Endoscopy

Our Vision

The Endoscopy department will provide high quality, patient centred care. It will be a centre of excellence and maintain its accredited service and will be the first choice for users. It will provide innovative, flexible and timely services to deliver a responsive efficient pathway of care to all.

Unit Information

On endoscopy we start at 8am and finish 5.30pm or 6pm, Monday to Friday. Full time staff usually work 4 days a week.

We do have a staff room for lunches with a fridge and microwave so you can bring your own food, there is access to the shop and relax at the royal which serve hot and cold food.

There is also a staff changing room with lockers to keep bags and valuables safe.

 

If you ever need to ring the unit for sickness or other queries call: 01246 512896, ideally you should talk to your assessor/supervisor but if that’s not possible please leave a message with the nurse in charge.

Procedures

Colonoscopy

 

A colonoscopy is an examination to look at the lining of your whole large bowel, to see if there are polyps or a cancerous tumour within any part of it.

 

A long flexible tube (Endoscope) with a bright light and tiny camera on the end is inserted through the anus and enables the doctor or nurse to get a clear view of the bowel lining. During the test, if the doctor sees anything that needs further investigation, photographs and samples (biopsies) can be taken. Simple polyps can be removed during a colonoscopy.

Flexible Sigmoidoscopy

A flexible sigmoidoscopy is an examination of the back passage (rectum) and some of the large bowel using a device called a Sigmoidoscope.

A sigmoidoscope is a long, thin, flexible tube attached to a very small camera and light. It’s inserted into the rectum and up into the bowel.

The camera relays images to a monitor and can also be used to take biopsies, where a small tissue sample is removed for further analysis.

It’s better for the lower bowel to be as empty as possible when a flexible sigmoidoscopy is performed, so patients are asked to carry out an enema – a simple procedure to flush the bowels – at home before their appointment.

A sigmoidoscopy can feel uncomfortable, but it only takes a few minutes and most people go home straight after the examination.

Gastroscopy

A gastroscopy often takes less than 15 minutes, although it may take longer if it’s being used to treat a condition. It’s usually carried out as an outpatient procedure, which means the patient won’t have to spend the night in hospital.

Before the procedure, the patients throat will be numbed with a local anaesthetic spay. The patient can also choose to have a sedative if they prefer. This means they will still be awake, but will be drowsy and have reduced awareness about what’s happening.

 

The doctor carrying out the procedure will place the endoscope in the back of the patient’s mouth and ask them to swallow the first part of the tube. It will then be guided down the oesophagus and into the stomach.

The procedure shouldn’t be painful, but it may be unpleasant or uncomfortable at times.

Bronchoscopy

A bronchoscopy is a test (procedure) where a doctor looks into the large airways (the trachea and bronchi). These are the main tubes that carry air into the lungs.

A fibre optic bronchoscope is the device usually used. This is a thin, flexible, telescope (it is about as thin as a pencil).

 

The bronchoscope is passed through the patients nose or mouth, down the back of the throat, into the windpipe (trachea) and down into the bronchi. The fibre-optics allow light to shine around bends in the bronchoscope and so the doctor can see clearly inside the airways.

ERCP – Endoscopic Retrograde Cholangiopancreatography

Doctors use this test to diagnose conditions of the liver, bile ducts, pancreas and gall bladder. They pass a tube called an endoscope down the patients throat to take x-rays if the pancreas and gallbladder. The endoscope is a long flexible tube with a small camera and light at the end.

The doctor can look down the endoscope or at pictures on a TV monitor and see if there are any growths or other abnormal looking areas in the pancreas or gallbladder. They can take samples (biopsies) of any abnormal looking areas. The test takes between 30 minutes and an hour.

Doctors may also use ERCP to give treatment. For example, to put a plastic or metal tube (stent) into the bile duct or pancreatic duct to clear a blockage.

An ERCP test can be done as an outpatient. The patient can’t eat for about 6 to 8 hours before the test so that the stomach and small bowel (duodenum) are empty. They may be allowed to drinks sips of water up to 2 hours before. The doctor will give written instructions about this beforehand or the instructions may arrive with an appointment letter. Many patients are seen by a consultant before the test to go through all the information.

The patients arrive at a ward and are brought to x-ray after the test they are then taken back to the ward to recover and if everything is ok they usually go home.

