One-Stop Colorectal Clinic May Facilitate Earlier Treatment

A one-stop colorectal clinic may significantly reduce the waiting time for patients waiting to have a lower GI endoscopy and therefore help speed diagnosis and treatment for colorectal cancer earlier in the disease process.

The efficacy of a one-stop colorectal clinic was tested by researchers at the Blackburn Infirmary in Blackburn, England to see how it might reduce the waiting times for lower GI endoscopy in nearly 200 patients who required an evaluation for various colorectal symptoms.

A weekly clinic was set up, held on Wednesday evenings from 6:00 p.m. to 9:00 p.m. Patient complaints included rectal bleeding, change in bowel habits, anorectal symptoms and screening requests due to a family history of colon cancer or polyps, according to the study published in the Journal of the Royal College of Surgeons of Edinburgh.

Of the patients seen during the study, 134 underwent proctoscopy, 72 had a rigid sigmoidoscopy and 85 had a flexible sigmoidoscopy. Flexible sigmoidoscopy was performed as indicated with just a phosphate enema rather than the normal full bowel preparation and sedation. Five cases of colon cancer were discovered in the participant group.

"Colorectal services have traditionally been arranged for the convenience of a hospital and its staff rather than for patients," wrote Dr. L. S. Jones of the Blackburn Infirmary. "Consultations and procedures are carried out in different places and at different times. This model is not ideal, particularly for minor interventions and diagnostic procedures."

When the clinic first opened, there were 119 patients on a waiting list for lower GI endoscopy but at the end of the six-month study period, the number had dropped to 63. Two months after the study concluded, the number climbed back to 108.

Because the main purpose of setting up the clinic was to determine if lower GI endoscopy would be well tolerated at the time of first consultation, the clinic was deemed a success. With the procedure done on a patient's first visit, it speeded up the diagnostic process and saved the patient from making an additional hospital trip. Although most of the patients observed in the clinic had minor ailments, it is that group, through early diagnosis, treatment and reassurance, who stand to gain the most from such clinics, said the researchers.

Other sources: Journal of the Royal College of Surgeons of Edinburgh