Medical clinics are currently located in the main outpatient area just beyond the main hospital entrance to the right. Reception staff will check you in, outpatient nurses will then weigh you and do observations such as blood pressure. There may then be another wait in the waiting room until the Gastroenterology doctor is able to see you. Clinical Nurse Specialist clinics are located in the OPRS (Older Persons Rehabilitation Services) clinic rooms which are on the right just before the hospital canteen. Reception staff will check you in and the nurse specialist will do any observations necessary alongside the appointment.

Within theatres there is a suite dedicated to endoscopic procedures which are camera tests looking into the gut. These are the best way to see what is going on inside the gut so help with diagnosing a condition and, in some cases, doing certain interventions. You will receive detailed instructions before any procedure. There are also specialised nurses in the unit able to support you throughout. There is also a unit in Taupo Hospital where the doctors do endoscopic procedures on a regular visiting basis.

Some patients may need intravenous (into the vein) medication to manage their condition; particularly those with Inflammatory Bowel Disease. The infusions unit (also called the ‘chemo suite’) run a nurse led service and are experienced at managing these treatments safely.

Sometimes people with gastroenterology problems will need to be admitted into hospital. Usually they will be looked after on the medical ward but, at times, surgical input might be required. We aim to work with a multidisciplinary approach so when individual cases need input from other specialists there will be joint care. That team might include colorectal surgeons, dietitians, specialist stoma therapy nurses and more.

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. During the test the tube is passed through your throat down into your stomach and the start of your small intestine. The back of your throat is sprayed with anaesthetic to make this comfortable. 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 tiny 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 with nurses assisting. 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 usually 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. More detailed instructions will be sent to you beforehand. 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 able to drive yourself until the following day so please make sure there is someone with you. The team can give you a copy of the report the doctor has written on the day of the procedure. However, 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.

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.

This is a procedure which allows the doctor to see inside your large bowel and examine the surfaces directly to take biopsies (tiny 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. 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. Before the procedure You will need to follow a special diet and take some medicine to make you go to the toilet and clear out your bowels (laxatives) over the days leading up to the test. Detailed instructions will be sent to you at the time. 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 special type of ultrasound to measure any damage in your liver. Just like an ultrasound it involves jelly on your tummy and a probe that is moved around over the area of your liver. You will feel a regular thud – a bit like someone tapping your skin with their finger. The specialist doing the fibroscan will usually be able to tell you at the time whether there is much scarring or damage in your liver. There is no special preparation or aftercare instructions needed for a fibroscan.

This is inflammation of the liver, commonly caused by viruses. Hepatitis B and C are viruses that can cause chronic (long term) inflammation and damage to the liver. These viruses live in blood and can be passed from person to person. For more information about Hepatitis B and C see https://www.hepatitisfoundation.org.nz/ Sometimes other things can also cause inflammation of the liver such as alcohol, drugs, or even too much fatty tissue. If not managed properly the liver can become permanently damaged so it is important to attend any appointments with the specialist helping with these.

Cirrhosis is the term used to describe a diseased liver that has been badly scarred, usually due to many years of damage. Many people who have developed cirrhosis have no symptoms or have only mild symptoms such as tiredness; which is very common. However, as the cirrhosis progresses, more serious symptoms can 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. Depending on the cause of the cirrhosis and the severity of damage, treatments may include dietary changes, avoidance of substances such as alcohol, or anti-viral medication if there is a virus present. Medication may also be given to prevent complications and treat symptoms of liver failure.

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 might be seen as blood in the stool, either in noticeable or microscopic amounts. Sometimes this will show as black and tarry stools that smell bad. Smoking, alcohol, anti-inflammatory medication (such as ibuprofen or diclofenac) and aspirin increase the risk of developing ulcers. Helicobacter pylori is a bacterium that is frequently found in the stomach and is a major cause of stomach ulcers. If this is found when you have a gastroscopy you will be given a course of antibiotics.

There are two types of IBD; ulcerative colitis and Crohn’s disease. It is not well understood what causes these conditions but part of the problem is that the immune system becomes over-active in the gut, damaging the gut lining. This damage causes inflammation which often leads to ulceration, bleeding and diarrhoea. In ulcerative colitis this only involves the large intestine, whereas in Crohn’s disease any area within the entire intestine could 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 and on how the disease is behaving at a particular time but might include: abdominal pain diarrhoea with, or without, bleeding weight loss tiredness fevers infections around the anus (bottom) Diagnosis is made by combining information from the symptoms, examination, blood tests and other investigations such as a colonoscopy with biopsies and/or radiological tests. Treatment depends on the severity of the symptoms and what part of the intestine is affected. Most medication is aimed at suppressing the immune system, because it is the immune system that is driving the inflammation damaging the gut. Medication could be oral (by mouth), by injection or by enema or suppository (via the bottom) depending on the individual situation. Treatment in some cases requires surgery to remove affected parts of the bowel. There are some important lifestyle considerations such as stopping smoking, if the diagnosis is Crohn's, or making some adjustments to diet in certain situations. For more information see www.crohnsandcolitis.org.nz