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Please select a service below for more information

Open Access Endoscopy
At GastroNorth we aim to work closely with your Primary Health Care provider.

We are pleased to offer a high quality open access Gastroscopy, Colonoscopy and Capsule Endoscopy service.

At GastroNorth you are not necessarily required to see a gastroenterologist for an appointment before your gastroscopy or colonoscopy. Some people are suitable to be referred directly for a procedure (open access endoscopy) after discussion with your treating doctor. People with significant medical concerns, severe constipation, diabetes, taking blood thinning medications should discuss the procedure with our staff before booking.

Please contact GastroNorth if you have any enquires regarding our open access endoscopy service.
Colonoscopy
COLONOSCOPY INFORMATION
A colonoscopy is a procedure that enables your doctor to examine the lining of the colon (large bowel). Under sedation, a flexible tube is gently passed via the rectum (back passage) into the colon. A tissue sample (biopsy) may be taken, or polyps (growths) removed and sent to the pathologist. Colonoscopy is the best test to assess for bowel polyps or cancers, although no test is 100% accurate.

The procedure usually takes approximately 30 minutes, and most patients will not remember the procedure at all.

What Bowel Preparation is required?
For the procedure to be accurate, the colon must be completely clean. This is achieved using a “BOWEL PREPARATION KIT” (see next page for further instructions), which causes mild-moderate diarrhoea. This is available at the GastroNorth main rooms or at your local pharmacy without a prescription for a small fee.

What do I need to bring?
You will need to bring your doctor’s referral if available, health fund card and medicare card. You will need to change into a patient gown for the procedure, and so please bring loose fitting clothing that can be easily removed and folded. Any jewellery and valuables should be left at home.

What happens afterwards?
You may be drowsy for several hours following the colonoscopy due to the sedation administered. A friend or family member needs to drive you home your procedure may be cancelled if this has not been organized. You must not drive or operate any machinery for 24 hours afterwards. You can continue taking all of your prescription medications as directed.

Please contact your doctor if you experience any severe abdominal pain, heavy bleeding, fevers/chills, breathing difficulty, or any other symptoms you are concerned about. Alternatively, contact the closest emergency department e.g. The Northern Hospital (9405 8000), The Austin Hospital (9496 5000).

Is Colonoscopy safe?
Colonoscopy is a safe and well tolerated procedure, although it is recommended that you seek advice prior to the procedure if you have significant heart, lung or kidney problems. It is normal to feel temporary bloating following the procedure due to inflation of the bowel during the procedure.

Occasionally there may be nausea or light headedness following the anaesthetic.

Serious complications are rare, but may include:
- Perforation (a hole in the bowel wall) which may require surgery – this is uncommon, 1:3000 cases
- Aspiration (inhaling of stomach contents into the lung whilst sedated) which may require antibiotic treatment or hospitalization if severe;
- Bleeding if a polyp is removed – this may occur up to 2 weeks following the procedure and rarely requires hospitalization or further procedures to stop the bleeding
- Death is extremely rare, although this is a possible consequence of any medical procedure.

If you wish to discuss the details of all possible rare complications, you should inform your doctor and/or anaesthetist prior to the procedure.

IF YOU DO NOT UNDERSTAND ANY OF THE ABOVE INFORMATION, OR HAVE FURTHER QUESTIONS OR CONCERNS, PLEASE CONTACT GASTRONORTH 9473 8865.

I have read and understood the above information regarding Colonoscopy. I understand the reason for my doctor to recommend that I undergo a Colonoscopy and understand the risks associated with this procedure as outlined above. I have been given an opportunity to discuss any concerns or queries.

COLONOSCOPY INSTRUCTIONS

Bowel Prep 1 - picolax/picoprep

Click Here to download instructions for: Bowel Prep 1 - picolax/picoprep. (pdf)


Bowel Prep 2 - Prep Kit C

Click Here to download instructions for: Bowel Prep 2 - Prep Kit C. (pdf)


Bowel Prep 3 - Double Prep

Click Here to download instructions for: Bowel Prep 3 - Double Prep. (pdf)


IF YOU DO NOT UNDERSTAND ANY OF THE ABOVE INFORMATION, OR HAVE FURTHER QUESTIONS OR CONCERNS, PLEASE CONTACT GASTRONORTH ON 9473 8865.
Gastroscopy
GASTROSCOPY INFORMATION

A gastroscopy is a procedure that enables your doctor to examine the lining of the oesophagus (food pipe/gullet), stomach, and duodenum (first part of the small intestine). Under sedation a thin flexible tube is passed through your mouth into your stomach and duodenum. During the procedure, a tissue sample (biopsy) may be taken and sent to the pathologist. The procedure takes approximately 15 minutes.

