Endoscopy : Combined - Gastroscopy Oesophago-gastro duodenoscopy (OGD) and Colonoscopy

You have been advised by your GP or hospital doctor to have two separate procedures to investigate the upper gastrointestinal tract and the lower bowel at a single appointment.

If you are unable to keep your appointment, please notify the department as soon as possible. This will enable the staff to give your appointment to someone else and they will be able to arrange another date and time for you.

This leaflet has been written to enable you to make an informed decision in relation to agreeing to the investigations. It provides information about both procedures therefore please read it carefully.

As both are invasive tests they require your formal consent. 

If however there is anything you do not understand or wish to discuss further do not sign the form, but please bring it with you and sign it after you have spoken to a health care professional.

Should you wish to change your mind and withdraw your consent you can do this at any time even when the procedure is taking place. The endoscopist will stop the procedure and start to remove the endoscope although it may not be immediately removed as this needs to be done in a safe manner.

Combined Gastroscopy (OGD) and colonoscopy information

You have been invited to undergo two procedures as part of the investigations your doctors have recommended, the first procedure you will be having is called an oesophago-gastro duodenoscopy (OGD) sometimes known more simply as a gastroscopy or endoscopy. This is an examination of your oesophagus (gullet), stomach and the first part of your small bowel called the duodenum.

The other procedure you will be having is called a colonoscopy. This is an examination of your large bowel (colon).

They will be performed by or under the supervision of a trained doctor or clinical endoscopist and we will make the investigation as comfortable as possible for you.

Before you have a combined gastroscopy and colonoscopy procedure you will usually be offered sedation and a painkiller. If you prefer we are able to offer you a combination of local anaesthetic throat spray for the gastroscopy and Entonox (‘gas and air’) during the colonoscopy instead of injections. Entonox is an inhaled effective painkiller which has a sedative effect without loss of consciousness. Colonoscopy is often performed satisfactorily without any injections or Entonox. Colonoscopy can often be completed without the need for sedation or entonox. If you opt to try without these you may still have a small cannula inserted into a vein in case you want to change your mind at any time.

Why do I need to have an OGD and colonoscopy?

You have been advised to undergo these combined investigations to help find the cause for your symptoms thereby facilitating treatment, and if necessary, to decide on further investigations.

The most common reason for having these combined procedures is to investigate the cause of anaemia with or without changes in your bowel habit.

X-ray examinations are available as alternative investigations. These tests expose you to a small amount of radiation. They are not as informative as an endoscopy and have the added disadvantage that a tissue sample can not be taken if any areas of concern are identified.

During these investigations the endoscopist may need to take some tissue samples (biopsies) from the lining of your digestive tract for analysis, this is generally painless. These samples will be retained. Photographs can be taken for record and documentation purposes.

What is gastroscopy?

This test is a very accurate way of looking at the lining of your upper digestive tract, and to establish whether there is any disease present.

The instrument used in this investigation is called a gastroscope. It is flexible and has a diameter less than that of a little finger.

Within each gastroscope is an illumination channel which enables light to be directed onto the lining of your upper digestive tract and another which relays pictures back to the endoscopist onto a television screen.

What is colonoscopy?

This test is a very accurate way of looking at the lining of your large bowel (colon), to establish whether there is any disease present. This test also allows us to take tissue samples (biopsy) for analysis by the Pathology Department if necessary.

The instrument used in this investigation is called a colonoscope (scope) and is flexible. As with the gastroscope there is an illumination channel which enables light to be directed onto the lining of your bowel, and another which relays pictures back, onto a television screen. This enables the endoscopist to have a clear view and to check whether or not disease or inflammation is present.

Preparing for the investigation

Eating and drinking

It is necessary to have clear views of the lower bowel.

Two to three days before the examination

• You can follow a normal diet but we recommend that you avoid eating foods containing whole nuts or seeds such as granary breads.

The day before the examination

• You should take clear fluids only (no solid food) e.g. glucose drinks, Bovril, black tea and coffee with sugar, clear soups and fruit jelly.

• You will need to take a laxative which you should have received along with clear instructions on how and when to administer it. If you have not already received this please contact the endoscopy unit and someone will assist you.

On the day of the examination

It is very important that your stomach is empty for this investigation so on the day of your procedures it is important that you continue taking clear fluids up until 2 hours before the examination. You will not become dehydrated as the laxative effects are short lived.

What about my medication?

