Intus Specialist Health Care

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 with nurses assisting.

Complications from this procedure are very rare but can occur. They include:

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.

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 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. 

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.

Risks of a colonoscopy are rare but include:      

A long, narrow tube with a tiny camera attached (sigmoidoscope) is inserted into your anus and moved through your lower large intestine (bowel). This allows the surgeon a view of the lining of the lower large intestine (sigmoid colon). If necessary, a biopsy (small piece of tissue) may be taken for examination in the laboratory.

There are two types of IBD, ulcerative colitis and Crohn’s disease.  In these conditions, the immune system attacks the lining of the colon 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:                         

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. 

Haemorrhoids are a condition where the veins under the lining of the anus are congested and enlarged. Less severe haemorrhoids can be managed with simple treatments such as injection or banding which can be performed in the clinic while larger ones will require surgery.

Haemorrhoid Removal

Haemorrhoidectomy: each haemorrhoid or pile is tied off and then cut away.

Stapled Haemorrhoidectomy: a circular stapling device is used to pull the haemorrhoid tissue back into its normal position.

This is cancer that begins in your colon or rectum. Often, it may start as a polyp which is a growth of abnormal tissue on the lining of the colon or rectum.

Most people will not have symptoms of colorectal cancer until the disease is at a fairly advanced stage. Then they may experience symptoms such as:

Tests used to confirm a diagnosis of colorectal cancer include:

Stool blood tests, sigmoidoscopy, colonoscopy and barium enemas are also used as screening tests to look for colorectal cancer in people without symptoms. If these tests find cancers at an early stage, the chances of successful treatment are much higher than when the cancers are further advanced. Screening tests can also involve the removal of polyps that may become cancerous in the future.

Treatment

The choice of treatment depends on your overall health as well as how far advanced the cancer is. This is determined in a process known as ‘staging’ in which the tumour size, lymph node involvement and spread to other organs is assessed.

The three main forms of treatment for colorectal cancer are:

Surgery – the most common treatment. Surgery may involve ‘Open Surgery’ in which a large incision (cut) is made in your abdomen or ‘Laparoscopic Surgery’ in which several much smaller incisions are made. The section of the colon or rectum with the cancer is removed and the two ends are reconnected. In some cases, a temporary or permanent colostomy may be required to remove body wastes.

Chemotherapy – anticancer medicines, either taken by mouth (oral) or injected into a vein (intravenous), can destroy cancer cells and slow tumour growth. Chemotherapy is useful to treat cancers that have spread to other parts of the body and may also be used before or after surgery or in combination with radiation therapy.

Radiation Therapy – high energy x-rays are used to destroy cancer cells or shrink tumours. It is often used together with surgery, in some cases to shrink the tumour before surgery, or to destroy any cells that may be left behind after surgery.

Sometimes, some of the watery fluid (bile) stored in the gallbladder hardens into pieces of stone-like material known as gallstones. Gallstones may vary from the size of a grain of sand to a golf ball and there may be one or hundreds of stones.

Gallstones can cause abdominal pain, fever and vomiting if they block the movement of bile into or out of the gallbladder.

Laparoscopic Cholecystectomy is the surgical removal of the gallbladder. A laparoscope is inserted into the abdominal cavity at the level of the tummy button. Surgical instruments are inserted through other incisions and the gallbladder removed.

GEOD is caused by the backflow (reflux) of food and stomach acid into the oesophagus (the tube that connects the mouth to the stomach) from the stomach. This happens when the valve between the stomach and the lower end of the oesophagus is not working properly. The main symptom of GORD is heartburn (a burning feeling in the stomach and chest).

Laparoscopic Nissen Fundiplication is a surgical procedure for GORD that involves wrapping the top part of the stomach (fundus) around the lower end of the oesophagus. The valve between the stomach and the oesophagus is also replaced or repaired.

A hernia exists where part of the abdominal wall is weakened and the contents of the abdomen push through to the outside.

An inguinal hernia forms when part of the intestine pushes through the abdominal wall, causing a bulge in the groin.

A hiatus hernia is caused by part of the stomach and lower oesophagus bulging through the diaphragm (a sheet of muscle between the chest and the stomach) into the chest. A hiatus hernia can cause a burning feeling in the upper abdomen and chest (heartburn).

Laparoscopic Hernia Repair involves using surgical instruments to push the hernia back into its original position and repairing the weakness in the abdominal wall (or diaphragm in the case of a hiatus hernia).

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 are passed from person to person through body fluids.  For more information about Hepatitis B and C see https://www.hepatitisfoundation.org.nz/

Alcohol can affect the liver and cause inflammation which, if long term, can damage the liver permanently.

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:

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

If the uterus (womb) or bladder slips out of position, this is referred to as a prolapse. It is caused when the supporting muscles become weak, allowing a part of the uterus or bladder to bulge into the vagina. The most common reason that these muscles become weak is childbirth, and a uterine prolapse or bladder prolapse (also called cystocoele) is more common in women who have had a lot of babies. Symptoms include pain, heaviness in the vaginal area and a frequent need to pass urine. In mild cases, exercises may help improve the symptoms, but women with more severe prolapses may need to have surgery.

This is when a patient’s kidneys are unable to remove wastes and excess fluid from the blood. Kidney failure is divided into two general categories, acute and chronic.  

Acute kidney failure occurs suddenly and may be the result of injury, loss of large amounts of blood, drugs or poisons. Kidneys may return to normal function if they are not too badly damaged.

Chronic renal failure means kidney function has slowly worsened over a number of years and often the kidneys do not get better. When chronic renal failure has progressed to end stage renal disease (ESRD), it is considered irreversible or unable to be cured.

Renal replacement therapy

Renal replacement therapy is a treatment that removes wastes and excess fluid from the blood when patients’ kidneys are not able to do it on their own. It comes in a number of forms, both continuous and intermittent, involving filtration and dialysis.  In acute renal failure, the dialysis may only be needed for a few days or weeks while the kidneys recover. In some cases long-term dialysis and or a kidney transplant may be needed.

This term refers to stones in the urinary system. They form in the kidneys but can be found anywhere in the urinary system. They vary in size and the amount of pain they cause. Many of these stones can pass though without help but some require medical intervention. 

Extracorporeal shockwave lithotripsy (ESWL) is the most frequently used procedure for the treatment of kidney stones. In ESWL, shock waves that are created outside the body travel through the skin and body tissues until they hit the denser stones. The stones break down into very small particles and are easily passed through the urinary tract in the urine.