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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 is a state-of-the-art endoscopy unit, opened in 2012 and comprising six endoscopy rooms. It delivers the full range of diagnostic and therapeutic procedures which include ERCP, EUS, EMR, colonoscopy, OGD, GI Physiology and a bronchoscopy service. 

The Royal Stoke University Hospital is JAG accredited and a Bowel Cancer Screening Centre, which includes the Bowel Scope service.  We are also providers of specialised training and education for medical and nursing staff.

The department comprises a dedicated team including Endoscopists, Nurses, Healthcare Assistants, GI Physiologists and admin teams, including reception and appointment clerks, who all work together to care for you.​​

Getting Here

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

Royal stoke map

royal stoke road map

Please note car parking charges may apply.

There is a shuttle bus service running between Royal Stoke and County at a charge of £5 return. 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 may apply.

There is a shuttle bus service running between Royal Stoke and County at a charge of £5 return. 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
Ashraf, Sohail​​
Brind, Alison
Bullen, Timothy
Dawson, Robin
Desai, Rajeev
Farmer, Adam D
Farmer, Martin
Garimella, Veerabhadram
Hebbar, Srisha
Glass, Robert
Kurup, Arun
Lau, Kar Wai
Nkhoma, Alick
Priest, Oliver​
Rajikumar, Sarveson
Sen, Sandip
Sringeri, Rakesh
Tsiamis, Achilles
Varghese, Philip

Yeomans, Neil

​​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.

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 aged 60 to 74. Its aim is to identify people who appear healthy but are at an increased risk of developing bowel cancer. Anyone above the age of 74 can opt into the programme by telephoning the free phone hub on 0800 707 60 60.

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 41,000 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 eventually improving the diagnosis and eventual prognosis for patients with bowel cancer.

UHNM's team has 11 members. Recently, they have focused on carrying out health promotion events across catchment areas.

The team provide bowel scope testing for over 55-year olds and that is helping the team raise awareness of the disease.

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

The wider team

  • Dr Sandip Sen, Consultant Gastroenterologist: BCS Clinical Director and Accredited Screening Colonoscopist
  • Dr Srisha Hebbar, Consultant Gastroenterologist: Accredited Screening Colonoscopist
  • Dr Alan Bohan, Consultant Gastroenterologist: Accredited Screening Colonoscopist
  • Dr Alison Brind, Consultant Gastroenterologist: Accredited Screening Colonoscopist
  • Dr Sarveson Rajkumar, Consultant Gastroenterologist: Accredited Screening Colonoscopist
  • Dr Cordelia Howitt, Lead Pathologist
  • Dr Ingrid Britton, Lead Radiologist
  • Carol Beeston, Lead Specialist Screening Nurse
  • Gloria Garlick, Screening Nurse
  • Adrian Black, Screening Nurse
  • Deborah Maccioni, Screening Nurse
  • Rachel Owen, Screening Nurse
  • Edna Beaty, Screening Nurse
  • Julie Holland, Lead Administrator, Bowel Cancer Screening
  • Pam Hawkes, Lead Co-ordinator, Bowel Scope
  • Karen Davies, Assistant Administrator
  • Louise Booth, Assistant Administrator
  • Angela Power, Bowel Cancer Screening Programme Manager​

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

TOpening 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 names. If you are making a special journey, please ring to make an appointment so you are not kept waiting.​

We were the very first hospital to offer 'hands on' training in upper and lower endoscopic procedures, holding our very first course in 1976.  Our training team provides training to doctors and nurses from around the county, including JAG accredited training courses:

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

    We also run ERCP up-skilling courses, nurse's courses and ad-hoc training to promote excellence in Endoscopy.

    Our trainers link with other Trusts working as faculty members, both in this county and overseas and we host an annual ERCP Symposium in conjunction with Aquilant Endoscopy. 

    For further information on any of our courses please follow the link below, or email our Training Coordinator: Emily.Meakin@uhnm.nhs.uk
    https://www.jets.nhs.uk/RoyalStoke

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

About the condition

In the UK, it is estimated that well over 100,000 people have Crohn's disease and over 140,000 have a diagnosis of ulcerative colitis.

Inflammatory bowel disease (IBD) can be painful, disrupt normal activities and reduce quality of life, particularly during periods of active disease.

Crohn's disease is a chronic inflammatory disease that mainly affects the gastrointestinal tract. The disease may be progressive in some people, and a proportion may develop extra‑intestinal manifestations. The causes of Crohn's disease are widely debated. Smoking and genetic predisposition are two important factors that are likely to play a role. Typically people with Crohn's disease have recurrent attacks, with acute exacerbations interspersed with periods of remission or less active disease.