Routine medication

Your routine medication should be taken. If your appointment is in the morning your medication should be taken at 6am with a little water, however if your appointment is in the afternoon your medication should be taken by 8am.

Digestive medication

If you are presently taking tablets to reduce the acid in your stomach please discontinue them 2 weeks before your investigation.

If you are having a follow up OGD to check for healing of an ulcer or inflamed oesophagus found in the last 2-3 months, or as part of a long term monitoring of a condition such as Barretts Oesophagus then please continue your acid reducing medications right up to the day of your procedure.

If you are taking iron tablets you must stop these one week prior to your appointment. If you are taking stool bulking agents (e.g. fybogel, regulan, proctofibe), loperamide (Imodium) lomotil or codeine phosphate you must stop these 3 days prior to your appointment.

People with diabetes

If you have diabetes controlled on insulin or medication, please ensure the Endoscopy department is aware so that the appointment can be made at the most appropriate time. Please see guidelines printed at the back of the book.

Anticoagulants/Allergies

If you are taking anticoagulants or blood thinning medication such as apixaban, edoxaban warfarin, clopidogrel, ticragelor, prasugrel, Dabigatran, Phenindione, or Rivaroxaban (Xarelto) and have not discussed this with your doctors or GP please contact the unit. Phone for information if you think you have a latex allergy.

Patients with Implanted Medical Devices

If you have an implanted medical device such as a cardiac defibrillator or cochlear implant please bring any information about the type of device you have with you. We will need to know this information so that we can be aware of any precautions or provisions that we need to take whilst you are having your procedure.

How long will I be in the endoscopy department?

This largely depends on what type of pain relief you require, how quickly you recover from the sedation and how busy the department is. You should expect to be in the department for approximately 3 hours. The time given on your letter is your admission time not the time for your procedure.

The department also looks after emergencies and these can take priority over our out-patient lists.

What happens when I arrive?

When you arrive in the department you will be met by a trained member of staff who will ask you a few questions, one of which concerns your arrangements for getting home. You will also be able to ask further questions about the investigations.

The nurse will ensure you understand the procedures and discuss any outstanding concerns or questions you may have. As you may need to have sedation the nurse may insert a small cannula (small plastic tube) into a vein in the back of your hand through which the sedation can be administered later.

Following sedation you will not be permitted to drive or use public transport unaccompanied, so you must arrange for a family member or friend to collect you. The nurse will need to be given their telephone number so that they can contact them when you are ready for discharge.

The nurse will ask you some questions regarding your medical condition and any surgery or illnesses you have had in the past to confirm that you are fit to undergo the investigation.

Your blood pressure, oxygen levels and heart rate will be recorded and if you have diabetes, your blood glucose level will also be recorded.

Intravenous sedation and Entonox explained

The sedation will be administered into a vein in your hand or arm. This will make you drowsy and relaxed but not unconscious. You will be in a state called co-operative sedation: this means that, although drowsy, you will still hear what is said to you and will therefore be able to follow simple instructions during the investigation. Sedation also makes it unlikely that you will remember anything about the procedure.

Please note if you have had sedation you must not drive, take alcohol, operate heavy machinery or sign any legal binding documents for 24 hours following the procedure and you must have someone to accompany you home and stay with you for at least 12 hours.

Many patients are happy for the gastroscopy procedure to be carried out without sedation and just have throat spray instead. Local anaesthetic throat spray numbs the back of the throat very much like a dental injection.

Entonox is a short acting painkiller which you breathe in or inhale. It is a mixture of nitrous oxide and oxygen. The effects last no more than 10 minutes. If you do not have someone to stay with you after the procedure you may find this a good alternative to intravenous sedation and pain relief. Following the use of entonox you would need to remain in the unit for a short while and you would not be able to drive for at least 30 minutes.

During the procedure we will monitor your breathing and heart rate so changes will be noted and dealt with accordingly. For this reason you will be connected by a finger probe to a pulse oximeter which measures your oxygen levels and heart rate during the procedure. Your blood pressure may also be recorded.

The investigation

Your consent to the procedure will be confirmed by the endoscopist and you will be given the opportunity to ask any further questions before you are escorted to the treatment room.

Gastroscopy

If you have any dentures you will be asked to remove them – any remaining teeth will be protected by a small plastic mouth guard which will be inserted immediately before the examination commences.

