Cheshire Gallstone and Hernia Clinic
A Patient Centred Care for Gallstones and Hernia
Patient Centred Care
Patient care is consistently prioritised, with every individual treated with dignity, compassion, and respect. Our service is centred around our patients’ needs, preferences, and overall wellbeing. Our aim is to ensure that the care is tailored, responsive, and delivered in a supportive and professional manner.
Highly Experienced Consultants
The Cheshire Gallstone Clinic is led by Mr Giuseppe De Santis who is a highly experienced consultant. He is the National Emergency Laparotomy Audit for Leighton Hospital. The Clinic is supported by other consultants who have have interest in inflammatory bowel diseases, pancreatic diseases and nutrition.
Leading Private Hospitals
Its main sites are based within leading private hospitals serving patients from a wide range of counties, including Cheshire, Shropshire and Wales. With demand for its high-quality services continuing to grow, the clinic is expanding by opening additional branches in prestigious private hospitals in Staffordshire. This will make its services more accessible while maintaining the same top standard of care for a wider patient community.
Locations
Where are the clinics held?
Consultants
Who are my consultants?
Mr. Giuseppe De Santis
Consultant General and Laparoscopic Surgeon
Mr De Santis is a General Surgeon. He does most of his surgery laparoscopically (keyhole). This ensures a smaller scar and faster recovery.
He has an interest in laparoscopic and other ‘minimally invasive’ surgical treatments including gallbladder diseases, hiatus hernias, inguinal hernia and umbilical hernia.
For further information go to his website on Giuseppe De Santis
To book a clinic consultation: book online (Chester) or book online (Macclesfield)
Dr. Kevin Yoong
Consultant Gastroenterologist
Clinical Director of the Bowel Cancer Screening Programme (Cheshire)
Dr Kevin Yoong, Consultant Gastroenterologist trained in medicine and graduated in 1993 at the University of Glasgow. His gastroenterology and liver training was at London and Liverpool. He undertook some work with the NHS Modernisation Agency and Changing Workforce Programme.
He became a lecturer at St George’s Hospital Medical School where he did research at St George’s Hospital Medical School and has published papers on endoscopy and health services improvement. After working in London for more than 5 years, he took up a consultant appointment in Cheshire as he enjoyed the outdoor and country pursuits. He will therefore give you the experience of a London trained doctor in Cheshire.
For further information go to his website on Kevin Yoong or www.kevinyoong.co.uk
To book a clinic consultation: book online (Chester) or book online (Northwich)
Dr. Muthu Rajaram
Consultant Gastroenterologist
Dr Muthu Rajaram qualified in 1999 and after gaining further experience in the Midlands and Devonshire, he was appointed as a Consultant Gastroenterologist in 2020. He has an interest in therapeutic endoscopy. He did his gastroenterology training in the Midlands and Southwest and undertook an advanced endoscopy fellowship in Nottingham. He was appointed as a nationally accredited NHS bowel cancer screening colonoscopist in 2022.
For further information go to his website on Muthu Rajaram
To book a clinic consultation: book online (Shrewsbury)
Dr. Gill Townson
Consultant Gastroenterologist
Dr Townson graduated from University of Leicester in 1990 and continued her training at Leicester General Hospital where she completed an MD thesis on Inflammatory Bowel Disease. She continued her training as a registrar in Wessex (Swindon, Winchester & Portsmouth) before returning to Leicester as a senior Registrar.
She completed a fellowship at McMaster in Toronto, Canada before taking up a substantive consultant post in Shrewsbury and Telford NHS Trust.
For further information go to her website on Gill Townson
To book a clinic consultation: book online (Northwich)
Dr. Salman Ahmed
Consultant Gastroenterologist
Dr Ahmed is a Consultant Gastroenterologist and Hepatologist at Aintree University Hospital, Liverpool. He obtained his MBBS in 2008 and went on to complete higher specialist training in Gastroenterology and General Internal Medicine at leading London teaching hospitals, including Imperial College Healthcare NHS Trust, Chelsea & Westminster Hospital, and St Mark’s Hospital. He also holds a Master’s degree in Gastroenterology (with Merit) from Queen Mary University of London and the European Specialty Certificate in Gastroenterology and Hepatology (ESEGH).
Alongside his clinical work, Dr Ahmed maintains an active academic profile, with multiple peer-reviewed abstracts, national and international conference presentations. He has a strong interest in medical education.
For further information go to his website on Salman Ahmed
Dr. Raluca Prodan
Consultant Gastroenterologist
Dr Raluca Prodan has been a Consultant Gastroenterologist for the past 6 years. She has an interest in Inflammatory Bowel Disease (IBD), Liver Diseases, Upper and Lower GI endoscopy (OGD, Colonoscopy, Small bowel capsule endoscopy).
As a highly trained Gastroenterologist, she recently obtained a Masters degree in Gastroenterology with the University of South Wales and was appointed the position of a Honorary Senior Lecturer of the University of Buckingham, UK.