Is Gastroscopy safe?
Gastroscopy is a very safe and well tolerated procedure. It is common to feel temporary mild bloating afterwards due to inflation of the stomach. Occasionally there may be nausea or lightheadedness following the anaesthetic.

Serious complications are very rare, but may include:
- Perforation (a hole in the bowel wall) which may require surgery
- Aspiration (inhaling of stomach contents into the lung whilst sedated) which may require antibiotic treatment or hospitalization if severe;
- Teeth Damage – whilst a protective mouthguard is used, damage may uncommonly occur
- Death is extremely rare, although this is a possible consequence of any medical procedure.

If you wish to discuss the details of all possible rare complications, you should inform your doctor and/or anaesthetist prior to the procedure.

What Preparation is required?
For the procedure to be accurate and good views obtained your stomach must be empty. You should have nothing to eat or drink for six hours prior to the procedure. If you have significant heart, lung or problems, you should seek advice prior to the gastroscopy. You can usually take all of your regular medication with a sip of water. If you take warfarin/coumadin, clopidogrel (Plavix/Iscover), Pradaxa, or Insulin please seek advice at least 10 days prior to the gastroscopy. Oral diabetes medications should be withheld on the morning of the procedure.

What do I need to bring?
Please bring your doctor’s referral letter if available, health fund details and medicare card. You may need to change into a patient gown, and so please wear loose fitting clothing that can be easily removed and folded. Any jewellery and valuables should be left at home.

What happens afterwards?
You may have minor throat discomfort for a few hours which may be helped by a warm drink. You may feel temporarily bloated afterwards due to the air that was introduced to examine the stomach.

You will be drowsy afterwards due to the anaesthetic. A friend or family member must drive you home, your procedure may be cancelled if this has not been organized. You must not drive or operate any machinery for 24 hours afterwards. Continue taking all of your usual medications as directed.

You should contact your doctor immediately if you experience any severe abdominal pain, vomiting blood, difficulty breathing, fevers/chills, or any other symptoms you are concerned about. Alternatively, contact the closest emergency department e.g. The Northern Hospital (9405 8000), The Austin Hospital (9496 5000)

IF YOU DO NOT UNDERSTAND ANY OF THE ABOVE INFORMATION, OR HAVE FURTHER QUESTIONS OR CONCERNS, PLEASE CONTACT GASTRONORTH 9473 8865.
Capsule Endoscopy
What is Capsule Endoscopy?

Capsule endoscopy is a new technology which painlessly examines the small intestine/bowel. It is often used in patients with unexplained iron deficiency (cause not found with gastroscopy or colonoscopy) to determine if there is any bleeding in the small intestine.

The test involves swallowing a capsule (about the size a large vitamin pill) that takes multiple digital images of the small intestine. The small intestine is about 6 metres long, and the capsule can take about 8 hours to travel through it. During this time, images are transmitted to a data recorder which is placed around your waist. The capsule does not need to be retrieved as it is passed (usually unnoticed) into your stools.

Capsule Endoscopy is a day procedure. No sedation or anaesthetic is required. You will need to observe some dietary restriction the day prior, and also to take some bowel preparation (see instructions below).

You will need to attend the GastroNorth rooms in the morning for about half an hour (8am-8.30am) where the data recorder is attached, and you will be given the capsule to swallow. You may then leave the rooms and return late afternoon (4.00 – 4.30 pm) to return the attached equipment. Subsequently, the recorded digital images are downloaded to a computer and examined by the doctor the following day.

Are there any risks?
There is a small risk that the capsule could become stuck in the small bowel. This is uncommon. The estimated risk is less than 1 in 200. Surgery may be required to remove a retained (stuck) capsule. An x-ray may be requested after the test if the capsule is not seen to enter the large bowel on the recorded images. On rare occasions technical problems or capsule retention in the stomach may mean a repeat procedure needs to be performed.

How much will it cost?
No out of pocket fees apply. However, it is a Medicare requirement that you have had a gastroscopy and colonoscopy in the 6 months before the Capsule Endoscopy to receive the government funding.

Results
Your Gastroenterologist will contact you by phone within 3 days of the test. Please contact GastroNorth on 9473-8865 if contact has not made.

Instructions for Capsule Endoscopy
You will need to obtain one sachet of Glycoprep-C from GastroNorth or your pharmacist. A prescription is not required.

