Colorectal Assessment Clinic

This leaflet provides a guide to what will happen now that your doctor has referred you to the colorectal (bowel) team.

Have you got bowel symptoms?

Your doctor (GP) believes that you may have a problem with your bowel. They have referred you to the hospital to have an appointment with the colorectal (bowel) team for some tests or to see a specialist.

We know that bowels can be an embarrassing subject and difficult to talk about. We want you to feel as comfortable as possible talking about your bowels. Please use whatever words you find easiest to describe what has been happening. If you can talk freely about your problems, this helps us to find out more information which helps us to assess your symptoms.

Most people with bowel symptoms do not have cancer, but it is important to have your symptoms checked out. The cause is usually something minor like piles, irritable bowel syndrome or diverticular disease. If you have piles these can possibly be treated at the time of your test.

This booklet will explain how the colorectal telephone assessment clinic works and what to expect when we call you. It also has some information about the types of tests we might arrange for you.

What will happen at the appointment?

Your appointment will be with one of our colorectal consultant surgeons, our colorectal consultant nurse or a specialist registrar.

If you are unable to attend, or would like to change your appointment, please ring 01305 254109 as soon as possible.

During the appointment you will be asked questions about your health, your symptoms and your personal circumstances. You may be examined, including a rectal examination, and in some cases a rigid sigmoidoscopy. A rigid sigmoidoscopy is when a tube is inserted into the back passage to examine the rectum more clearly. You do not need to prepare your bowel for this examination. The colorectal specialist will discuss with you which test they recommend you have to investigate your symptoms. You will then be contacted by telephone to confirm a date before being sent an appointment for this test. Most tests take place within two weeks. It is helpful if you can tell us of any holidays you may have planned, or dates when you are not able to come to hospital for tests.

What tests am I likely to need?

Different tests give us different information about you and your bowels. The most common tests are:

• Flexible sigmoidoscopy
• Colonoscopy
• Gastroscopy
• CT colonography
• CT scan
• Ultrasound scan
• Blood tests
• Stool tests.

Descriptions of these different tests are listed in the glossary at the back of this booklet. If blood tests are needed, we will send you a letter with a blood test form. We will ask you to make an appointment with the nurse at your GP surgery and take the form with you.

You can also have your blood test taken at Dorset County Hospital Outpatient Department from 8.30am to 2pm, Monday to Friday, or at Weymouth Community Hospital from 8.15am to 2pm on a Monday and Wednesday.

Most people are booked for one of these tests. However, in some cases, we may ask you to come to the out-patient department first for a face-to-face appointment. The colorectal specialist will explain the test to you and answer any questions that you may have. You will be sent more information about the test including any risks and benefits in the post.

What if I choose not to have the tests that are recommended?

You will have an opportunity to discuss this with the colorectal specialist at your telephone assessment appointment. There may be alternatives that you are happy to have. If you do not want to have the tests that we recommend, you should discuss this with your GP.

What happens after I have had my investigation or test?

There will be three possible situations that could occur after you have had your test:

• In some cases, we will be able to tell you your results at the time of your test. We will be able to offer you treatment straight away or refer you on for treatment.
• For some people more tests may be needed, and we will arrange these for you. If you have had a scan, you will be contacted either by telephone or letter with the results. Please contact us if you have not heard anything within a few weeks of your test.
• In all cases we will write to you to confirm your results and give you advice. Your GP will also receive a copy of all the results from your tests.

Useful tips

It is helpful if you think about your symptoms carefully before your telephone assessment.

Your symptoms:

• What has been happening with your bowels?
• How long have the symptoms been going on?
• Are they continuous or do they come and go?
• Is there any pattern, eg same time of day, before or after meals?
• If you have pain, where is it? What is it like? How long does it last for?

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?
• Do you have any heart problems?
• Do you take any blood thinning medicines?
• Are you diabetic? If so, do you take tablets or insulin?

Family medical history:

• Have any of your family members had cancer, especially bowel cancer?
• Have any of your family members had a bowel disorder such as Crohn’s Disease or Colitis?

Your person circumstances:

• Do you live alone?
• How mobile are you/do you need help getting around?
• What support do you have around you?

You may find the Bristol Stool Chart below helpful to describe how your bowels are working:

I have not had my test results, what happens next?

We will write to you to explain your test results. It can take up to four weeks for some test results to be available.

If you have not heard after this time, please call the hospital and ask to speak to one of the colorectal secretaries.

About this leaflet

Author: Julie Lane, Colorectal Consultant Nurse
Written: January 2020
Updated and approved: February 2023
Review date: February 2026
Edition: v2

If you have feedback regarding the accuracy of the information contained in this leaflet, or if you would like a list of references used to develop this leaflet, please email patientinformation.leaflets@dchft.nhs.uk