For further information go to her website on Raluca Prodan
Dr. Rebecca Preedy
Consultant Gastroenterologist
Dr Rebecca Preedy, Consultant Gastroenterologist graduated from the University College of London in medicine in 2006. She is the clinical lead for inflammatory Bowel Disease and Nutrition.
She completed her specialist training in gastroenterology rotating through major teaching hospitals in London, learning from leaders in their fields.
For further information go to her website on Rebecca Preedy
Mrs. Cristine Daniel-Naguib
Senior Dietician
Mrs. Cristine Daniel-Naguib holds a BSc in Nutrition from Liverpool and a Postgraduate qualification in Nutrition and Dietetics from Chester. She currently serves as a Senior Gastroenterology Specialist Dietitian and leads the Dietetic Gastroenterology team at Mid Cheshire Hospitals NHS Foundation Trust. With over six years of experience working alongside gastroenterology consultants, she provides expert care in both acute inpatient settings and outpatient clinics.
Cristine is a registered member of the Health and Care Professions Council (HCPC) and the British Dietetic Association. She is also affiliated with BAPEN (British Association for Parenteral and Enteral Nutrition) and remains committed to staying current with the latest evidence-based research in nutrition and health.
For further information go to her website on Cristine Daniel-Naguib
What can my symptoms mean?
Abdominal pain can present with different degrees of severity, from mild discomfort to severe pain. It must always be taken very seriously and could indicate a variety of underlying conditions. In particular, patients experiencing persistent pain must seek medical help immediately.
Oneof the causes of abdominal pain with due to gallstones. This mainly occurs in the right upper quadrant of your abdomen. It may radiate to your right shoulder blade.
Abdominal pain can present with different degrees of severity, from mild discomfort to severe pain. It must always be taken very seriously and could indicate a variety of underlying conditions. In particular, patients experiencing persistent pain must seek medical help immediately.
One of the causes of abdominal pain with due to gallstones. This mainly occurs in the right upper quadrant of your abdomen. It may radiate to your right shoulder blade.
Heartburn is a rising, burning sensation behind the chest caused by reflux of stomach acid into the oesophagus. Nearly everyone has or will experience heartburn on occasion. Heartburn is the most common symptom of gastro (stomach)-oesophageal (gullet) reflux disease (GORD). Frequent heartburn that disrupts one’s lifestyle suggests the diagnosis of GORD.
Severe, long-standing GORD can damage the oesophagus and cause a condition known as Barrett’s oesophagus wherein the normal lining of the oesophagus is replaced by a lining more like that of the stomach or intestine. The risk of oesophageal cancer appears to increase significantly in patients with Barrett’s oesophagus. The only way to diagnose Barrett’s oesophagus is by endoscopy.
Nausea and vomiting are symptoms of an underlying disease and not a specific illness. Nausea is the sensation that the stomach wants to empty itself, while vomiting (being sick) or throwing up, is the act of forcible emptying of the stomach. They are symptoms of many conditions. Dehydration is the main concern with most vomiting.
Most of the time, nausea and vomiting do not require urgent medical attention. However, if the symptoms continue for days, they are severe, or you cannot keep down any food or fluids, you may have a more serious condition.
Difficulty in swallowing can be serious. Someone who cannot swallow well may not be able to eat enough of the right foods to stay healthy or maintain an ideal weight. Sometimes, when foods or liquids enter the windpipe of a person who has difficulty in swallowing, coughing or throat clearing cannot remove it. Food or liquid that stays in the windpipe may enter the lungs and create a chance for harmful bacteria to grow. A serious infection (aspiration pneumonia) can result.
The oesophagus (gullet) may be too narrow, causing food to stick. This food may prevent other food or even liquids from entering the stomach.
Unintentional weight loss is a decrease in body weight that is not voluntary. In other words, you did not try to loss the weight by dieting or exercising. Any illness can affect a previously hearty appetite. If the illness is treatable, the appetite should return when the condition is cured. Loss of appetite can cause unintentional weight loss.
This could be related to other symptoms such as diarrhoea or abdominal pain, but should always be taken very seriously. It may indicate an underlying serious problem that requires further investigation.
Unintentional weight loss is a decrease in body weight that is not voluntary. In other words, you did not try to loss the weight by dieting or exercising. Any illness can affect a previously hearty appetite. If the illness is treatable, the appetite should return when the condition is cured. Loss of appetite can cause unintentional weight loss.
This could be related to other symptoms such as diarrhoea or abdominal pain, but should always be taken very seriously. It may indicate an underlying serious problem that requires further investigation.
Hiatus hernia is a condition in which the upper portion of the stomach protrudes into the chest cavity through an opening of the diaphragm called the oesophageal hiatus. This opening usually is large enough to accommodate the oesophagus alone. With weakening and enlargement however, the opening (or herniation) can allow upward passage or even entrapment of the upper stomach above the diaphragm.
Symptoms of hiatus hernia can range from chest pain, heartburn to coughing.
Anaemia is a deficiency in the number of red blood cells which can lead to a variety of different symptoms. Patients may present with numerous problems such as tiredness, headaches, dizziness to bleeding from the back passage. There are various types of anaemia and some require investigation of the gastro-intestinal tract.
There are various symptoms associated with liver problems.
