The ability to directly visualise upper and lower ends of the digestive tract with minimal invasion adds value to diagnosis and treatment. The endoscopy unit at the Wellington Hospital is accredited by the Joint Advisory Group for GI Endoscopy. To attain accreditation, the service must provide high quality care, specialist training for all staff and agree to be monitored on an ongoing basis.
Patients can be assured of a welcoming environment, private space with ensuite facilities and a quick follow up appointment.
Endoscopist experience. Both unit and individual endoscopist performance is audited regularly. Professor Bloom is an accredited bowel cancer screening colonoscopist, has carried out over 8000 endoscopies and has an exceptional success rate. Your endoscopy or colonoscopy will be carried out after consultation about wishes regarding sedation; procedures can be carried out with no sedation, minimal sedation, or deep sedation.
Upper GI Endoscopy
Endoscopy is a general term involving a camera examination of the upper or lower part of your digestive system.
Upper gastrointestinal (GI) endoscopy looks at the oesophagus, stomach and duodenum. A high quality digital image is shown on a screen and images are routinely recorded, a copy of the images is available for patients. Tissue samples can be taken at the same time, for laboratory analysis.
Preparation for endoscopy is quite straightforward. You will need to avoid solid foods for 6 hours and liquids for about 2 hours, advice will be available on whether you should temporarily stop any medication.
Sedation involves local anaesthetic spray to numb the throat. If required, intravenous medication is given which reduces anxiety, as well as providing sedation and amnesia for the procedure. Endoscopy is not a painful procedure and normally only lasts 15 to 30 minutes. After recovery for about an hour patients go home – accompanied if sedation has been given.
If you decide to have a sedative, please ensure someone is available to take you home, then rest for a few hours. Complications from upper GI endoscopy are extremely rare.
Lower GI Endoscopy: Flexible Sigmoidoscopy & Colonoscopy
Endoscopy of the lower gastrointestinal tract can be either flexible sigmoidoscopy, or colonoscopy. A flexible sigmoidoscopy is usually done with minimal preparation (an enema given in the department just before the procedure) and no sedation. It is a very safe procedure, enabling a specialist to examine the rectum and lower colon.
Colonoscopy uses the same instrument but involves a more complete examination of the whole of the large bowel (colon) as well as the last part of the small bowel. This involves preparation at home, with a laxative the day before the procedure.
Diagnostic colonoscopy involves a risk of about 1 on 1000 of damaging the bowel; bleeding can also result if any procedure such as polyp removal is carried out.
Professor Bloom will again advise on any changes needed in taking medication and discuss whether you wish to use sedation, which is quite common for colonoscopy.
Wireless capsule endoscopy involves swallowing a disposable camera the size of a pill. This capsule contains a light, a camera, a transmitter and a battery which lasts about 7 hours – long enough to allow imaging of the whole of the small intestine.
As computing power has increased, so has the ability to have a virtual colonoscopy, where CT scans are used to build a 3D internal model of your body. This is a notable advance for patients unable or unwilling to have regular colonoscopy, although biopsy or polyp removal are not possible with virtual colonoscopy.
The same would apply to both newer methods and using a standard approach may be best for you, or your diagnosis. Every suitable option will be discussed with you and carried out with care.