ON THE DAY BEFORE THE EXAMINATION
You should consume only approved clear fluids after 12.00 midday. Approved clear fluids include: Water, Clear fruit juices (e.g. Apple), lemonade, cordial or jelly, clear broth/soup permitted. AVOID red or purple coloured liquids.

AT 7.00PM - Mix the sachet of Glycoprep-C in one litre of water and stir until dissolved. Drink half the volume (approximately two glasses) of the mixture slowly over 30 minutes. This should be followed by a glass of water. Have at least 1 glass of water per hour until 10.00pm. The Glycoprep-C may cause loose bowel actions. The remaining mixture can be discarded.

IMPORTANT: You will need to fast from midnight. Have nothing to eat or drink after midnight. Take any regular morning medications at 6am with water. If you take diabetic medications please discuss this with your doctor BEFORE undertaking this process.

ON THE DAY OF THE EXAMINATION
Remain fasting. You will be required to attend at 8.15am.

PLEASE NOTE: You will be allowed to leave the hospital after swallowing the capsule (about 8.30am). You should have a glass of water hourly for 4 hours, and then may have a light meal. You will need to return to the hospital at 4 pm for the equipment to be removed.
ERCP
What is an ERCP?
Endoscopic retrograde cholangiopancreatography, or ERCP, is technique performed with a special endoscope designed to treat conditions affecting the drainage tubes of the liver (bile ducts) and pancreas (pancreatic duct).

The endoscope is passed via the mouth, through the stomach to the opening of the ducts in the first part of the small intestine. These ducts are then accessed allowing contrast to be injected for x-ray imaging and therapy to be performed.

Reasons to perform an ERCP include the removal of stones from the bile duct, to biopsy abnormalities of the ducts or to provide therapy for a narrowing or compression (stricture) of the ducts from a variety of conditions. Sometimes this therapy includes the insertion of a plastic or metal stent (drainage tube) or dilation of the narrowing with a special balloon.

Sometimes a small cut in the muscular opening of the duct (a sphincterotomy) is performed in order to aid the removal of stones or the insertion of a stent.

What preparation is required?
An empty stomach is required for a safe examination. This means no food or drink for 6 hours before the procedure. Regular medications may be taken with a sip of water. Medications that thin the blood may need to be discontinued before ERCP and should be discussed with your doctor 1-2 weeks prior. If you have diabetes then special instructions will be need to be given to you in order to manage your blood sugar around the time of the procedure. As x-rays are used in the procedure you must advise the doctor if you could be pregnant.

What can I expect during ERCP?
Your doctor will first discuss the procedure with you including the benefits and risks and address any questions you may have. You will also meet the anaesthetist who will discuss the anaesthetic. ERCP is often performed with an intravenous sedation and most people remember little to none of the procedure.

Following this you will be taken to the procedure room. You'll then lie on your stomach or left side. Once you are asleep, your doctor will commence the procedure, which usually takes around 30-60 minutes.

What are the benefits of ERCP?
ERCP is a minimally invasive way of treating disorders affecting the bile duct and pancreatic duct that might otherwise have required a more invasive approach or surgery. It is usually performed as a day-only procedure.

What are the risks of ERCP?
ERCP is a safe and well-tolerated procedure when performed by doctors who are specially trained and experienced in the technique. Although complications requiring hospitalisation can occur, they are uncommon. Complications can include pancreatitis (inflammation of the pancreas), uncommonly infections and rarely bleeding or bowel perforation (a hole in the wall of the bowel). Sometimes the procedure cannot be completed for technical reasons. Risks vary, depending on why the test is performed, what is found during the procedure, what therapy is undertaken and a person’s other medical problems. Pancreatitis is the most frequent serious complication, occurring in approximately 1 in 20 procedures and causes pain in the abdomen. It is usually mild and settles within a couple of days in hospital with pain relief, bowel rest and intravenous fluids. However, occasionally pancreatitis can more severe, and very rarely can even result in death. Since the risks vary with each person and procedure, your doctor will discuss this with you.

