Colonoscopy is the examination of your colon (large bowel) using a colonoscope (long, flexible tube with a camera on the end). The colonoscope is passed into your rectum (bottom) and then moved slowly along the entire colon, while images from the camera are displayed on a television monitor. The procedure takes from 10 minutes to an hour. Sometimes a small tissue sample (biopsy) will need to be taken during the procedure for later examination at a laboratory. A colonoscopy may help diagnose conditions such as polyps (small growths of tissue projecting into the bowel), tumours, ulcerative colitis (inflammation of the colon) and diverticulitis (inflammation of sacs that form on the walls of the colon). Colonoscopy may also be used to remove polyps in the colon. Risks of a colonoscopy are rare but include: bleeding if a biopsy is performed; allergic reaction to the sedative; perforation (tearing) of the bowel wall. What to expect It is important that the bowel is completely empty before the procedure takes place. This means that you will only be able to have liquids on the day before, and will probably have to take some oral laxative medication (to make you go to the toilet more). When you are ready for the procedure, you will be given medication (a sedative) to make you go into a light sleep. This will be given by an injection into a vein in your arm or hand. The colonoscopy will usually take 15 – 30 minutes, but you will probably sleep for another 30 minutes. Because you have been sedated (given medication to make you sleep) it is important that you arrange for someone else to drive you home. Some patients may experience discomfort after the procedure, due to air remaining in the colon.

Gastroscopy allows examination of the upper part of your digestive tract i.e. oesophagus (food pipe), stomach and duodenum (top section of the small intestine), by passing a gastroscope (long, flexible tube with a camera on the end) through your mouth and down your digestive tract. Images from the camera are displayed on a television monitor. Sometimes a small tissue sample (biopsy) will need to be taken during the procedure for later examination at a laboratory. Gastroscopy may be used to diagnose peptic ulcers, tumours, gastritis etc. Complications from this procedure are very rare but can occur. They include: bleeding if a biopsy is performed; allergic reaction to the sedative or throat spray; perforation (tearing) of the stomach with the instrument (this is a serious but extremely rare complication). What to expect All endoscopic procedures are viewed as a surgical procedure and generally the same preparation will apply. You will not be able to eat or drink anything for 6 hours before your gastroscopy. When you are ready for the procedure, the back of your throat will be sprayed with anaesthetic. You will also be offered medication (a sedative) to make you go into a light sleep. This will be given by an injection into a vein in your arm or hand. The gastroscopy will take approximately 15 minutes, but you will probably sleep for another 30 minutes. You will spend some time in a recovery unit (probably 1-2 hours) to sleep off the sedative and to allow staff to monitor you (take blood pressure readings etc). Because you have been sedated (given medication to make you sleep) it is important that you arrange for someone else to drive you home. If biopsies are taken for examination, your GP will be sent the results within 2-3 weeks.

A long, narrow tube with a tiny camera attached (sigmoidoscope) is inserted into your anus and moved through your lower large intestine (bowel). This allows the surgeon a view of the lining of the lower large intestine (sigmoid colon). If necessary, a biopsy (small piece of tissue) may be taken for examination in the laboratory

This is cancer that begins in your colon or rectum. Often, it may start as a polyp which is a growth of abnormal tissue on the lining of the colon or rectum. Most people will not have symptoms of colorectal cancer until the disease is at a fairly advanced stage. Then they may experience symptoms such as: change in bowel habit that lasts for more than a few days blood in the stool stomach pain. Tests used to confirm a diagnosis of colorectal cancer include: stool blood test – a sample of stool is tested for traces of blood sigmoidoscopy colonoscopy barium enema – a chalky white substance (barium) and air are pumped into the colon and x-rays are taken biopsy – a small piece of tissue is removed for examination under a microscope Stool blood tests, sigmoidoscopy, colonoscopy and barium enemas are also used as screening tests to look for colorectal cancer in people without symptoms. If these tests find cancers at an early stage, the chances of successful treatment are much higher than when the cancers are further advanced. Screening tests can also involve the removal of polyps that may become cancerous in the future. Treatment The choice of treatment depends on your overall health as well as how far advanced the cancer is. This is determined in a process known as ‘staging’ in which the tumour size, lymph node involvement and spread to other organs is assessed. The three main forms of treatment for colorectal cancer are: Surgery – the most common treatment. Surgery may involve ‘Open Surgery’ in which a large incision (cut) is made in your abdomen or ‘Laparoscopic Surgery’ in which several much smaller incisions are made. The section of the colon or rectum with the cancer is removed and the two ends are reconnected. In some cases, a temporary or permanent colostomy may be required to remove body wastes. Chemotherapy – anticancer medicines, either taken by mouth (oral) or injected into a vein (intravenous), can destroy cancer cells and slow tumour growth. Chemotherapy is useful to treat cancers that have spread to other parts of the body and may also be used before or after surgery or in combination with radiation therapy. Radiation Therapy – high energy x-rays are used to destroy cancer cells or shrink tumours. It is often used together with surgery, in some cases to shrink the tumour before surgery, or to destroy any cells that may be left behind after surgery.

