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Gastroenterology

The Gastroenterology service provides for diagnosis and management of all gastroenterological conditions including; Hepatology, Inflammatory Bowel Disease (IBD) and functional GI (gastrointestinal) disorders.

Patients with functional gut disorders, such as Irritable Bowel Syndrome (IBS), are supported by a Clinical Nurse Specialist in IBS, together with a Specialist Dietitian and Clinical Psychology services.

Inflammatory Bowel Disease (IBD)

The IBD Service is a nurse-led service, supported by the Consultant Physicians, for advice, support and management of patients with IBD and those receiving immuno-modulating therapy. Nurse-led clinics in IBD include; a telephone helpline, immunosuppressant monitoring and evaluation, and education health promotion and psycho-social support. They are available both for follow-up of stable patients and rapid access to patients with a 'flare'. Monthly joint clinics are held for patients with complex IBD with a Consultant Surgeon and Physician, and facilities for restorative Proctocolectomy (pouch) surgery are available locally and supported by a Pouch Nurse Specialist.

Endoscopy

Endoscopy - a full range of diagnostic and therapeutic endoscopy service is available, including ERCP (Endoscopic Retrograde Cholangio-Pancreatography) and is accessed either by direct referral to Consultant Physicians, Consultant Surgeons or via the open access endoscopy scheme. Endoscopy is undertaken in a dedicated three room endoscopy suite at York Hospital and ERCP in the vascular imaging unit. The Endoscopy Unit is recognised by JAG (Joint Advisory Group on Gastrointestinal Endoscopy) for training purposes and participates in the global rating score (GRS).

Imaging

Imaging facilities include, access to MRI and MRCP (magnetic resonance cholangio- pancreatography­), ERCP, ultrasound guided biopsy, CT colonography (virtual colonoscopy), small bowel imaging, radiologically guided biopsy and stent placement. Weekly meetings are held between Surgeons, Radiologists and Physicians.

Palliative stenting

Palliative stenting for both oesophageal and rectal carcinomas is available in York and currently separate MDTs exist for upper GI cancer patients, pancreatico biliary cancer and colorectal cancer. These are supported by Clinical Nurse Specialists.

Coeliac Disease

Patients with Coeliac Disease are jointly managed by Consultant Gastroenterologists and Dietitians, with a scheduled programme of annual review.

Liver services

Liver services are provided by Consultant Physicians and supported by an inpatient Substance Abuse Clinical Nurse Specialist for patients with alcoholic liver disease. The Gastroenterologists work closely with their colleagues on the Liver Unit in Leeds for patients requiring transplantation. A full range of diagnostic services for patients with Liver disease including biopsy (inpatient and outpatient) and imaging, including MRI (magnetic resonance imaging), is available at York. Patients requiring antiviral treatment for Hepatitis B and C are referred to the Regional Unit in Leeds at present, when treatment is initiated.

Useful Websites

British Society of Gastroenterology www.bsg.org.uk

CORE (Formerly known as The Digestive Disorders Foundation) http://www.corecharity.org.uk

National Association for Colitis and Crohn's Disease www.nacc.org.uk

Inflammatory Bowel Disease Support Club http://www.ibdsupport.org

IA (the Ileostomy and Internal Pouch Support Group) www.iasupport.org

Information on York's lleostomy and Internal Pouch group

http://york.iasupport.org Tel 0800 0184724 or 02893344043.

British Liver Trust Foundation www.britishlivertrust.org.uk

Royal College of Nurses www.rcn.org.uk/

Coeliac UK www.coeliac.org.uk

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