If you are having local anaesthetic throat spray this will be sprayed on to the back of your throat whilst you are sitting up and swallowing: the effect is rapid and you will notice loss of sensation to your tongue and throat.

The nurse looking after you will ask you to lie on your left side. The nurse will then place the oxygen monitoring probe on your finger. If you have decided to have sedation, a small tube will be placed into your nose so you can be given a little bit of oxygen to assist your breathing. The sedation will then be administered into a cannula (tube) in your vein. Any saliva or other secretions produced during the investigation will be removed using a small suction tube, again rather like the one used at the dentist.

The endoscopist will introduce the gastroscope into your mouth, down your oesophagus into your stomach and then into your duodenum. Your windpipe is deliberately avoided and your breathing unhindered.

During the procedure samples may be taken from the lining of your digestive tract for analysis in our laboratories.

Colonoscopy

Should you wish to try the procedure without any sedation or pain relief to start with these drugs can still be given at any time during the test if you change your mind.

The colonoscopy involves manoeuvring the colonoscope around the entire length of your large bowel. There are some bends that naturally occur in the bowel and some people may find that negotiating these is rather uncomfortable for a short period of time but pain relief should minimise any discomfort. Your nurse looking after you will help you cope with this.

Gas and/or water is gently passed into the bowel during the investigation to facilitate the examination but most of this is removed as the scope is withdrawn from the bowel.

During the procedure samples may be taken from the lining of your bowel for analysis in our laboratories. These will be retained.

Risks of the procedures

Upper gastrointestinal endoscopy and lower gastrointestinal endoscopy are classified as invasive investigations and because of that it has the possibility of associated complications. These occur extremely infrequently, we would wish to draw your attention to them.

The doctor who has requested these tests will have considered this carefully. The risks must be compared to the benefits of having the procedure carried out.

The risks can be associated with the procedure itself and with the administration of the sedation.

The endoscopic procedure - Gastroscopy

The main risks are of mechanical damage;

• To teeth or bridgework.
• Perforation or making a hole in the wall of the stomach or oesophagus which could entail you being admitted to hospital. Although perforation generally requires surgery to repair the hole, certain cases may be treated conservatively with antibiotics and intravenous fluids.
• Bleeding may occur at the site of biopsy and nearly always stops on its own.

Colonoscopy

• Bleeding (risk approximately 1:150) may occur at the site of biopsy or polyp removal. Typically minor in degree, such bleeding may either simply stop on its own or if it does not, be controlled by cauterization or injection treatment.

• Perforation (risk approximately 1 for every 1,500 examinations) or making a hole in the bowel. This is a serious and potentially life threatening complication for which an operation is nearly always required to repair the hole. The risk of perforation is higher with large polyp removal, especially from the right side of the bowel.

• There are other extremely rare complications which can occur during a procedure. Most of these are related to specific people or conditions. There are rare occasions when the endoscopist may fail to detect abnormalities on either of these examinations. This most often occurs when the preparation is inadequate although lesions can also be missed when fully cleansed. Should you have any particular concerns or worries regarding this please discuss this with your endoscopist when you attend and before you sign your consent form.

Sedation

Sedation can occasionally cause problems with breathing, heart rate and blood pressure. If any of these problems do occur, they are normally short lived. Careful monitoring by a fully trained endoscopy nurse ensures that any potential problems can be identified and treated rapidly.

Older patients and those who have significant health problems (for example, people with significant breathing difficulties due to a bad chest) may be assessed by a doctor before having the procedure.

Additional information

Occasionally polyps are found during the procedure.

What is a polyp?

A polyp is a protrusion from the lining of the bowel. Some polyps are attached to the intestinal wall by a stalk, and look like a mushroom, whereas others are flat without a stalk. Polyps when found are generally removed or sampled by the endoscopist as they may grow and later cause problems. Flat polyps are generally a little more difficult to remove.

Polypectomy

Various removal techniques are available to remove polyps in the large bowel. Most involve removing them with a wire loop or biopsy forceps, sometimes using an electric current. This is called a polyp resection or polypectomy.

It will depend on the size of the polyp, the location of the polyp in the bowel and the appearance of the polyp as to what method the endoscopist uses to perform the polypectomy.

 For large polyps with a stalk, a snare (wire loop) is placed around the stalk of the polyp, a high frequency current is then applied and the polyp is removed.

