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Gastroenterology and Hepatology | Auckland | Te Toka Tumai

Public Service, Gastroenterology, Endoscopy (Gastroenterology), Hepatology

Today

8:00 AM to 4:30 PM.

Description

What is Gastroenterology?

Gastroenterology is the branch of medicine that looks at diseases of the oesophagus (gullet), stomach, small and large intestines (bowel), liver, gallbladder and pancreas. 

The oesophagus is the tube that joins your mouth with your stomach. It is a muscular tube that contracts to push the food through when you swallow.

The stomach is where food is broken down by acid and emptied into your intestines. The stomach has special cells lining its wall to protect it from these acids.

The intestines consist of the small intestine (duodenum, jejunum and ileum – different sections of small intestine) and the large intestine (colon).  As food passes through the small intestine, nutrients are broken down and absorbed.  When it passes into the colon, water is absorbed.  The waste that is left is passed as faeces (poo).

The liver is roughly the size of a football and is on your right side just under your ribs. It stores vitamins, sugar and iron which are used by cells in the body for energy. It also clears the body of waste products and drugs, produces substances that are used to help blood clot and aid the immune system, and produces bile which aids in digestion.

 
The pancreas is an elongated organ that lies in the back of the mid-abdomen. It is responsible for producing digestive juices and certain hormones, including insulin, the main hormone responsible for regulating blood sugar.
 
A gastroenterologist is a doctor specialising in the field of medicine which involves these closely related organs.
 
The Department of Gastroenterology and Hepatology at Auckland City Hospital and Greenlane Clinical Centre provides services to the Auckland District Health Board (DHB) catchment area via GP referral and tertiary services via specialist referral from other DHBs.
 
Almost all outpatient clinic appointments are run through the ground floor at Greenlane Clinical Centre with a minority being held at Auckland City Hospital, Level 6, Support Building.
 
Routine outpatient gastroscopy and colonoscopy procedures are carried out through the Endoscopy Suite on Level 2 at Greenlane Clinical Centre. This unit has a waiting room with reception, a small prep area, 1 procedure room and a 9 bed recovery.
 
For information about the Greenlane Clinical Centre location please click here.
 
The Endoscopy Suite at Auckland City Hospital is reserved for acute inpatient work and urgent, or more complicated, outpatient procedures. This unit has a 10 bed recovery and 3 procedure rooms.
 
There is a dedicated team of nurses who work with the doctors over both sites to ensure patients are ready for their procedures. They are available over the phone to answer questions prior to appointments about prepping instructions, informed consent and medication information. 
 
 

Consultants

Referral Expectations

Your GP will refer you to our department if they are concerned that you have problems that require a specialist opinion regarding the diagnosis or treatment of the condition. 
Outpatient clinics are held at Greenlane Clinical Centre. Waiting times for clinics range from 1-6 months depending on urgency, which is assessed from the letter we receive from your GP.
Before coming to our clinic, you may be asked to undergo tests such as blood tests, urine tests or stool/faeces tests (you collect a sample of your urine or bowel motion for analysis).
Clinic appointments last 30 minutes for new patients and 15 minutes for follow up appointments. A history of your symptoms will be taken as well as a review of any medications you are on (please bring these with you).  You will then be examined which may involve, depending on your complaints, a rectal examination.  This involves the insertion of the doctor’s finger or a tube into your bottom to examine the inside.
You may be referred on for some of the following radiology tests, depending on your condition: ultrasound scan, CT scan or MRI.
 
If you have been referred for a routine gastroscopy or colonoscopy at the Greenlane Clinical Centre, you may expect to be between 1 - 3 hours and will need to be picked up from the Endoscopy Suite on discharge.
Where possible, diabetics will be given morning appointments for procedures.
 
For information about the Greenlane Clinical Centre location please click here.

Hours

8:00 AM to 4:30 PM.

Mon – Thu 8:00 AM – 4:30 PM

 All Gastro clinics are run from Reception D and E on the Ground Floor, GCC.  Some clinics are held at ACH, Outpatients Clinic,  Level 6 Support Building.

GCC endoscopy procedures are performed in the Endoscopy Unit located on Level 2, Reception N, GCC.

Auckland City Hospital (ACH) procedures are performed in the Endoscopy Unit located on Level 6, Support Building, ACH.

