your back passage depending on your symptoms.

Please be assured that we will make every effort to ensure your privacy and dignity is maintained during the procedure.

You do not need to be sedated for the procedure.

What are the benefits and risks to biofeedback therapy?

  • The procedure is safe and should not be painful.
  • There are no known risks or complications.
  • Results from the program are largely dependent upon your commitment and effort with the exercises you will be given to do at home.
  • A small proportion of patients do not find any benefit from it.
  • In many patients biofeedback is an alternative to surgery.

Preparation Instructions

Day of the biofeedback therapy

 

·        No special preparation is necessary.

·        You can eat and drink as normal before your appointment.

·        You should, if possible, have a bowel movement before coming for the procedure.

What should I bring on the day?

·        Your prescription medication.

·        Your reading glasses so that you can read the consent form.

When you arrive

 

Please report to the Endoscopy Reception. You will be greeted by a Physiologist and then:

·      You will be asked several questions about your health and current medication. 

·      You may be asked to sign a consent form.

·      Please talk to us about any worries or concerns that you may have.

What about my medication?

  • You may continue to take your prescribed medication as usual.
  • If you have any other concerns about your medication, please seek advice from your GP.

Your biofeedback therapy

The procedure will take place in a clinical room.

  • You will be asked to undress from the waist down and you will be provided with a sheet to cover yourself.
  • You will need to lie on your left side.
  • Each stage of the procedure will be explained to you as it happens.
  • Your level of comfort will be monitored.

During your therapy

  • A small probe will be inserted into your back passage. The probe is connected to a computer.
  • You will be asked to squeeze and relax your back passage muscles at certain times this will allow you to see the progress you are making whilst doing your muscle exercises,
  • The probe will then be removed and you can get dressed.
  • From the initial assessment your individual programme will be discussed with you. This will consist of exercises and possible diet and lifestyle changes.  You may be asked to keep a bowel diary,

After your therapy

You will be able to continue your day as normal.

Follow up appointments?

The biofeedback programme will include three sessions.  These will either be face to face consultations or telephone consultations.

In order to obtain the best results you need to follow the agreed programme.

We can only give you the information, exercises and advice but only you can make the difference.  These exercises should become part of your daily life.

 

Concerns or questions

For further advice please contact the Endoscopy Unit between 8am and 5pm Monday to Thursday:

Endoscopy Unit Tel: 01782 676009.

Please leave your contact number, full name, date of birth and date of your therapy as this is a voicemail facility.  We will return your call as soon as possible.

Additional sources of information and support

Bladder and Bowel Foundation

www.bladderandbowelfoundation.org

Free Bus Service

There is a free shuttle bus service between Royal Stoke and County sites.

Members of the public who wish to use this service are required to pre-book their journey in advance:

Shuttle Bus booking line Tel: 01782 824232

How to find us

County Hospital

(formerly Stafford Hospital),

Weston Road,

Stafford, ST16 3SA.

Tel: 01785 257731

Endoscopy Unit is on the ground floor.

Royal Stoke Hospital,

Newcastle Road,

Stoke-on-Trent,

ST4 6QG.

Tel: 01782 715444

Endoscopy Unit is on lower ground floor 1.

Please note, car parking charges apply.

Oesophageal Manometry

and

24 hour pH and Impedance test

Please speak to a member of staff if you need this leaflet in large print, braille, audio or another language

 

Contents

Introduction. 3

Your appointment 3

What is oesophageal manometry?. 4

What is a pH and impedance test?. 4

What are the benefits and risks to oesophageal manometry/pH and impedance monitoring?. 4

Preparation instructions. 5

What about my medication?. 6

During your tests. 6

What happens during your test?. 7

After your test 7

When will I know the results?. 8

Concerns or questions. 8

Free Bus Service. 8

How to find us. 8

 

Introduction

Your Specialist has recommended that you have an oesophageal manometry/pH/impedance test to investigate your symptoms.  

You will be asked to attend Royal Stoke Hospital Endoscopy Unit.

Your appointment

Expect to be in the unit for up to 1 hour approximately.

If you call to cancel your appointment, you will need to provide:

  • Your full name.
  • Date of birth.
  • Date of your tests.
  • Contact telephone number.

You are advised to discuss with your Doctor the implications of not having this procedure.

 

What is oesophageal manometry?

Oesophageal manometry is a test which measures the pressures in the oesophagus and how the sphincters (ring like muscles which open and close at either end of the oesophagus) are working.

