Regular | North Bristol NHS Trust

Surgery Research Team

Read more about Surgery Research Team

Regular Off Off

Surgery Research Team

Our Surgery Research team is a dedicated group of nurses, administrators, and surgeons, conducting studies across specialities including Colorectal, Upper Gastrointestinal (UGI) and Vascular.

Our research is supported by the Department of Health with our research projects encompassing a wide breadth of both laboratory-based and clinical work, to improve patient health, wellbeing and care.

We work on a range of commercial and non-commercial, qualitative and quantitative projects and collaborate with colleagues locally, nationally and internationally in order to improve outcomes for patients suffering from various conditions.

Our work benefits patients not only here in the NHS, but also increases care standards globally.

The team has a wealth of experience conducting research studies and trials, and improving training, guidelines, and patient outcomes.

Our staff work in close collaboration with a number of partners, primarily linked with the University of Bristol and University of the West of England (UWE) as well as a number of other NHS Trusts.

As part of our Colorectal & Upper Gastrointestinal portfolio, we also work closely with Bristol’s Haematology and Oncology Centre (BHOC) and operate a shared care research pathway between us so patients can receive the highest standard of care whilst taking part in a research study.

Colorectal & Upper Gastrointestinal (UGI) Research Team:

Dr Anne Pullyblank

Consultant Colorectal Surgeon

Anne was appointed consultant colorectal surgeon at North Bristol NHS Trust in 2003 and has held many leadership positions within the trust including chair of the clinical risk committee, Clinical Director for Surgery and lead for colorectal and emergency surgery. Anne performs open and laparoscopic bowel (keyhole) surgery and has an interest in bowel cancer, surgical infections, vacuum dressing for the open abdomen and emergency surgery. She was awarded an MD for laboratory-based research from University of London examining the role of monoclonal antibodies in colorectal cancer. She was principal investigator for CREST, PPAC2, Bluebelle, Selfi and DISCOVER. She is currently PI for VODECA, CREST2 and CONSIDER-19 and sits on the trial management group for CREST2.

Kathryn McCarthy

Consultant Colorectal Surgeon

Miss Kathryn McCarthy studied at UCL (1993-1998), attained her MD with the University of London (2005), following which she completed her FRCS at Royal College of Surgeons of England (2007), and her Gynaecological Fellowship (2009) and Laparoscopic Subspecialty Fellowship in Glasgow (2011-12).

Her clinical interests include laparoscopic colorectal surgery, endometriosis and pelvic surgery. Her academic interests include the IGF pathway in colorectal cancer and surgical outcomes in older people (OPSOC.eu). Her subspecialty interests include minimally invasive trans anal surgery, early rectal cancer and pelvic floor surgery.

She is clinical lead for Endoscopy and GI physiology. Nationally, she is the NIHR lead for surgical research (West of England).

She is also a member of The Royal College of Surgeons of England, National Pelvic Floor Society and European Society of Coloproctology.

Ann Lyons

Consultant Colorectal Surgeon

Miss Ann Lyons was appointed as a consultant colorectal surgeon at North Bristol Trust in 2005. Prior to joining North Bristol NHS Trust, Ann was a fellow at international centres of St Marks Hospital, London and Mount Sinai Hospital, Toronto expanding her management of complex pelvic conditions. Graduated with Hons, Surg and Antomy Medal Ann completed by Higher Surgical Training in the South West Deanery, centred on Bristol. During her Higher Surgical Training, she had valuable out of training experience, educated with Professor Hohenberger in colon and rectum cancer surgery and Prof Matzel in pelvic floor disorders, in the University of Erlangen. She has actively engaged programmes for cancer patient communication, including in the NCAT cancer care programme 2013.

Within this experience Ann has developed a holistic approach to cancer care, and a specialty interest in delivering safe careful pelvic surgery for regional patients; and surgery for early and advanced cancer. I have extensive experience in minimally invasive surgery.

Ann has clinical, educational and research experience. Awarded MD for her bench to bed side T cell immune response to major stresses, Harvard Medical School and since appointment has been PI for several clinical research trials at North Bristol NHS Trust. Ann has presented both nationally and internationally. Ann is the lead surgeon for Colon and Rectum Cancer at North Bristol. She has a position on the SWAG CAG Colorectal Cancer Alliance.

Miss Ann Lyon is a member of RCSE, ACPGBI, ESCP, ASCRS and RSM.

Andy Smith

Colorectal Surgeon

Angus McNair

Colorectal Surgeon

Jodie Rawlings

Colorectal Research Nurse

James Hopkins

Upper Gastrointestinal Surgeon

Suzie Royle

Colorectal Research Nurse

Suzanna is a research nurse specialising in colorectal research, and has worked for North Bristol Trust since 2023. Prior to this, Suzanna worked at Surrey and Sussex Healthcare NHS Trust (SASH) across both elective and emergency surgical wards, for upper and lower gastrointestinal surgery. She is passionate about improving patient outcomes and patient experience, and therefore finds her role in colorectal research highly rewarding.

Vascular Surgery Research Team:

Dr Marcus Brooks

Consultant Vascular Surgeon

Dr Marcus Brooks is a Consultant Vascular Surgeon at North Bristol NHS Trust, Honorary Secretary elect for the Vascular Society of Great Britain and Ireland, and clinical member of NHSE Specialised Services Vascular Clinical Reference Group. His main clinical interest is in the management of aortic disease, including complex endovascular repair of aortic aneurysms and aortic dissection.

He is also the Principal Investigator for the EXcel Registry (Gore Conformable aortic stent graft) in the UK and also recruits to the COMPASS trial (Observational study of patients with juxta-renal abdominal aortic aneurysms).

Chris Twine

Vascular Surgeon

Chris is a vascular surgeon in Bristol and is clinical lead for vascular research. He has a research interest in amputation, chronic limb threatening ischaemia and antithrombotic therapy for peripheral arterial disease. He is an associate editor of CVIR endovascular and is on the editorial board of the European Journal of Vascular and Endovascular Surgery. He is a council member of the British Society for Endovascular Therapy where he is research lead, the Vascular Society special interest research group for peripheral arterial disease where he is intervention lead, and the European Society of Vascular Surgery guidelines steering committee where he is chair of the upcoming antithrombotic guideline. He has published over 100 original papers and his scientific work has received several prizes.