Ulcerative colitis is the most common type of inflammatory disease of the bowel. The cause of ulcerative colitis is unknown. It can develop at any age, but peak incidence is between the ages of 15 and 25 years, with a second, smaller peak between 55 and 65 years (although this second peak has not been universally demonstrated). Ulcerative colitis usually affects the rectum, and a variable extent of the colon proximal to the rectum. The inflammation is continuous in extent. Inflammation of the rectum is referred to as proctitis, and inflammation of the rectum and sigmoid as proctosigmoiditis. Left-sided colitis refers to disease involving the colon distal to the splenic flexure. Extensive colitis affects the colon proximal to the splenic flexure, and includes pan-colitis, where the whole colon is involved. Symptoms of active disease or relapse include bloody diarrhoea, an urgent need to defaecate and abdominal pain.

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. ​

The units at Royal Stoke and County Hospital are both open Monday to Friday, 8am - 5pm​​

The unit at Royal Stoke is also open on Saturday from 8-5pm

Pictured: Mr David Hardy and Chief Nurse Liz Rix presenting the Endoscopy team with the UHNM Hero award for showing great care and compassion

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. 

UHNM Hero award

Mr David Hardy (pictured above) gave the team the UHNM Hero award to thank them for their care. He had been feeling apprehensive about his appointment, but after staff helped to reassure and calm him, he felt a lot better.

Mr Hardy said: "I just want to pass on my sincere thanks for the way in which my appointment went. The reception staff were smiling, happy, and extremely helpful, and my fears were well and truly calmed when the nurses and auxiliary staff continued the first class treatment. After being called through, all of the staff were very efficient and really helped to calm my concerns. Dr Rabbi and his team were marvellous and talked me through everything. They were very attentive to me throughout the whole procedure."

Exemplary treatment

"From the receptionist to the discharge team, my experience and treatment was exemplary. I was really dreading this, but I can honestly say my fears were for nothing. The staff really are amazing people."

Mrs KB

Thank you for looking after my mum

"I would like to convey my thanks to your staff for the care provided to my mum, who had an endoscopy carried out on a Saturday morning. I accompanied my mum and found the staff to be very professional, kind and caring. They all took the time explaining the procedure clearly to my mum, which alleviated her anxieties. After the procedure my mum was monitored closely and the results were explained to her and myself."

Ms FB 

 

An anxious time made a lot easier

"Everything was very punctual and the staff were lovely. They kept me informed of all the procedures and made an anxious time a lot easier. I can't think of any improvements, I really felt like I received the best treatment."

Anonymous comment from department patient feedback card

 

A professional point of view following a training session

"We received feedback on how well your staff communicated during the procedures today and how, even when things got tough, they remained calm and prepared all the accessories promptly and with confidence. It is comments like these that mark out your ERCP Courses as outstanding and congratulations should go to you and your team on another course well executed."

Claire Kneeshaw, Territory Manager, COOK Medical

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.

 

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.
  • Your procedure will be cancelled if you do not have an escort.
  • 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.

Endoscopy appointments are in high demand so, if you are unable to attend your appointment, please contact the Endoscopy Unit as soon as possible on 01782 676010 or 01782 675713

This will allow your appointment to be offered to another patient.

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

  • Your full name.
  • Date of birth.
  • Date of your colonoscopy.
  • 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

Diagram to show 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.
  • 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. The Endoscopist will discuss the procedure with you and identify any risks which 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.
  • If a polyp is removed the risk of a significant bleed is less than 1 in 200. It is advisable not to travel overseas for the 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 procedures. (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.

What about my Medication?

  • If you are taking any blood thinning medication for example, Warfarin, Clopidogrel, Apixaban, Rivaroxaban, Dalteparin etc. please contact the Endoscopy Unit on 01782 676010 or 675713.
  • There is no need to stop low dose aspirin, for example, 75mg once a day only.
  • If you are diabetic, please contact the diabetic nurse specialist for advice on 01782 679770 / 715444.
  • If you take IRON tablets, please stop those 5 days before the test.
  • Essential medicine required on the morning of the procedure; please see ‘Taking oral bowel cleansing agent’ patient information leaflet given to you in the out-patient clinic or during pre-assessment clinic. If you have any other concerns about your medication, please seek the advice from your GP or contact the Endoscopy unit.
  • If you have a stoma, please contact your specialist nurse for advice.

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.

Five Days before your colonoscopy

It is important that you follow the dietary and medication instructions provided in the information leaflet: ‘Taking 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 with you: 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

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

Please report to the Endoscopy Reception.

·        Only one escort/relative will be able to accompany you due to space restrictions.

You will be greeted by a Nurse and then:

·        Asked several questions about your health and current medication.

·        Your blood pressure and pulse will be taken

·        You will 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.

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 or arm.

During the 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 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 colonoscopy

  • 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

As the sedation impairs your reflexes and judgement it is important that an 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.

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 routine advice contact the Endoscopy Unit between 8am and 5pm (Monday to Friday): on 01782 676010 or 01782 675713.

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

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.

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.

Bowel Preparation Instructions - PICOLAX

You have been supplied an oral 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. The person prescribing the oral bowel cleansing agent will have assessed your risk and identified the most appropriate medication for you. You MAY require a blood test to check your kidney function. You will have been informed if this is the case.

