GIRSIG 2002 was a weekend conference, organised by the national committee and held at Redwood Lodge Hotel and Country Club, Bristol.

The first morning session began at nine with an introductory speech my Robert Law, who is not only the current GIRSIG chairman but a clinical specialist radiographer at Frenchay Hospital in Bristol who has been at the for front of role extension for GI radiographers for example t-tube cholangiograms and nephrostograms are all radiographer performed.

The first lecture was given by Dr Farrow a consultant GI radiologist in Bristol. This speech was centred around "Judgment and Evidence of Senses", and discussed the use of metaphors, for example "apple core carcinoma". The main focus of the lecture was that of going from "seeing what you believe is present on the radiograph to what your senses tell you is there" which reiterated to us not to use a preconcepted idea of what you believe might be wrong with a patient and look at the radiographs as a blank canvas. Using "aesthetic engagement to transform casual looking into sensitive seeing".

The rest of the morning session was based around Irritable Bowel Disease (IBD) and Colitis.

The first of these three lectures was given by Dr Hussaini a consultant Gastroenterologist, who discussed the endoscopy, diagnosis and medical management of IBD from a medical view. It outlined the main differences between Ulcerative Colitis and Chron's disease and how diagnosis is made using endoscopy, histology and radiology. Dr Hussaini also touched on treatment of IBD and how a lot of it was dependant on the site of IBD and would either be treated medically or surgically.

The next lecture was titled "Background to IBD". Did you know that the first modern description of Ulcerative Colitis was as far back as 1859??!! written by Samuel Wilks. This speech was quite interesting as it discussed the new method of diagnosis for IBD, the capsule, which is like a small "disposable camera" which is swallowed by the patient and takes up to 15,000 photos throughout the small bowel. Once the capsule has passed through, the images are processed. Some of the disadvantages of the system at the moment are that the capsule can get stuck at points of strictures and there is no way to get an accurate measurement to correlate a photo to a definite point in the small bowel, but there is new technology coming out using a strap around the patient and a system whereby they can detect where the capsule is within a couple of centimetres of where it actually is in the small bowel.

The final lecture of the morning was that on Colitis given by a consultant GI radiologist. Colitis was split into seven categories and the Dr then went on to explain the observations that should be made on a barium enema examination such as the haustral pattern, filling defects and strictures.

Saturday afternoon

Following a good lunch, the afternoon began with a dual presentation that compared two techniques for examination of the small bowel: small bowel enteroclysis (enema) and small bowel meal +/- pnemocolon.

Robert Law, one of the most experienced GI radiographers in the country, talked about enteroclysis and demonstrated the quality of images that can be produced, but pointed out that patient compliance can be a problem. He also compared radiographer and radiologist performed studies and it was heartening to note that relative reporting sensitivity for both operators was comparable.

Christine Bloor, a Clinical Specialist Radiographer who has trained to do both barium enemas and flexible sigmoidoscopy, currently offers a ''one-stop'' clinic for colonic investigation in Truro. She presented a convincing case for the small bowel meal and pnemocolon and was able to demonstrate that the sensitivity was comparable to the enema without the need for intubation.

The debate was finally settled when Christine quoted a large, well-respected American study that supported her assertion. Overall a good presentation, but the audience was left with the feeling that the existing research had already settled the argument.

The next speaker was Sarah Noonan, a nurse counsellor working with patients with inflammatory bowel disease (IBD). She outlined her role within the multi-disciplinary team and the service she is able to offer patients. She explained the specialist support she is able to give at all stages of the patient pathway from diagnosis, through treatment and long term follow-up. Her role included practical and psychological support as well feedback of information between the patient and medical teams.

The final speaker was Mr Steve Mitchell, a consultant colorectal surgeon who looked at the different surgical approaches to inflammatory bowel disease. Ulcerative colitis is essentially cured by colectomy and the key decision for the patient is often whether to accept an ileostomy or have restorative pouch surgery. The approach to Crohns is different because this disease tends to recur and the patients often need repeated surgical intervention. Their care is concerned more with preserving functional small bowel length to avoid short bowel syndrome and associated nutritional problems. The recurrent nature of Crohns disease means it is managed medically with surgical intervention only when essential.

Sunday morning

CONTINUOUS PROFESSIONAL DEVELOPMENT
Alison Booth

There are good reasons for continuous professional development at any level; professional requirements (Statements for Professional Conduct, CoR); pride and satisfaction in a job well done; adding to the knowledge base and earning the respect of all colleagues. There are a wide variety of ways this can be achieved: research, either doing it or critiquing it; clinical audit, locally and nationally; promoting the profession and GI radiographers in particular by doing poster and/or oral presentations, locally, regionally, nationally and internationally.

The speaker's experience of doing an MSc in Advanced Radiography Practice, meant she could say with authority that research is very hard work, requires long hours and dedication; an understanding partner/family and a dogged persistence to see you through. For her the rewards had been getting a two-year secondment to the Centre for Reviews and Dissemination (CRD), a centre for health research and a role supporting clinical governance activities within radiology, while still maintaining her clinical skills.

Acknowledging that undertaking research or advanced study was not for everyone, she encouraged everyone to read and learn to critique what is published. This was going to become an increasingly necessary skill to support evidence based practice. She suggested that a research paper could be used as a focus for discussion at regional GIRSIG meetings.

The audience was encouraged to write letters and articles for journals, to register with the CoR as experts and to record their changing roles with the modernisation agency (www.modern.nhs.uk and search for Role Redesign Database). Looking positively at opportunities was another theme, for example those who liked the idea of lecturing but didn't want to loose their clinical skills could apply for posts on a part time, secondment or job share basis.

For more information a number of Web addresses were given:
Commission for Health Improvement: www.chi.nhs.uk
Department of Health R&D: www.doh.gov.uk/research/whatsnew.htm
Advice/information on research: www.rddirect.org.uk
Funding opportunities for research: www.rdinfo.org.uk
Instructions to Authors: www.mco.edu/lib/instr/libinstr.html
National electronic Library for Health: www.nelh.nhs.uk

There was a final call to encourage everyone to join, support and get involved with GIRSIG. As a voluntary organisation, it has already raised the profile and advanced the practice of GI radiography by providing a pooling of ideas and experience for safe, best practice and career progression. GI radiographers were encouraged to join GIRSIG, and help take it further by becoming active members of their regional group. People are always needed to attend, talk or organise meetings and to stand as regional representatives on the national committee. New people with different ideas are essential to the future.

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