It is helpful to the Nurse Specialist to think about your symptoms carefully before your telephone assessment. You may find the following guide helpful:
- What has been happening with your bowels?
- How long have the symptoms been going on for?
- Are they continuous or do they come and go? Is there a pattern?
Change in your lifestyle:
- Have you changed your diet or exercise?
- Have you recently felt stressed?
- Have you been overseas lately?
- Have your friends, family or colleagues had similar problems?
- Are you on any new medication?
Your medical history:
- Have you had any bowel or digestive problems in the past?
- Have you had any operations on your abdomen or bottom?
- Do you have any problems with your heart?
- Have a list of your current medications to hand.
- Family medical history:
- Have any of your family members had cancer, especially bowel cancer?
- Have any of your family members had a bowel disorder – Crohn’s disease or colitis?
Your personal circumstances:
- Do you live alone?
- How mobile are you, do you need help getting around?
- What support do you have around you?
You have been referred on a two week wait pathway to see if you have bowel cancer. Most people with bowel symptoms do not have cancer but is important to have your symptoms checked out. The cause can be something benign (non-cancerous) like piles or irritable bowel syndrome. You will be offered a test or a consultation within 2 weeks. It is important that you attend this appointment.
If you are unsure about something or do not understand what you are being told please ask for clarification.
What test am I likely to need?
Different tests provide different information about your bowels. The most common tests that the Colorectal Telephone Assessment team use include:
- Flexible Sigmoidoscopy – a thin flexible telescope with a camera at the end that is inserted into the bowel via the back passage and the lower part of the bowel is examined.
- Colonoscopy – is a thin flexible telescope with a camera on the end that is inserted into the bowel via the back passage and the whole of the large bowel is examined. Patients take some strong laxatives the day before this procedure and are offered a sedative injection for the test if required.
- CT Scan/CT Colonography – is a specialised scan where a doughnut shaped x-ray machine takes cross sectional x-ray pictures of you whilst you lay on a table. Patients can be given an injection of dye and asked to drink a contrast fluid when they come in for this test. Patients may be asked to take some laxative medication or fast before this procedure.
- Gastroscopy – a thin flexible telescope with a camera at the end is inserted into the upper digestive system via the mouth. The oesophagus (gullet), stomach and first part of the intestine (duodenum) are examined.
Following your telephone assessment, most patients will be referred straight for one of these tests. Full details of the test will be sent to you in the post. The relevant department will then contact you with an appointment. In some cases however, we may ask patients to come in to the out-patients department first to see a specialist.
What if I choose not to have the tests that are recommended?
You will have an opportunity to discuss this with the Colorectal Nurse Specialist during your telephone assessment. If following this, you do not feel you want to proceed with the tests that are recommended, you will be sent an out-patients appointment to discuss this with a specialist doctor.
What happens after I have my investigation or test?
We hope to be able to tell patients what is causing their symptoms and discuss treatment shortly after their tests. Some patients may require additional tests including blood tests, further CT scans, colonoscopy or gastroscopy.
Once the results of the tests are available, including any biopsies (tissue samples) that were taken, your case will be discussed between a Colorectal Nurse Specialist and a Consultant. This can take up to six weeks.
Depending on your results you will then be referred back to the care of your GP or onto another relevant specialist department. Both you and your GP will receive a letter outlining the management plan.