What can I expect after ERCP?
If you have ERCP as a day-procedure, you will be observed until the effects of the medications have worn off and you are well. Your doctor will discuss the procedure with you. You may feel bloating or the need to pass gas because of the air introduced during the procedure. You should have a liquid only diet for the rest of the day and resume a regular diet the next day. You will need to have someone accompany you home and will not be able to drive. A responsible adult should stay with you overnight. Complications can occur after you go home so you should notify your doctor immediately if you have persistent abdominal pain, fever, fainting or passing red or black bowel movements.
EUS
What is an EUS?
Endoscopic ultrasonography (EUS) is a minimally invasive procedure performed with a special ‘echo-endoscope’ that along with a video camera, has a high resolution ultrasound probe on it’s tip. EUS allows excellent quality imaging and therefore the diagnosis of conditions affecting the lining of the gastrointestinal tract and the surrounding organs such as the gallbladder, the liver and bile duct (drainage tube), pancreas and pancreas duct as well as associated lymph nodes and blood vessels. EUS also allows for accurate and minimally invasive needle biopsy. This may be performed for the biopsy of lumps in the lining of the gastrointestinal tract, the bile duct, pancreas, liver or lymph nodes. The information gained by EUS is often essential for diagnosis and to direct future treatment. Specialised drainage of some cysts of the pancreas or blockages in the bile duct may also be performed.

The ‘echo-endoscope’ is passed via the mouth to the oesophagus, stomach and the first part of the small intestine where imaging and if appropriate a biopsy or other treatment is performed.

What preparation is required?
An empty stomach is required for a safe and effective examination. This means no food or drink for 6 hours before the procedure. Regular medications may be taken with a sip of water. Medications that thin the blood may need to be discontinued and should be discussed with your doctor 1-2 weeks prior. If you have diabetes then special instructions will be need to be given to you in order to manage your blood sugar around the time of the procedure.

What can I expect during EUS?
Your doctor will first discuss the procedure with you including the benefits and risks and address any questions you may have. You will also meet the anaesthetist who will discuss the anaesthetic. EUS is often performed with an intravenous sedation and most people remember little to none of the procedure. Following this you will be taken to the procedure room. You'll then lie on your left side. Once you are asleep, your doctor will commence the EUS, which usually takes around 30 - 45 minutes. Your doctor may give you a dose of antibiotics in some situations such as for the drainage or biopsy of a cyst.

What are the benefits of EUS?
EUS has revolutionised the diagnosis and management of many conditions affecting the lining of the gastrointestinal tract and surrounding organs by allowing minimally invasive and highly accurate diagnosis and thus the ability to direct the best course of future treatment for a particular person. It is also a minimally invasive way of treating difficult problems such as pancreatic fluid collections that might otherwise have required major surgery.

What are the risks of EUS?
EUS is a safe and well-tolerated procedure when performed by doctors who are specially trained and experienced in the technique. The risk of a significant complication is less than 1%. Complications include infection, bleeding, inflammation of the pancreas, as with any endoscopic procedure, there is an extremely rare risk of a perforation (hole to the wall of the bowel).

What can I expect after EUS?
You will be observed until the effects of the medications have worn off and you are well. Your doctor will discuss the procedure ad findings with you. You may feel bloating or the need to pass gas because of the air introduced during the procedure. You may commence a regular diet. You will need to have someone accompany you home and will not be able to drive. A responsible adult should stay with you overnight. Complications can occur after you go home so you should notify your doctor immediately if you have persistent abdominal pain, fever, fainting or passing red or black bowel movements.
Specialist Consultation
GastroNorth doctors are medical specialists in the field of gastroenterology, hepatology and endoscopy (gastroscopy, colonoscopy & capsule endoscopy). A current referral from your general practitioner (GP) is required to make an appointment or have an endoscopy.
Bowel Cancer Screening
What is Bowel Cancer? Bowel cancer (also known as colorectal cancer) affects the large bowel (colon) and rectum. It is one of the most common types of cancer in Australia.

How does Bowel Cancer form?
Most bowel cancers form from small growths or “polyps” in the large bowel or rectum. Over time some polyps can slowly progress to form cancer. Removal of these polyps at an early stage can prevent cancer. This is why screening is important (see below).

What are the symptoms of Bowel Cancer?
Bowel cancer may not cause symptoms during the early stages. The common symptoms of bowel cancer can include: iron deficiency, blood in the bowel motions, change in bowel habit, abdominal discomfort, persistent lethargy, or weight loss.

What tests are available for Bowel Cancer screening?
Screening can help identify bowel cancer at an early and potentially curable stage. Bowel cancer screening may initially include a faecal occult blood test (FOBT), which can be performed at home, and subsequently sent to the pathology laboratory for analysis. A colonoscopy (hyperlink) may also be recommended.