Flat polyps (without any stalk) may need to be lifted up from the lining of the bowel. This involves injecting the lining of the bowel that surrounds the flat polyp. This raises the area and allows the wire loop snare to capture the polyp.

For smaller polyps biopsy forceps (cupped forceps) may be used.

The risk of making a hole in the bowel during a polypectomy can be as high as one in every 750 examinations.

After the procedure

You will be allowed to rest for as long as is necessary. Your blood pressure, oxygen levels and heart rate will be recorded and if you have diabetes, your blood glucose will be monitored. Once you have recovered from the initial effects of the procedure (which normally take 30-60 minutes), you will be offered a hot drink and something to eat and may be moved to a comfortable chair. Before you leave the department, the nurse or endoscopist will discuss the findings and any medication or further investigations required. They will also inform you if you require further appointments.

The sedation may temporarily affect your memory, so it is a good idea to have a member of your family or friend with you when you are given this information although there will be a short written report given to you.

If you have had sedation, the drug remains in your blood system for about 24 hours and you may feel drowsy later on, with intermittent lapses of memory. If you live alone, you will need to arrange for someone to stay with you for at least 12 hours after the procedure or, if possible, arrange to stay with your family or a friend for this time.

If the person collecting you leaves the department, the nursing staff will telephone them when you are ready for discharge.

What if I choose not to have this procedure?

If you decide not to proceed with the examination, your doctors will still treat your symptoms, however they may find it harder to identify the underlying cause of your problems. This may affect their ability to provide a long-term solution or treatment for your condition or exclude conditions like cancers.

General points to remember

• If you have any problems with a persistent sore throat, chest or abdominal pain or bleeding please contact your GP immediately informing them that you have had an endoscopy.

• If you are unable to contact or speak to your doctor, you must contact the A&E department. If your symptoms persist or worsen, go immediately to casualty.

• It is our aim for you to be seen and investigated as soon as possible after your arrival.

• However, the department is very busy and your investigation may be delayed. If emergencies occur, these patients will obviously be given priority over less urgent cases.

• The hospital cannot except any responsibility for the loss or damage to personal property during your time on these premises.

Dietary instructions for colonoscopy preparation

You should have received the medication required to clean out your bowels in the pack you received along with this information booklet. If not, please contact the Endoscopy appointments booking team (01228) 210430 who can arrange for this to be supplied to you. Please read the instructions carefully and follow them as appropriate for the time of your appointment. To enable a more effective examination, we would be grateful if you would take a clear fluid only diet for the period of time stated on the attached instruction sheet.

Fluids allowed

Twenty-four hours before your examination you should take clear fluids only (no food):

tea (no milk), black coffee, water, strained fruit juice, strained tomato juice, fruit squash, soda water, tonic water, lemonade, Oxo, Bovril, Marmite (mixed into weak drinks with hot water), clear soups and broths, consomme.

• You may eat clear jellies.
• You may suck clear boiled sweets and clear mints.
• You may add sugar or glucose to your drinks.

Foods and fluids not allowed

For 2-3 days before your colonoscopy avoid eating nuts and seeds or foods such as granary bread which contain whole seeds.

Whilst taking your preparation do not take drinks or soups thickened with flour or other thickening agents.

Guidance from the Diabetes team for People with Diabetes having bowel preparation

This guidance is provided to assist with your preparation for your endoscopic procedure. If you feel unclear about how to proceed after reading this information, please contact your diabetes specialist nurse, or practice nurse or general practitioner for personalised advice.

Do I need to inform the endoscopy department?

In preparing for your procedure it is important to inform the endoscopy department that you have diabetes; you may have already discussed this with the hospital doctor in clinic. If you are not sure we know about your diabetes please contact whoever you receive your diabetes care from at your GP Practice.

This information is for people with type 1 diabetes and type 2 diabetes who are on medication for their condition. If you have type 2 diabetes managed by diet alone you do not need to read this.

Diabetes Treatments

What type of medication am I on?

• Oral diabetes medication (tablets): Metformin, Gliclazide/ Gliclazide MR, Glibenclamide, Glimepiride, Pioglitazone, Sitagliptin, Saxagliptin, Vildagliptin, Lingaliptin, Repaglinide, Dapagliflozin, Empagliflozin and Rybelsus.

• Long acting insulin: Lantus/Glargine, Levemir/Detemir, Tresiba/degludec, Abasaglar, Toujeo.

• Intermediate acting insulin: Insulatard, Humulin I, animal isophane.

