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Gastroenterology

The Gastrointestinal and Hepatology Department at the Royal Cornwall Hospital looks after patients with stomach and intestinal problems. Our specialist team is renowned for their delivery of high quality, patient­-focused care.

We see patients both as inpatients and outpatients, whether for ongoing management and treatment for a long-term condition, for surgery or simply for screening purposes.

The department is developing an international reputation for its research into hepatitis E and has been consistently praised by the national Joint Advisory Committee for Gastrointestinal Endoscopy for our nurse training.

Bowel Cancer Screening in Cornwall

Bowel cancer is the fourth most common cancer in the UK. If it’s detected at an early stage, before symptoms appear, it’s easier to treat and you are more likely to survive.

All men and women in Cornwall between the ages of 60 and 74 are invited for screening every two years. People over age 74 can also request a screening kit from the programme hub on the freephone number below.

What’s involved in screening?

The testing is carried out at home using a faecal occult blood (FOB) test. If you’re between 60 and 74 and registered with a GP, we’ll send you a home test kit in the post, with full instructions that you can use to collect a tiny stool sample. You then send this back to us in a hygienically sealed freepost envelope.

The test kit is used to detect tiny traces of blood that are invisible to the naked eye and will let you know whether you need to come in for further investigations.

Receiving your test results

You’ll usually get your results within two weeks of returning your sample.

There are three types of results. Most people (98 in 100) will receive a normal result. Sometimes we get an unclear result and we’ll ask you to take the test again.

If you receive an abnormal result it means we may have found blood in your sample. This is not a cancer diagnosis, the abnormal result may have been caused by bleeding from bowel polyps or other conditions such as haemorrhoids (piles). We will invite you in for a colonoscopy so that we can investigate sooner.

You can read more about the faecal occult blood test on the NHS Choices website.

Colonoscopy

If you have an abnormal FOB test result, we’ll offer you an appointment with a specialist screening practitioner to discuss having a colonoscopy. During a colonoscopy, we examine the lining of the bowel wall using a thin flexible tube, called a colonoscope, passed into the rectum (back passage) whilst you’re under sedation. At your appointment we’ll fully explain the procedure to you, take a full medical history and assess your fitness for a colonoscopy. If you decide to go ahead with the colonoscopy, we’ll book you in for an appointment.

A colonoscopy is the most effective way to diagnose bowel cancer and treatments are more likely to be effective if bowel cancer is detected early. A colonoscopy can also remove any polyps we find, and prevent cancer developing in the future.

Find out more about having a colonoscopy on the NHS Choices website.

After your colonoscopy, we will send you a letter with your results, or give you the option to come in for a follow up appointment to discuss your results.

Contacts and further information

Bowel Cancer Screening Programme Hub Freephone

0800 707 60 60

Bowel Cancer Screening department at Royal Cornwall Hospital

01872 252076

For further information on bowel cancer:

Endoscopy Services

We use endoscopy, where we use a long, thin and flexible tube with a light and camera at one end, to investigate, diagnose and treat a full range of gastrointestinal conditions.

We have two specialist endoscopy suites at the Royal Cornwall Hospital and West Cornwall Hospital in Penzance, where we offer a full range of endoscopic procedures, including;

  • Diagnostic and therapeutic gastroscopy
  • Flexible sigmoidoscopy
  • Colonoscopy (with scope guide)
  • Percutaneous endoscopic gastrostomy (PEG)
  • Capsule endoscopy
  • Enteroscopy
  • Endoscopic Ultrasound (EUS)
  • Oesophageal stenting
  • Endoscopic Mucosal Resection (EMR)
  • Argon beam therapy

Our units have the latest Olympus endoscopes and a new endoscopy reporting system that allow us to carry out regular audits of our endoscopy practice against national guidelines and standards.

Endoscopy services are provided by consultant physicians and surgeons, associate specialists, clinical assistants, nurse endoscopists and a consultant radiographer.

Find out more about endoscopy procedures and how you can prepare yourself for it on the NHS Choices website.

Gastroenterology Inpatients

We see a wide variety of emergency patients with problems such as acute upper gastrointestinal haemorrhage, colitis, hepato-biliary disease and decompensated liver disease. These patients are usually admitted through the Medical Admissions Unit and then then transferred to Carnkie ward, our specialist 29-bed gastrointestinal ward.

