Gastroenterology

We provide a specialist service for the treatment of upper GI conditions including:

• Oesophageal (gullet) problems (e.g hiatus hernia)
• Stomach problems
• Duodenal ulcer

Surgical treatments include laparoscopic (key hole) surgery where appropriate.

We are also a dedicated specialist surgical cancer centre for the treatment of upper GI cancer, and provide surgical treatment and specific surgical high dependency nursing for patients who live within the Black Country and Wyre Forest districts. This includes treatment for:

• Cancer of the stomach
• Cancer of the oesophagus

A comprehensive emergency and elective colorectal care service is provided. Investigation and treatment for all common colorectal conditions are offered together with a dedicated rapid access lower GI clinic where flexible sigmoidoscopy is carried out at a first visit.

The following conditions are provided for in the service:

• Emergency bowel conditions (e.g. obstruction, perforation)
• Inflammatory bowel disease (including ileal pouch surgery)
• Diverticular disease
• Bowel cancer
• Haemorrhoids
• Anal fissure
• Anal fistula
• Pilonidal sinus

The Trust has a dedicated full multi-disciplinary team for the management of bowel conditions including gastroenterologists, surgeons, radiotherapists, oncologists, radiologists, pathologists and clinical nurse specialists.

The Trust has a large and well-resourced team managing clinical nutrition needs both for in-patients and for out-patients, which includes referrals from other areas of the Midlands.
Examples of patients treated are:

• Malnutrition due to chronic inflammatory bowel disease
• Intestinal failure due to loss of gut function (e.g after surgery or cancer)
• Examples of treatments offered are:
• Nasogastric Feeding tubes
• Gastric feeding tubes (PEG, percutaneous endoscopic gastrostomy)
• Intravenous feeding (PN, parenteral nutrition)

The Trust treats a range of patients with liver disease such as viral hepatitis, autoimmune hepatitis, primary biliary cirrhosis, and alcoholic liver disease. There are specialist nurses supporting patients with viral hepatitis undergoing treatment (who are offered treatments from the full range of antiviral agents, where appropriate), and for patients with alcohol dependency.

This includes conditions such as:

• Gallstones
• Pancreatitis
• Pancreatic cancer

There is a range of treatments available at the Trust which include endoscopic interventions such as ERCP (which usually involves removal of stones trapped in the bile duct), endoscopic ultrasound (imaging and treatment of bile duct and pancreatic disease) and surgery (keyhole or open). Patients with potentially curable pancreatic cancer are referred to the local regional referral centre at the Queen Elizabeth Hospital.

Central to the investigation and treatment of many patients with gastrointestinal disease, endoscopy involves examination of the digestive tract with flexible video-endoscopes. The Trust has a large, modern and well-equipped unit and carries out over 15 ,000 procedures per year. This includes:

• Advanced endoscopy such as ERCP and EUS (see pancreaticobiliary section above)
• Treatment of early cancers by specialised methods (such as endoscopic submucosal dissection and endoscopic mucosal resection)
• Wireless capsule endoscopy (normally used for examination of the mid-gut or small bowel