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Frequently Asked Questions & Glossary

Frequently asked questions relating to consultations with a specialist and other common questions.

How do I get referred?

If you think you are suffering with a problem of the bowel (gut, intestines), colon, rectal or anal area and wish to be seen by a one of our specialist Consultants, it is prudent to discuss this first with your general practitioner. He will forward a referral letter letting us know about any relevant past medical history and also any medication that you may be on. However, we are happy to see you without a GP referral, but most insurance companies require one before reimbursing you for fees incurred.

How long will I have to wait?

We aim to see all referrals within a week and often, if it is urgent, patients can be seen within 48 hours.

How long will an appointment last?

New patients are scheduled at 30 minute intervals and follow up appointments last 15 minutes. Experience has shown that this is the optimal time to enable a history and examination to be taken and for treatment options to be discussed. Obviously individual cases vary and consultations can be longer or shorter depending upon the complexity of the symptoms.

What will happen at my consultation?

Your specialist will take a detailed history asking you questions about your symptoms and about any other relevant medical facts. He will then examine you, before discussing a potential diagnosis and the need for any diagnostic tests or treatment. By the time you leave the consultation you will have a clear understanding of the pathway along which you will travel to reach a diagnosis and, hopefully, resolution of your symptoms.

What if I need surgery?

Consultant surgeons at North Birmingham Colon Care have operating sessions most weeks at Spire Hospital, Little Aston. A mutually convenient time will be discussed with you. Prior to your admission date for surgery you will be asked to attend for a pre-operative assessment. This will be performed by a nurse, who will take any relevant blood tests, arrange heart tracings and any other work up that is needed for your surgery.

What is the OPCS code that my insurance company have asked me to obtain?

Every operation/procedure has an OPCS code. Your surgeon will tell you what this code is. If you hold medical insurance it is important that this code is passed on to your insurers to ensure that you are covered for that procedure. Occasionally your treatment may consist of more than one OPCS code.

What form of anaesthetic will I need?

This will be discussed with your surgeon at the time of your consultation. Depending upon the procedure options for anaesthesia vary from local anaesthetic to regional anaesthetic (such as spinal anaesthesia). The anaesthetist will discuss the various forms of anaesthesia available for your treatment prior to surgery.

Who will do my operation?

Your operation or procedure will be performed by the specialist who sees you. Occasionally, for more complex procedures, he will be joined by a colleague.

Who will look after me following my procedure/operation?

You will be nursed on the ward and your surgeon will visit you on a daily basis to ensure that you are making good progress and recovering from your treatment. Private hospitals always have a doctor on site should there be an untoward event that requires emergency action. Your surgeon will always be available and contactable by the nurses via telephone, while you are in hospital. Occasionally, he may ask one of his colleagues from North Birmingham Colon Care to cover him. This will be discussed with you.

What happens if things go wrong?

Occasionally surgery can result in adverse consequences. If you feel that you have suffered an adverse consequence please do not hesitate to raise it with your surgeon. Alternatively the matter can be discussed with Matron in charge of the hospital. All doctors working with North Birmingham Colon Care are fully indemnified for any potential complications or adverse events.

Glossary

Anal abscess

Perianal abscesses are collections of pus that occur around the anus. These are extremely common. They can be very painful. Anal abscess' rarely respond to antibiotics and require incision and drainage of the pus under general anaesthetic.

Anal cancer

Anal cancer is a rare skin cancer that affects the anus. Most anal cancers can be treated without the need for radical surgery.

Anal fissure

This is a split in the lining of the anus, which results in intense pain on defecation and bright red rectal bleeding.

Anal sphincter

This is the muscle around your bottom, which ensures that you remain continent of faeces.

Anterior resection

A major surgical operation to remove the rectum, usually performed for rectal cancer.

Anus

This is part of your bottom from where faeces emerge.

Barium Enema

An x-ray investigation whereby, having cleared the bowel out with a strong laxative, barium is squirted through the anus, around the bowel and x-rays are taken. This test is very useful for diagnosing structural diseases of the large bowel.

Botulinum Toxin

This is a very powerful drug, which relaxes muscles. As well as being used for cosmetic purposes, it is also used to relax the anal sphincter for patients who have anal fissures.

