Gastroenterology

The Gastroenterology Department treats a variety of conditions related to the digestive system, including:

• Dyspepsia
• Gastro-oesophageal reflux
• Oesophageal dysmotility
• Peptic ulceration
• Pancreatic disease
• Acute and Chronic Liver disease
• Coeliac disease and other small bowel diseases
• Ulcerative colitis
• Crohn’s disease and other inflammatory bowel diseases
• Assessment of change in bowel habit
• Iron deficiency anaemia
• Weight loss

Sub-speciality clinics and services

In addition to general gastroenterology services, the department offers specialized clinics for:

• Iron Deficiency Anaemia
• Inflammatory Bowel Disease
• Hepatology, including:
  • Decompensated Liver Disease
  • Haemochromatosis
  • Tertiary In-Reach Clinic (QE-UHB)
• Nutrition Support
• Upper GI Symptom Clinic (Dyspepsia, Dysphagia, Barrett’s Oesophagus)

Urgent Suspected CAncer Referral - appointment and diagnosis within 24 days

The Urgent Suspected Cancer(USC) Referral pathway is a referral pathway for patients with signs and symptoms of suspected cancer. The USC pathway aims to provide patients with a diagnosis or ruling out of cancer within 28 days of referral. Your GP should let you know if you have been referred to us under this pathway.  

Patients will be contacted by the hospital on receipt of their referral and invited for an appointment. If you have not received an appointment from Wye Valley NHS Trust within one week of the GP referral please contact your GP.

National guidance no longer indicates for patients to have their first appointment within two weeks, so your first appointment may be more than two weeks after your referral from your GP.  However, as part of the 28-day Faster Diagnosis Standard patients should have their first appointment, relevant tests and diagnosis within 28 days from their GP referral.  This standard is in place to improve cancer care by reducing the time between referral and diagnosis.

Dedicated helplines

The department provides dedicated helplines for patients under its care, including:

• Inflammatory Bowel Disease
• Hepatology

Referral process

All Gastroenterology and Hepatology referrals undergo consultant triage to ensure:

• Optimal pre-clinic tests are performed
• The most appropriate clinic and healthcare professional is assigned to the case

GP advice and guidance service

A consultant-delivered GP advice and guidance service is available to respond to Primary Care enquiries within two working days.

Diagnostic and therapeutic tests

The department provides various diagnostic and therapeutic tests, including:

1. Endoscopy:

   • Upper GI Endoscopy (including Transnasal Endoscopy)
   • Lower GI Endoscopy
   • ERCP (Endoscopic Retrograde Cholangiopancreatography)
   • Endoscopic Ultrasound
   • Capsule Endoscopy (Small Bowel and Colon)

2. GI Physiology:

   • High Resolution Oesophageal Manometry
   • 24-Hour pH Monitoring
   • Hydrogen Breath Tests

3. Radiology:

   • Barium GI Studies
   • CT Enterogram
   • CT Colonography (Virtual Colonoscopy)
   • MRI (MRCP and Enterogram)
   • Ultrasound Guided Liver Biopsy
   • SeHCAT Scans
   • Other nuclear medicine investigations

4. Other:

   • Fibroscan

Department structure

The Gastroenterology Department is supported by a team of Medical Secretaries and Clerks.

The clinic staff includes:

• 5 Consultant Gastroenterologists and 1 Hepatologist
• 3 Gastroenterology Specialist Registrars
• 1 Advanced Nurse Practitioner and Lead Nurse
• 3 Clinical Nurse Specialists in IBD (Inflammatory Bowel Disease) and 1 Gastroenterology Pharmacist
• 1 Clinical Nurse Specialist in IDA (Iron Deficiency Anaemia) / Coeliac Disease
• 1 Nurse Consultant and 2 Clinical Nurse Specialists in Hepatology
• 1 Nurse Endoscopist
• 1 Clinical Nurse Specialist in Nutrition Support
• 1 Clinical Nurse Specialist in Alcohol Liaison
• 2 Upper GI Cancer Nurses (Macmillan)
• Inpatient Ward-based Team, including:
  • 1 Physician Associate
  • 1 Clinical Fellow
  • 3 IMT/FY Junior Doctors

Links with other departments

The department maintains close internal links with:

• Endoscopy
• Upper and Lower GI Surgery
• Dietetics
• Histopathology
• Radiology Departments

Additionally, there are important multi-disciplinary external links with:

• Gloucester Hospitals NHS Foundation Trust (for Upper GI Cancer)
• University Hospitals Birmingham – Queen Elizabeth (for complex Hepatology and HPB Cancer)

Patient leaflet

Upper Gastrointestinal (Upper GI) Urgent Suspected Cancer (USC) Referral leaflet

Useful Links

British Society of Gastroenterology

Coeliac UK

Haemochromatosis Society UK

Crohns and Colitis UK