Endoscopy

You have been referred for an Endoscopy examination. This guide will tell you about the procedure and help you prepare for the appointment.

What is an Endoscopy?

These tests involve a tube with a light source at the end called an endoscope being inserted into your bowel. Then the doctor can look for evidence of bleeding, swelling, unusual growths or ulcers. It can also be used to look for early signs of cancer in the lower bowel.
We may have to take a small piece of bowel tissue for further investigation (a biopsy). This is done painlessly through the endoscope using tiny forceps.
We can do the test with or without sedation. If you choose to have sedation, this will make you sleepy and relaxed but not unconscious. Sometimes the doctor may proceed with a minor treatment or procedure during the examination. You will be asked for your consent to this at the time of the examination.

Are there any side effects?

Flexible sigmoidoscopy, colonoscopy and biopsies are safe when performed by doctors with appropriate training and experience. Complications are rare, but they can happen.
The main complication of this type of test is damage to the bowel wall, which may result in a tear or bleeding. This is more likely to happen after a polyp (fleshy growth) is removed. If the bowel wall does tear, you may need surgery to repair it.

Before your appointment

If you need help because you speak a different language, or you want a friend, relative or carer to come with you, please let the Patient Referral Centre know so that the hospital staff are ready for you when you arrive for your appointment

Please arrive 15 minutes before your appointment time; if you are late we may not be able to carry out your test. Please do not bring children to your appointment.

Before you have the examination - pre-assessment

You will gave been given an appointment for a pre-assessment at the hospital. A nurse will ask you to complete a questionnaire about your health and medical history and will then explain the procedure to you and discuss in detail any relevant medical history, allergies and your current medication. They will also run through a simple safety checklist to make sure it is safe for you to have the procedure. You will also be able to ask any questions you may have. This will take about 30 minutes to 1 hour.

The preparation for the examination will be explained to you. So that we can get a clearer view of your bowel, we may ask you to take a laxative the day before your examination and follow some dietary instructions. The medication and instructions for taking it will be given to you at the pre-assessment appointment. If you have any queries about the bowel preparation please contact the hospital. You may need to follow some specific instructions from your GP if you are diabetic, are taking anticoagulation treatment or have an artificial heart valve.

You will then be given a date for the endoscopy examination to be carried out. If you are unable to make your appointment for your pre-assessment please contact the Patient Referral Centre as soon as possible on 0844 581 0301.

On the day of the examination

When you arrive, one of our staff will meet you and check your details.
We will ask you to change into a gown. If you have not taken a laxative before the examination, or if the laxative did not work, the nurse will give you an enema. This will help you empty your bowel. If this is necessary, your overall examination time will be longer than usual.

The consultant carrying out the examination will ask you to complete a consent form.
Your procedure may not be carried out immediately as the consultant will have a list of patients to see. The staff will tell you approximately when the test will take place.

The examination

We will ask you to lie on your left side on the examining couch. You will be awake during the examination and should experience nothing more than mild discomfort. The doctor will insert an endoscope into your bowel and slowly guide it along the lower section. The endoscope sends an image to a screen so the doctor can carefully examine the bowel lining. The endoscope also blows out air to enlarge your bowel a little so that the doctor can see the lining more clearly. If anything unusual is identified, like a polyp or inflamed tissue, the doctor can remove a piece of it using instruments inserted into the endoscope.

The doctor will send the piece of tissue (biopsy) for testing. During the procedure, you might feel pressure and slight cramping in your lower stomach area. You will feel better afterwards when the air leaves your body.

How long will it take?

A sigmoidoscopy or colonoscopy takes about 20 minutes.

How soon will I recover?

If you have not had sedation you will be able to get dressed and leave as soon as you feel ready, you will usually be offered something to eat before you leave. If you have had sedation you will need to stay in the unit’s recovery area for about one hour until you are fully awake, and for the next 24 hours you must not drink alcohol, use heavy machinery, drive or sign any legally binding documents.

Following this procedure, someone over the age of 16 must accompany you home. If you do not have anyone to go home with you, your appointment may have to be cancelled. If you have any questions about this, please contact the hospital where you are having your examination before your appointment.

