Tuesday Evening Proctology Clinic
Clinic A, Lanesborough Outpatient Department
Lanesborough Wing
Patient information
What is the Tuesday Evening Proctology Clinic?
It is a walk-in clinic for people with bowel symptoms, who have been referred by their General
Practitioner (GP). It is called a rapid access proctology clinic as it has been set up to prevent patients
waiting several weeks for appointments in daytime clinics. We hope that you find the evening clinic
times suit you, particularly if you work office hours or have to arrange childcare.
The clinic is on Tuesday evenings. You can arrive and register at the clinic between 16.30 and 19.00
hours on Tuesdays. Some patients choose to arrive early and wait as this clinic is run on a first come,
first served basis, however please note that arriving early does not ensure you are prioritised. From
16.30 hours patients are given a ticket number and this will determine their position in the queue.
Patients are seen from 18.00 hours when the doctors arrive and the clinic formally begins. After you
have registered (completed a registration form) you will be seen by a doctor in turn. This clinic can
run as late as 22.00 hours and will not shut until the last registered patient has been seen.
This clinic is in high demand and the number of patients attending will not be known in advance.
Unfortunately, such an arrangement can also mean that patients may have to wait a long time
(sometimes 2 to 3 hours). The clinic staff will keep you informed of any delays. We apologise in
advance for such delays which we try to keep to a minimum. Please be aware that should the
number of patients requiring an appointment exceed the allotted amount based on the number of
doctors in clinic, for example if very large numbers of patients turn up, patients will be turned away.
What do I need to know about proctology?
In this leaflet we talk about your back passage, which is your bottom. The medical term for this is
your rectum, and the opening to your rectum is called the anus. Anorectal is a term that covers both
the anus and the rectum. Proctology is the name of the medical speciality that deals with anorectal
problems.
Who is it for?
The clinic is for people who have had any of the following symptoms:
 Short-term change of bowel habit
 bleeding from their back passage
 acute anorectal symptoms, such as pain or discharge (leakage) from their back passage that
started suddenly
Before coming to the clinic you must have had an appointment with your GP about your symptoms
(as listed above). You must bring a GP referral letter with you to the clinic.
We will only see you if:
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you bring your GP referral letter with you
your GP referral letter was written within the last month
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If you are an overseas visitor and have been in the UK for less than a year, you may have to pay for
NHS treatment (including the Rapid Access Proctology Clinic). You may need to be interviewed by
the Overseas Patients Department before being seen in the clinic. Please note that the Overseas
Patients Officer will not be on duty during the clinic times, but can be contacted on 020 8725 3439
(from Monday to Friday 09.00 to 17.00 hours).
Before you come
You do not need to take laxatives before attending the clinic. Please tell the doctor if you are on
anticoagulant or antiplatelet medication such as warfarin or clopidogrel, or need antibiotic cover
before any procedure.
The examination
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You will be asked to lie on your left side and to bend your knees up towards your stomach. A
clinic nurse will be available to assist the doctor and to chaperone (accompany you during the
examination).The doctor will gently carry out the internal examination with a gloved finger first.

Then a plastic tube, called a sigmoidoscope, will be inserted into your back passage. Air is
passed through the tube into the rectum so that the lining of the rectum can be seen more
clearly. This may cause some windy discomfort but it will not last long. Air that has been
passed into the rectum may make you feel as though you are going to pass wind. Some air
may escape during the examination; please do not worry about this, it is perfectly normal. You
may also feel like you may open your bowels. Please do not worry; you will not!

The sigmoidoscope examination is usually followed by a proctoscope examination. This is a
shorter plastic tube which will be inserted into your back passage and helps the doctor to look
at the lower part of your rectum.

A biopsy (a small sample of the lining of the rectum) may be taken if one is needed; you will
not feel this. The sample will be sent to the laboratory to be examined. If the doctor is going to
take a biopsy he or she will inform you before taking it.
The doctor will tell you the results of the examination immediately. Biopsy results will take 1 to
2 weeks. The results will be sent to your GP or given to you if you have a follow up
appointment in the daytime clinic.
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If the doctor diagnoses a minor anal condition, you can usually be treated immediately in the
rapid access proctology clinic. These conditions include:
 piles (haemorrhoids)
 fissure (a tear or crack in the back passage)
 perianal haematoma (blood clot in the back passage).
The clinic nurse will give you separate leaflets about these conditions (if applicable) and their
treatments.
 If the doctor suspects that you have a bowel disease, they will discuss the options for further
tests and treatment with you.
Are there any complications?
The examinations above are very safe. However, there may be discomfort following the procedure
and you might need some pain relief, such as paracetamol (or whatever you normally take for a
headache). It is very unusual to have severe pain but if this happens you may need to see your GP
or attend the A & E (Accident and Emergency) department for a stronger prescription of painkillers.
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We are unable to give pain relief tablets from the clinic.
When a biopsy is taken, there may be a little bleeding. If this does not stop within 24 hours or is
excessive (clots with no signs of bleeding decreasing), please contact St George’s Hospital switch
board on 020 8672 1255 and ask to speak to the surgical doctor on-call or attend the A & E
department.
What happens next?
Before you leave the outpatients department, you will be told whether you need a further
appointment, further tests or treatment. Please make sure you see the receptionist before you leave
the clinic. If you have any questions or concerns, please speak to the specialist doctor or clinic nurse.
For any further advice, please contact the medical secretaries, Monday to Friday, 09.30 to
16.30 hours:
Lyn Thomas (Mr Melville’s secretary) on 020 8725 0121 or Kim Cook (Mr Hagger’s secretary) on 020
8725 1872
To book, confirm or cancel appointments at St George’s following rapid access proctology
clinic:
Please call the call centre on 020 8725 3000
Exclusion Criteria for referrals
Please refer the following groups of patients to the standard outpatient clinic in the daytime. Urgent
cases are usually seen within 2 weeks of receiving a fax from a GP:
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Patients with chronic symptoms.
Elderly patients or wheel chair users who require the assistance of the patient
transport service.
Children under the age of 16, who should be referred to paediatrician.
Patients whose examination may require general anaesthesia, such as some people
with physical or learning disabilities.
Patients for follow up (including post-operative).
Patients who are under active follow-up by a colorectal consultant.
Patients who have been seen by another team with the same complaint or attended
the Accident & Emergency Department or the walk-in centre.
Please ensure that patients are aware of the availability of standard outpatient appointments in the
daytime.
January 2014.
Review date: January 2016
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Living our values – excellent, kind, responsible, respectful