Treatments provided by Laurence Lovat

Bowel cancer or "CRC", includes cancerous growths in the colon, rectum and appendix. With 655,000 deaths worldwide per year, it is the fourth most common form of cancer in the United States and the third leading cause of cancer-related death in the Western world. Colorectal cancers arise from adenomatous polyps in the colon. These mushroom-shaped growths are usually benign, but some develop into cancer over time. Localized colon cancer is usually diagnosed through colonoscopy.

Sigmoidoscopy is an examination of the lower intestine, including your rectum, using a flexible tube containing a camera or scope. It is a way of detecting colorectal cancer prolapse and diagnosing other bowel problems. The procedure usually takes around 15 minutes and can be done as an outpatient procedure.

Colorectal cancer (aka colon cancer); Many strains of colon cancers start as colon polyps which develop into their cancerous forms within a decade of appearing in the colon . As a result, many doctors advocate colon cancer screening and colon polyp removal for at-risk patients. The process of removing colon polyps is fairly straightforward. A colonoscopy or sigmoidoscopy tube with a wire loop is used to cauterize the polyp and its base completely. Larger polyps that cannot be removed using the flexible colonoscopy tube are typically removed via laparoscopy while the patient is under general anesthesia

Colonoscopy is a diagnostic procedure which enables a doctor, usually a gastroenterologist, to examine the appearance of the inside of the colon or large bowel. The doctor inserts a flexible tube into the anus, and then, into the rectum and through to the colon. The doctor controls the colonoscope by looking through the scope or by using a camera image projected onto a screen.

A consultation with a consultant is the main opportunity for the specialist or doctor to explore a patient's health complaints and concerns in order to identify any underlying reasons for their ill health.

An upper gastrointestinal endoscopy uses a long endoscope to see the lining of the upper GI tract. This is used to identify the cause of many symptoms, from persistent heartburn to unexplained weight loss. There are a wide range of diseases that may be diagnosed by an Upper GI Endoscopy.

Eosinophilic Oesophagitis is an inflammatory condition of the wall of the oesophagus. The most common cause of Oesophagitis is acid reflux, which most frequently results in heartburn. Acid reflux can also cause ulcers in the inner lining of the Oesophagus. Eosinophils, or white blood cells, causing the inflammation are prominent in other diseases too, such as allergies and asthma, hay fever, allergic rhinitis, and atopic dermatitis. The diagnosis is confirmed by biopsy of the Oesophagus or via an endoscopy. First line of treatment of Eosinophilic Oesophagitis is with proton pump inhibitors and swallowed fluticasone propionate. Gentle oesophageal dilatation can also be used when medications fail to relieve dysphagia (Difficulty swallowing). More often allergies are the cause of this inflammatory disease and these can be tested for by blood and food patch tests. The main management of this condition is with an elimination diet closely monitored by an allergist/immunologist, as well as different medical treatments such as corticosteroids or proton pump inhibitors.

The symptoms of irritable bowel syndrome (IBS) can often be managed with diet and lifestyle changes alone, and it is important to understand the nature of the condition. Changing your diet will play an important part in controlling your symptoms. However, everyone reacts differently to different foods. It is helpful to keep a diary of your food intake and your reaction to it in order to avoid those that may trigger your symptoms. It is important to learn the difference between soluble and insoluble fibre foods and avoid the latter. Often patients are advised to study the FODMAP diet. Sometimes the condition is managed with medication, such as antispasmodics or even anti-mobility medicines, depending on your particular type of IBS. In some cases psychological treatments are also helpful.

Oesophageal motility disorder is a term used to cover any medical disorder causing difficulty in swallowing, regurgitation of food and a spasm-type pain which can be brought on by an allergic reaction to certain foods. The term encompasses conditions such as: 1. Achalasia, which is a condition in which the muscles of the lower part of the oesophagus fail to relax, preventing food from passing into the stomach. One of three diagnostic procedures can be used to diagnose the problem, e.g. Barium Swallow, Endoscopy and a Manometry (a tube passed through the mouth or nose, which measures the pressure in your gullet at different points. There are four methods of treatment; the first being medication to relax the gullet, the second being dilation (a balloon is passed down the gullet to dilate and stretch the muscle fibres of the gullet under general anaesthetic); the third being a Botulinum toxin (Botox injection), which can be injected relatively easily via an endoscopy, but may give only temporary relief. The final procedure is laparoscopic surgery, where the gullet sphincter is accessed through the stomach and the damaged muscle fibres are divided. This procedure usually involves only a one night stay in hospital. 2. Jackhammer oesophagus is another oesophageal motility disorder.It is characterised by oesophageal spasms that involve all or most of the muscles of the oesophagus. The spasms can be very intense and tend to last for a long time. Symptoms also overlap those with those of Achalasia. There is still uncertainty about the cause, but the condition often affects people with psychiatric disorders. The first line of treatment therefore are tricyclic antidepressants, but medications used for the treatment of Achalasia also apply for this disorder. For those patients who do not respond to medication, a surgical technique called Per Oral Endoscopic Myotomy (POEM) may be used, otherwise a standard myotomy (surgical procedure to cut esophageal muscle) may need to be performed.

An oesophageal stent is a flexible mesh tube that is placed through the constricted area of your oesophagus (food tube) to allow food and beverages to pass from your mouth to your stomach for digestion and absorption of nutrients. Constrictions of the oesophagus are often caused by a tumour or radiotherapy treatment. The stent is inserted down the oesophagus and through the blockage, where it expands to open up the passage. The stent may only need to stay in a short time or, depending on the reason it may need to stay in permanently. If a biodegradable stent is used, this will usually dissolve in approximately 3-4 months.

Gastroscopy is an examination of the upper digestive tract (the oesophagus, stomach and duodenum) using an endoscope — a long, thin, flexible tube containing a camera and a light — to view the lining of these organs.

Radiofrequency ablation (RFA) is a medical procedure in which part of the electrical conduction system of the heart, tumour or other dysfunctional tissue is ablated using the heat generated from high frequency alternating current (in the range of 350–500 kHz). There are different types of RF ablations used for different conditions, one of which is called the HALO System, which is used via an endoscopy to treat conditions such as Barrett's Oesophagus (abnormal lining of the oesophagus).