Following your examination

The results of your examination will be discussed with you before you leave the hospital. Your GP or referring clinician will receive a copy of the report, and if a biopsy has been taken the results will be sent to your GP.

It is important to contact your GP if you experience severe stomach pain or bloating, nausea (feeling sick), fever or chills or if you lose more than half a cup of blood from your bowel. You can bleed for up to several days after a biopsy. You should be able to go back to work the day after the test, unless you are told otherwise.

If you haven’t already done so, you will need to make an appointment about 10 days after your examination with your GP or clinician who referred you for the test to discuss the results with them. If you have any queries about the test or to change the date of the examination you need to contact the hospital directly.

Giving your consent for the procedure

The information in this leaflet will give you an idea of what is involved in your sigmoidoscopy or colonoscopy. Before any medical procedure can be performed, the health-care professional carrying out the procedure will let you know what to expect. It is your right to be given all the information you need to make an informed choice about whether you want to go through with the procedure or not. Please feel free to ask any questions.

The nature of the examination means that you must give your consent and you must sign a consent form before the examination.

In addition to giving consent for the test or procedure to be undertaken, either verbal or written, all NHS patients are required to give written consent to data sharing. This is because we have to share patient identifiable information with other organisations in order to report a patient’s scan/test and we have to share the test results with the referring GP or consultant. Occasionally it is necessary to request a further report for a second opinion. We are also obliged to provide a sample of our images and reports to an independent clinician for clinical audit and quality assurance. Any audit reports issued contain no patient identifiable information.

InHealth has a strict policy regarding patient confidentiality which means that we never share information about patients with anyone/organisation that does not need to know about the patient’s clinical condition. InHealth never shares any information about patients with commercial companies or gives personal details to anyone who works outside of our company, its clinical providers and the local NHS. All our clinical providers conform with our confidentiality policy.

If you are not willing to complete the consent process in accordance with our requirements it may not be possible to complete your test or procedure.

Further information

For further information, please contact the Patient Referral Centre - 0844 581 0300 or visit our website at www.inhealthlondon.com

About InHealth (London) Ltd

We are a leading independent health-care provider and we provide X-rays, scans and other tests on behalf of the NHS. We are committed to helping GPs meet their 18-week 'referral-to-treatment' waiting-time targets by providing various tests and scans locally to help GPs make a diagnosis as quickly as possible. GPs are able to refer you directly to us for tests so you won't need to attend a hospital outpatient appointment. We will send your test results to your GP so that they can decide whether you need to see a hospital specialist. For more information, please visit our website www.inhealthlondon.com or contact us as shown below:
Patient Information Line: 0844 581 0300
Email: londoninfo@inhealthgroup.com

How to Complain

If you have a complaint about any part of the service you have received from us, you can do one of the following.
1. Discuss it with the Unit Manager during your visit.
2. Call our Customer Care Team on 0844 581 0300, please select option 1.
3. Write to the Quality Manager, InHealth (London) Ltd, Beechwood Hall, Kingsmead Road, High Wycombe, Bucks, HP11 1JL.
4. Use the NHS complaints procedure on the Department of Health’s website at:
www.dh.gov.uk/PolicyAndGuidance/OrganisationPolicy/ComplaintsPolicy/fs/en.
We welcome your comments about our service. We recognise that the way we monitor and handle complaints reflects the quality of our service and represents an opportunity for us to continuously improve.
When we are handling your complaint, we promise to:
• be accessible – you can contact us to check on the progress of your complaint;
• be impartial – we will treat every complaint fairly;
• be responsive – we will reply to you as soon as we can, and let you know if there will be a delay; and
• respect your confidentiality.
We will attempt to sort out your complaint as soon as possible after receiving it. We will usually acknowledge written complaints within 48 hours of receiving them, and send you a full reply within 20 working days of your complaint. If we cannot sort out your complaint within 20 working days, we will tell you what progress we have made and why there has been a delay.
A complaints handler will deal with your complaint. If you are not satisfied with their reply, you can ask for your complaint to be referred to the Operations Director.
If you have any other questions or you would like a copy of our customer complaints policy, please call our Customer Care Team on 0844 581 0300