More information about Chris and his work can be found on the University of Bristol website.

Helen Cheshire

Vascular Research Nurse

Helen is a senior research nurse specialising in vascular. She has worked for North Bristol NHS Trust since 2015. Prior to this Helen was a key member of the intensive care team at the Bristol Royal Infirmary, where she worked as a senior nurse for sixteen years.

Helen has extensive experience, spanning multiple studies and specialties, delivering ground-breaking research. She ran gastro-hepatology research for two years, before moving to lead the vascular portfolio in 2017. Under Helen’s leadership, the vascular portfolio has grown exponentially.

Helen welcomes the challenges research presents as a continuously growing field. It can enable patients to participate in adjustments that result in a longer, better quality of life. She enjoys working at the forefront of new developments in treatments for our patients.

Seeve Suppiah

Vascular Research Nurse

Seeve is a surgical research nurse specializing in Vascular research and two colorectal research as well as helping with the AHEAD study - Preclinical Alzheimer's Disease with Elevated Amyloid. Prior to this, Seeve was an ITU nurse, a Renal dialysis nurse, a Research nurse for AVONCAP-COVID-19, pneumococcus, and respiratory syncytial virus (RSV), and a Haematology Research Nurse.

Cross-Portfolio Team:

Samantha Loud

Lead Research Nurse

Sam currently works as the Lead Research Nurse for the Surgery Research team overseeing Colorectal, UGI and Vascular Research at Southmead Hospital, managing a team of 6 competent research practitioners. Having qualified in 2000 as a Children’s Nurse, she began her career working in the Paediatric Intensive Care Unit at Bristol Children’s Hospital where she worked for 7 years. She then moved and worked for 4 years on a busy Surgical and Trauma ward.

After seeing an advert for the opportunity of a research nurse post at led jointly with NBT (North Bristol Trust) and UoB (University of Bristol) working with Children and their families researching into the risk of developing Type 1 diabetes she jumped at the chance for a new challenge. She spent 9 years in this post working her way up, initially as a junior nurse band 5 to a senior nurse band 7 role where she then led the team and managed the research project. This came to an end in 2020 when the study funding finished.

Sam was then offered the opportunity of a completely new role and challenge within NBT as the Senior Research Nurse for Surgery. This involved putting together smaller teams within different areas of Surgery research bringing them together as one team. This has been a success; the team has grown and consists of dedicated research nurses and administrators and is still growing! We have opened and reopened many studies across all the areas which are recruiting well.

Sam has lots of plans to extend this over time and build a bigger team to be able to cover more areas of surgery in the future.

Gosia Slowinska

Surgery Research Nurse

Gosia is a research nurse in vascular surgery team. She has worked for North Bristol Trust since 2020 in Intensive Care Unit and in HIV and Immunology Research team.

Prior to this Gosia worked as a nurse in Intensive Care Units in Royal Papworth Hospital, Yeovil District Hospital and Specialised District Hospital in Wroclaw, Poland.

Alice Smith

Research Administrator - Colorectal & Vascular

Patient instructions for further bowel preparation for CT colonography

Read more about Patient instructions for further bowel preparation for CT colonography

Regular Off Off

Information for patients whose initial preparation of your bowel has not been sufficient to produce a diagnostic result from your examination, a further 24 hours of additional bowel preparation is required.

Please follow these instructions to continue bowel preparation for your examination.

Diarrhoea may occur so make sure you have easy access to a toilet.

It is important to drink plenty of clear fluids during the entire period and aim for at least three pints of clear fluid every day. Examples of clear fluids are water, fruit squash, clear soup (e.g. Oxo, Marmite or Bovril), fizzy drinks (such as lemonade or cola), tea, or coffee. You should continue with any prescribed medication throughout.

On the day of the original appointment (today):

Continue Low Residue Diet (see the information below).
Drink plenty of clear fluids.
Prepare and drink water and Gastrografin mixture:

In a glass, mix one bottle of Gastrografin (20ml) with 200ml (half a pint) of water. (You can add fruit squash/cordial if you prefer).
Drink the mixture with a meal.

Day of re-booked examination:

Please drink plenty of clear fluids.
No solid food.
Prepare and drink water and Gastrografin mixture:

In a glass mix one bottle of Gastrografin (20ml) with 200ml (half a pint) of water. (You can add fruit squash/cordial if you prefer).
Drink this mixture at least 2 hours before your new appointment time.

Low Residue Diet for CT Colonography preparation

Please continue this diet to prepare for your new appointment. Eat no solid food on the day of your new appointment.

You will be given further advice if you are undergoing other treatments such as dialysis. If you are diabetic avoid all foods marked with a *.

Foods allowed

White flour: cornflour, custard powder, arrowroot, tapioca, sago, semolina.
White pasta: spaghetti, macaroni, other pasta shapes and noodles, tinned spaghetti in sauce.
White breads: pitta bread, soda bread, naan bread. (Except high fibre white breads).
White rice: any types.
Potatoes: peeled or cooked in any way but don’t eat the skin.
Fruit and tomato juice.
Breakfast cereals: cornflakes, Rice Krispies, Frosties*, Honey Smacks*, Ricicles*, Coco Pops*, Special K.
Biscuits*: any made with white flour e.g. rich tea.
Cakes*: any made with white flour e.g. sponge, plain scones, doughnuts.
Milk, plain yoghurt, all cheese, cream, butter, ice cream, plain fromage frais.
Eggs.
Fish.
Texturised vegetable protein (e.g. Quorn).
All oils, margarine, low fat spread, and butter.
All drinks including tea, coffee, squash, fizzy drinks, cocoa, drinking chocolate, malted drinks.
Sugar*, golden syrup*, treacle*, honey*, fruit sweets*, choco-toffee*, jelly jam*, jelly marmalade*, jelly*, fruit sorbets*.
All meat including tinned and corned.

