This page contains information for patients who have had a CT colonoscopy at North Bristol NHS Trust.

What can I expect after CT colonoscopy?

You can return to normal activities as soon as the scan is finished. You can return to your normal diet, but we suggest you eat little and often to reduce nausea and bloating. Drink plenty of water for the next 24 hours, as the preparation diet and medication can cause mild dehydration.

Feeling bloated and abdominal (tummy) pain

You may feel bloated, have tummy pain, or pass wind (fart) after the test because of the gas we put in your bowel. This should settle quickly, usually within 2 hours. Eating and drinking normally will help. Food may pass quickly through you for several hours after the examination. If you have diarrhoea up to 4 days after the procedure, contact your GP.

If you have any of these in the 5 days after your examination, phone NHS 111, your GP, or go to the nearest Emergency Department (A&E):

• Severe abdominal pain.
• Bleeding from your rectum (bottom) which is not normal for you.
• Sweating and/or feeling sick or generally unwell.

Possible symptoms from the hyoscine butylbromide (Buscopan) injection 

You may have been given an injection of hyoscine butlybromide (Buscopan) to help relax the muscles of the bowel, to get clearer images.

If you have any of these side effects please tell the radiographer:

• Blurred vision - if this happens you need to wait before driving. This side effect is very rare, and your vision should return to normal quickly.
• Sudden difficulty breathing or increased heart rate.
• Feeling faint.

If you have any of the following symptoms in the next 24 hours, please call NHS 111, your GP, or go to to the nearest Emergency Department (A&E):

• A skin rash and/or itching.
• Difficulty breathing and/or increased heart rate.
• Increased pressure behind the eye and/or eye pain (see below).

If you have eye pain in the next 24 hours it is important you go to your nearest eye hospital immediately. Take this leaflet with you as we will write down the drug information you need.

Bristol Eye Hospital is open 7 days a week 08:30-16:30. Outside of these times go to the nearest Emergency Department to you and you will be referred to the on-call eye team.

Alternatively call NHS 111. If you are unsure if you need to go to the Eye Hospital, please call 0117 923 0000.

Please be reassured that these side effects are very rare.

Possible symptoms from the contrast media injection

You may have been given an injection of contrast media to give us a more detailed scan. Complications are rare but some people may experience an allergic reaction.

Please tell the radiographer if you experience weakness, sweating, skin reactions, shortness of breath, or increase in heart rate.

If you have any of these symptoms at home please call NHS 111, your GP, or go to the nearest Emergency Department (A&E). Take this leaflet with you.

Your results 

The radiologist will examine the images from your scan in detail and send the results to the doctor who referred you. Waiting times can vary.

• If you were referred by an outpatient department at North Bristol NHS Trust, they will contact you with an appointment or to discuss the results.
• If your GP referred you, they will contact you. If you do not hear from them please call them directly.
• If you have come from the Bowel Screening Programme (BCSP) the results will be sent to the specialist screening practitioner who will contact you.

If you have any side effects or symptoms that require medical assistance from your GP or Emergency Department, please tell the Imaging Department by phoning 0117 414 8989.

The Imaging Department staff will write down

• If you have had hyoscine butylbromide (Buscopan):
  • The batch number
  • The expiry date
  • The dose
• If you have had contrast media:
  • The batch number
  • The expiry date
  • The dose

© North Bristol NHS Trust. This edition published July 2024. Review due July 2027. NBT003705.

What is a tattoo?

Tattoos are caused by pigment or ink being embedded into the skin. The body forms a fibrous coating around the pigment particles so that they are not absorbed and removed by the body.

We can treat the following types of tattoo:

• Indian ink tattoos (often used in amateur tattoos).
• Single colour tattoos.
• Multicoloured tattoos.
• Accidental tattoos - where something like pencil graphite or gravel gets embedded in the skin during an accident.

How does laser treatment fade the tattoo?

We use Qswitched NdYag and Ruby lasers for treating tattoos. These lasers use short bursts of energy that are absorbed by the tattoo particles. This breaks up the pigment particles and fibrous coating around the pigment so the body can absorb them. This is a safe and effective way of treating tattoos.

How successful is treatment?