What is the National Bowel Cancer Screening Program?
The Australian Government introduced the National Bowel Cancer Screening Program in 2008. The eligibility criteria for this program are:

- those turning 50 years of age between January 2008 and December 2010
- those turning 55-65 years of age between July 2008 and December 2010

Screening is for people who do not have any symptoms. If you have any of the symptoms listed above, you should seek further advice from your doctor

What if I don’t meet National Bowel Cancer Screening Program criteria?
The current criteria for the National Bowel Cancer Screening Program is the second phase of the program, and is aimed at introducing the program slowly so that health services can meet the increased demand. It does not currently include people between the ages of 50-55. You should seek further advice from your doctor if you fit into this category and would like to undergo screening for bowel cancer.

Screening may be recommended at an earlier age if the risk of colon cancer is higher. This can include people with a family history of bowel cancer or multiple polyps. Your doctor can provide you with more advice on your risk of bowel cancer, and the most appropriate age for screening.

Where can I get more information?

Contact GastroNorth
www.cancerscreening.gov.au
Cancer helpline 13 11 20
Haemorrhoid Treatment
What are haemorrhoids?
Haemorrhoids are veins around the anus or lower rectum, also known as “Piles” which may get swollen or inflamed. They are very common with almost half the population having them at the age of 50 years. Haemorrhoids may result from constipation or straining to pass stool. Other contributing factors include pregnancy, family history, chronic constipation or diarrhea. Haemorrhoids are either inside the anus (internal) or under the skin around the anus (external).

What are the symptoms of hemorrhoids?
Most people with haemorrhoids do not experience any symptoms at all. Although some people pass bright red blood from their bottom, haemorrhoids may also cause itch and pain (which can be severe). In most cases, symptoms resolve in a few days.

How are hemorrhoids diagnosed?
Any rectal bleeding should be discussed with your doctor. Haemorrhoids may be visualized or felt if external. Sigmoidoscopy and colonoscopy (hyperlink) are diagnostic procedures that also involve the use of lighted, flexible tubes inserted through the rectum.

What is the treatment?
Medical treatment of hemorrhoids is aimed initially at relieving symptoms. Measures to reduce symptoms include;

- baths several times a day in plain, warm water for about 10 minutes
- application of a haemorroidal cream or suppository to the affected area for a limited time (examples include; Rectinol, Anusol, Proctosedyl, Scheriproct, Xyloproct)

Preventing the recurrence of hemorrhoids will require relieving the pressure and straining of constipation. Increasing fibre & fluids in the diet may be helpful. A bulkier and softer stool makes emptying the bowels easier and lessens the pressure on hemorrhoids caused by straining. Eliminating straining also helps prevent the hemorrhoids from protruding. Good sources of fibre are fruits, vegetables, and whole grains. In addition, doctors may suggest a bulk stool softener or a fiber supplement such as psyllium (Metamucil) or methylcellulose (Citrucel).

In some cases, hemorrhoids must be treated endoscopically or surgically. These methods are used to shrink and destroy the hemorrhoidal tissue. A number of methods may be used to remove or reduce the size of internal hemorrhoids. These techniques include:

- Rubber band ligation. A rubber band is placed around the base of the hemorrhoid inside the rectum. The band cuts off circulation, and the hemorrhoid withers away within a few days.
- Sclerotherapy. A chemical solution is injected around the blood vessel to shrink the hemorrhoid.
- Infrared coagulation. A special device is used to burn hemorrhoidal tissue.
- Hemorrhoidectomy. Occasionally, extensive or severe internal or external hemorrhoids may require removal by surgery known as hemorrhoidectomy.

Haemorrhoid banding is a common treatment for grade 2 and 3 haemorrhoids. A haemorrhoid is grasped with a suction device and a rubber band is then placed at its base. This cuts off the blood supply to the haemorrhoid which then ‘dies’ and drops off after a few days. The tissue at the base of the haemorrhoid heals with some scar tissue.

Banding of internal haemorrhoids is usually painless as the base of the haemorrhoid originates above the anus opening – in the very last part of the gut where the gut lining is not sensitive to pain. Up to three haemorrhoids may be treated at one time using this method. In about 8 in 10 cases, the haemorrhoids are ‘cured’ by this technique but in a small number of people they may recur.

More Information?
Contact GastroNorth
Specialist Dietician Services
At GastroNorth we recognise the important role of diet in many gastrointestinal and liver problems. We are pleased to offer the services of specialist gastrointestinal dieticians at our Bundoora rooms. Our dieticians work closely with the GastroNorth medical specialists and can offer advice regarding dietary matters involved in the management of conditions such as:

Irritable Bowel Syndrome, Bloating, Inflammatory Bowel Disease, Gastroparesis, Pancreatic problems or Fatty Liver Disease.

Conditions commonly treated at GastroNorth

P: (03) 9468-9700

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