Foods not allowed

Wholemeal, brown, rye flours and bran.
All wholemeal pasta including spinach flavoured, lasagna verdi, wholemeal spaghetti in sauce.
Wholemeal, brown, granary, high-fibre white, malt breads, poppadums and wholemeal pitta breads.
Wholegrain rice, wild rice, and barley.
All other vegetables including baked beans, other pulses, tinned tomato, crisps, potato snacks.
Breakfast cereals: Shredded Wheat, Shreddies, Bran Flakes, All Bran, Alpen and other muesli, Farmhouse Bran, Oat Crunchies, Start, Ready Brek, porridge, and oatmeal.
Cakes: made with wholemeal flours including pastries, pies, and wholemeal crumbles.
All fruit including fresh, frozen, stewed, canned, and dried e.g. raisins and currants.
Fruit, muesli, and nut yoghurts.
All nuts and seeds, including peanut butter, hummus, tahini, marzipan.
All dietary supplements that come as a tablet e.g. vitamins, glucosamine, and herbal extracts.
All alcoholic drinks.
Sweet mincemeat, jam with seeds, ordinary marmalade, chocolate made fruit and nuts, fruit in jelly.
Meat pies, pasties, puddings if made with wholemeal flour.
Meat dishes which contain vegetables e.g. curries, casseroles, chilli-con-carne.

Support your local hospital charity

Find out about what we do and how you can support us.

Imaging Department Contact Centre

If you are unable to attend your appointment please let us know as soon as possible. You can also contact the Imaging Department Contact Centre if you wish to change or discuss your appointment.

Telephone: 0117 414 8989

Bowel preparation for CT colonography: information for patients with constipation

Read more about Bowel preparation for CT colonography: information for patients with constipation

Regular Off Off

This page has information for patients with constipation referred for CT colonography at North Bristol NHS Trust.

Please follow these instructions to ensure adequate bowel preparation for your examination. Diarrhoea will occur so make sure you have easy access to a toilet.

It is very important to drink plenty of fluid during the entire period. You may become dehydrated otherwise. It also helps ‘flush’ the bowel through. Aim to drink at least three pints of clear fluid every day. Clear fluids include water, fruit squash, clear soup, fizzy drinks, tea or coffee.

Gastrografin and Citrafleet instructions:

You will be given 2 medicines to prepare your bowel for your examination. You will need to prepare these as advised below and drink them as instructed further down the page.

Gastrografin

Pour 1 bottle of Gastrografin (20ml) into a glass.
Into the same glass add at least 200ml or half a pint of water. You can add fruit squash/cordial as well if you prefer.
Stir with a spoon until mixed well.

Citrafleet

Empty all of the powder from 1 sachet into a glass.
Into the same glass add water (at least 150ml).
Stir with a spoon until the powder is completely dissolved.

Two days before your appointment:

Begin following the Low Residue Diet.

Drink plenty of clear fluids.

Day before your appointment:

Continue following the Low Residue Diet Drink plenty of clear fluids (at least 3 pints/1.7 litres).

You will have 2 Gastrografin and 2 Citrafleet mixtures today.
Drink 1 Citrafleet mixture in the morning.
Drink 1 Gastrografin mixture with your morning meal.
Drink your next Citrafleet mixture in the evening.
Drink your next Gastrografin mixture with your evening meal.

Day of your examination

You must have no solid foods from midnight.

Drink plenty of clear fluids.
At least 2 hours before your appointment drink one Gastrografin mixture.

Low Residue Diet foods and drinks

The table below contains foods which you are not allowed to eat while preparing for a CT Colonography. Not following these instructions could result in your scan being unsuccessful and delaying your examinations and/or treatment.

Patients with diabetes should avoid all foods marked with a*. You may have sugar-free alternatives for example pure fruit spread without skin or pips, instead of jam.

Patients with kidney failure or on renal dialysis, should only select foods and drinks from the lists which are normally allowed in your diet. Keep to your normal fluid allowance.

Low Reside Diet foods and drinks

Food type	Allowed	Not allowed
Flour products	White flour, custard powder, arrowroot, tapioca, sago, semolina.	Wholemeal, brown, and rye flours. Bran.
Pasta	Any white pasta including tinned in tomato sauce and noodles.	Any wholemeal pasta including spinach flavoured pasta
Rice	White rice.	Wholemeal, brown rice. Wild rice. Barley.
Potatoes	Peeled and cooked in any way. Do not eat the skin.	Crisps, potato based snacks, potato skins.
Vegetables	None	Vegetables and salad including all pulses and baked beans.
Fruit	Fruit juices. Tomato juice.	All fruit including fresh, frozen, stewed, canned, and dried (currants and raisins).
Cakes*	Cakes made with white flour e.g. sponge cakes, plain scones, doughnuts.	Made with wholemeal flours, pastries or pies. Wholemeal crumbles.
Breakfast cereals	Cornflakes, Rice Krispies, Frosties, Honey Smacks, Ricicles, Coco Pops*, Special K.	Shredded wheat, Shreddies, Bran Flakes, All Bran, Alpen and other muesli, Farmhouse Bran, Oat Crunchies, Start, Ready Brek, porridge, oatmeal.
Biscuits*	Any made with white flours e.g. Rich Tea biscuits, water biscuits.	Any made with wholemeal flour e.g. digestives, crispbreads, cereal bars.
Dairy and eggs	Eggs cooked in any way. Milk, plain yoghurt, all cheese, cream, butter, ice-cream, plain fromage frais.	Fruit, muesli and nut yoghurts.
Fish	All fish (fresh, froze, or tinned).
Meat substitutes	Any texturised vegetable protein.
Fats	Oils, margarine, low fat spread, butter.
Sweet foods*	Sugar, golden syrup, treacle, honey, fruit sweets, choco-toffee, jelly jams, jelly marmalades, jelly, fruit sorbets.	Jam with seeds, ordinary marmalade, chocolate made with fruit and nuts, fruit in jelly, sweet mincemeat.
Meat	Any meat including tinned and corned.	Meat in pies made with wholemeal flour. Meat dishes with vegetables e.g. curries, casseroles, chilli concarne.
Nuts and seeds	None	Any nuts and seeds including peanut butters, hummus, tahini and marzipan.
Dietary supplements	None	Any dietary supplements that come as a tablet e.g. vitamins, glucosamine and herbal extracts.
Drinks	All non-alcoholic drinks.	Alcoholic drinks.