There are two types of IBD, ulcerative colitis and Crohn’s disease. In these conditions, the immune system attacks the lining of the colon causing inflammation and ulceration, bleeding and diarrhoea. In ulcerative colitis this only involves the large intestine, whereas in Crohn’s disease areas within the entire intestine can be involved. Both diseases are chronic (long term) with symptoms coming (relapse) and going (remission) over a number of years. Symptoms depend on what part of the intestine is involved but include: abdominal pain diarrhoea with bleeding tiredness fevers infections around the anus (bottom) weight loss can occur if the condition has been present for some time.Treatment depends on the severity of the symptoms and what part of the intestine is affected. Medication is aimed at suppressing the immune system, which is harming the lining of the bowel. This is done via oral or intravenous medication as well as medication given as an enema (via the bottom). Other treatments include changes in the diet to optimise nutrition and health. Treatment in some cases requires surgery to remove affected parts of the bowel. For more information see http://crohnsandcolitis.org.nz/ Diagnosis is made when the symptoms, examination and blood tests suggest inflammatory bowel disease, infection is ruled out, and you undergo a colonoscopy with biopsy.

Haemorrhoids are a condition where the veins under the lining of the anus are congested and enlarged. Less severe haemorrhoids can be managed with simple treatments such as injection or banding which can be performed in the clinic while larger ones will require surgery. Haemorrhoid Removal Haemorrhoidectomy: each haemorrhoid or pile is tied off and then cut away. Stapled Haemorrhoidectomy: a circular stapling device is used to pull the haemorrhoid tissue back into its normal position.

GORD is caused by the backflow (reflux) of food and stomach acid into the oesophagus (the tube that connects the mouth to the stomach) from the stomach. This happens when the valve between the stomach and the lower end of the oesophagus is not working properly. The main symptom of GORD is heartburn (a burning feeling in the stomach and chest).

Sometimes, some of the watery fluid (bile) stored in the gallbladder hardens into pieces of stone-like material known as gallstones. Gallstones may vary from the size of a grain of sand to a golf ball and there may be one or hundreds of stones. Gallstones can cause abdominal pain, fever and vomiting if they block the movement of bile into or out of the gallbladder.

Your GP will refer you us if they are concerned that you have problems that require a specialist opinion regarding the diagnosis or treatment of the condition. Before coming to our clinic, you may be asked to undergo tests such as blood tests, urine tests or stool/faeces tests (you collect a sample of your urine or poo for analysis). During your appointment a history of your symptoms will be taken as well as a review of any medications you are on (please bring these with you). You will then be examined which mayinvolve, depending on your complaints, a rectal examination. This involves the insertion of the doctor’s finger or a tube into your bottom to examine the inside.

Regular bowel screening can help find bowel cancer at an early stage, before it spreads. Colonoscopy is the gold standard way to check the bowel and can also be used to remove any pre-cancerous polyp lesions that may be found to prevent you developing bowel cancer in the future.

The Bravo™ pH Monitoring System is used to measure gastroesophageal pH and monitor gastric reflux. A small capsule is temporarily attached to the wall of the oesophagus. The capsule measures pH levels in the oesophagus and transmits readings to a receiver worn on your belt or waistband.

A non-invasive way to view the gastrointestinal tract by the patient swallowing a small capsule with a video attached.

Helicobacter pylori, a bacteria that is frequently found in the stomach is a major cause of stomach ulcers. If this is found you will be given a course of antibiotics.

Manometry is a diagnostic test used to measure the pressure and function of muscles, usually in the gastrointestinal (GI) tract. It evaluates the muscle contractions and the coordination of these muscles in areas such as the oesophagus, stomach, and rectum. The test is commonly used to diagnose conditions related to abnormal muscle function in these regions, such as: Oesophageal manometry: Evaluates the function of the oesophagus and the lower oesophageal sphincter (LES) to diagnose disorders like achalasia, gastroesophageal reflux disease (GERD), and oesophageal motility disorders. Anorectal manometry: Assesses the function of the rectum and anal sphincter, often used to diagnose conditions like chronic constipation or fecal incontinence.

Breath testing is a non-invasive diagnostic method used to detect various conditions related to digestion and metabolism by analysing the composition of exhaled breath. It is commonly used in gastrointestinal disorders and can provide information about bacterial activity, malabsorption, and enzyme deficiencies. Key types of breath tests include: Hydrogen Breath Test (HBT): Purpose: Diagnoses conditions like small intestinal bacterial overgrowth (SIBO), lactose intolerance, and fructose malabsorption. Method: After consuming a sugar solution (like lactose, glucose, or fructose), the amount of hydrogen and methane in the breath is measured. Elevated levels indicate malabsorption or bacterial fermentation. Urea Breath Test: Purpose: Used to detect Helicobacter pylori infection, which can cause ulcers and gastritis. Method: The patient ingests a urea solution labelled with carbon isotopes. If H. pylori is present, the bacteria break down the urea, releasing carbon dioxide that can be detected in the breath. Methane Breath Test: Purpose: Sometimes used alongside hydrogen breath testing to detect methane-producing bacteria in the gut, often linked to constipation-predominant irritable bowel syndrome (IBS-C). Method: Similar to hydrogen breath tests, methane levels are measured after consuming a sugar solution. Carbon-13 (C13) Breath Test: Purpose: Assesses fat malabsorption or gastric emptying. Method: The patient ingests a substrate (often a fat or carbohydrate) labelled with C13. The breakdown of this substrate is monitored through exhaled C13-labeled carbon dioxide. Breath tests are widely used because they are simple, non-invasive, and effective in diagnosing many GI conditions.