Procedures / Treatments

Gastroscopy

This is a procedure which allows the doctor to see inside your oesophagus, stomach, and the first part of the small intestine (duodenum) and examine the lining directly. What to expect The gastroscope is a plastic-coated tube about as thick as a ballpoint pen and is flexible. It has a tiny camera attached that sends images to a viewing screen. During the test you will swallow the tube but the back of your throat is sprayed with anaesthetic so you don’t feel this. You will be offered a sedative (medicine that will make you sleepy but is not a general anaesthetic) as well. If the doctor sees any abnormalities they can take a biopsy (a small piece of tissue) to send to the laboratory for testing. This is not a painful procedure and will be performed at the day stay unit in a theatre suite (operating room) by a specialist doctor or nurse with nurses assisting. Auckland hospital is a teaching hospital and as such, some of the procedures may be performed by fully qualified doctors or nurses who are training to become specialists. Complications from this procedure are very rare but can occur. They include: bleeding after a biopsy, if performed an allergic reaction to the sedative or throat spray perforation (tearing) of the stomach with the instrument (this is a serious but extremely rare complication). Before the procedure You will be asked not to eat anything from midnight the night before and not to take any of your medications on the day of the procedure. Information will be sent out to you prior to your appointment. After the procedure You will stay in the day stay unit until the sedation has worn off which usually takes 1-2 hours. You will be given something to eat or drink before you go home. If you have been sedated, you are not to drive until the following day. If biopsies are taken these will be sent for analysis and results are available within 2-3 weeks. A report and copies of these are sent to your GP.

This is a procedure which allows the doctor to see inside your oesophagus, stomach, and the first part of the small intestine (duodenum) and examine the lining directly. 
 
What to expect
The gastroscope is a plastic-coated tube about as thick as a ballpoint pen and is flexible.  It has a tiny camera attached that sends images to a viewing screen.  During the test you will swallow the tube but the back of your throat is sprayed with anaesthetic so you don’t feel this.  You will be offered a sedative (medicine that will make you sleepy but is not a general anaesthetic) as well.  If the doctor sees any abnormalities they can take a biopsy (a small piece of tissue) to send to the laboratory for testing. 
This is not a painful procedure and will be performed at the day stay unit in a theatre suite (operating room) by a specialist doctor or nurse with nurses assisting. Auckland hospital is a teaching hospital and as such, some of the procedures may be performed by fully qualified doctors or nurses who are training to become specialists.
 
Complications from this procedure are very rare but can occur. They include:
  • bleeding after a biopsy, if performed
  • an allergic reaction to the sedative or throat spray
  • perforation (tearing) of the stomach with the instrument (this is a serious but extremely rare complication).
Before the procedure
You will be asked not to eat anything from midnight the night before and not to take any of your medications on the day of the procedure. Information will be sent out to you prior to your appointment.
 
After the procedure
You will stay in the day stay unit until the sedation has worn off which usually takes 1-2 hours.  You will be given something to eat or drink before you go home.  If you have been sedated, you are not to drive until the following day.
 
If biopsies are taken these will be sent for analysis and results are available within 2-3 weeks.  A report and copies of these are sent to your GP.
Endoscopic Retrograde Cholangio Pancreatography (ERCP)

A flexible tube with a tiny video camera attached (endoscope) is inserted through the mouth into the stomach and small intestine while you are under sedation (you have been given medication to make you drowsy). A smaller tube is then moved through the first tube into the bile duct (the tube that connects your gallbladder to your intestines) through which dye is injected and an x-ray is taken to visualise the ducts. This procedure also enables the removal of stones from the ducts without the need for surgery.

A flexible tube with a tiny video camera attached (endoscope) is inserted through the mouth into the stomach and small intestine while you are under sedation (you have been given medication to make you drowsy). A smaller tube is then moved through the first tube into the bile duct (the tube that connects your gallbladder to your intestines) through which dye is injected and an x-ray is taken to visualise the ducts. This procedure also enables the removal of stones from the ducts without the need for surgery.
Colonoscopy

This is a procedure which allows the doctor to see inside your large bowel and examine the surfaces directly and take biopsies (samples of tissue) if needed. Treatment of conditions can also be undertaken. What to expect The colonoscope is a flexible plastic-coated tube a little thicker than a ballpoint pen which has a tiny camera attached that sends images to a viewing screen. You will be given a sedative (medicine that will make you sleepy but is not a general anaesthetic). The tube is passed into the rectum (bottom) and gently moved along the large bowel. The procedure takes from 10 minutes to 1 hour and your oxygen levels and heart rhythm are monitored throughout. The procedure is performed in a day stay operating theatre by a specialist doctor or nurse with nurses assisting. Auckland hospital is a teaching hospital and as such, some of the procedures may be performed by fully qualified doctors or nurses who are training to become specialists. Before the procedure You will need to follow a special diet and take some laxatives (medicine to make you go to the toilet) over the days leading up to the test. More detailed information will be sent out to you prior to your appointment. Risks of a colonoscopy are rare but include: bleeding if a biopsy is performed allergic reaction to the sedative perforation (tearing) of the bowel wall.

