What to expect from your colorectal appointment

Your first appointment in the clinic will be 30 minutes long. During your appointment the consultant will ask you a number of questions. This will include history of your current problem. For example how long it has been going on, what the symptoms are and when you believe it started. The consultant will also ask you about your past medical history and any current medication you are taking. He will also ask if there is any history of bowel problems in your family.

The consultant will then ask your permission to examine you. This may include

  • Abdominal examination – the consultant will feel around your stomach for any tender spots or lumps.
  • Digital rectal examination - the consultant will look at your anus to see if there are any obvious abnormalities, he will then use a finger to feel for any lumps or sore areas in and around the anus.
  • Rigid sigmoidoscopy - it allows your doctor to look inside your rectum (back passage) and lower part of your bowel using a narrow, tube-like telescopic camera called a sigmoidoscope
  • Proctoscopy -is used to examine the anal cavity, rectum or sigmoid colon. A proctoscope is a short, straight, rigid, hollow metal tube, and usually has a small light bulb mounted at the end, allowing an unobstructed view of the interior of the rectal cavity. This procedure is normally done to inspect for haemorrhoids or rectal polyps
  • Injections - if the consultant feels it necessary and with your permission he will inject haemorrhoids for treatment, this is a minimally invasive procedure and you may feel uncomfortable for a day.

All our consultations are held in the presence of a clinic assistant/chaperone

What happens next?

Depending on the consultants diagnosis a number of different routes can be taken:

Prescription – The consultant may give you a prescription of creams or tablets to help with your bowel problem. If you are prescribed treatment at one of your CSC clinics and have run out, repeat prescriptions can be obtained through your GP. The doctor you saw will dictate a letter to your GP after your appointment, which will provide details your treatment/management plan, including any medications you may be started on.

Endoscopy appointment - the consultant may feel that he needs a more comprehensive look at your bowels and refer you on for one of the following procedures :

  • Flexible sigmoidoscopy - it allows your doctor to look inside your rectum (back passage) and lower part of your bowel using a narrow, flexible tube-like telescopic camera called a sigmoidoscope
  • Colonoscopy - is similar to, but not the same as, sigmoidoscopy—the difference being related to which parts of the colon each can examine. A colonoscopy allows an examination of the entire colon (measuring four to five feet in length).
  • Gastroscopy - is a procedure that shows the upper part of the gastrointestinal tract up to the first section of the small intestine. This investigation is through the mouth rather than rectally.

Hospital Procedure – the consultant may decide to refer you for a day case operation at a local hospital. This will involve an examination under anaesthetic (EUA) and treatment of your condition.

Radiology – the consultant may decide to send you for an ultrasound or CT colonography to examine the abdomen and bowels.

Once you have received your appointment at the hospital we ask you to contact our admin team to book a follow-up appointment at the clinic. This is to have a look at your results as well as go over further treatment options and advice for the future.

Common colorectal problems

Anal Fissure - a crack or tear in the skin of the anal canal. Anal fissures may be noticed by bright red anal bleeding on the toilet paper, sometimes in the toilet. These can cause pain when going to the toilet.

Haemorrhoids - Haemorrhoids are painful, swollen veins in the lower portion of the rectum or anus.

Irritable bowel syndrome (IBS) - is a common gut disorder. The cause is not known. Symptoms can be quite variable and include abdominal pain, bloating, and sometimes bouts of diarrhoea and/or constipation. Symptoms tend to come and go. There is no cure for IBS, but symptoms can often be eased with treatment.

Constipation - bowel movements that are infrequent and/or hard to pass. Constipation is a common cause of painful defecation. There are a number of causes of constipation, and treatment can range from dietary changes to medication

All our clinics are consultant led and we aim to see patients within 4-6 weeks.

At CSC we see all patients suffering with any benign colorectal condition including:

  • PR bleeding with or without symptoms
  • Haemorrhoidal diseases
  • Anal pain & itching
  • Chronic Constipation
  • Anal Fissure
  • Anal/faecal Incontinence
  • Rectal prolapse

Services offered include:

  • proctoscopy
  • rigid sigmodoscopy
  • haemorrhoid injections
  • banding
  • GI Physiology
  • Tibial Nerve Stimulation for faecal incontinence

Patients not suitable for referral:

  • all patients meeting the criteria for a lower GI cancer target referral
  • patients under the age of 18

Referring to CSC

All our clinics are directly bookable through the NHS e-referral system.

Clinicians can also use this form to refer to our colorectal clinics:

CSC_Colorectal Referral Form

TNS (Tibial Nerve Stimulation)

for faecal incontinence & over-active bladder

TNS works by inducing gentle electrical impulses using a nerve in the lower leg (the tibial nerve)

This treatment fills the gap between conservative therapies (medication, pelvic floor exercises) and surgery.

A course of treatment includes an initial assessment by Mr P Giordano followed by 12 sessions of  treatment and a final assessment.

This service is offered at Ching Way site only.

If you believe you may benefit from this treatment please ask your GP to refer you to our Colorectal Clinic.


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