Support your local hospital charity

Find out about what we do and how you can support us.

Imaging Department Contact Centre

If you are unable to attend your appointment please let us know as soon as possible. You can also contact the Imaging Department Contact Centre if you wish to change or discuss your appointment.

Telephone: 0117 414 8989

Bowel preparation for CT colongraphy (20ml Gastrografin)

Read more about Bowel preparation for CT colongraphy (20ml Gastrografin)

Regular Off Off

This page has information for patients referred for CT colonography at North Bristol NHS Trust with a 20ml bottles of Gastrografin for preparation.

Please follow these instructions to ensure adequate bowel preparation for your examination.

To prepare your bowel for your CT Colonography you will need to drink mixtures of water and Gastrografin. The instructions for this are below. Gastrografin often causes diarrhoea. The amount of diarrhoea is very variable. Please make sure you have easy access to a toilet during this 2 day preparation period.

You also need to follow a Low Residue Diet for the 2 days of preparation, which involves eating foods with little to no fibre. Eating food with fibre may result in failure of bowel preparation, which can delay your scan and/ or treatment.

While completing this preparation you should continue to take any of your normal medication as prescribed. If you normally take laxatives for constipation, continue to take these.

How to prepare your Gastrografin mixtures:

Pour 1 bottle of Gastrografin (20ml) into a glass.
Into the same glass add at least 200ml or half a pint of water. You can add fruit squash/cordial as well if you prefer.
Stir with a spoon until mixed well.

Two days before appointment

Start Low Residue Diet.
You will have 2 Gastrografin mixtures today.
Drink one Gastrografin mixture with your morning meal.
Drink your next Gastrografin mixture with your evening meal.
Remember to drink plenty of clear fluids.

Day before appointment

You will have 2 Gastrografin mixtures today.
Drink 2 Gastrografin mixture with your morning meal.
Drink your next Gastrografin mixture with your evening meal.
Remember to drink plenty of clear fluids.

Day of appointment

You must have no solid food from midnight.
At least 2 hours before your appointment, drink 1 Gastrografin mixture.
Keep drinking plenty of clear fluids.

Low Reside Diet foods and drinks

Patients with diabetes should avoid all foods marked with a*. You may have sugar-free alternatives for example pure fruit spread without skin or pips, instead of jam.

Patients with kidney failure or on renal dialysis, should only select foods and drinks from the lists which are normally allowed in your diet. Keep to your normal fluid allowance.

Table of foods and drinks allowed on Low Residue Diet

Food type	Allowed	Not allowed
Flour products	White flour, custard powder, arrowroot, tapioca, sago, semolina.	Wholemeal, brown, and rye flours. Bran.
Pasta	Any white pasta including tinned in tomato sauce and noodles.	Any wholemeal pasta including spinach flavoured pasta
Rice	White rice.	Wholemeal, brown rice. Wild rice. Barley.
Potatoes	Peeled and cooked in any way. Do not eat the skin.	Crisps, potato based snacks, potato skins.
Vegetables	None	Vegetables and salad including all pulses and baked beans.
Fruit	Fruit juices. Tomato juice.	All fruit including fresh, frozen, stewed, canned, and dried (currants and raisins).
Cakes*	Cakes made with white flour e.g. sponge cakes, plain scones, doughnuts.	Made with wholemeal flours, pastries or pies. Wholemeal crumbles.
Breakfast cereals	Cornflakes, Rice Krispies, Frosties, Honey Smacks, Ricicles, Coco Pops*, Special K.	Shredded wheat, Shreddies, Bran Flakes, All Bran, Alpen and other muesli, Farmhouse Bran, Oat Crunchies, Start, Ready Brek, porridge, oatmeal.
Biscuits*	Any made with white flours e.g. Rich Tea biscuits, water biscuits.	Any made with wholemeal flour e.g. digestives, crispbreads, cereal bars.
Dairy and eggs	Eggs cooked in any way. Milk, plain yoghurt, all cheese, cream, butter, ice-cream, plain fromage frais.	Fruit, muesli and nut yoghurts.
Fish	All fish (fresh, froze, or tinned).
Meat substitutes	Any texturised vegetable protein.
Fats	Oils, margarine, low fat spread, butter.
Sweet foods*	Sugar, golden syrup, treacle, honey, fruit sweets, choco-toffee, jelly jams, jelly marmalades, jelly, fruit sorbets.	Jam with seeds, ordinary marmalade, chocolate made with fruit and nuts, fruit in jelly, sweet mincemeat.
Meat	Any meat including tinned and corned.	Meat in pies made with wholemeal flour. Meat dishes with vegetables e.g. curries, casseroles, chilli con-carne.
Nuts and seeds	None	Any nuts and seeds including peanut butters, hummus, tahini and marzipan.
Dietary supplements	None	Any dietary supplements that come as a tablet e.g. vitamins, glucosamine and herbal extracts.
Drinks	All non-alcoholic drinks.	Alcoholic drinks.

Imaging Department Contact Centre

If you are unable to attend your appointment please let us know as soon as possible. You can also contact the Imaging Department Contact Centre if you wish to change or discuss your appointment.

Telephone: 0117 414 8989

Support your local hospital charity

Find out about what we do and how you can support us.

Bowel preparation for CT colongraphy (100ml Gastrografin)

Read more about Bowel preparation for CT colongraphy (100ml Gastrografin)

Regular Off Off

This page has information for patients referred for CT colonography at North Bristol NHS Trust with a 100ml bottle of Gastrografin for preparation.

Please follow these instructions to ensure adequate bowel preparation for your examination.