This depends on the type of ink used, and can be difficult to predict because there are hundreds of different ink recipes. Some tattoos clear completely following laser treatment but it is never possible to guarantee 100% removal.

Indian ink and single colour black or red tattoos usually respond well to treatment. Other colours like green, blue, purple, and orange do not respond as well.

How well your tattoo may respond will be discussed with you at your consultation.

What does treatment involve? 

The number of sessions needed varies depending on the type of ink and size of tattoo but may be around:

• Indian ink - 4-6 treatment sessions.
• Professional tattoos - 10-12 sessions.

Treatments are spaced at least 8 weeks apart to allow the body to absorb the pigment.

You will need to look after your skin carefully for 1-2 weeks after each treatment. You may also need to wear high factor sunblock on the tattoo for the whole course of treatment.

You are advised not to have a tattoo treated if you have a heavy suntan because this increases the risk of scarring and is not as effective.

We recommend you do not have tattoo removal laser treatment during pregnancy.

Are there any side-effects?

The risk of scarring from treatment with the Qswitched laser is low.

The treatment can occasionally cause the normal pigment in skin to decrease or increase, leaving a pale or dark mark where the treatment was. This usually returns to normal but can take a long time.

Side-effects are more common if your skin is tanned when treated. Laser treatment may not be suitable for people with very dark skin because of the increased risk of side-effects.

Some light-coloured tattoo inks can get darker with laser treatment, which may be temporary or permanent.

The risk of side-effects will be fully discussed with you at your consultation.

Funding for laser treatment

Laser treatment for tattoo removal is not routinely funded on the NHS. In severe or exceptional cases the Exceptional Funding Panel in your area may consider this. If you think you may be eligible, discuss this with your GP.

If you cannot get NHS funding you can self-fund your consultation and treatment at Bristol Laser Centre. We offer a sensitive, personal, honest approach.

An initial consultation with a specialist doctor is always required. This costs £120. During the initial consultation you will discuss your specific needs. We may then offer a test patch to show how well you may respond to the treatment

Tattoo removal laser treatments start from £70 per session.

How do I book in? 

If you have any questions or would like to arrange a consultation, please phone us on 0117 414 1212.

Or fill in our online form: Contact Bristol Laser Centre

© North Bristol NHS Trust. This edition published April 2025. Review due April 2028. NBT002020

Anorectal physiology tests 

You have been asked to attend this test for problems associated with faecal incontinence or constipation, or other bowel problems.

Your consultant has requested these tests so that they can establish what exactly is causing your particular problem. They can then offer the most appropriated treatment.

Anorectal physiology tests are used to assess the function of the muscles in your anal canal to see if they are working normally, and also checks the sensitivity of the rectum to small volumes of air and its response to distension. 

This page outlines what to expect both during and after the test.

Upon arrival

• When you arrive you will be greeted and taken into a private room by the clinical scientist who will be performing the test.
• A chaperone will also be present to assist. The clinical scientist will ask you some questions about the symptoms you have been having and take a brief history. You will have the opportunity to ask questions or discuss any concerns you may have regarding the test.
• What does the test involve?
• You will be asked to undress from the waist down, put on a gown and lie, covered with a sheet, on your left side. Every effort will be made to preserve your privacy and dignity during the procedure.
• The clinical scientist will perform a gentle rectal examination and ask you to push and squeeze to check how your muscles are working.
• A thin, water-filled tube (catheter) with a small balloon on the end will then be put through the anus into the rectum. You will be asked to perform manoeuvres such as squeezing, pushing, and coughing to assess the functionality of the anal muscles. This catheter is approximately the width of a pencil.
• Next, the balloon on the end of the tube will be inflated with a very small amount of air, and you will be asked to comment on your sensations as this happens. This is the last part of the test.
• If your consultant has requested a treatment called “biofeedback”, the clinical scientist may show you the computer screen and talk you through techniques to improve the function of your anal muscles (but only if you need it). You may also be required to attend clinic on another day for further sessions of biofeedback.

Frequently asked questions

How shall I prepare for the test?

Are there any risks associated with these tests?

What happens after I have had the test?

How long does the test take?

Are there any alternatives to the test?

What will happen after your tests?

