The Queen Margaret Hospital unit has two state-of-the-art endoscopy rooms within a newly designed environment with excellent admission, assessment and recovery facilities. The rooms are equipped with the newest endoscopic equipment, computers, software and monitoring facilities.
The unit is staffed by fully trained, Specialist Endoscopists employed by NHS Fife and NHS Lothian, supported by experienced NHS Fife endoscopy nursing and clerical staff.
The procedures which take place within the unit are:
- Colonoscopy
- Gastroscopy
- ERCP or Endoscopic Retrograde Cholangiopancreatography
- Flexible Sigmoidoscopy
Colonoscopy
A Colonoscopy is a procedure that allows the Endoscopist (doctor or nurse) to look into your large bowel. A thin, flexible tube called an endoscope, about the thickness of your thumb, is passed through your back passage and into your bowel. The endoscope is equipped with a light and a camera which is linked to a television monitor.
By performing a Colonoscopy, the cause of your symptoms may be found and sometimes treated at the time of the procedure. Pictures (for your health records) and biopsies may be taken to assist with your diagnosis which are usually pain free.
A Colonoscopy is a safe procedure; however there are some risks that you need to be aware of;
- Small abnormalities may be missed though this is very unlikely.
- Bleeding may occur if you have had biopsies or removal of a polyp during your procedure.
- Heavy bleeding is rare, however this would require further treatment and admission to hospital.
- There is also a possibility that your large bowel may be damaged or perforated during the procedure, although this is extremely rare. If this occurs, you may require further treatment or surgery. In extreme cases this can be life threatening.
Alternative treatments
A CT colonography or barium enema examination are x-ray based tests and are alternative examinations to colonoscopy. However, if abnormalities are observed during these tests, biopsies cannot be taken and a colonoscopy will be required.
Gastroscopy
A gastroscopy is a procedure that allows the Endoscopist (doctor or nurse) to look into your digestive tract. This includes the oesophagus (gullet), stomach, and duodenum (first part of the small bowel). A thin, flexible tube called an endoscope, about the thickness of your little finger, is passed through your mouth, into the oesophagus and down towards the stomach and duodenum. The endoscope is equipped with a light and a camera which is linked to a television monitor.
By performing a Gastroscopy the cause of your symptoms may be found and in some cases can be treated at the time. Pictures (for your health records) and biopsies may be taken to assist with your diagnosis. These are pain free.
A Gastroscopy is a safe procedure; however there are some risks that you need to be aware of;
- Damage can be caused during the procedure to your teeth or bridgework. This is rare as your teeth will be protected with a small mouth guard during the procedure.
- Small abnormalities may be missed although this is very unlikely. There is also a possibility that the oesophagus, stomach or duodenum may be damaged or perforated during the procedure, although this is extremely rare. If this occurs it can lead to bleeding and/or infection which will require further treatment or surgery. In extreme cases this can be life threatening.
Alternative treatments
A barium meal/swallow is an x-ray based test. However it does not provide as much of a detailed view or the opportunity to take biopsies. If you would like to discuss this option, please speak to your GP.
ERCP (Endoscopic Retrograde Cholangiopancreatography)
ERCP is an endoscopy procedure that examines the tubes (ducts) that drain bile from your liver and gallbladder and digestive juices from the pancreas. A thin, flexible tube called an endoscope, about the thickness of your index finger, is passed through your mouth into your stomach and into the first part of your small intestine (duodenum) to find the small opening (called the Ampulla of Vater) where the bile and digestive juices drain into the intestine. A thin tube is then passed through the endoscope and up into the Ampulla so that dye, which can be seen on X-Ray, can be injected. X-rays are then taken. If required, the Endoscopist can do various interventions to relieve your symptoms. The test takes between 20 minutes to an hour but in some cases may be longer.
An ERCP allows your doctor to gain accurate information about the cause of your symptoms. It allows treatment of pain and/or jaundice caused by a blockage in the bile drainage system from gallstones or a narrowing of the ducts.
ERCP is generally safe but complications can sometimes occur. Minor complications can include;
- Mild discomfort in the abdomen and a sore throat, which may last for a few days.
- Loose teeth, crowns and bridgework can be dislodged, but this is rare.
Major complications are rare, these are;
- Pancreatitis is inflammation of the pancreas and can occur in approximately five in 100 people. This usually requires further treatment and admission to hospital. Although it is very rare, severe pancreatitis can be life threatening (less than one in 500 cases).
- Bleeding - If a sphincterotomy (a small cut in the bottom of the bile duct) is performed, there is a risk of bleeding (1 in 100 patients) which usually stops quickly by itself or following treatment. In severe cases, a blood transfusion, special x-ray procedure or an operation may be required to control the bleeding.
- Some patients can develop pneumonia from stomach juices getting into the lung (approximately one in 500 cases).
- A hole (perforation) may be made in the wall of the duodenum. This happens in less than one in 750 cases and will usually require admission to hospital and sometimes surgery. In some cases this can be life threatening.
Alternative treatments
Percutaneous Transhepatic Cholangiography (PTC) is a procedure performed by Radiologists (doctors who specialise in x-ray). A thin needle is inserted through the liver into the bile duct to inject dye to look at the bile ducts. Stents and drains can also be placed.
Surgical exploration - this is where an operation is performed to remove stones from the bile ducts. An endoscopic ultrasound scan can be performed to confirm the presence of stones, but no treatment such as stone removal, sphincterotomy or stent replacement is possible with this intervention.
Before your ERCP you will have a pre-assessment which will be completed a few days prior to the procedure and will take about half an hour. Blood samples will be taken at this appointment and you should bring a list of all current medications.
Flexible Sigmoidoscopy
A flexible sigmoidoscopy is a procedure that allows the endoscopist (doctor or nurse) to look into the first part of your large bowel. A thin, flexible tube called an endoscope, about the thickness of your thumb, is passed through your back passage and into your bowel. The endoscope is equipped with a light and a camera which is linked to a television monitor. By performing a flexible sigmoidoscopy, the cause of your symptoms may be found and sometimes we are able to treat them at the time. Pictures (for your health records) and biopsies may be taken to assist with your diagnosis and are pain free.
A flexible sigmoidoscopy is a safe procedure; however there are some risks that you need to be aware of;
- Small abnormalities may be missed though this is very unlikely.
- Bleeding may occur if you have had biopsies or removal of a polyp during your procedure.
- Heavy bleeding is rare, however this would require further treatment and admission to hospital.
- There is also a possibility that your large bowel may be damaged or perforated during the procedure, although this is extremely rare. If this occurs, you may require further treatment or surgery. In extreme cases this can be life threatening.
Alternative treatments
CT colonography or barium enema examinations are x-ray based tests and are alternative examinations to flexible sigmoidoscopy. However, if abnormalities are observed during these tests, biopsies cannot be taken and a flexible sigmoidoscopy or a full colonoscopy test will be required.