This is a procedure which allows the doctor to see inside your large bowel and examine the surfaces directly and take biopsies (samples of tissue) if needed.  Treatment of conditions can also be undertaken.
 
What to expect
The colonoscope is a flexible plastic-coated tube a little thicker than a ballpoint pen which has a tiny camera attached that sends images to a viewing screen. You will be given a sedative (medicine that will make you sleepy but is not a general anaesthetic). The tube is passed into the rectum (bottom) and gently moved along the large bowel.  The procedure takes from 10 minutes to 1 hour and your oxygen levels and heart rhythm are monitored throughout.
The procedure is performed in a day stay operating theatre by a specialist doctor or nurse with nurses assisting. Auckland hospital is a teaching hospital and as such, some of the procedures may be performed by fully qualified doctors or nurses who are training to become specialists.
 
 
Before the procedure
You will need to follow a special diet and take some laxatives (medicine to make you go to the toilet) over the days leading up to the test. More detailed information will be sent out to you prior to your appointment.
 
Risks of a colonoscopy are rare but include:     
  • bleeding if a biopsy is performed          
  • allergic reaction to the sedative
  • perforation (tearing) of the bowel wall.
Cirrhosis

Cirrhosis is the term used to describe a diseased liver that has been badly scarred, usually due to many years of injury. Many people who have developed cirrhosis have no symptoms or have only fatigue, which is very common. However, as the cirrhosis progresses, symptoms often develop as the liver is no longer able to perform its normal functions. Symptoms include: swollen legs and an enlarged abdomen easy bruising and bleeding frequent bacterial infections malnutrition, especially muscle wasting in the temples and upper arms jaundice (a yellow tinge to the skin and eyes). Cirrhosis is diagnosed using a number of tests including: blood tests, ultrasound scans and a biopsy of the liver. Treatment options depend on the severity of damage to the liver and include dietary changes and avoidance of substances such as alcohol that can further damage the liver. Medication may be given to prevent complications and treat symptoms of liver failure. There is no cure other than liver transplantation.

Cirrhosis is the term used to describe a diseased liver that has been badly scarred, usually due to many years of injury. Many people who have developed cirrhosis have no symptoms or have only fatigue, which is very common. However, as the cirrhosis progresses, symptoms often develop as the liver is no longer able to perform its normal functions.
Symptoms include:
  •    swollen legs and an enlarged abdomen
  •    easy bruising and bleeding
  •    frequent bacterial infections
  •    malnutrition, especially muscle wasting in the temples and upper arms
  •    jaundice (a yellow tinge to the skin and eyes). 

Cirrhosis is diagnosed using a number of tests including: blood tests, ultrasound scans and a biopsy of the liver.

Treatment options depend on the severity of damage to the liver and include dietary changes and avoidance of substances such as alcohol that can further damage the liver. Medication may be given to prevent complications and treat symptoms of liver failure. There is no cure other than liver transplantation.

Peptic Ulcers

Peptic ulcers are sores or eroded areas that form in the lining of the digestive tract. They usually occur in the stomach (gastric ulcer) or in the duodenum (duodenal ulcer), which is the first part of the small intestine. People with peptic ulcers can have a wide variety of symptoms and signs, can be completely symptom-free or, much less commonly, can develop potentially life-threatening complications such as bleeding. Signs and symptoms of ulcers include: pain / burning or discomfort (usually in the upper abdomen) bloating an early sense of fullness with eating lack of appetite nausea vomiting bleeding, which is made apparent by blood in the stool, either in noticeable or microscopic amounts (very brisk bleeding will result in black and tarry stools that smell bad). Smoking, alcohol, anti-inflammatory medication and aspirin increase the risk of developing ulcers. Psychological stress and dietary factors (once thought to be the cause of ulcers) do not appear to have a major role in their development. Helicobacter pylori, a bacteria that is frequently found in the stomach is a major cause of stomach ulcers. If this is found you will be given a course of antibiotics. Diagnosis is made by the history, examination and sometimes blood tests. You may be asked to have a gastroscopy (see above) to clarify the diagnosis and aid with treatment. Treatment consists of medication to reduce the amount of acid in the stomach which aids in the healing of ulcers and avoidance of things that cause ulcers in the first place.