Find out more:

Gastroenterology Outpatients

We see around 6000 new and 9000 follow-up patients at our outpatient clinics each year.

Our outpatient clinics take place at both Royal Cornwall Hospital and West Cornwall Hospital and at outreach clinics at St Austell, Bodmin, Redruth, Hayle, Helston and the Isles of Scilly.

Most are general gastroenterology clinics but we also hold clinics specifically for:

  • Inflammatory Bowel Disease (IBD)
  • Hepatology.
  • Hepatitis C and alcohol related liver disease (nurse-led and based in Redruth Hospital)

We also run telephone clinics for :

  • Coeliac disease
  • Inflammatory Bowel Disease (IBD)
  • Jaundice hot-line
  • Dysphagia clinic
  • Direct referrals to investigate iron deficiency

Find out more about visiting the Royal Cornwall Hospital as an outpatient.

Inflammatory Bowel Disease

The Gastroenterology department at the Royal Cornwall Hospital cares for more than 2000 patients with Inflammatory Bowel Disease (IBD), the majority of whom are suffering with either Crohn’s disease or ulcerative colitis.

We have eight medical Gastroenterologists and six surgical Gastroenterologists who are specialists in managing IBD. They work primarily at the Royal Cornwall Hospital but also hold weekly clinics in West Cornwall Hospital and a variety of other community hospitals across the county. The team is supported by two IBD specialist nurses as well as specialist radiologists, histopathologist, a pharmacist, stoma care nurses and dieticians.

Being referred to the IBD team

If your GP suspects that you might have IBD, you will be referred to a Gastroenterology clinic via NHS Choose and Book. You will be able to choose who you see and where you are seen. You will be seen by either your named consultant or a registrar (a junior doctor in specialist training) working under the supervision of that consultant.

In the rare event that your GP feels that you are too ill to wait to be seen in the clinic then your GP can liaise directly with one of the team and either arrange a more urgent outpatient appointment or admission to hospital.

Admission to hospital

If you need to be admitted to hospital, you’ll come in either via your GP or A&E. Initially, you’ll be seen in A&E, the Ambulatory Care Unit or in the Medical Admissions Unit. Once you’ve been assessed, you’ll then be transferred to a ward, most likely Carnkie.

Day Unit

Some treatments require a day visit to hospital. Commonly this is for intravenous medications.

Monitoring your IBD

Long term follow up arrangements depend on your personal preference and the severity of your IBD.

We prefer to see you at a clinic if your symptoms are severe or complicated, or if your treatment requires close supervision.

For more stable patients, our two specialist nurses provide annual telephone follow up clinics. We’ll give you a date and time for a short telephone consultation to check on how you’re doing. If during your telephone review, we feel your symptoms warrant further investigation then we’ll arrange a face to face consultation with either the specialist nurse or your consultant.

If your condition deteriorates between your telephone review dates, it is important that you speak to your GP or call our IBD telephone helpline as soon as possible.

The IBD Helpline Service

This is a 24hr answerphone helpline that patients can contact at any time. Simply call 01872 252178 and leave a message. In your message, please tell us clearly your full name, hospital number (if known) or date of birth, along with a contact number and best time to call. One of our IBD nurses will call you back as soon as possible (usually within 2 working days). Please don’t call the helpline if it’s an emergency, contact your GP or call NHS 111, or dial 999/come to the Emergency Department if you think your condition is life threatening.

Additional help and support for patients with IBD

When you are diagnosed with IBD, your consultant will give you an explanation of the specific disease and possible treatments. If you require further information, the IBD nurses are very happy to see you face to face at the Royal Cornwall Hospital in Truro or speak to you on the phone.

The Crohn’s and Colitis UK support group have a wealth of information and are strong supporters of IBD related research. There is also a local Crohn’s and Colitis UK support group. Meetings are held in the Knowledge Spa at the Royal Cornwall Hospital every two to three months. Please ask your IBD nurse for details about the next meeting.

You can also read more about IBD on the NHS Choices website.

Contacts for the IBD team

IBD helpline

01872 252178

IBD email

rch-tr.IBDnurse@nhs.net