You also need to follow a Low Residue Diet for the 2 days of preparation, which involves eating foods with little to no fibre. Eating food with fibre may result in failure of bowel preparation, which can delay your scan and/ or treatment.

While completing this preparation you should continue to take any of your normal medication as prescribed. If you normally take laxatives for constipation, continue to take these.

How to prepare your Gastrografin mixtures:

You will be given a 100ml bottle of Gastrografin and a measuring cup to make the mixture yourself at home. This will give you enough for 5 drinks over the two days before, and the day of your appointment. To prepare the Gastrografin mixture:

Pour 20ml of Gastrografin into the measuring cup then pour this from the cup into a drinking glass.
Into the same glass add at least 200ml or half a pint of water. You can add fruit squash/cordial as well if you prefer.
Stir with a spoon until mixed well.

Two days before appointment

Start Low Residue Diet.
You will have 2 Gastrografin mixtures today.
Drink one Gastrografin mixture with your morning meal.
Drink your next Gastrografin mixture with your evening meal.
Remember to drink plenty of clear fluids.

Day before appointment

You will have 2 Gastrografin mixtures today.
Drink 2 Gastrografin mixture with your morning meal.
Drink your next Gastrografin mixture with your evening meal.
Remember to drink plenty of clear fluids.

Day of appointment

You must have no solid food from midnight.
At least 2 hours before your appointment, drink 1 Gastrografin mixture.
Keep drinking plenty of clear fluids.

Low Reside Diet foods and drinks

Patients with diabetes should avoid all foods marked with a*. You may have sugar-free alternatives for example pure fruit spread without skin or pips, instead of jam.

Patients with kidney failure or on renal dialysis, should only select foods and drinks from the lists which are normally allowed in your diet. Keep to your normal fluid allowance.

Table of foods and drinks allowed on Low Residue Diet

Food type	Allowed	Not allowed
Flour products	White flour, custard powder, arrowroot, tapioca, sago, semolina.	Wholemeal, brown, and rye flours. Bran.
Pasta	Any white pasta including tinned in tomato sauce and noodles.	Any wholemeal pasta including spinach flavoured pasta
Rice	White rice.	Wholemeal, brown rice. Wild rice. Barley.
Potatoes	Peeled and cooked in any way. Do not eat the skin.	Crisps, potato based snacks, potato skins.
Vegetables	None	Vegetables and salad including all pulses and baked beans.
Fruit	Fruit juices. Tomato juice.	All fruit including fresh, frozen, stewed, canned, and dried (currants and raisins).
Cakes*	Cakes made with white flour e.g. sponge cakes, plain scones, doughnuts.	Made with wholemeal flours, pastries or pies. Wholemeal crumbles.
Breakfast cereals	Cornflakes, Rice Krispies, Frosties, Honey Smacks, Ricicles, Coco Pops*, Special K.	Shredded wheat, Shreddies, Bran Flakes, All Bran, Alpen and other muesli, Farmhouse Bran, Oat Crunchies, Start, Ready Brek, porridge, oatmeal.
Biscuits*	Any made with white flours e.g. Rich Tea biscuits, water biscuits.	Any made with wholemeal flour e.g. digestives, crispbreads, cereal bars.
Dairy and eggs	Eggs cooked in any way. Milk, plain yoghurt, all cheese, cream, butter, ice-cream, plain fromage frais.	Fruit, muesli and nut yoghurts.
Fish	All fish (fresh, froze, or tinned).
Meat substitutes	Any texturised vegetable protein.
Fats	Oils, margarine, low fat spread, butter.
Sweet foods*	Sugar, golden syrup, treacle, honey, fruit sweets, choco-toffee, jelly jams, jelly marmalades, jelly, fruit sorbets.	Jam with seeds, ordinary marmalade, chocolate made with fruit and nuts, fruit in jelly, sweet mincemeat.
Meat	Any meat including tinned and corned.	Meat in pies made with wholemeal flour. Meat dishes with vegetables e.g. curries, casseroles, chilli concarne.
Nuts and seeds	None	Any nuts and seeds including peanut butters, hummus, tahini and marzipan.
Dietary supplements	None	Any dietary supplements that come as a tablet e.g. vitamins, glucosamine and herbal extracts.
Drinks	All non-alcoholic drinks.	Alcoholic drinks.

Support your local hospital charity

Find out about what we do and how you can support us.

Imaging Department Contact Centre

If you are unable to attend your appointment please let us know as soon as possible. You can also contact the Imaging Department Contact Centre if you wish to change or discuss your appointment.

Telephone: 0117 414 8989

CT abdomen and pelvis with 48 hour preparation

Read more about CT abdomen and pelvis with 48 hour preparation

Regular Off Off

This page has information for patients referred for CT abdomen and pelvis with 48 hour preparation at North Bristol NHS Trust.

Please follow these instructions to ensure adequate bowel preparation for this examination.

To prepare your bowel for your CT Colonography you will need to drink mixtures of water and Gastrografin. The instructions for this are in this leaflet. Gastrografin often causes diarrhoea. The amount of diarrhoea is very variable. Please make sure you have easy access to a toilet during this 2 day preparation period.

It is very important to drink plenty of fluid during the entire period. You may become dehydrated otherwise. For this examination to be successful, please follow these instructions.

How to prepare your Gastrografin mixture:

Pour 1 bottle of Gastrografin (20ml) into a glass.
Into the same glass, add at least 200ml or half a pint of water. You can add fruit squash/cordial if you prefer.
Stir with a spoon until mixed well.

Two days before your appointment

Prepare and drink 1 Gastrografin mixture with a meal.

One day before your appointment

Prepare and drink 1 Gastrografin mixture with a meal.

On the day of your appointment

In the morning prepare 1 Gastrografin mixture.

Drink this slowly over the 1.5 hours before your appointment.

Imaging Department Contact Centre

If you are unable to attend your appointment please let us know as soon as possible. You can also contact the Imaging Department Contact Centre if you wish to change or discuss your appointment.

Telephone: 0117 414 8989

Support your local hospital charity

Find out about what we do and how you can support us.

