Clinical News

Streamlining diagnostic pathways for patients with vague symptoms

Monday, 15 May 2017 13:38

The ACE Programme has recently published a report looking at the most effective ways to diagnose patients with non-specific but concerning symptoms. A number of projects across England piloted a range of different approaches to improve early diagnosis of cancer, demonstrating conversion rates ranging from around 3% to over 40%. With common symptoms including weight loss and non-specific abdominal discomfort, the pathways proved effective at identifying a range of gastroenterology-related pathology. This included pancreatitis, chronic liver disease and diverticulitis. The report links to a number of useful practical resources developed by the projects.

Guidance on Decontamination of Equipment for Gastrointestinal Endoscopy: 2017 Edition

Tuesday, 25 April 2017 08:36

The Report of a Working Party of the British Society of Gastroenterology Endoscopy Committee

April 2017

Flexible endoscopes are complex reusable instruments that require unique consideration with respect to decontamination. Their external surfaces and internal channels for air, water, aspiration and accessories are all potentially exposed to body fluids and other contaminants.

In contrast to rigid endoscopes, flexible endoscopes are heat labile and cannot be autoclaved. Most flexible endoscopes are classed as "semi-critical devices" as they come into contact with mucous membranes during use and present a moderate degree of infection risk if contaminated at the time of use. The process of flexible endoscope decontamination is referred to as "high level disinfection". This is the term given to a process that eliminates or kills all vegetative bacteria, mycobacteria, fungi and viruses, except for small numbers of bacterial spores.

The Health and Social Care Act: Code of Practice on the prevention and control of infections and related guidance was published in England in 2008 (updated in 2015). This stipulates the roles of decontamination leads and decontamination programmes. It emphasises the need for staff to be trained in decontamination processes and to hold appropriate competencies for their role. It decrees the need for monitoring systems to ensure that decontamination processes are fit for purpose and meet required standards. Finally it requires that there are systems in place for tracking reusable medical devices (such as endoscopes and reusable accessories) through decontamination processes, not only to assist with assuring their quality, but also to enable the identification of patients on whom the medical devices have been used. Similar guidance is employed in the other UK devolved nations.

The BSG first published guidelines on decontamination in 1998. Over the years many changes have occurred in recommendations for the decontamination of flexible endoscopes. In order to be responsive to these changes this document has been revised as guidance, this allows the flexibility to update this document in line with changes issued by Government agencies and other professional bodies.


BSG statement on "Use of intravenous Hyoscine Butylbromide (Buscopan) during Gastrointestinal Endoscopy"

Tuesday, 04 April 2017 11:02

The MHRA has recently circulated a Drug Safety Update regarding the risk of serious adverse events following the use of intravenous Hyoscine Butylbromide (Buscopan) in patients with underlying cardiac disease.

Buscopan is commonly used during endoscopic procedures. It induces smooth muscle relaxation and reduces spasm in the gastrointestinal tract. It is used during upper GI Endoscopy and small bowel enteroscopy to reduce contraction and aid mucosal visualisation. During endoscopic retrograde cholangiopancreatography, it is used to facilitate access to the common bile duct during cannulation of the Ampulla of Vater. During colonoscopy, it is used to reduce haustral definition to optimise mucosal visualisation and lesion detection.


'FIT for symptomatic patients' workshop - NHSE in partnership with the BSG and ACPGBI

Tuesday, 04 April 2017 09:20

NHSE in partnership with BSG and ACPGBI ran a workshop on the 8th March, with clinicians from across the colorectal pathway, to scope activity and opinions on the potential use of FIT in symptomatic patients. Discussions focused on: what data collection was ongoing already, what the gaps were in our knowledge of FIT, and how clinicians could work collaboratively to fill the gaps in a timely manner. If you would like to find out more please see the summary of the meeting on the website, or contact Sophie Lumley at NHS England This e-mail address is being protected from spambots. You need JavaScript enabled to view it . We are interested to hear about other projects that are either ongoing (as research or service evaluation) or currently in the planning stages, or hear from areas interested in collecting data on FIT in symptomatic patients.

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