A root cause analysis system to establish the most plausible explanation for post-endoscopy upper gastrointestinal cancer.

BACKGROUND : Missing upper gastrointestinal cancer (UGIC) at endoscopy may prevent curative treatment. We have developed a root cause analysis system for potentially missed UGICs at endoscopy (post-endoscopy UGIC [PEUGIC]) to establish the most plausible explanations. METHODS : The electronic records of patients with UGIC at two National Health Service providers were examined.

Optimising bowel preparation before colonoscopy.

A clean colon is required for a colonoscopy to be effective. Therefore, patients undergo a bowel preparation in advance of the procedure to clear the colon. Typically, this involves drinking 2 litres of polyethylene glycol or macrogol (PEG) solution, but dislike of the taste or having to drink such a large volume causes some patients not to adhere to this regimen.

Acute upper gastrointestinal bleeding: a guide for nurses.

This article outlines latest evidence-based care for patients with acute upper gastrointestinal (GI) bleeding. It aims to help gastroenterology and general medical ward nurses plan nursing interventions and understand the diagnostic treatment options available. Acute upper GI bleeding can present as variceal or non-variceal bleeding and has a high death rate.

Patients with computed tomography-proven acute diverticulitis require follow-up to exclude colorectal cancer.

Background/aims: Traditionally, patients with acute diverticulitis undergo follow-up endoscopy to exclude colorectal cancer (CRC). However, its usefulness has been debated in this era of high-resolution computed tomography (CT) diagnosis. We assessed the frequency and outcome of endoscopic follow-up for patients with CT-proven acute diverticulitis, according to the confidence in the CT diagnosis.

Observed high incidence of buried bumper syndrome associated with Freka PEG tubes.

Background: Buried bumper syndrome (BBS) is an uncommon but significant complication of percutaneous endoscopic gastrostomy (PEG), which occurs due to overgrowth of gastric mucosa over the inner bumper of the gastrostomy tube. A high incidence of BBS was observed in patients with Freka PEG tubes.

Objective: To review case numbers of BBS and confirm the observed association with Freka tubes to determine whether change of practice should be considered.

The principles of decontamination in gastrointestinal endoscopy.

Modern endoscopes can be used to examine the whole of the gastrointestinal (GI) tract. During these examinations, biopsies may be taken, or treatment provided via working channels in the endoscope. Demand for GI endoscopy is increasing because of the National Bowel Cancer Screening Programme and a rise in dyspepsia.

Exploring the nurse endoscopist role: a qualitative approach.

Background: Previously, gastrointestinal endoscopy was undertaken only by medical staff. The nurse endoscopist role has recently been developed and is now in great demand. Barriers and facilitators are identified in similar nursing roles, though little research has been undertaken on the nurse endoscopist role.

Barrett's oesophagus: an audit of surveillance over a 17-year period.

Objective: To audit whether our patients with Barrett's oesophagus (BO) enter into our endoscopic surveillance programme and whether they continue with it after entry. We have determined the incidence of oesophageal adenocarcinoma among our surveyed patients.

Design: We retrospectively audited prospectively collected data from our BO surveillance programme over the years 1987-2003.

Joint primary-secondary care design of PEG care pathways.

The use of PEG feeding has increased over the past decade. This article describes the development of a care pathway to support patients and maintain standards of care in PEG feeding.