Always refer to the manufacturer’s instructions when taking your preparation. However the following rules apply in all cases:

• One sachet to be mixed with 150mls (approximately half a glass) of cold water. Heat can be generated during mixing so allow the solution to cool before drinking.
• The bowel prep will cause diarrhoea – it usually acts within 3 hours of the first dose so you will need to stay close to toilet facilities.
• The bowel prep can cause dehydration so you should maintain a good fluid intake whilst taking these medications. Drink plenty of clear fluids (avoid red coloured juices) and follow the diet below.
• If you develop symptoms of dehydration and cannot increase your fluid intake, then you should seek medical attention. These symptoms include: dizziness or light headiness (particularly on standing up), thirst or reduction in passing urine.
• Diabetic patients to contact the diabetic clinical nurse specialist (as per written information sheet) if further advice is required.

If you have not received specific advice regarding your regular medications then you should continue to take them as normal. However, you may need to amend the timing as it is preferable to avoid taking them less than one hour either side of any dose of oral bowel cleansing agent.

Occasionally you may be asked to stop:

• Anti-hypertensive (Blood pressure tablets).

• Diuretics (Water tablets).

• Anti-inflammatory drugs

• Iron preparations (You WILL need to discontinue at least 7 days before the investigation)

• Blood thinning tablets (aspirin, warfarin, and clopidogrel) – this will depend on the reason for your bowel investigation).

Two days before you test please commence a low residue diet. Examples are written below.

PLEASE DO NOT EAT ANY SOLID FOODS ON THE DAYS THAT YOU TAKE THE PICOLAX BOWEL PREPARATION

DO NOT eat any fruit, Pulses or lentils, Vegetables, Nuts/ seeds, Wholemeal bread, Brown rice, High fibre breakfast cereals

Breakfast

Tea/coffee (with milk and sugar/sweetener).

Choose from the following:
• Crisp rice cereal or cornflakes with up to 100ml milk (NO bran).
• 2 slices white bread/toast with a thin spread of butter/margarine and honey as desired.
• 1 boiled/poached egg and 1 slice white bread/toast with thin spread of
butter/margarine.
• 50grams of cottage cheese and 1 slice of white bread/toast with a thin spread of butter/margarine.

Mid-morning
Tea/coffee (with milk and sugar/sweetener).

Lunch and dinner choices

Choose one of the following (smaller portions are allowed)

• 75g meat/fish.
• 2 boiled/poached eggs.
• 100g cheese (may be cream cheese, cottage cheese or cheese sauce).

And one of the following:

• 2 slices of white bread/toast with thin spread of butter/ margarine.
• 2 egg sized potatoes without the skin (may be boiled, mashed or baked).
• 2 tablespoons of plain white rice/pasta/plain macaroni or noodles.

Gravy may be made using stock cubes, white flour or corn flour for thickening.

Deserts/sweets:

• Clear jelly (not red), boiled sweets or mints.

If you have a morning appointment...

You will need to take the bowel preparation at 6pm the evening before your procedure and and 6am on the day of the procedure.

Please take the first sachet of picolax at 6pm on the day BEFORE your procedure. You are not allowed to eat any solid food but it is very important that you drink plenty of clear fluid.

You should aim to drink a glass of water, juice (please avoid red coloured juices), tea or coffee WITHOUT milk every hour up to two hours before your investigation. (Except when sleeping).

The second sachet of Picolax is to be taken at approximately 6am on the day of the procedure. Please make the second sachet up in the same manner as the first sachet.

If you have an afternoon appointment...

You will need to take the bowel prep at 6pm the day before the investigation and 9am on the day of the investigation.

Please take the first sachet of picolax at 6pm on the day BEFORE your procedure. You will need to take your second sachet of picolax at 9am on the morning of your procedure. You are not allowed to eat any solid food but it is very important that you drink plenty of clear fluids. You should aim to drink a glass of water, juice (please avoid red coloured juices), tea
or coffee WITHOUT milk every hour up to two hours before your investigation. (Except when sleeping).

NOTE – If you suffer from constipation it may be advisable to take laxatives for two days before you start the picolax sachets. Please contact the endoscopy department for advice if this is required.

Adult Moviprep Cleansing Instruction for Gastrointestinal Endoscopy

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

Introduction

Your appointment

What is an oesophageal manometry test?

What are the benefits and risks to oesophageal manometry?

Preparation instructions

What about my medication?

During your test

After your test

When will I know the results?

Concerns or questions

Free Bus Service

How to find us

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 may 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

Your appointment

What is an anorectal manometry test?

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

What about my medication?

Your anorectal manometry test

During your test

After your test

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 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 may 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

Your appointment

What is biofeedback therapy?

What are the benefits and risks to biofeedback therapy?

Preparation Instructions

What about my medication?

Your biofeedback therapy

During your therapy

After your therapy

Follow up appointments?

Concerns or questions

Additional sources of information and support

Free Bus Service

How to find us

 

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 may 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

Your appointment

What is oesophageal manometry?

What is a pH and impedance test?

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

Preparation instructions

What about my medication?

During your tests

What happens during your test?

After your test

When will I know the results?

Concerns or questions

Free Bus Service

How to find us

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 may apply.