This is done by passing a multi-channel probe which has sensors situated at 1cm intervals via the nose. 

What is a pH and impedance test?

This test provides information about the amount of reflux that is coming up into the oesophagus from the stomach.

A small tube is passed via the nose which measures the acidic or non- acidic reflux you get over a 24 hour period and how it relates to your symptoms. . 

You do not need to be sedated for either of these procedures.

What are the benefits and risks to oesophageal manometry/pH and impedance monitoring?

The tests help to investigate symptoms and be able to treat them. 

The tests do have their risks but major and serious complications are rare.

These tests will be discussed with you and any risks identified before you sign the consent form.

These can include: 

  • A sore throat.
  • A nose bleed or a runny nose, however this is rare.
  • Occasionally the tube may enter the larynx (voice box) and cause you to cough. When this happens the tube will be gently pulled back a few centimeters.

 

Preparation instructions

Seven Days before your tests.

 

It is important that you stop taking pump inhibitors (PPI) such as:

·        Esomeprazole (Nexium).

·        Lansoprazole (Zoton).

·        Omeprazole (Losec).

·       Pantoprazole (Protium).

·       Rabeprazole (Pariet).

 

Three Days before your tests.

 

Stop taking:

·        Cimetidine (Tagamet).

·        Famotidine (Pepcid).

·        Ranitidine (Zantac).

·        Alverine citrate (Spasmonal).

·        Buscopan.

·        Baclofen.

·        Domperidone (Motilium).

·        Mebeverine (Colofac).

·        Metoclopramide (Maxolon).

One Day before your tests.

Stop taking:

·        Gaviscon.

·        Rennies.

·        Settlers

Day of the tests.

 

·        Do not have anything to eat (including sweets and chewing gum) FOUR HOURS before the test.

·        Unless you are told otherwise, please stop drinking clear fluids TWO HOURS before your appointment at the hospital.

·        If you are diabetic, continue with your normal diet.

·        Wear loose fitting clothes if possible.

·         Do not apply face cream or wear make-up.

What should I bring on the day?

 

·        If you are diabetic please bring your insulin or tablets.

·        Your prescription medication.

·        Your reading glasses so that you can read the consent form.

When you arrive

 

Please report to the Endoscopy Reception. You will be greeted by a Physiologist and then:

·      You will be asked several questions about your health and current medication. 

·      You may be asked to sign a consent form.

·      Please talk to us about any worries or concerns that you may have.

 

What about my medication?

  • If you are taking any medication for your heart, breathing problems or hormone therapy, please continue to take them as usual.
  • If you are diabetic, please contact the Diabetic Nurse Specialist for advice Tel: 01782 679770 or 01782 715444 and ask if you should change your morning dose.
  • Oral hypoglycaemic medicines are usually not taken that morning until completion of the test and you start eating again.
  • If you have any other concerns about your medication, please seek advice from your GP.

During your tests

  • You will be asked to sit upright on a couch.
  • A probe (tube) will be passed via your nostril down the back of your throat and into your stomach. You will be given some water to drink to ease the passage of the tube.
  • Once in position it will taped to your nose to hold it in place for the duration of the study.
  • Each stage of the procedure will be explained to you as it happens.
  • Your level of comfort will be monitored.
  • The process of placing the tube and undertaking the study is around 20 -30 minutes.
  • You will be asked to try not to swallow for the first 30 seconds as this allows for a baseline measurement to be taken.
  • You will be given 5ml of water to swallow approximately 10 times in the upright position.
  • You will then be given five 2ml water swallows and a 200ml glass of water to drink.
  • Following this, a further five 5ml water swallows will be given to you in the lying down position.
  • You may then be asked to swallow solid foods such as bread or rice (if this is required you may be asked to bring some in with you).
  • The tube will then be removed.
  • The 24 hour tube will then be inserted via the nose, taped into place and connected to a recording device (slightly bigger than a mobile phone).
  • The Physiologist will then explain how to use the recorder and give you a diary sheet to fill in.

What happens during your test?

  • It is important that you record when you experience symptoms such as heartburn, regurgitation, belching, coughing etc. You will do this by pressing buttons on the recorder and also documenting this on your diary sheet.
  • During the study you will not be able to take your anti reflux, indigestion medication or antacids for the 24 hour period.
  • You should not shower or take a bath during the study as this will damage the equipment.
  • You will be given instructions to return the following day where the tube and the recording device will be removed. You will be in the department no more than15 minutes.

After your test

  • You will be free to leave straight away and resume your daily activities.
  • You may restart taking you medication again after your 24 hour test is completed.