Further appointments 

If you require any additional information concerning the investigations or any advice please contact us using the details below. If unavailable please leave a message and you will be contacted.

References and sources of additional information

© North Bristol NHS Trust. This edition published June 2024. Review due June 2027. NBT002923

The Department of Cellular Pathology provides a wide-ranging and comprehensive Histopathology, diagnostic Cytopathology and Cervical cytology screening service to both North Bristol NHS Trust and University Hospitals Bristol and Weston NHS Foundation Trust, as well as GPs and other healthcare providers. The service is accredited to ISO15189:2022 with UKAS (Lab 8130) and relevant activities are licensed by the Human Tissue Authority (license 12413).  There is extensive participation in External Quality Assurance schemes.  The department is well-equipped and is housed in a purpose-designed laboratory opened in 2016.

The Department is open for service and opinion Monday to Friday, 09.00–17.00 hrs. Outside of these times, a renal on-call service exists and contact with on-call consultant staff can be made via switchboard. There is no general on-call service.

The diagnostic service in fully computerised with extensive databases. The current LIMS is Clinisys WinPath Enterprise. Results are all available through ICE and all requesting can be made through ICE.

The service has implemented specialist reporting to support the wide range of services at the Trusts. The consultants are members of one or more specialist teams working to common standards. Clinical consolidation of services had brought together the work of some teams whilst in others cellular pathology has instigated this. A number of the consultants support referral practices and, in all specialisms, consultants are core members of the multidisciplinary teams for cancer services.

The department works closely with the Bristol Genetics Laboratory for the provision of a portfolio of molecular genetics testing.

Services offered include consultation with clinical colleagues to assist in the interpretation of reports and to provide advice about the collection, handling, fixation and submissions of specimens for investigation.

A number of individuals in the department have research interests and the department as a whole is keen to support such activity within the Trusts.

The accreditation status of our tests can be found in the Quality section of the Severn Pathology website.

The automated laboratory provides a routine clinical biochemistry testing service to all inpatient, outpatient and GP surgeries in the North Bristol area.

It has a workload of 1 million specimen requests per annum, with a repertoire of over 50 tests. The laboratory offers a routine service and processes over 20,000 test requests per day.

Our laboratory is equipped with Beckman Coulter instrumentation, which processes the majority of routine biochemistry tests.

Endocrinology, cardiac and a number of tumour markers are also analysed using these systems. As well as processing routine samples, an urgent service is provided throughout the routine working day. Between 10pm - 8am the automated laboratory provides an out-of-hours service.

Contact our services using the key contacts below.

Contact Details

Antenatal and Newborn Screening for Sickle and Thalassaemia (SCT)

Background:

Haemoglobinopathies are a group of inherited blood disorders that fall into two main categories: haemoglobin variants such as sickle cell disease (SCD) and thalassaemias. If a patient is a carrier of the sickle cell or thalassaemia gene, it can be passed onto the baby. All pregnant women in England who have accepted screening will have laboratory testing for haemoglobin variants and thalassaemia. If the mother is found to be a carrier, screening may also be offered to the father. 

Haematology Department:

The department of Haematology provides a Sickle Cell and Thalassaemia (SCT) Screening service for antenatal patients in North Bristol and offers a confirmatory service for the newborn screening provided by Clinical Biochemistry. Further information on newborn blood spot testing can be found on the NBT newborn screening page. 

The SCT screening provided by the laboratory follows the government’s published handbook for antenatal laboratories and handbook for newborn laboratories which set out interpretation and reporting guidelines, including which types of carrier states to report.

SCT testing on antenatal patients is undertaken on whole blood samples taken at booking, preferably before 10 weeks gestation. This allows for prenatal diagnosis (PND) to be offered to at risk women and couples by 12 weeks +6 days of pregnancy. Early detection of SCT through screening allows for personal informed choice, timely counselling, clinical monitoring and preparation for those patients identified as having an “at risk” pregnancy.

As well as the general sample labelling requirements, it’s also necessary for the patients’ family origin questionnaire (FOQ) to be completed either on the reverse of the antenatal form or by following prompts when requesting on ICE. Our UKAS accredited laboratory currently screens approximately 7000 pregnant women each year and confirms results for approximately 500 babies for the newborn screening laboratory.