Bowel

The human body has a large bowel and a small bowel. The small bowel starts at the stomach and finishes near the appendix. At this point the bowel becomes known as the large bowel, which includes the colon, rectum and anus.

Bowel cancer / colorectal cancer

Bowel cancer affects about 1 in 30 patients. If it is caught early it can be treated and cured by surgery.

Colectomy

This is an operation where part of the large bowel (colon) is removed.

Colitis

An inflammation of the large bowel characterised by diarrhoea and the passing of dark blood. There are many causes of colitis; most of them can be treated by medication and only rarely is surgery indicated.

Colonoscopy

This is a very sensitive test for looking at the lining of the large bowel. Prior to the test the bowel needs to be purged by a strong laxative and then a camera is passed from the anus through the whole of the large bowel to where it joins the small bowel. This test can be uncomfortable and is usually performed with a degree of sedation.

Colostomy / Ileostomy

This is a surgical operation whereby a piece of large or small bowel is brought onto the tummy wall. Faeces pass through the abdominal (tummy) wall where it is collected into a bag (pouch). Unlike the passing of faeces through your anus there is no control over its loss.

Crohn's Disease

This is a form of colitis, which can affect the whole of the bowel from mouth to anus. It can usually be controlled by medication but occasionally surgery is necessary, if the inflammation becomes very severe.

CT Scan

This is a highly sophisticated type of x ray that provides a three-dimension reconstruction of your internal organs.

CT Colonography

This is a specialised type of CT, which enables diseases of the large bowel to be identified. It requires bowel preparation but is less invasive than a barium enema or a colonoscopy.

Diarrhoea

This is the loss of loose/liquid stool on a frequent basis; often every few hours. It can be accompanied by colicky abdominal pain.

Diverticular disease / diverticulitis

This affects the large bowel, most often the sigmoid colon. Characterised by “pockets” in the wall of the bowel, which can give a variety of symptoms such as pain, diarrhoea and constipation. It is common as one gets older and rarely requires surgery.

Faecal Incontinence

This is the uncontrollable loss of wind or solid stool from the back passage.

Flexible Sigmoidoscopy

This is a telescope test that inspects the left hand side of your bowel. Bowel preparation is required to clear faeces prior to the test. The telescope is flexible and requires the surgeon to blow some air into the back passage to enable good views of the lining of the bowel.

Haemorrhoids

Also known as piles. These are fleshy skin cushions around the anus, which are responsible for anal soreness, bright red rectal bleeding and mucus discharge.

Mucus

This is a clear, jelly like substance that is often lost from the anus. It is associated with large haemorrhoids and/or constipation.

Perianal haematoma

This is a small blood clot, which occurs under the skin near the anal verge. It is often associated with haemorrhoids and constipation. It can be extremely painful and may require surgical drainage.

Polyps

These are benign growths of the large bowel, which are extremely common. We believe that about 1 in 10 polyps, greater than 1cm, if left long enough within the bowel, will turn into cancer.

Proctitis

This is inflammation of the rectum and can be due to many causes. It often responds to the use of suppositories.

Proctoscopy

This is a procedure where a 6cm tube is inserted into your anus to allow inspection of your anal canal. It is used for diagnosing anal problems such as fissures or haemorrhoids.

Pruritus Ani

This simply means “itchy bottom”, the causes for itchy bottom are many.

Rectal Prolapse

This is a condition whereby the rectum protrudes outside the anus, especially when opening one’s bowels.

Rigid Sigmoidoscopy

This is a test, often performed at the initial out-patient consultation. It involves the passing of a long tube through the back passage to allow the doctor to look at the lining of your rectum. A small amount of air is blown in at the time to allow the rectum to distend.

Rubber band ligation

This is a simple out patient treatment for second degree haemorrhoids. Occasionally, it can cause discomfort around the back passage. This normally disappears within 48 hours. It can result in some bright red rectal bleeding when the bands drop off at about 2-3 days after the procedure.

TEM

Transanal Endoscopic Microsurgery is a technique to remove polyps and small rectal cancers by local excision.
This avoids the need for a radical excision (anterior resection) and possibly the need for a stoma.

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