 

When will I know the results?

The results will be sent within 5 working days of the completion of your test to your Consultant in charge of your care.  A copy will also be sent to your GP. 

The Consultant will then decide the most appropriate treatment for you and you will receive a clinic appointment.

If you do not hear anything from the hospital within 6 weeks, please contact your Consultant’s secretary via the hospital switchboard on 01782 715444. 

Concerns or questions

For further advice please contact the Endoscopy Unit between 8am and 5pm Monday to Thursday:

Endoscopy Unit Tel: 01782 676009.

Please leave your contact number, full name, date of birth and date of your test as this is a voicemail facility.  We will return your call as soon as possible.

Free Bus Service

There is a free shuttle bus service between Royal Stoke and County sites.

Members of the public who wish to use this service are required to pre-book their journey in advance:

Shuttle Bus booking line Tel: 01782 824232

How to find us

County Hospital

(formerly Stafford Hospital),

Weston Road,

Stafford, ST16 3SA.

Tel: 01785 257731

Endoscopy Unit is on the ground floor.

Royal Stoke Hospital,

Newcastle Road,

Stoke-on-Trent,

ST4 6QG.

Tel: 01782 715444

Endoscopy Unit is on lower ground floor 1.

Please note, car parking charges apply.

Gastroscopy

 

How to find us

 

Introduction

Your specialist has recommended that you have a gastroscopy to investigate your symptoms. 

You will be asked to attend either Royal Stoke Hospital Endoscopy Unit or County Hospital Endoscopy Unit.

Your appointment

  • Please check your appointment letter before attending to make sure you attend the correct site.
  • Your procedure will be cancelled if you request sedation, and do not have a suitable escort to collect you and take you home. The escort will also need to stay with you for 12 hours once you return home.
  • As you will need to see the Nurse first, the time you are given to attend is not the time of your gastroscopy.
  • The time is approximate due to different procedures taking different time periods.
  • Emergency procedures will take priority.
  • Expect to be in the unit for up to 3 hours approximately.

If you call to cancel your appointment, you will need to provide:

  • Your full name.
  • Date of birth.
  • Date of your procedure.
  • Contact telephone number.

You are advised to discuss with your Doctor the implications of not having this procedure.

What is a gastroscopy?

A gastroscopy (or simple endoscopy) is a test which allows the Doctor/Nurse Specialist (Endoscopist) to look directly at the lining of the oesophagus (gullet), the stomach and the first part of the small intestine (duodenum).

 

  • A thin flexible tube called a gastroscope is passed through your mouth. The digital camera it contains transmits pictures to a monitor.
  • A biopsy (small piece of tissue) may be taken using tiny biopsy forceps. This does not cause any pain.
  • A gastroscopy takes approximately 5 minutes.

 

What are the benefits and risks to a gastroscopy?

The procedure helps to investigate symptoms and be able to treat them. 

Procedures do have their risks but major and serious complications are rare.

These will be discussed with you and any risks identified before you sign the consent form.

These can include: 

  • You may have a mild sore throat.
  • Aspiration. This is where fluid/food residue could go into your lungs.
  • Bleeding can happen. Slight spotting of blood on the toilet paper or small drops in the toilet bowl should be expected however, this should stop quickly within a few days.
  • A perforation (tear in the small bowel). The risk of perforation is less than 1 in 1000.  If a significant bleed or perforation were to happen, further treatment may be required such as a blood transfusion or surgery.
  • Reaction to medication for example, sedation and painkillers.
  • Damage to teeth, crowns or bridges.
  • Missed pathology. This is where a diagnosed was not noticed.

 

Preparation instructions

Day of your procedure

Unless you are told otherwise, no food for SIX HOURS prior to your appointment.  Please stop drinking clear fluids TWO HOURS before your appointment at the hospital.

What should I bring on the day?

If you are diabetic please bring:

  • your insulin or tablets.
  • Your prescription medication.
  • Your reading glasses so that you can read the consent form.

When you arrive

Only one escort/relative will be able to accompany you due to limited space.  If you need someone to support you, please call the unit to arrange.

Please report to the Endoscopy Reception. You will be greeted by a Nurse and then:

  • You will be asked several questions about your health and current medication.
  • Your blood pressure and pulse will be taken.
  • You may be asked to sign a consent form.
  • A cannula (small needle) will be inserted so intravenous medication can be given.
  • Please talk to us about any worries or concerns that you may have.

 

What about my medication?

