DR LEIGH DONNELLY, PHD, RGN, BSc (Hons), MA, PG Dip (Ed), Endoscopy Education and Development Lead at Northumbria Healthcare NHS Foundation Trust, UK.

DR SHELLIE RADFORD, PHD, RN, BSc (Hons), MSc (research), PGCert (gastroenterology), Assistant Professor of Gastroenterology at the University of Nottingham, UK.

List of Contributors xxii Foreword xxiv Preface xxv 1 Anatomy and Physiology 1Conor Hamilton 1.1 Introduction 1 1.2 Overview of the Digestive System 1 1.3 Basic Cell Structure of the GI Tract 2 1.4 Mouth and Pharynx 4 1.5 The Oesophagus 8 1.6 The Stomach 10 1.7 The Pancreas 13 1.8 The Liver 18 1.9 The Gallbladder 20 1.10 The Small Intestine 22 1.11 The Large Intestine 26 1.12 Reflective Questions 29 References 30 2 The Oesophagus 32Paula Brayford 2.1 Gastroesophageal Reflux Disease 32 2.2 Hiatus Hernia 36 2.3 Oesophagitis and Oesophageal Ulcers 38 2.4 Barrett's Oesophagus 41 2.5 Tumours of the Oesophagus 45 2.6 Oesophageal Strictures 49 2.7 Oesophageal Webs and Rings 51 2.8 Oesophageal Dysmotility 53 2.9 Achalasia 55 2.10 Oesophageal Diverticula/Pouch 57 2.11 Eosinophilic Oesophagitis 59 2.12 Oesophageal Varices 62 2.13 Mallory Weiss Tear 65 2.14 Reflective Questions 66 References 66 Contents xi 3 The Stomach 69Regina Raymond and Marta Da Silva Teixeira 3.1 Gastritis 69 3.2 Gastric Ulcers 71 3.3 Helicobacter Pylori 74 3.4 Gastroparesis 77 3.5 Vascular Conditions of the Stomach 80 3.6 Gastric Cancers 82 3.7 Reflective Questions 93 References 93 4 Small Bowel 97Isobel Mason and Jennie Burch 4.1 Introduction 97 4.2 Small Bowel Bleeding 98 4.3 Small Bowel Tumours 100 4.4 Managing Ida 101 4.5 Small Bowel Crohn's Disease 102 4.6 Ileostomy 102 4.7 Small Bowel Bacterial Overgrowth 103 4.8 Acute Diarrhoea 104 4.9 Giardiasis 105 4.10 Lactose Intolerance 105 4.11 Irritable Bowel Syndrome 106 4.12 Chronic Intestinal Pseudo-Obstruction 107 4.13 Case Studies and Reflective Questions 108 References 108 5 Pancreas and Neuroendocrine Tumours 110Stacey Munnelly, Alex Hadall, Scott Oakes, Lynne McCallum, and Nikie Jervis 5.1 Pancreatitis 110 5.2 Pancreatic Cysts 120 5.3 Pancreatic Adenocarcinoma 125 5.4 Pancreatic Neuro-Endocrine Neoplasms 131 5.5 Reflective Questions 138 References 138 6 Liver and Biliary System 147Sarah Hogg, Nicola Holmes-Long, Kathryn Jack, and Kathryn Houghton 6.1 The Liver 147 6.2 Genetic Disorders of the Liver 157 6.3 Autoimmune Liver Disorders 161 6.4 Biliary System 163 6.5 Reflective Questions 173 References 173 7 Colon, Rectum and Anus 180Jennie Burch Introduction 180 7.1 Polyps 180 7.2 Colorectal Cancer 181 7.3 Bowel Cancer Screening 182 7.4 Primary Colorectal Lymphomas 186 7.5 Gastrointestinal Stromal Tumours 186 7.6 Neuroendocrine Tumours 187 7.7 Lynch Syndrome 188 7.8 Familial Adenomatous Polyposis 188 7.9 Anal Cancer 189 7.10 Diverticular Disease 190 7.11 Appendicitis 191 7.12 Haemorrhoids 191 7.13 Anal Fissure 192 7.14 Irritable Bowel Syndrome 193 7.15 Pilonidal Abscess 193 7.16 Perianal Abscess 193 7.17 Anal Fistula 194 7.18 Constipation 195 7.19 Diarrhoea 195 7.20 Anal Incontinence 196 7.21 Low Anterior Resection Syndrome 197 7.23 Melaena 199 7.24 Colostomy 199 7.25 Reflective Questions 200 References 200 8 Inflammatory Bowel Disease 203Stephanie Massey and Shellie Radford 8.1 Introduction 203 8.2 Extra Intestinal Manifestations 205 8.3 Classification of Disease 205 8.4 Treatments 207 8.5 Psychological Impact and Quality of Life 210 8.6 The Ibd Mdt 210 8.7 Reflective Questions 211 References 211 9 Nursing In the Endoscopy Setting 215Lindsey Scarisbrick and Leigh Donnelly 9.1 Introduction 215 9.2 The Endoscopy Service 215 9.3 Governance 217 9.4 Joint Advisory Group For GI Endoscopy (Jag) 218 9.5 Endoscopy Workforce 218 9.6 Training 225 9.7 Unit Leadership Team 226 9.8 Innovation of Roles 227 9.9 Sustainable Endoscopy Services 227 9.10 Reflective Questions 230 References 230 10 Nutrition In Gastrointestinal Disease 235Annelie Shaw 10.1 Introduction 235 10.2 The Importance of Nutrition In GI Disease 235 10.3 The GI Tract: A Nutritional and Immunological Organ 236 10.4 Clinical Consequences of Nutritional Deficits 236 10.5 Nutrition In Specific GI Conditions 236 10.6 Malnutrition In GI Disease 237 10.7 Oral Nutritional Support 240 10.8 Oral Nutritional Support Strategies 242 10.9 Individualisation and Monitoring 248 10.10 Enteral Nutrition 249 10.11 Benefits of Enteral Nutrition (En) Compared to Parenteral Nutrition (Pn) 250 10.12 Enteral Feed Delivery 251 10.13 Parenteral Nutrition 254 10.14 Home Parenteral Nutrition 255 10.15 Types of Feeding Tubes 255 10.16 The Nursing Role In Nutritional Care 258 10.17 Summary 259 References 259 11 Psychosocial Impact of Gastrointestinal Disease 263Wladyslawa Czuber-Dochan 11.1 Introduction 263 11.2 Pain 263 11.3 Fatigue 268 11.4 Urgency and Fi 273 11.5 Anxiety, Depression and Distress 275 11.6 Body Image 280 11.7 Relationship, Intimacy, Sexuality and Family Planning 282 11.8 Work and Education 287 11.9 The Role of Nurses In the Care of Individuals With GI Conditions 288 11.10 Reflective Questions 290 References 290 Index I- 1