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Colorectal Services

Introduction and Overview

Colorectal Services at Nottingham Road Clinic provide specialist-led assessment, diagnosis and management of conditions affecting the colon, rectum and anal canal. Colorectal symptoms are common and may represent benign functional disorders, inflammatory disease or serious underlying pathology, including colorectal cancer. Accurate assessment and timely investigation are essential to ensure safe diagnosis, appropriate treatment and reassurance where serious disease is excluded.

The service is delivered by experienced colorectal specialists with expertise across benign and malignant colorectal disease. Care is supported by access to diagnostic investigations, including endoscopy, imaging and pathology services, enabling comprehensive evaluation within a coordinated outpatient setting.

Nottingham Road Clinic adopts a structured, evidence-based approach to colorectal care. Assessment focuses on identifying the cause of symptoms, recognising red-flag features, excluding malignancy and developing an appropriate management plan tailored to the individual. Colorectal conditions often have a significant impact on quality of life, continence, bowel function and psychological wellbeing. Management therefore considers both physical and functional outcomes and, where required, integrates care with multidisciplinary teams and NHS pathways.

Introduction and Overview

Colorectal Services at Nottingham Road Clinic provide specialist-led assessment, diagnosis and management of conditions affecting the colon, rectum and anal canal. Colorectal symptoms are common and may represent benign functional disorders, inflammatory disease or serious underlying pathology, including colorectal cancer. Accurate assessment and timely investigation are essential to ensure safe diagnosis, appropriate treatment and reassurance where serious disease is excluded.

The service is delivered by experienced colorectal specialists with expertise across benign and malignant colorectal disease. Care is supported by access to diagnostic investigations, including endoscopy, imaging and pathology services, enabling comprehensive evaluation within a coordinated outpatient setting.

Nottingham Road Clinic adopts a structured, evidence-based approach to colorectal care. Assessment focuses on identifying the cause of symptoms, recognising red-flag features, excluding malignancy and developing an appropriate management plan tailored to the individual. Colorectal conditions often have a significant impact on quality of life, continence, bowel function and psychological wellbeing. Management therefore considers both physical and functional outcomes and, where required, integrates care with multidisciplinary teams and NHS pathways.

Who the Service Is For

Colorectal Services are suitable for adults presenting with bowel or anorectal symptoms that require specialist assessment beyond primary care.

This includes patients with:

  • Rectal bleeding or altered bowel habit
  • Persistent diarrhoea or constipation
  • Abdominal or anorectal pain
  • Iron deficiency anaemia of unknown cause
  • Unexplained weight loss or change in appetite
  • Faecal incontinence or evacuation difficulties
  • Anal pain, swelling or discharge
  • Family history of colorectal cancer or inflammatory bowel disease

Specialist input is particularly important where symptoms are persistent, progressive, associated with systemic features, fail to respond to initial treatment or meet recognised criteria for urgent cancer assessment. The service supports both insured and self-pay patients and provides clear guidance for GPs and referrers on investigation, referral thresholds and shared care.

Conditions Assessed and Managed

The Colorectal Service assesses and manages a wide range of colorectal and anorectal conditions.

Bowel habit change and functional bowel symptoms 
Altered bowel habit, bloating and abdominal discomfort may reflect functional bowel disorders but require assessment to exclude inflammatory or neoplastic causes.

Rectal bleeding 
Bleeding may arise from benign conditions such as haemorrhoids or anal fissures but can also indicate colorectal cancer or inflammatory disease, requiring structured assessment.

Colorectal cancer and suspected malignancy 
Symptoms such as persistent bleeding, iron deficiency anaemia, weight loss or change in bowel habit warrant urgent investigation in line with national cancer referral guidance.

Inflammatory bowel disease 
Crohn’s disease and ulcerative colitis may present with diarrhoea, bleeding, abdominal pain or anaemia. Specialist assessment supports diagnosis, monitoring and coordination of care.

Haemorrhoids and anal disorders 
Pain, bleeding, itching or prolapse may relate to haemorrhoids, fissures, fistulae or abscesses and require tailored management.

Faecal incontinence and pelvic floor dysfunction 
Continence problems can significantly impact quality of life and often involve complex functional and structural factors.

Diverticular disease 
Diverticulosis and diverticulitis may cause abdominal pain, bleeding or recurrent symptoms requiring assessment and management planning.

Red-flag colorectal symptoms 
Unexplained anaemia, persistent rectal bleeding, weight loss, abdominal mass or significant change in bowel habit require timely specialist assessment.

Clinical Assessment and Diagnostic Approach

Assessment begins with a detailed history focusing on bowel habit, bleeding patterns, pain, weight change, systemic symptoms and family history. Medication use, dietary factors and previous investigations are reviewed.

Clinical examination may include:

  • Abdominal examination
  • Digital rectal examination where appropriate
  • Anorectal examination

Diagnostic pathways are guided by clinical findings and may include:

  • Endoscopic investigation, including colonoscopy or flexible sigmoidoscopy
  • Imaging such as CT or MRI when indicated
  • Blood tests including inflammatory markers and iron studies
  • Stool tests where relevant
All investigations align with national colorectal and cancer referral guidelines, ensuring investigations are clinically justified and proportionate.

Treatments, Procedures and Management Pathways

Management is tailored to diagnosis, symptom severity, cardiovascular risk and patient preference.
Treatment pathways may include:
  • Conservative management including dietary modification and medical therapy
  • Targeted treatment for inflammatory bowel disease
  • Management of haemorrhoids and anal conditions
  • Endoscopic procedures where appropriate
  • Ongoing surveillance for high-risk patients
  • Referral for surgical intervention when indicated
Care plans are evidence-based and prioritise conservative approaches when appropriate, with escalation guided by clinical response, disease progression and risk.

Multidisciplinary Working and Onward Referral

Colorectal care often involves close multidisciplinary collaboration. The service works with:

  • Gastroenterology services
  • Radiology and endoscopy units
  • Specialist colorectal nursing
  • Pelvic floor physiotherapy
  • Pain management services
  • Mental health support where chronic symptoms affect wellbeing
  • Primary care for shared management
  • NHS colorectal and cancer services for onward treatment
This integrated approach ensures patients receive coordinated and timely care.

What Patients Can Expect from an Appointment

Appointments are consultant-led and structured to provide clarity and reassurance.
Patients can expect:
  • Detailed discussion of symptoms and medical history
  • Appropriate physical examination
  • Explanation of possible diagnoses
  • Discussion of investigations and management options
  • Development of a personalised care plan and follow-up
Clear written communication is provided to patients and referrers to support continuity of care.

Frequently Asked Questions

Do all bowel symptoms require investigation?
Many symptoms are benign, but assessment is important to exclude serious disease.

Will I need a colonoscopy?
Endoscopic investigation is arranged where clinically indicated.

Are colorectal symptoms always related to cancer?
Most are not, but cancer must be excluded when red-flag features are present.

Can this service support NHS referrals?
Yes. Findings can support NHS referral and shared care pathways.

Will my GP be informed?
With patient consent, correspondence is shared with primary care.

Is follow-up always required?
Follow-up depends on diagnosis and investigation results.

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