  • If you are taking any blood thinning medication for example, Warfarin, Clopidogrel, Apixiban, Rivaroxaban,etc., please contact the Endoscopy Unit Tel: 01782 676010 or 01782 675713.
  • There is no need to stop low dose aspirin, for example, 75mg/day.
  • If you are diabetic, please contact the Diabetic Nurse Specialist for advice Tel: 01782 679770 or 01782 715444.
  • If you have any other concerns about your medication, please seek advice from your GP.

Your gastroscopy procedure

The procedure will take place in the Endoscopy theatre.

  • You will be kept as comfortable as possible.
  • You will need to lie on your left side.
  • A Nurse will stay with you throughout the procedure.
  • Each stage of the procedure will be explained to you as it happens.
  • Your oxygen levels and pulse will be monitored as well as your level of comfort.
  • You may be given oxygen during the test, through little prongs that fit just inside your nostrils.

Procedure options for gastroscopy

  • Local anesthetic spray. This is sprayed to the back of your throat which numbs the area and makes it easier to pass the tube. This also reduces retching.

And/ Or

  • Sedative. This method will help you to relax but it is not a general anaesthetic. This is given through a small needle placed in a vein on the back of your hand or arm.

 

During your procedure

  • Your throat will be sprayed with local anesthetic which numbs the back of your throat. The sedation will then be administered if you request it.
  • A plastic mouth guard will be placed gently in your mouth.
  • The endoscope will be passed across the top of your tongue to the back of your throat.
  • It will then be passed down the gullet, into the stomach and the small intestine. It is normal if you feel bloating during this.
  • Biopsies can be taken which is painless.
  • If you get saliva in your mouth, the nurse will clear this using a suction tube.
  • The endoscope is removed slowly taking some air out.
  • The mouth guard will be removed. A tissue will be provided to wipe your mouth.

 

After your procedure

  • You may feel bloated because air remains in your bowel. This will settle as you pass wind.
  • Your blood pressure and pulse will be monitored.
  • If you have been given intravenous sedation you will need to rest in the recovery area until you are fully awake (usually one hour).
  • If you have had throat spray without sedation, you can be discharged once you feel ready.

Going home

If you have received intravenous sedation:

This impairs your reflexes and judgment so it is important that a responsible adult escorts you home and stays with you for 12 hours.  Please note that your procedure will be cancelled if you do not have an escort.  We cannot escort you home.

For 24 hours after the procedure you must not:

  • Drive.
  • Operate machinery.
  • Drink alcohol.
  • Sign legal documents.
  • Breast feed.

You will be given any written information that you need when you leave the hospital.

 

Your medication after the procedure

We will talk to you about your medication after the procedure and before you go home in case changes to your medication are needed.

When will I know the results?

You will be told about the results when you are ready to be discharged and provided with a copy of the report.  A copy will also be sent to your GP or whoever referred you.

It is suggested that when you receive your results, you have your escort or relative with you in case you forget any information due to the sedation you have received.    

Concerns or questions

For further advice please contact the Endoscopy Unit between 8am and 5pm Monday to Friday:

Endoscopy Unit Tel: 01782 676010 or 01782 675713.

Please leave your contact number, full name, date of birth and date of your procedure as this is a voicemail facility.  We will return your call as soon as possible.

Sources of information and support

Free Bus Service

There is a free shuttle bus service between Royal Stoke and County sites.

Members of the public who wish to use this service are required to pre-book their journey in advance:

Shuttle Bus booking line Tel: 01782 824232

How to find us

County Hospital

Weston Road

Stafford

ST16 3SA

Tel: 01782 715444

Endoscopy Unit is on the ground floor

 

Royal Stoke Hospital

Newcastle Road

Stoke-on-Trent

ST4 6QG

Tel: 01782 715444

Endoscopy Unit is on lower ground floor 1.

 

Please note car parking charges will apply

Taking Moviprep oral bowel cleansing agents safely and effectively for colonoscopy/flexible sigmoidoscopy

What is a colonoscopy/flexible sigmoidoscopy?

This is where a soft, flexible tube with a camera at the end is passed through your back passage (anus) and up inside your bowel by a specially trained doctor or nurse.

You should have received the procedure leaflet with your appointment letter which explains the procedure in more detail. If you have not received a copy of this, please ask us for one.

Why do I need to prepare for this procedure?

Your bowel needs to be empty for the procedure so that the doctor or specialist nurse can see the lining of your bowel.

To achieve this you will need to alter your diet and take specific preparations for a few days before the procedure.

