Endoscopy / Gastroscopy
An endoscopy test is a relatively safe and quick method of examining the lining of the oesophagus (gullet), stomach and the first, second and sometimes the third part of the small bowel. A thin flexible fibre-optic camera is passed over the back of the throat via the mouth to gain entry to the oesophagus. This is normally done whilst the patient is sedated (requiring and anaesthetist to be present). It can, however, be done whilst the patient is awake using a throat numbing local anaesthetic spray.
After the test, there are few side effects but one may have sore throat for a few hours, but recovery should be fast and one would normally go home a couple of hours after the procedure. If biopsies are taken they may take a few days to get results. If sedation has been used one will need an adult to take them home and keep an eye on them overnight as sedatives can remain in the body for 24 hours. Driving and operation of machinery is not recommended for 24 hours post procedure. Rare side effects of this test include bleeding and perforation (where the lining of the bowel is damaged) this may require hospitilisation and surgical repair.
Colonoscopy
Colonoscopy is a relatively safe method of examining the large bowel or the colon. Succesful colonoscopy depends on the preparation of the colon that occurs from a few days before the test. Reduction in dietary fibre (grains, seeds, fruit and vegetables from 5 days before) and taking the prescribed preparation sachets, encourage the clearance of solid stool. On the day of the test, it is often performed under sedation (requiring the anaesthetist to be present). Once sedated a thin flexible fibre-optic camera is passed into the anus and to the right side of the colon, aiming to visualise the appendix or an area called the terminal ileum (end of the small bowel). This is defined as a successful test.
On the withdrawal of the camera if any abnormalities are seen in the bowel lining these may be biopsied or removed (for example polyps).
After the test, there are few side effects but one may have a windy tummy for a few hours, but recovery should be fast and one would normally go home a couple of hours after the procedure. If biopsies or polyps have been taken they may take a few days to get results. If sedation has been used one will need an adult to take them home and keep an eye on them overnight as sedatives can remain in the body for 24 hours. Driving and operation of machinery is not recommended for 24 hours post procedure. Rare side effects of this test include bleeding and perforation (where the lining of the bowel is damaged) this may require hospitilisation and surgical repair.
Flexible sigmoidoscopy
Much like a colonoscopy test but not as extensive. It is designed to examine the first part of the colon just inside the anus and does not require the week long dietary change or the prescribed preparation. Instead an enema is normally given about 30 minutes before the test.
If sedation has been used one will need an adult to take them home and keep an eye on them overnight as sedatives can remain in the body for 24 hours. Driving and operation of machinery is not recommended for 24 hours post procedure. Rare side effects of this test include bleeding and perforation (where the lining of the bowel is damaged) this may require hospitilisation and surgical repair.
Small bowel capsule endoscopy
This is a very specialised investigation of the small bowel. It requires preparation of the bowel to clear any contents so as to get the best results. The study is performed by attending a clinic visit and the equipment will be attached to you (belt), this will monitor and record the progress of a small capsule (like a vitamin tablet) once swallowed. This information is recorded by the data recorder and the following day you will be invited to re-attend clinic to have this information downloaded.
Fibroscan
Fibroscan is an ultrasound based device that can be used at the bedside. It is used see if patients have scarring in the liver. This is important as scarring can lead to cirrhosis which is irreversible and predisposes to liver cancer. It is painless and takes approxiamatley 30 minutes to complete.
It is to help stratify risk in patients who have abnormal liver function tests, fattly liver disease, HBV, HCV or any other liver disorder.
It may also be used pre-operatively to grade cirrhosis and provide an indication to the surgeon and to the patient of surgical risk.
Attach Fibroscan leaflet pdf (from lauren Rogers at Juno)
Treatments for Hepatitis C
This year from March 2016 new treatments that are interferon free will be available for patients who have Hepatitis C. These treatments look very promising and offer patients excellent outcomes with studies reporting that treatment courses for as little as 12-24 weeks may eliminate the virus, with few side effects and greater than 80% -90% success rates. These may have a significant number of drug interactions so care will be needed in determining this to avoid health problems.
Treatments for Hepatitis B
Current treatments for Hepatitis B are in the form of a tablet taken daily. They are prescribed if certain conditions are met and are not curative. They help to suppress the quantity of virus in the blood and by doing this they reduce the risk of further damage to the liver, rates of liver cancer and other problems associated with Hepatitis B. If tablets are stopped suddenly it can lead to the virus becoming very active and can lead to significant health problems. Currently, these tablets are often prescribed life long.