Your CT virtual colonoscopy

Read more about Your CT virtual colonoscopy

Regular Off Off

Introduction

You have been advised by your doctor to have a Computerised Tomography investigation, more commonly called a CT scan. This leaflet explains what a CT is, the benefits and risks, and what the virtual colonoscopy CT involves. If you have any further questions please speak to the member of the team looking after you.

CT scans are done in the Imaging department - also known as Radiology or X-ray department. This is the department in the hospital that does radiological examinations such as X-rays, CT scans, and others.

Radiographers are highly trained operators that carry out CT scans with the help of radiology department assistants. They make sure the best possible images are taken while using the minimum dose of radiation. Radiologists are doctors specially trained to interpret the images when the scan is complete.

What is a CT virtual colonoscopy?

A CT scanner machine uses ionising radiation (X-rays), and a computer to produce very detailed cross-sectional images of any part of the body. The information is built up into a series of pictures for the radiologist to view.

CT virtual colonoscopy is different from other CT scans because carbon dioxide is used to inflate the colon (large bowel), via a thin flexible tube that is inserted into the back passage (anus). The CT scanner the puts together a detailed 3D model of the colon, which the radiologist uses to view the bowel in a way that simulates travelling through the bowel. This is why the procedure is called a virtual colonoscopy.

At the same time, 2D images of the colon, abdomen, and pelvis are taken without any additional radiation.

Are there alternatives to a CT virtual colonoscopy?

The alternative way of looking at the large bowel is endoscopy. Endoscopy involves using a tube with a camera on the end (colonoscope) which is passed into the back passage, an moved up and around the bowel. Although it doesn‘t use radiation, it is more invasive than a virtual colonoscopy and usually requires sedation. However, it does allow for a biopsy or removal of small polyps at the same time.

Do I need to prepare for this examination?

We will send you a special medicine before the scan. Please mix this with water and follow the instructions given to you on a separate leaflet. This medicine may cause diarrhoea, which is required to empty the bowel. It also coats the lining of the bowel so we can see it on the scan.
You will also be given a separate leaflet with what foods you can and cannot eat. Please follow these instructions carefully.
Please drink plenty of water over the 2 days before the scan.
If you are diabetic and have received an afternoon appointment, please let us know. Morning appointments are available to ensure you can follow the preparation safely.

What happens during the scan?

The Radiology department assistant will explain the process and ask you to change into a hospital gown. You will then be taken into the scan room where the radiographer will again explain and answer any questions.
A small cannula will be put into your arm so that a muscle relaxant can be injected. This drug is used to relax the involuntary muscles of your bowel to reduce discomfort and decrease bowel movement on the scan.
You will be asked to roll onto your side and a small flexible tube (around the width of a pencil and 2 inches in length) will be inserted into your back passage. A lubricant is used to ease this process.
Carbon dioxide gas will then be passed through the tube and into the large bowel for the duration of the examination to maintain inflation. You will be asked to move into different positions on the scanning table (on your front, back and sides) and several scans will be taken.
The radiographers will check the quality of the images and ensure they have all the information required from each position. Occasionally, more information may be required, and the scan will also include your chest. A contrast dye will be inserted into your cannula during the scan if this is required.
During the scan you will be asked to hold your breath and retain the gas as much as possible whilst the table moves slowly. You will move in and out several times. Occasionally, a contrast dye may be given through the cannula and the scan to provide more information.
The whole examination will take around 30 minutes and is very clean. A small balloon on the tube keeps the tube in place and any faeces (poo) left inside you will go down the tube. You will not be given sedation for this examination.
Once all the images are taken the tube will be gently removed. You will then be taken into a joining room where there is a toilet and your clothes to get dressed. The team will talk to you before you go to ensure you feel ok.

What happens after the scan?

You may eat and drink as normal. Please drink plenty of water as the bowel preparation medicine may dehydrate you.

The carbon dioxide gas will naturally be absorbed by the body and the bloated feeling will subside quickly once you have passed wind and used the toilet.

The radiologist will examine the images in detail and send the written results to the consultant or GP that referred you for the scan. You will get your results from that doctor.

What are the risks and benefits of having a CT virtual colonoscopy scan?

A CT scan involves the use of ionising radiation (X-rays); we are all exposed to natural background radiation every day from radioactivity in the air, food that we eat and even from space.

Exposure to ionising radiation from a CT scan carries a small risk, however, the main benefit of having the scan is to get an accurate diagnosis so that you can get the right treatment for you. A specialist will have agreed that the benefit, of the scan, outweighs the risk of the ionising radiation and we can assure you that all safeguarding to minimise ionising radiation exposure is taken.

If there is a possibility that you may be pregnant, then please contact the radiology department prior to the scan.

During the CT virtual colonoscopy, you may experience abdominal discomfort and bloating, this is normal but if it becomes too painful then please let the radiographer know. Once the scan is complete you could become faint when sitting up, however, the team follow several steps to limit.

There is a very small risk that inflating your bowel with air could cause injury to or perforation of the bowel, however, this occurs in fewer than 1 in 10,000 patients. This will, in most cases, heal itself, however, may require medical assistance or antibiotics.

If you have had the injection of muscle relaxant, you may experience a dry mouth and blurred vision. The latter is very rare, but if it does happen, it will wear off within 30 minutes but please do not drive until your vision is back to normal. Please let the radiographer know if you suffer from angina, any heart problems or glaucoma.

Some patients may require an injection of contrast medium, also described as X-ray dye, for their scan which increases the amount of information seen on the scan. There is a small chance of an allergic reaction to the injection of contrast medium, however, the Imaging team are trained to deal with any complication, and again the risk is very small. The Imaging team will make sure you are feeling alright and have recovered before letting you leave the department.

References

CT Colonography or Virtual Colonoscopy

National Health Service: Your CT scan:
Available from CT scan - NHS [Accessed on July 2022]

United States Food and Drug Administration: Computed Tomography (CT).
Available from Computed Tomography (CT) | FDA [Accessed July 2022]

Computed Tomography (CT or CAT scan) Procedures

Radiation Dose from X-Ray and CT Exams

Imaging Department Contact Centre

If you are unable to attend your appointment please let us know as soon as possible. You can also contact the Imaging Department Contact Centre if you wish to change or discuss your appointment.