The changes are explained in this leaflet.

 

What is bowel prep?

You have been supplied with an oral preparation which is a bowel cleansing agent (sometimes called “bowel prep”).

The purpose of this is to clear out your bowels and ensure safety and effectiveness of the planned endoscopic procedure.

There is a risk of developing dehydration, low blood pressure or kidney problems with this medication.

 

Frequently Asked Questions (FAQs)

Q: How long does the procedure take?

A: A colonoscopy usually takes between 10 and 45 minutes. A flexible-sigmoidoscopy takes between

10 and 20 minutes. You may be in the department for approximately 3 hours.

Q: Does it hurt?

A: Sometimes patients find the test painful, gas and air (Entonox) or sedation is available to use for pain relief if needed.

Q: Can I take my tablets as normal?

A: Yes unless you have been instructed otherwise see page 4, 5, 8 & 12. If your tablets need to be taken at the same time you are drinking the Moviprep please

take them at least one hour before or at least one hour after drinking Moviprep. Please see separate patient procedure information that will be sent with your appointment letter for more advice e.g. Diabetics,

those on antiplatelets and anticoagulants.

Q: Will I be asleep for this procedure?

A:  No. Gas and air (Entonox) or sedation is available (if your circumstances permit).

You will be awake throughout the procedure.

Points to Remember

You will experience watery bowel movements so stay close to a toilet.

If you have not had your bowels open after taking the solution please seek medical advice.

If your health has deteriorated since seeing the doctor or specialist nurse in clinic, please call the

consultants who referred you for this test or your GP.

On the day of your test

IT IS IMPORTANT THAT YOU ONLY DRINK CLEAR (NO MILK) FLUIDS UP TO 2 HOURS BEFORE THE TEST.

After your test, you will be advised when to return to your usual diet and medication.

The person prescribing the oral bowel cleansing agent will have assessed your risk and identified the most appropriate medication for you.

You may also require a recent blood test to check your kidney function.

The following conditions apply in all cases:

  • The bowel prep will cause diarrhoea and urgency so you will need to stay close to toilet facilities.
  • If after taking your bowel preparation you have not had your bowels open within 7-8 hours after taking the last sachet of Moviprep, please seek medical advice as soon as possible.
  • Make sure that you drink plenty of water up

to 2 hours before your test as the bowel prep can cause dehydration.

  • Do not drink dark coloured juices or milk.
  • If you experience symptoms of dizziness or light headedness (particularly on standing up), thirst or reduction in passing urine, then you may be dehydrated and should seek medical attention.

All bowel cleansing agents cause diarrhoea so if regular medication is required, it should be taken either one hour or more before taking the cleansing agent. Or, it should be taken 1 hour or more after taking the cleansing agent.

Please tell the nursing staff as soon as possible on the number at the end of the leaflet if you:

  • Take any medicines to thin the blood or to prevent blood from clotting (anticoagulants or antiplatelets, such as warfarin, rivaroxaban, dalteparin or clopidogrel).
  • Have diabetes (contact your nurse specialist).
  • Have an allergy to Moviprep or its ingredients.

If you only take low dose 75mg aspirin, you do not need to call.

Do not take any other medication at the same time as you are taking the bowel prep.

Please let us know if you are taking any regular medicines at your pre-assessment appointment (including anything you buy yourself over the counter or any herbal or homeopathic medicines).

Female Patients diarrhoea can make oral contraceptive pill less effective. Continue with the pill and use extra precautions for the next 7 days.

Refer to the manufacturer’s instructions when taking your preparation for a list of ingredients and allergies.

Please adhere to the low residue diet advice sheet as certain foods can affect the outcome of your test and may result in a failed test.

How to take Moviprep

  1. About 6.00pm mix your first litre of MOVIPREP.
  2. Empty the contents of ONE sachet A and ONE sachet B in to a jug and add 1 litre (1¾ pints) of cold water and stir until dissolved. (if desired, cordial can be added to taste).
  3. Drink 250ml (½ pint) of Moviprep mixture every 15-30 minutes until you have drunk it all (usually over about 1-2 hours - no need to rush).
  4. It is important to drink an additional 500ml (1 pint) of water or fluid of your choice (No Milk).
  5. At 8.00am on the morning of the appointment, please mix

the remaining sachets of Moviprep following the instructions above.

  1. Drink 250ml (½ pint) of Moviprep mixture every 15-30 minutes until you have drunk it all (usually over about 1-2 hours) – no need to rush.
  2. It is important to drink an additional 500ml (1 pint) of water/ clear fluids in the morning (No Milk).