• Short acting insulin: Novorapid, Humalog, Apidra,Humulin S, Fiasp, animal neutral.

• Mixed insulin: Novomix 30, Humulin M3, Humalog Mix 25 or 50.

• Other injectable treatment (GLP-1): Exenatide (Byetta), Liraglutide (Victoza), Lixisenatide (Lyxumia), Dulaglutide (Trulicity), Bydureon, Semaglutide (Ozempic).

If you are not clear on your insulin type or other diabetes medications please contact your diabetes specialist nurse, or practice nurse or general practitioner for personalised advice.

How do I adjust my medications the day before a colonoscopy?

• Continue to take Metformin and Pioglitazone as usual
• Do not take any other ORAL diabetes medications
• Continue to take GLP-1 injections as usual
• Check your blood glucose level before all insulin injections
• If you have type 2 diabetes, halve the usual dose of short-acting or mixed insulin
• If you have type 1 diabetes and are carbohydrate counting, you can continue this. Otherwise, halve the usual dose of short-acting or mixed insulin
• Take 80% of your usual long-acting or intermediate-acting insulin doses.

On the day of the procedure

If your procedure is in the morning:

• Continue liquid diet with clear fluids such as black tea or coffee, sugar-free squash, clear soups or water up to up to 5am

If your procedure is in the afternoon:

• Drink clear fluids such as black tea or coffee, sugar free squash or water up to 10am. When you travel to and from the hospital for your procedure carry some glucose tablets or 200mls (a small carton) of smooth orange juice.

What to do if you have a ‘hypo’?

• If you have any symptoms of a low blood sugar such as sweating, dizziness, blurred vision or shaking please test your blood sugar if you are able to do so.

If it is less than 4mmol/L (or if you are not able to check your blood sugar), take 4 glucose tablets or 200ml carton of smooth orange juice or 4-5 jelly babies. Please tell staff at the hospital that you have done this because it is possible that your endoscopy (if you are having a combined procedure) may have to be rearranged.

Remember to bring with you to hospital:

• Glucose tablets or smooth orange juice
• Blood glucose testing equipment (if you usually monitor your blood glucose)
• The tablets or injections you usually take for your diabetes, and prescription if available.

The following tables will guide you on how to adjust your diabetes medication ON THE DAY of your procedure.

If you are able to check your blood sugar, you should monitor this closely (e.g. on waking, on arrival at the hospital, after the procedure).

What to do with your oral diabetes medications

 

Tablets	If your procedure is in the morning	If your procedure is in the afternoon
Metformin	Omit your morning dose. If only taken at this time take at lunchtime	Omit morning and lunchtime Take again with evening meal
Sulphonylureas Gliclazide/Gliclazide MR Glibenclamide, Glimepride	Omit your morning dose. If only taken at this time take this dose at lunch time	Omit your morning dose
Pioglitazone	Delay until after the procedure	Delay until after the procedure
Meglitinide (repaglinide or nateglinide)	Omit your morning dose	Omit your morning and lunchtime dose Take again with evening meal
DPP-IV inhibitors (sitagliptin, Saxagliptin, Vildagliptin, Linagliptin)	Omit your morning dose. If only taken at this time take at lunch time	Omit your morning dose. If only taken at this time, delay until after the procedure
SGLT2 (Dapaglifozin Canagliflozin Empaglifozin)	Delay until after the procedure	Delay until after the procedure
Rybelsus (semaglutide)	Delay until after the procedure	Delay until after the procedure

 

 