The SCT screening programme is provided in close collaboration with health care professionals throughout the region.

Requesting:

The majority of SCT requests should be made on ICE, however, if ICE is unavailable please complete a manual request form below.

Analysis:

Initial screening is performed on our primary analyser using capillary electrophoresis (CE). 

Abnormal samples are then reanalysed using isoelectric focussing (IEF). IEF separates the proteins into bands allowing our skilled biomedical scientists to identify the types of haemoglobins.    

Quality Assurance:

Turnaround times (TATs), standards and key performance indicators (KPIs)
The laboratory is accredited by UKAS under ISO15189 registration number 8066 and participates in UK NEQAS Quality Assurance Scheme.
Screening laboratories must be able to release > 90% of antenatal results, interim reports and requests for repeat tests in < 3 working days in accordance with SCT screening standards.

Please see below for responses to our most recent user survey:

Developments:

We report our rare, affected babies (those with severe disease) on a named patient basis, and this is to the newborn outcomes solution (which reports to NCARDRS).

SCT Newborns (mdsas.nhs.uk)

More recently, paper copies of the forms have become unavailable: all patient leaflets are held centrally and are available on the government website.

Laboratory Visits:

We offer half-day training sessions to midwives, health visitors, nurses, doctors and other allied healthcare professionals involved in the collection of samples. Please contact us to arrange a visit.

Key Contacts for Haematology Laboratory

Dr Sophie Otton
Clinical Lead for SCT & Consultant Haematologist 
Via Haematology secretaries - Telephone: 0117 414 8401

Jemma Cable
Clinical Scientist

Grace Van Der Mee
Lead Biomedical Scientist

Helen Izzard
Senior Biomedical Scientist

Pathology Sciences Laboratory
Southmead Hospital
Westbury-on-Trym
Bristol
BS10 5NB
Email: NBTHaemoglobinopathyService@nbt.nhs.uk
Telephone: 0117 414 8356

Opening times: 9am - 5pm Monday - Friday excluding bank holidays.

Clinical advice & interpretation is available during working hours.

Q-Pulse Ref HA/WE/008 V2

Urgent release of blood for patients with antibodies present

Approximately 2% of patients will have red cell antibodies in their plasma as a result of transfusion or pregnancy.  Every group and save includes an antibody screen, and where antibodies are detected, additional testing is required.  Depending on the complexity this can take several hours for uncomplicated cases and 24-48 hours if the complexity requires referral to the regional reference laboratory. This can cause a delay in blood provision.  Most of the antibodies screened for are clinically significant with the potential to cause haemolytic transfusion reactions and/or haemolytic disease of the fetus and newborn (HDFN).  The lab will do the utmost to provide suitable units, however sometimes urgency warrants the issue of potentially incompatible units.  

The flowchart below is a guide to the process:

Information for adults who attend the Anticoagulation Monitoring Service at Southmead Hospital or Bristol Royal Infirmary 

This page provides information about the anticoagulant medication warfarin. If you are unsure why you have been prescribed warfarin or have other concerns, please discuss this with the clinician who recommended the treatment. 

This page has 3 sections:

• Section A: anticoagulation and warfarin, side effects, general advice about how to take warfarin.
• Section B: Anticoagulation Monitoring Service (warfarin clinic) at Southmead Hospital (North Bristol NHS Trust).
• Section C: Anticoagulation Monitoring Service (warfarin clinic) at the Bristol Royal Infirmary (BRI) (University Hospitals Bristol and Weston).

You will also be given a yellow Warfarin Anticoagulant Therapy Package which includes:

• An anticoagulant alert card that you should carry with you. This is important if you are involved in an accident, as it will allow medical staff to identify that you are taking warfarin.
• An information leaflet with further details on warfarin.
• A yellow record book to record your INR results and warfarin dose if you would like. Otherwise, you may be given a letter or text message with your dose that you can keep. 

Section A

What is anticoagulation?

Why are anticoagulants used?

How long will I be on warfarin?

Warfarin tablets

How to take your warfarin

Blood test monitoring (INR results)

Is warfarin affected by other medicines I take?

Can I drink alcohol whilst taking warfarin?

Diet and warfarin

Injury

Side effects

Bleeding

What about operations?