Telephone: 0117 414 8989

Requesting

Read more about Requesting

Regular Off Off

Sample acceptance and rejection

It is the policy of North Bristol NHS Trust that all samples taken for laboratory investigations and accompanying request forms will be labelled to a minimum standard which minimises the risk of harm to patients. The Specimen Labelling Policy (CG-163) is attached below.

Key points are:

The patients primary identifier is the NHS number and this must be used wherever possible.
In normal circumstances, unlabelled or inadequately labelled samples will not be processed. There is a recognition that there are certain circumstances where samples are unrepeatable. The circumstances and actions in this case are documented within the policy.
Each request received by the laboratory is considered an agreement between the requestor and laboratory for provision of Pathology Services.

Requests can be made in Sunquest ICE. Where this is unavailable, dedicated NBT Pathology Request forms are obtainable which should be completed in full.

Samples may be rejected when received in the wrong container, underfilled/overfilled, insufficient, haemolysed, clotted, contaminated or when subject to incorrect storage, temperature, transport or time-dependent requirements. See the individual test information pages for special requirements and precautions.

The reason for rejection of a sample should be clear on the report for that specimen.

[attachments]

Test Information

Includes details of sample types, volumes, special precautions, turnaround times & reference ranges.

Managing phosphate in your diet - Information for kidney patients

Read more about Managing phosphate in your diet - Information for kidney patients

Regular Off Off

Why do I need to eat less phosphate?

Phosphate (also known as phosphorus) is found in a variety of foods. It is needed for healthy bones. The kidneys help control the amount of phosphate in the blood and when they are not working properly, the level of phosphate in the blood can rise.

The normal range for blood phosphate is between 0.8mmol/l and 1.5mmol/l.

High levels of phosphate can cause:

Hardening of blood vessels.
Damage to your heart.
Weak bones.
Aching joints.
Itchy skin.
Sore eyes.

How can I control my phosphate levels?

You can help to lower phosphate levels in your blood by reducing foods that are high in phosphate. If your phosphate levels stay high you may be prescribed tablets called phosphate binders. These are taken with food to reduce the amount of phosphate absorbed from food. The dietitian can give you more information on how and when to take these tablets if they are prescribed.

How can I eat less phosphate?

Avoid phosphate additives where you can and eat more fresh foods.
Choose foods lower in phosphate.
Choose meals based on beans, lentils, tofu or Quorn when you can (instead of meat, fish and dairy foods).
Eat moderate amounts of dairy foods.
Eat the right amount of protein for you.

If you are following another diet please remember to continue. Your dietitian can help you with this.

Eating less processed food

Processed foods and ready meals can be high in phosphate if additives containing phosphate are used to preserve or flavour the food.
The phosphate from the additives is well absorbed by your body. Additives can have a large effect on your blood phosphate levels.
Choose fresh, unprocessed food to help you eat less phosphate from additives.

The table in the section below shows a list of additives containing phosphate.

Your dietitian can also give you a phosphate additives card to help identify these on labels when shopping.

Phosphate additives

E number	Name	Where found
E338	Phosphoric acid	Processed meat, sweets, cakes, chocolate, cola drinks
E339	Sodium phosphates	Dried milk powder, canned soup, breaded chicken and fish, UHT
E340	Potassium phosphates	Processed meats and cheeses, sports drinks, dried milk powder
E341	Calcium phosphates	Shop-bought desserts and powder dessert mixes, instant pasta mixes
E343	Magnesium phosphates	Bakery products, liquid egg, salt substitutes
E450	Diphosphates	Bakery products, processed meat and cheeses, soups and sauces
E451	Triphosphates	Processed cheese, icing sugar, flavoured syrups
E452	Polyphosphates	Processed potato products

How do I eat fewer phosphate additives?

You will always see the name of phosphate additives, or their E numbers listed on the ingredients labels where they have been used. Look out for additives with ‘phos’ in their name as these will contain phosphate. You may be able to swap to a different brand without additives.

To help you avoid phosphate additives, here are some examples of food labels showing how phosphate additives are listed on a food label.

Sausages

Sausage ingredients label with "stabiliser: E452" circled

Cake

If a food contains phosphate additives try checking other brands or similar alternatives to find one without.

Eating moderate amounts of dairy foods

Dairy foods such as milk, cheese, yoghurts and eggs contain phosphate. They are also good sources of protein and calcium which are essential for a healthy diet. It is recommended that you eat moderate amounts of these foods.

A healthy amount for most people is 2 portions per day from this list

1/3 pint or 200ml milk per day (including milk in drinks, puddings and sauces).
125g or a small pot of yoghurt per day.
1oz or 30g cheese (size of a small matchbox) per day.

Tip – cottage, ricotta, and cream cheese are lower in phosphate. Your dietitian can advise you on appropriate portion sizes.

Eggs

A healthy amount for most people is 4-6 per week. Your dietitian may advise on a different amount for you.

Choosing foods lower in phosphate

Food	Lower phosphate foods - Your dietitian can advise you on amounts to eat.
Meat	Fresh meat e.g. beef, lamb, pork, chicken, turkey
Fish	Fresh fish e.g. haddock, cod, salmon, trout. Tinned tuna, salmon or mackerel - without bones
Shellfish	Tinned crab
Cheese	Eat in moderation. See above
Milk	Eat in moderation. See above
Potato products	Any fresh potatoes
Nuts/seeds	Chestnuts
Snacks	Popcorn, breadsticks, prawn crackers, corn snacks, pretzels, potato crisps
Breakfast cereals	Weetabix, cornflakes, porridge, rice krispies
Bread	White, wholemeal, granary bread, pitta, croissants, english muffins
Cakes	Madeira cake, doughnuts, meringues, jam swiss roll, danish pastry (without nuts), jam tart, iced bun
Biscuits	Plain biscuits, cream biscuits, shortbread, plain crackers e.g. water biscuits, cream crackers
Confectionary	Fruit pastilles, boiled sweets, sherbet, peppermints, marshmallows, chewing gum, turkish delight, fruit gums
Drinks	Tea, coffee, herbal tea, drinking chocolate made with water, fizzy drinks (except cola), fruit squash, fruit juice. Spirits, sherry, cider, white wine
Miscellaneous	Jam, marmalade, honey