Injections	If your procedure is in the morning	If your procedure is in the afternoon
Once daily insulin ONLY (type 2 diabetes) Glargine (Lantus) Levemir (Detemir) Insulatard Humulin I Toujeo	Continue your usual dose*         *See below	Halve your normal dose if taken in the morning
Twice daily mixed insulin Novomix 30 Humalog Mix 25 or 50 Humulin M3	Halve your usual morning dose.   Resume your normal insulin regimen with your next meal	Halve the usual morning dose.   Resume your normal insulin regimen with your next meal.
Twice daily – separate injections of short-acting (e.g. animal neutral, Humulin S, Fiasp, Novorapid, Humalog, Apidra) and intermediate-acting (e.g. animal isophane, Insulatard, Humulin I )	Calculate the total dose of both morning insulins and give half as intermediate acting only in the morning.   Leave the evening meal dose unchanged.	Calculate the total dose of both morning insulins and give half as intermediate acting only in the morning.   Leave the evening meal dose unchanged.
Three times daily mixed insulin Novomix 30 Humalog Mix 25 or 50 Humulin M3	Halve your usual morning dose.   If you miss lunch do not take your lunchtime dose.   Resume your normal insulin regimen with your next meal.	Halve your usual morning dose.   Omit lunchtime dose.   Resume your normal insulin regimen with your next meal.
Basal bolus regimens: Combination of once or twice daily background (basal) long acting insulin with short acting insulin at meal times (see page 1 for insulin types)	Basal (long-acting): Continue with your normal dose*   Short-acting: Omit morning dose   Resume your normal insulin regimen with your next meal   *see below	Basal (long-acting): Continue with your normal dose*   Short-acting: Omit morning dose Omit lunchtime dose   Resume your normal insulin regimen with your next meal
Exenatide (Byetta)	Omit morning dose	Omit morning dose
Liraglutide (Victoza) Lixisenatide (Lyxumia)	Delay until after procedure	Delay until after procedure
Bydureon, Semaglutide (ozempic) and dulaglutide (trulicity)	Delay by one day if due	Delay by one day if due

 

*If you normally graze through the day or normally eat snacks without taking extra insulin you should reduce this insulin dose by one third (e.g. if on 30 units normally, take 20).

What if I have an insulin pump?

• Maintain your usual basal rate, and only give boluses if you need to correct for a significantly elevated reading.

• If you have any concerns about hypoglycaemia, you can use a temporary basal rate that is 80% of your usual rate.

• You can contact your diabetes specialist nurse, or practice nurse or general practitioner for personalised advice.

After the procedure

How do I manage my diabetes after the procedure?

• After your procedure you can drink when you feel able to.

• Once you are eating and drinking you should resume taking your diabetes medications as normal.

• Your blood glucose levels may be higher than usual for a day or so.

• When you get home, if you feel nauseated or vomit and are unable to eat, please refer to the ‘What should I do if I am unwell?’ section below.

What should you do if you are unwell?

• NEVER stop taking your insulin or tablets – illness usually increases your body’s need for insulin

• TEST your blood glucose level every 2 hours, day and night

• TEST your urine for ketones every time you go to the toilet or your blood ketones every 2 hours if you have type 1 diabetes and have the equipment to do this

• DRINK at least 100 mls water/sugar free fluid every hour – you must drink at least 2.5 litres per day during illness (approximately 5 pints)

• REST and avoid strenuous exercise as this may increase your blood glucose level during illness

• EAT as normally as you can. If you cannot eat or if you have a smaller appetite than normal, replace solid food during illness, with one of the following:
  • 400 mls milk
  • 200 mls carton fruit juice
  • 150-200 mls non-diet fizzy drink
  • 1 scoop ice cream

When should you call the Diabetes Specialist Nurses or your GP?

• CONTINUOUS diarrhoea and vomiting, and / or high fever
• UNABLE to keep down food for 4 hours or more
• HIGH blood glucose levels with symptoms of illness (above 15 mmol/L – you may need more insulin)

• KETONES in type 1 diabetes at ++2 or +++3 in your urine or 1.5 mmol/L blood ketones or more – you may need more insulin. In this case, contact the person who normally looks after your diabetes immediately.

• OUTSIDE NORMAL WORKING HOURS consult the local out of hour’s service or go to your local hospital A&E department.

Am I prepared for my endoscopic procedure?

• Write down your medication plan for the 2 days before, the procedure day, and the day after your endoscopic procedure. Sedation can affect your thinking, so it may be helpful to write your plan in the table below.
• If you are unclear you can contact your diabetes specialist nurse, practice nurse, the endoscopy department or general practitioner for personalised advice.

Contact details 

Cumberland Infirmary Endoscopy Unit: 01228 814289

West Cumberland Endoscopy Unit: 01946 523061

Endoscopy booking/appointments: 01228 210430

 

Confidentiality

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For further information on confidentiality contact the Information Governance Team:

Information.Governance@ncic.nhs.uk | 01228 603961

Feedback

We appreciate and encourage feedback, which helps us to improve our services. If you have any comments, compliments or concerns to make about your care, please contact the Patient, Advice & Liaison Service:

pals@ncic.nhs.uk | 01228 814008 or 01946 523818

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complaints@ncic.nhs.uk | 01228 936302