Jaundice is usually due to liver disease. This is a yellowish discoloration of the skin, the conjunctival membranes over the sclera (whites of the eyes), and other mucous membranes caused by hyperbilirubinaemia (increased levels of bilirubin in the blood). Sometimes the urine becomes dark in colour. Common causes include acute hepatitis (inflammation of the liver), hepatotoxicity (liver injury) and alcoholic liver disease, whereby cell necrosis reduces the liver’s ability to metabolise and excrete bilirubin leading to a build-up in the blood.
What investigations do I need?
Following your consultation you may have been informed that you require a procedure called a gastroscopy .
This is when a thin flexible tube called an endoscope is used to view the oesophagus, stomach and duodenum. Details of any preparation required will be given to you prior your examination. The procedure is minimally invasive, relatively painless and at worst only mildly uncomfortable.
The gastroscopy will be performed in purpose built theatres using technically advanced, state of the art equipment. Your consultant views images produced via video linked screens allowing excellent vision of each area facilitating early, accurate diagnosis of each symptom. You many require sedation.
Following your gastroscopy, you will be taken to recovery to be expertly looked after until you are fully recovered. You will be offered light refreshments prior to going safely home.
Ultrasound is like ordinary sound except it has a frequency (or pitch) higher than human beings can hear. When sent into the body from a transducer resting on a patient’s skin, the sound is reflected off internal structures. The returning echoes are received by the transducer and converted by an electronic instrument into an image of the internal structures on a viewing screen. These continually changing images can be recorded on film, paper, videotape, or computer. In an abdominal examination, ultrasound produces images of the major organs, including the liver, gallbladder, bile ducts, pancreas, spleen, kidneys, and large blood vessels.
A CT (computerised tomography) scan, sometimes also called a CAT scan, takes pictures of the body and uses a computer to put them together. A CT scanner uses X-rays and is a painless procedure. A series of X-rays are taken of your body at slightly different angles, to produce very detailed pictures of the inside of your body. The pictures produced by CT scans provide your consultant with information to him them reach a diagnosis about a variety of conditions. The CT scanner is a large machine. The pictures are taken while you lie on a couch, which moves backwards and forwards through the hole of the machine that is shaped rather like a giant doughnut. The scan may need a contrast dye or substance that improves the picture of certain tissues or blood vessels. This material may be swallowed, given as an enema or injected into the blood stream, depending on the part of your body that is to be scanned.
An MRI (Magnetic Resonance Imaging) scan is a medical imaging technique used to create detailed images of the organs and tissues inside the body. It is a powerful diagnostic tool that provides detailed and precise images, aiding in the accurate diagnosis and treatment of various medical conditions.
Oesophageal manometry and pH monitoring are tests that assess the function of the oesophagus and the amount of acid in the oesophagus.
Oesophageal manometry
- Measures the strength of the oesophageal muscles
- Determines how well the oesophageal sphincters open and close
- Measures the pressure and speed of muscle contractions
- Involves passing a thin tube through the nose and into the oesophagus
- Measures the amount of acid in the oesophagus over a 24-hour period
- Helps diagnose gastro-oesophageal reflux disease (GORD)
- Involves placing a tube in the oesophagus that’s connected to a data recorder
onto a computer and 8 hours of video footage will be read by the consultant. A report will be issued after the test has been completed.
Small intestinal bacterial overgrowth (SIBO) occurs when there is an abnormal increase in the overall bacterial population in the small intestine — particularly types of bacteria not commonly found in that part of the digestive tract. This condition is sometimes called blind loop syndrome.
Small intestinal bacterial overgrowth (SIBO) commonly results when a circumstance — such as surgery or disease — slows the passage of food and waste products in the digestive tract, creating a breeding ground for bacteria. The excess bacteria often cause diarrhea and may cause weight loss and malnutrition.
Hydrogen and methane breath testing is a widely accepted means of identifying changes to the gut microbiome and is used to detect abnormal growth of bacteria in the small intestine, or small intestinal bacterial overgrowth (SIBO).
How Can I make An Appointment?
Referrals are made to us by your GP. The vast majority of GPs are familiar with us already and may direct you to our unit. However, if they are not familiar with the Cheshire Gallstone Clinic, you can suggest they consider us, should you wish to be referred to a specialist unit such as ours. Once your NHS or Private GP believes there may be a possibility of a stomach, gallbladder or a hernia problem, they may consider that it is more appropriate that you are seen by a gastroenterologist, and this is when the Cheshire GallbladderClinic might be considered.
Please click onto the individual consultant webpage.
We welcome everyone to the Cheshire Gut Clinic, whether you have private health insurance or are paying for your own consultation, investigations and continuing care. We are recognised by all major health insurance companies.
If you have health insurance, please contact your insurer to confirm that your policy is valid and it covers you for the categories of treatment you could receive at the Cheshire Gut Clinic.
If you are paying yourself, please ensure you are fully aware of the cost of your treatment and aftercare. Please contact the hospital for the cost of treatment. You will be asked to pay in full for each visit after each appointment. An invoice will be given if required listing the care package you are to receive.