Higher phosphate foods to limit

Food	Higher phosphate foods
Meat	Liver, liver sausage, liver paté, saveloy sausage
Fish	Sardines, pilchards, whitebait, fish paste
Shellfish	Scampi, fresh crab
Cheese	Cheese spread, processed cheese e.g. cheese triangles
Milk	Condensed milk, evaporated milk, coconut cream, coconut milk, dried milk powder
Potato products	Frozen, chilled, dried potato products e.g. chips, waffles, instant mashed potato
Nuts/seeds	All other nuts, seeds, pine nuts
Snacks	Twiglets, oriental mix
Breakfast cereals	Muesli, cereals with nuts or chocolate
Bread	Naan bread, crumpets
Cakes	Scones, muffins, chocolate cake, packet cake mixes
Biscuits	Biscuits with nuts, seeds or chocolate, oat cakes, cereal bars
Confectionary	Chocolate, marzipan, fudge
Drinks	Cocoa, Ovaltine, Bournvita, Horlicks, milk shakes, cola, drinking yoghurts. Guinness, stout, red wine
Miscellaneous	Marmite, peanut butter, pesto

Useful websites

Patients Know Best

An easy-to-use online service that allows you to monitor your own blood test results. You can find out more and register to use it at:

Kidney Kitchen

Kidney-friendly cooking and eating, information, recipes and Kidney Kitchen videos.

Kidney Kitchen | Kidney Care UK

Next steps: what I can do to help control my phosphate

It can be helpful to write down what you can do to help control your phosphate.

Contact your dietitian if you need further help.

Contact Nutrition & Dietetics

Kendon House
Kendon Way
Southmead Hospital
Bristol

Telephone: 0117 414 5428 or 0117 414 5429

Support your local hospital charity

Find out about what we do and how you can support us.

Overnight polysomnography (with MSLT)

Read more about Overnight polysomnography (with MSLT)

Regular Off Off

Please read this information carefully before coming in for your overnight polysomnography.

What is a polysomnography?

Polysomnography (also known as sleep studies) is a test used to diagnose sleep disorders. Electrodes and sensors are placed on the body and head to record different information that allow your sleep to be studied in detail for 1 or 2 nights. A video recording is taken during the study to help diagnose your sleep problem.

Why do a polysomnography?

The main reason is to try to classify (work out exactly) the problem you are having with your sleep so that the referring doctors can treat it more effectively.

What happens during the test?

Small discs (electrodes) are applied to your scalp, around your eyes, and under your chin. These will be attached with special glue, so they do not fall off in your sleep.

2 belts will be placed around your chest and abdomen that measure your breathing, with additional boxes attached where the wires are connected. A nasal cannula will rest in your nose to also measure breathing. 2 sticky pads will be placed: 1 on your shoulder and 1 on your hip to detect your heart rate. A pulse oximeter will be placed on your finger to detect blood oxygen saturation. A movement sensor is placed on your arm and 1 on each of your legs to detect any movements in your sleep.

The equipment will stay in place until the end of the test, and it is removed by a neurophysiologist.

The night-time recording is started as close to your normal sleep time as possible. Wake time is usually before breakfast at around 08:30.

It may be necessary to do a Multiple Sleep Latency Test (MSLT). This involves settling down to sleep at specific sections of the day. These periods are about 20-40 minutes and are about 2 hours apart. You will be woken up at the appropriate time by your neurophysiologist.

Preparation for the test

Follow these instructions carefully for the MSLT

Do not consume any alcohol, coffee, or stimulating drugs (medication) the night before or morning of the test.
Stop smoking at least 30 minutes before each test.
Do not doze off in-between the test sessions.

General preparation for polysomnography

Please follow the guidance provided by your consultant neuropsychiatrist about reducing or stopping medications before coming for the test. This information should be in the clinic letter following your appointment. Please call 0117 414 1048 or 0117 414 0452 if you have any concerns or questions.
You must arrive with clean, dry hair with no grease, gel, wax, or other hair products.
You will be set up in the clothes you sleep in, and won’t be able to change during the test. Please make sure you bring suitable nightwear such as shorts, pyjamas, t-shirt, or tracksuit bottoms. Nighties are not suitable.

Are there any side-effects?

You will not feel anything during or after the recording. The machine records the normal natural activity seen during your sleep. After the equipment is removed, great care will be taken to remove as much of the glue as possible from your hair. Applying a hair conditioner and combing through your hair before having a shower or bath will help soften any glue left.

How long until I get my results?

The results will be sent to your GP/consultant. You will not receive any results during the test. Your consultant may send you a letter with the results or see you again for a follow-up appointment. Please note, results are not sent directly to you.

Contact details

This information is intended as a guideline only. If you have any further questions about your test (excluding about results) please contact the department on 0117 414 1048 or 0117 414 1052 and a member of staff will be happy to help.

Your responsibility as a patient

Outpatient services at North Bristol NHS Trust are in great demand. Even so, every week an average of 600 patients fail to attend, which wastes appointments. Please tell us with as much notice as possible if you no longer need your appointment and we can allocate this to another patient.

What if I am unwell or need to change my appointment?

If you have an infectious condition, such as COVID-19, measles, mumps, chickenpox, flu, stomach upset, have head lice, or are unable to attend your appointment for any other reason, please let us know with as much notice as possible so that your appointment can be rescheduled and offered to someone else.

If you want to change the appointment for a second time, we cannot offer you another date unless there are exceptional circumstances.

What if I don’t attend?

We will assume that you no longer require your appointment, and we will not offer you another one. We will write to the consultant/doctor who referred you and inform them that you did not attend.

Support your local hospital charity

Find out about what we do and how you can support us.

Subscribe to Regular