Hepatitis C ODN

The Bristol and Severn Region Hepatitis C Network (ODN) incorporates a main hub, namely University Hospitals Bristol and Weston NHS Trust, alongside further treatment centres working across the region in Bath (Royal United Hospitals Bath), Gloucestershire (Gloucestershire Royal Hospital NHS Foundation Trust), North Bristol (North Bristol NHS Trust), and Yeovil (Yeovil District Hospital). You can find out more on their dedicated webpages: The Bristol and Severn Hepatitis C Network (uhbristol.nhs.uk)

Alright My Liver?

The Alright My Liver? Project screens for liver disease in people with risk factors across the region. You can find out more about the project on their webpages: Alright My Liver? (uhbristol.nhs.uk)

The paracentesis clinic is a day case clinic provided by the Hepatology team at Bristol Royal Infirmary. It is usually run by Victoria Iji, the Hepatology Physician Associate. The aim of the clinic is to help manage symptomatic ascites and to try and alleviate some of those associated symptoms, such as abdominal discomfort, shortness of breath, poor appetite and help reduce or control the accumulation of fluid (oedema) in the legs. We consider this procedure when diuretics (water tablets) are not effective in keeping the fluid away.

It is also an opportunity to keep in touch with those patients with decompensated cirrhosis and identify any new issues/symptoms that we may be able to help with, as well as flag any patient that may need to be seen by a consultant for further assessments and interventions.

The procedure is usually performed on ward A900, the patient will attend at 8am for an assessment and if the procedure is appropriate, it will then be performed usually by Victoria, though there are many other professions involved in this service who may also perform the procedure, including doctors and specialist nurses. The patient remains on the unit for 6 hours, during this time they will have their bloods reviewed and may receive some protein via a drip to help prevent the fluid from re-accumulating to their abdomen too quickly.

Before the procedure it is important that we ensure it is safe to perform and to do this the patient will need to have a tense abdomen and we usually agree an ideal weight to reach before we drain. It is important we only perform a drain when it is safe to do so as there are many risks associated with the procedure if drained too early.

You can call the hepatology secretaries on 0117 342 7707 or email Victoria.Iji@uhbw.nhs.uk to book a drain slot or discuss whether you might be ready for a drain.

Alcohol is one of the major causes of liver disease in the UK. Our Alcohol Nurse Specialist team based at Bristol Royal Infirmary, provides support to those patients who experience alcohol dependence or drink alcohol to a harmful level. They also work to provide colleagues with education and training in alcohol care.

Our Alcohol Nurse Specialist team attend the weekly hepatology multi-disciplinary team meeting (MDT) to support complex decision making, provide education and teaching to the nursing and medical workforce, run an 'Alcohol Champions' programme on the wards, attend alcohol and hepatology conferences and are currently involved in a study to support standardisation of Alcohol Care Teams nationally.

The team also work with the community alcohol support services Bristol ROADS (Recovery Orientated Alcohol and Drug Service) and the North Somerset We Are with You.

The focus of the service is to:

Assess adult patients who are admitted to the hospital with alcohol use disorder (including patients drinking and using substances like heroin/crack. We aim to assess within 24 hours and provide further reviews during their time in hospital for support and motivation.
Provide advice and information for patients to access community services for alcohol and drug use. Self-referral is the fastest way for patients to access these services, but we may refer patients if required.
Provide brief intervention to increase insight and awareness of alcohol and its effect on their health and wellbeing.
Deliver harm minimisation advice to promote safety and encourage change.
Offer support for patients who are undergoing surgery.
Monitor and provide support for patients and staff on the management of medically assisted alcohol withdrawal in the hospital setting.
Prescribe relapse prevention medication for patients who are motivated for abstinence and are engaging with psychological support.
Perform Fibroscans to screen for alcohol related liver disease.

Assessment

The alcohol nurse specialists will assess people suffering from alcohol use disorder. They provide a safe, confidential, non-judgemental approach. During the assessment patients will receive feedback, education and advice on their alcohol intake.

Working hours

Monday to Friday, 8.30am to 4.30pm at Bristol Royal Infirmary.

Contact details

Grace Cameron and Lucy Krouma

Email: AlcoholNurseTeam@uhbw.nhs.uk

Tel: 0117 342 7255

Bleep: 3444/6110

Advice and support

If you are concerned about the amount of alcohol you are drinking, don't be afraid to ask for help. Your GP and the following services can provide you with help, advice and support.

Breaking Free (use access code bristol11)

The Swan Project - We are here to help

The department plays an active role in supporting research to help develop new treatments. We regularly participate in national clinical trials, which have recently included a large UK-wide study investigating the best treatment for alcohol-related liver disease.

Currently, we are recruiting to:

ASEPTIC (BASL)

BOPPP (BASL)

Pearl (Prospective Cohort for Early Detection of Liver Cancer) Study

Outreach services

Hepatitis C ODN

Alright My Liver?

The Alright My Liver? Project screens for liver disease in people with risk factors across the region. You can find out more about the project on their webpages: Alright My Liver? (uhbristol.nhs.uk)