Dental appointments

Women’s health

What about holidays or going away?

Section B

Anticoagulation monitoring at Southmead Hospital (North Bristol NHS Trust)

Section C

Anticoagulation monitoring at Bristol Royal Infirmary

References and further information

References and further information

© North Bristol NHS Trust. This edition published April 2025. Review due April 2028. NBT002417

This leaflet has been produced to help explain the procedure of an ultrasound guided vacuum excision. 

What is an ultrasound guided vacuum excision?

An ultrasound guided vacuum excision uses a needle to remove a small area of tissue from your breast. This tissue is then examined by a pathologist.

Why am I having this procedure carried out?

The main reasons why we use this procedure are:

• To remove benign (non-cancerous) lumps.
• To remove a wart-like lump (papilloma) which has been found within the milk ducts.
• To remove ducts from the nipple area because of discharge of the nipple and surrounding area.
• To remove an area that has shown unusual cells.

If only benign tissue is removed during the procedure, no further action is needed. 

However, if cancerous cells are found an operation may be necessary. The benefit of this procedure is that it is carried out under local anaesthetic as an outpatient.

What happens during the procedure?

The procedure will take approximately 30 - 45 minutes, with a 15 to 30 minutes wait in the breast care centre afterwards. There will be somebody with you all the time. With this technique, there are no stitches, and usually little external scarring. 

You will be asked to undress to the waist and lie down for the procedure. 

We will be using an ultrasound machine to identify the area of concern within your breast. The clinician will use a local anaesthetic to numb the area. Once the area is numbed, we will insert the biopsy needle. This procedure uses a vacuum system and you will hear a noise, similar to a sewing machine and some suction noises, when the samples are taken.

Marker clips

Sometimes, a tiny sterile metallic clip is placed in your breast. This is a three mm clip made up of titanium (and sometimes some gel). This acts as a marker if the area needs to be found again. If the area we have biopsied is normal the clip remains in place. There are no side effects from this and it will not cause a problem at an airport or if you ever need an MRI (magnetic resonance imaging) scan. 

You can eat and drink normally before this procedure. It is recommended that you not drive yourself home after this procedure and ideally arrange for somebody to take you home. 

Please let us know at least three days in advance if you are on Warfarin or any other blood thinning agents. Please inform us about any allergies, in particular local anaesthetic.

Your results

You will be informed before you leave the clinic how and when you will get the results of the investigations. It usually will take one or two weeks.

After the procedure

You have had some local anaesthetic, which has numbed the area. This will wear off after a few hours and you may feel some soreness. A mild painkiller such as paracetamol may be taken.

Wound dressing

You have had some paper stitches and you can remove them after three days by soaking them off in the bath. A bandage is applied around your chest. This reduces the risk of bleeding and bruising after the procedure. Ideally, the bandages should be kept on overnight but can be removed the next morning. If uncomfortable you can take them off earlier.

Bruising

Bruising The amount of bruising after this procedure varies. It is likely that you will develop a bruise or lump around the area of the biopsy. However, it may extend more widely. This bruising may take several weeks to clear up, but if the bruising becomes gradually worse, please contact the breast care nurses for advice 0117 414 7072 or 0117 414 7018.

Bathing /swimming

It is fine to have a shower or a shallow bath. Do not soak in the bath until the paper stitches are removed. Do not swim until the wound has healed.

Bleeding

Very occasionally people experience bleeding from the biopsy site. If this happens, apply firm pressure over the top of the dressing with the flat of your hand for at least ten minutes, this should control any bleeding. If you have any concerns about the wound please contact the breast care nurses on 0117 414 7072 or 0117 414 7018 or your general practice.

Infection

Although we take care to prevent infection, there is a very small possibility that the wound may become infected. If your breast becomes hot, red and swollen, then you should contact your GP, or nearest minor injury centre.

When can I resume normal activities?

Avoid strenuous activity, such as lifting, heavy housework or sports for at least 48 hours. It may help to wear a soft bra for 24 - 48 hours afterwards.

Follow up

In some cases annual mammography follow up for five years will be recommended.

© North Bristol NHS Trust. This edition published January 2024. Review due January 2027. NBT003049