You will experience watery bowel movements so stay close to a toilet. If you have not had your bowels open after taking the solution please seek medical advice.

 

Adult Moviprep instructions for an afternoon appointment

 

There may be medicines which you are asked to stop taking and these may include:

  • Heart/Blood pressure tablets e.g. Lisinopril, Ramipril, Perindopril, Captopril, Losartan, Candesartan, Irbesartan, Valsartan;
  • Diuretics (Water tablets) e.g. Furosemide,

Bendroflumethiazide , Spironolactone, Amiloride, Co-Amilofruse, Bumetanide, Metolazone,

Indapamide, Eplerenone;

  • Anti-inflammatory drugs e.g. Ibuprofen, Naproxen
  • Tolvaptan: Used for progressive Autosomal Dominant Polycystic Kidney disease or conditions causing low sodium.

Your medication will have been discussed and advice given during your clinic or pre-assessment appointment.

Dietary Management – Low Residue Diet

Three days before your procedure you should start to eat a low residue (fibre) diet. This reduces the stool residue in the bowel. The main sources of fibre in the diet are cereal products, vegetables, seeds and fruits, so these foods need to be reduced.

It is important to have regular meals and a varied diet which includes foods such as meat, poultry, fish, eggs and dairy products (milk, cheese, yoghurt).

It is important to drink plenty of fluid and at least 8-10 cups of water, black tea/coffee, or squash per day. This helps to flush the bowel contents out and will improve the effect of the bowel preparation. It will also prevent you

from becoming dehydrated.

Suggested meals you can eat that are low residue.

Vegan option available on request from Endoscopy

 

MOVIPREP INSTRUCTIONS

 

STEP 1

 

Empty the contents of 1 sachet A and 1 sachet B in to a 1 litre Jug of water.

 

STEP 2

Stir until the solution is clear

 

STEP 3

Drink 1 glassful 250ml (¼ litre or

½ pint) of Moviprep every 15 minutes until you have drunk it all.

You can eat any combination of the following:

 

Adult Moviprep instructions for a morning appointment

Please adhere to the low residue diet advice sheet as certain foods can affect the outcome of your test and may result in a failed test.

 

How to take Moviprep

  1. At 6pm empty the contents of ONE sachet A and ONE sachet B in to a jug and add 1 litre (1¾ pints) of cold water and stir until dissolved. (if desired, cordial can be added to taste).
  2. Drink 250ml (½ pint) of Moviprep mixture every 15-30 minutes until you have drunk it all (usually over about 1-2 hours - no need to rush).
  3. It is important to drink an additional 500ml (1 pint) of water or fluid of your choice (No Milk).
  4. Make up your second litre of Moviprep as above and continue to drink, followed by 500ml water or fluid of your choice (No Milk).
  5. Allow 2 hours after taking the second litre for the Moviprep to work.
  6. Go to bed when you stop going to the toilet (e.g. 11.00pm or 12.00 Midnight).

 

You will experience watery bowel movements so stay close to a toilet. If you have not had your bowels open after taking the solution please seek medical advice.

ON THE DAY OF YOUR TEST IT IS IMPORTANT THAT YOU ONLY DRINK CLEAR (NO MILK) FLUIDS UP TO 2 HOURS BEFORE THE TEST

 

Q:          How can I make the Moviprep more palatable?

A:           It is important to sip the Moviprep and not gulp it down to reduce nausea. A straw is sometimes helpful to drink the Moviprep with and you can add cordial (not blackcurrant) to taste if you prefer. Chilling your Moviprep solution can also sometimes help.

Q:          What shall I wear to attend the procedure?

A:           You will be asked to wear a hospital gown and dignity shorts. You can bring your own dressing gown and slippers.

If you have any further questions

Please telephone the Endoscopy Booking Office on 01782 676010, or 01782 675713 this is a voice message facility so please leave your name, hospital number and contact number.

Patient's life saved with POEM

Patient Maggie Palmer has described how an innovative endoscopic procedure performed at University Hospitals of North Midlands NHS Trust (UHNM) has saved her life. Surviving only on Cuppa soups and liquids, Maggie lost almost 16 kilogrammes in weight before being diagnosed with ‘corkscrew oesophagus’, a variant of the condition Achalasia. Maggie underwent the corrective procedure ‘Peroral Endoscopic Myotomy’ (POEM) and is now able to eat proper meals again.

Read the full story