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What is Gastroenterology?
Gastroenterology is the branch of medicine that looks at diseases of the oesophagus (gullet), stomach, small and large intestines (bowel), liver, gallbladder and pancreas.The oesophagus is the tube that joins your mouth with your stomach. It is a muscular tube that contracts to push the food through when you swallow.
The stomach is where food is broken down by acid and emptied into your intestines. The stomach has special cells lining its wall to protect it from these acids.
The intestines consist of the small intestine (duodenum, jejunum and ileum – different sections of small intestine) and the large intestine (colon). As food passes through the small intestine, nutrients are broken down and absorbed. When it passes into the colon, water is absorbed. The waste that is left is passed as faeces (poo).
The liver is roughly the size of a football and is on your right side just under your ribs. It stores vitamins, sugar and iron which are used by cells in the body for energy. It also clears the body of waste products and drugs, produces substances that are used to help blood clot and aid the immune system, and produces bile which aids in digestion.
The pancreas is an elongated organ that lies in the back of the mid-abdomen. It is responsible for producing digestive juices and certain hormones, including insulin, the main hormone responsible for regulating blood sugar. A gastroenterologist is a doctor specialising in the field of medicine which involves these closely related organs. The Department of Gastroenterology and Hepatology at Auckland City Hospital and Greenlane Clinical Centre provides services to the Auckland District Health Board (DHB) catchment area via GP referral and tertiary services via specialist referral from other DHBs. Almost all outpatient clinic appointments are run through the ground floor at Greenlane Clinical Centre with a minority being held at Auckland City Hospital, Level 6, Support Building. Routine outpatient gastroscopy and colonoscopy procedures are carried out through the Endoscopy Suite on Level 2 at Greenlane Clinical Centre. This unit has a waiting room with reception, a small prep area, 1 procedure room and a 9 bed recovery. For information about the Greenlane Clinical Centre location please click here. The Endoscopy Suite at Auckland City Hospital is reserved for acute inpatient work and urgent, or more complicated, outpatient procedures. This unit has a 10 bed recovery and 3 procedure rooms. There is a dedicated team of nurses who work with the doctors over both sites to ensure patients are ready for their procedures. They are available over the phone to answer questions prior to appointments about prepping instructions, informed consent and medication information. Services provided Gastroscopy 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 or nurse with nurses assisting. Auckland hospital is a teaching hospital and as such, some of the procedures may be performed by fully qualified doctors or nurses who are training to become specialists. Complications from this procedure are very rare but can occur. They include: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.
Treatment options depend on the severity of damage to the liver and include dietary changes and avoidance of substances such as alcohol that can further damage the liver. Medication may be given to prevent complications and treat symptoms of liver failure. There is no cure other than liver transplantation.
Peptic ulcersPeptic 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:
Smoking, alcohol, anti-inflammatory medication and aspirin increase the risk of developing ulcers. Psychological stress and dietary factors (once thought to be the cause of ulcers) do not appear to have a major role in their development.
Helicobacter pylori, a bacteria that is frequently found in the stomach is a major cause of stomach ulcers. If this is found you will be given a course of antibiotics.
Diagnosis is made by the history, examination and sometimes blood tests. You may be asked to have a gastroscopy (see above) to clarify the diagnosis and aid with treatment.
Treatment consists of medication to reduce the amount of acid in the stomach which aids in the healing of ulcers and avoidance of things that cause ulcers in the first place.
Inflammatory bowel disease (IBD)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.
HoursMon - Thu: 8:00am - 4:30pm
All Gastro clinics are run from Reception D and E on the Ground Floor, GCC. Some clinics are held at ACH, Outpatients Clinic, Level 6 Support Building.
GCC endoscopy procedures are performed in the Endoscopy Unit located on Level 2, Reception N, GCC.
Auckland City Hospital (ACH) procedures are performed in the Endoscopy Unit located on Level 6, Support Building, ACH.
Auckland City Hospital
Street address
2 Park Road
Grafton
Auckland 1023
Postal address
Private Bag 92 024 Auckland Mail Centre Auckland 1142
Greenlane Clinical Centre
Street address
214 Green Lane West
One Tree Hill
Auckland 1051
Postal address
Private Bag 92 189 Auckland Mail Centre Auckland 1142
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