Peptic ulcers are sores or eroded areas that form in the lining of the digestive tract. They usually occur in the stomach (gastric ulcer) or in the duodenum (duodenal ulcer), which is the first part of the small intestine.
People with peptic ulcers can have a wide variety of symptoms and signs, can be completely symptom-free or, much less commonly, can develop potentially life-threatening complications such as bleeding. Signs and symptoms of ulcers include:
  • pain / burning or discomfort (usually in the upper abdomen)
  • bloating
  • an early sense of fullness with eating
  • lack of appetite
  • nausea
  • vomiting
  • bleeding, which is made apparent by blood in the stool, either in noticeable or microscopic amounts (very brisk bleeding will result in black and tarry stools that smell bad).
Smoking, alcohol, anti-inflammatory medication and aspirin increase the risk of developing ulcers. Psychological stress and dietary factors (once thought to be the cause of ulcers) do not appear to have a major role in their development.
Helicobacter pylori, a bacteria that is frequently found in the stomach is a major cause of stomach ulcers.  If this is found you will be given a course of antibiotics.
Diagnosis is made by the history, examination and sometimes blood tests.  You may be asked to have a gastroscopy (see above) to clarify the diagnosis and aid with treatment.
Treatment consists of medication to reduce the amount of acid in the stomach which aids in the healing of ulcers and avoidance of things that cause ulcers in the first place.
Inflammatory Bowel Disease (IBD)

There are two types of IBD, ulcerative colitis and Crohn’s disease. In these conditions, the immune system attacks the lining of the gastrointestinal tract causing inflammation and ulceration, bleeding and diarrhoea. In ulcerative colitis this only involves the large intestine, whereas in Crohn’s disease areas within the entire intestine can be involved. Both diseases are chronic (long term) with symptoms coming (relapse) and going (remission) over a number of years. Symptoms depend on what part of the intestine is involved but include: abdominal pain diarrhoea with bleeding tiredness fevers infections around the anus (bottom) weight loss can occur if the condition has been present for some time. Diagnosis is made when the symptoms, examination and blood tests suggest inflammatory bowel disease, infection is ruled out, and you undergo a colonoscopy with biopsy. Treatment depends on the severity of the symptoms and what part of the intestine is affected. Medication is aimed at suppressing the immune system, which is harming the lining of the bowel. This is done via oral or intravenous medication as well as medication given as an enema (via the bottom). Other treatments include changes in the diet to optimise nutrition and health. Treatment in some cases requires surgery to remove affected parts of the bowel. For more information see http://crohnsandcolitis.org.nz/

There are two types of IBD, ulcerative colitis and Crohn’s disease.  In these conditions, the immune system attacks the lining of the gastrointestinal tract causing inflammation and ulceration, bleeding and diarrhoea.  In ulcerative colitis this only involves the large intestine, whereas in Crohn’s disease areas within the entire intestine can be involved.  Both diseases are chronic (long term) with symptoms coming (relapse) and going (remission) over a number of years.
Symptoms depend on what part of the intestine is involved but include:                          
  •  abdominal pain
  •  diarrhoea with bleeding
  •  tiredness
  •  fevers
  •  infections around the anus (bottom) 
  •  weight loss can occur if the condition has been present for some time.
Diagnosis is made when the symptoms, examination and blood tests suggest inflammatory bowel disease, infection is ruled out, and you undergo a colonoscopy with biopsy.
Treatment depends on the severity of the symptoms and what part of the intestine is affected.  Medication is aimed at suppressing the immune system, which is harming the lining of the bowel.  This is done via oral or intravenous medication as well as medication given as an enema (via the bottom).  Other treatments include changes in the diet to optimise nutrition and health.  Treatment in some cases requires surgery to remove affected parts of the bowel.  For more information see http://crohnsandcolitis.org.nz/

Contact Details

Auckland City Hospital

Central Auckland

8:00 AM to 4:30 PM.

Phone: (09) 367 0000

  • Patient enquiries

    (09) 375 4300

  • Known extension/pager

    (09) 307 4949

  • Admission & Planning Unit

    Ext 24210 / 23225 

  • Acute Referrals Service

    (09) 375 7030, Ext: 24048

  • Outpatient appointments & surgical booking enquiries

    (09) 638 0400

Mental Health Services

  • 24 Hour Crisis Line

    0800 800717

  • GP / External Specialist Help Desk

    (09) 307 2800

2 Park Road
Grafton
Auckland 1023

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Street Address

2 Park Road
Grafton
Auckland 1023

Postal Address

Private Bag 92 024
Auckland Mail Centre
Auckland 1142

Greenlane Clinical Centre

Central Auckland

8:00 AM to 4:30 PM.

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This page was last updated at 9:53AM on December 5, 2024. This information is reviewed and edited by Gastroenterology and Hepatology | Auckland | Te Toka Tumai.