Simple test to end lengthy delays for bowel treatment
THOUSANDS of bowel disease patients could soon be spared regular hospital visits and long waits for treatment – t hanks t o new t est that would allow GPs or even a practice nurse, for the first time, to monitor the disease.
Currently, sufferers of ulcerative colitis, an incurable inflammatory condition that affects the colon, must visit an outpatient clinic for two days every few months for check- up. This involves a sigmoidoscopy, during which a camera on a thin tube is inserted into the back passage.
Sigmoidoscopies can be done only in a hospital and three members of staff are needed to operate the equipment. Patients then have to return a week later to speak to their doctor about their results.
Now, thanks to a new portable device called the LumenEye, sigmoidoscopies could be a thing of the past for colitis patients.
Ulcerative colitis occurs when the colon and rectum, the lower parts of the bowel, become inflamed and ulcerated.
It’s the most common type of i nf l a mmatory di s e a s e o f t he bowel, with nearly 150,000 Britons currently diagnosed.
It is thought to occur when a genetic defect causes the immune system turns inward and attacks healthy body tissue. Symptoms include stomach pain, recurring diarrhoea and urgency.
The standard treatment for colitis is anti-inflammatory or immunesuppressing medication. As a result, doctors need to examine patients regularly, via a sigmoidoscopy, to make sure the drugs are having the desired effect of bringing down the inflammation.
But Dr Bu Hayee, consultant gastroenterologist at King’s College Hospital, says: ‘Sigmoidoscopy machines can only ever be found in one part of the hospital, the endoscopy unit. They’re in high demand and the waiting list to use them is usually about six weeks.
‘That means that even if I’m free tomorrow and so is my patient who’s suffering from a flare-up, they’ll still need to wait more than a month before they can be examined.’ This can mean delays in treatment to ease pain.
Dr Hayee adds that when sigmoidoscopies are performed, they are almost never carried by the patient’s consultant.
He said: ‘The results have to be passed along to the correct person so the patient will be sent home and instructed to come back in a week, all the while not knowing what their situation is.’
But since January, Dr Hayee, along with a number of other colitis specialists across the UK, has been using the LumenEye to assess patients. It uses a similarsized probe to a sigmoidoscopy, but is more compact in design so doctors can transport the device between clinics. It can be operated by one person and results can be relayed within the hour.
‘ It’s a much more streamlined process. Many of these patients are in incredible pain, and the ability to get them the right treatment quickly is invaluable,’ says Dr Hayee.
He believes that in the future, the devices could also be operated by GPs.
‘ We’ve already tested it out in local GP practices and received a good response. I think there’s potential for GPs across the country to use them too.’
ONE patient to benefit is Francesca Adams, a 41-year-old management consultant from London. She was diagnosed with colitis in 2009 and has been hospitalised four times due to the severity of her condition. ‘I constantly have awful stomach cramps,’ she says. ‘Whenever I need to go the loo, I have to dash really quickly.’
Francesca says she has to visit hospital several times a year for check-ups, taking time off work to do so. ‘Then I have to come back a week later to talk about my results with my consultant,’ she adds.
Francesca had a scan with the LumenEye in April. ‘I went to my consultant’s office and we did the scan within 45 minutes.’ She was able to decide a treatment plan with her doctor straight away.
The LumenEye is currently being used in six NHS hospitals. While Dr Hayee says he wouldn’t recommend abandoning sigmoidoscopy completely, he believes it is likely that the new test will become common practice across the country.
‘We could monitor the majority of colitis patients with it, and drastically cut waiting times,’ he says.