Common Conditions

Crohn’s and Colitis

Crohn’s Disease is a condition that causes inflammation of the digestive system or gut. Crohn’s can affect any part of the gut, though the most common area affected  is the end of the ileum (the last part of the small intestine), or the colon.

The areas of inflammation are often patchy with sections of normal gut in between. A patch of inflammation may be small, only a few centimetres, or extend quite a distance along part of the gut. As well as affecting the lining of the bowel, Crohn’s may also go deeper into the bowel wall. It’s one of the two main forms of Inflammatory Bowel Disease (IBD). The other is Ulcerative Colitis.

Crohn’s is a chronic condition. This means that it is ongoing and life-long, although you may have periods of good health (remission), as well as times when symptoms are more active (relapses or flare-ups).

 

Ulcerative Colitis is a condition that causes inflammation and ulceration of the inner lining of the rectum and colon (the large bowel). In UC, ulcers develop on the surface of the lining and these may bleed and produce mucus.

The inflammation usually begins in the rectum and lower colon, but it may affect the entire colon. If UC only affects the rectum, it is called proctitis, while if it affects the whole colon it may be called total colitis or pancolitis.

Ulcerative Colitis is a chronic condition. This means that it is ongoing and lifelong, although you may have long periods of good health known as remission, as well relapses or flare-ups when your symptoms are more active.

Diverticular Disease

 

Diverticula are small bulges or pockets that can develop in the lining of the intestine as you get older. Most people with diverticula don't get any symptoms and only know they have them after having a scan for another reason. When diverticula cause symptoms, such as pain in the lower tummy, it's called diverticular disease.

If the diverticula become inflamed or infected, causing more severe symptoms, it's called diverticulitis. You're more likely to get diverticular disease and diverticulitis if you don't get enough fibre in your diet.

 

Symptoms of diverticular disease include:

•tummy pain, usually in your lower left side

•feeling bloated

•constipation, diarrhoea or both

•occasionally, mucus in your poo

If your diverticula become infected and inflamed (diverticulitis), you may suddenly:

•get constant, more severe tummy pain

•have a high temperature of 38C or above

•feel sick or vomit

•feel generally tired and unwell

•get blood in your poo or bleeding from your bottom (rectal bleeding) 

Polyps

Bowel polyps are small growths on the inner lining of the large intestine (colon) or rectum. Bowel polyps are very common, affecting around 1 in 4 people at some point in their lives. They are slightly more common in men than women and are most common in people over the age of 60.Some people develop just one polyp, while others may have a few.

Polyps are usually less than 1cm in size although they can grow up to several centimetres. There are various forms:

  • Some are a tiny raised area or bulge known as a sessile polyp

  • Some look like a grape on a stalk known as a pedunculated polyp

  • Some take the form of many tiny bumps clustered together

 

Bowel polyps are not usually cancerous although if they’re discovered they’ll need to be removed as some will eventually turn into caner if left untreated.

Barrett’s Oesophagus

 

Barrett’s oesophagus is a condition where the cells of the oesophagus (gullet) grow abnormally. The oesophagus is the muscular tube that connected the mouth to the stomach. Barrett’s oesophagus is not a caner, but can develop into cancer in a very small number of people.

Acid reflux and GORD (gastro-oesophageal reflux disease) are the tow main causes of Barrett’s oesophagus. Acid reflux is when stomach acid splashes back into the oesophagus. Around 1 in 10 people with acid reflux will go on to develop Barrett’s oesophagus.

The most common symptom of Barrett’s oesophagus is ongoing heartburn and indigestion.

Dysphagia

Dysphagia is the medical term for swallowing difficulties.

Some people with dysphagia have problems swallowing certain foods or liquids while others can’t swallow at all.

 

Other signs of dysphagia include:

  • Coughing or chocking when eating or drinking

  • Bringing food back up, sometimes through the nose

  • A sensation that food is stuck in the throat or chest

  • Persistent drooling of saliva

 

Over time, dysphagia can also cause symptoms such as weight loss and repeated chest infections.

Contact Details: 

Rebecca Dixon - 01246 512197

The following graphic represents the nursing procedures that will be encountered in this placement area, according to the Annexe B section of the Future Nurse: Standards of proficiency for registered nurses (2018).

 

Green: Encountered frequently/daily

Amber: Encountered occasionally/rarely

Red: Never encountered

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