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Gastroenterology and Endoscopy


Gastroenterology Centre of Excellence

The high level steering group of the Cork Acute Hospitals Forum (commissioned by Mr. Micheal Martin, 2002) designated the Mercy University Hospital as the headquarters of Gastroenterology for Cork.
 
The Centre for Gastroenterology provides a holistic diagnostic and therapeutic gastroenterology service. The Centre provides a tertiary referral service for several endoscopic techniques and also provides a nationwide service (see below). The Centre provides approximately 3,500 endoscopic procedures per annum. There are two outpatient clinics per week. The department provides a 1:4 general medical call.
 
There is an active gastro-intestinal research programme and a full-time research registrar.
 
The Centre for Gastroenterology is currently the only centre in the country providing a full range of GI services. Therapeutic endoscopy has seen dramatic developments in the area of cancer staging, cancer treatment, cancer palliation, haemorrhage control and diagnosis, in the past 20 years.
 
Description of Services:
  • Tertiary referral GI endoscopy service - ERCP / diagnostic and therapeutic EUS / EMR / RFA / luminal stenting / colon cancer screening, etc.
  • IBD Centre (over 2,000 IBD patients on database).
  • Regional GI Physiology Service (oesophageal high resolution manometry / impedance / LPR studies, anorectal high resolution manometry, breath testing service (H. pylori, SIBO, disaccharide intolerance), video capsule endoscopy service).

Team

The team consists of:
2 Consultant Gastroenterologists
1 Nurse Endoscopist
1 IBD Advanced Nurse Practitioner
1 IBD Nurse Specialist
2 GI Physiology Technicians
1 GI Database Manager
Team of Experienced Endoscopy Nurses
2 Clerical Staff
 

Capsule Endoscopy

At present MUH provides a nationwide capsule endoscopy service. During this technique a small camera, approximately the size of a standard tablet, is swallowed by the patient and this allows excellent visualisation of the entire small bowel.  This allows us to diagnose sources of bleeding and other pathologies that previously may only have been diagnosed at surgery. This technique is performed on an outpatient basis. We currently provide a nationwide capsule endoscopy service.
 

Radial Endoscopic Ultrasound

Mercy University Hospital is the only centre outside of Dublin providing a radial endoscopic ultrasound service. During this technique an ultrasound probe attached to an endoscope is passed into the gastrointestinal tract. This allows a very accurate staging and diagnosis of gastrointestinal cancers. The more accurate staging provided by this technique allows more appropriate treatment for cancers and obviates the need for unnecessary invasive surgery. The Centre for Gastroenterology at  MUH currently provides a tertiary referral service for this technique.
 

Linear Endoscopic Ultrasound

The Centre for Gastroenterology has just commenced a linear endoscopic ultrasound service. During this technique organs and lesions adjacent to the gastrointestinal tract can be visualised using a special probe attached to an endoscope. It is now possible to take biopsies from area outside of the gastrointestinal tract or to insert drains, etc. This again allows for very accurate staging of cancers and palliation of cancer related symptoms. The Centre for Gastroenterology at MUH is the only Centre outside of Dublin providing this service.
 

ERCP

The Centre for Gastroenterology provides a full therapeutic ERCP service. This allows for diagnosis and treatment of hepatobilary tree disorders. We currently provide a tertiary referral service to the South Infirmary / Victoria University Hospital, Mallow General Hospital, Bantry General Hospital and Kerry General Hospital.
 

Endoscopic Mucosal Resection / Radiofrequency Ablation of Early Neoplasia

Endoscopic mucosal resection allows for the endoscopic removal of early gastrointestinal cancers.  MUH is the only centre outside of Dublin providing this service.
 

Gastrointestinal Stenting

Gastrointestinal stenting relieves obstruction along the gastrointestinal tract caused by malignant conditions.  At the Centre for Gastroenterology, a full stenting service is provided including palliation of oesophageal, gastric, small bowel and colorectal tumours.
 

Clinical Measurement Laboratory

The Clinical Measurement Laboratory opened in May 2006 with a technician having been appointed in early 2006.  The lab will provide a full oesophageal pH and Manometry service.  It will provide a complete ano-rectal physiology service.  It will continue to provide a full breath testing service including assessment of bacterial overgrowth, disaccharide intolerance, and helicobacter pylori status.
 

Multi-Disciplinary Approach

The Centre for Gastroenterology offers a multi-disciplinary approach with weekly gastrointestinal medical / surgical conferences.  We have an excellent relationship with specialist medical oncology, GI radiology, GI histopathology, microbiology, upper GI surgery and colorectal surgery.
 

Research

Members of the Centre of Gastroenterology have a strong research record and in the past year a full GI research programme has been developed.  We have initiated and are conducting trials in irritable bowel syndrome, diverticular disease and novel endoscopic techniques. We are also participants in multi-centre international studies.
 

Future Developments

The Centre for Gastroenterology has seen considerable change and progression in the past two years and looks forward to further developments in the near future.