The Gastroenterology Ambulatory Service’s success is derived from a multidisciplinary team of professionals, each specialising and governing innovation in their respective fields. Our commitment to high quality client centred care for patients with diseases of the gastrointestinal tract is achieved through specialist outpatient clinics, endoscopy and inpatient services and daily medical and nursing sessions. Our philosophy is to persistently strive for excellence through quality initiatives to better meet our patient’s needs and to achieve optimal digestive health within our communities.
An Integrated Care Clinic brings together a collaborative approach of Medical, Nursing and Allied Health with specialised knowledge and expertise in the management of complex chronic gastrointestinal disorders. Our collaborative team work closely with GP’s to ensure the best possible treatment and outcome is available to patients within the community setting. The Pre-Endoscopy Assessment nursing team provides pre- and post-endoscopy assessment, advice and support, management of comorbidities, determining patient fitness and suitability for all endoscopic procedures.
Innovation is an integral part of our culture and endeavour for excellence within Gastroenterology. Specialised care is delivered, and diagnostic and therapeutic endoscopic procedures are undertaken including upper endoscopy, colonoscopy, enteroscopy, ERCP, endoscopic ultrasound, peroral endoscopic myotomy (POEM) procedure and video capsule endoscopy. In addition, a broad range of non-endoscopic procedures are performed including faecal transplants, fibroscan, oesophageal manometry, PH Studies and functional Testing and venesection.
The Parenteral Nutrition Service is a multidisciplinary team (Gastroenterologist, TPN Associate CNC, Dietician, Pharmacist) responsible for ensuring optimal care for inpatients and home patients who require acute or chronic management for parenteral nutrition when anatomical and physiological abnormalities preclude enteral feeding. The team provides a comprehensive assessment with daily reviews and monitoring of the patient’s condition while Parenteral Nutrition is administrated.
The Department supports and facilitates the operation of a dedicated IBD service using a Gastroenterologist led shared care mode comprising of Gastroenterologist, Colorectal surgeon, IBD Associate CNC, Dieticians and Pharmacists.
The National Bowel Cancer Screening Program (NBCSP) aims to reduce deaths from bowel cancer by detecting the early signs of the disease. Eligible Australians from 50 to 74 years of age are sent a free, simple test that is completed at home. Find out how the program works and how to do the test.
The Gastroenterology Ambulatory Service further supports the NBCSP through dedicated nursing and health promotion roles to support program participants through their screening journey. A Gastroenterology Nurse Coordinator assists Program participants referred to the Princess Alexandra Hospital by ensuring access to follow up care and assisting them through the assessment colonoscopy pathway. The Health Promotion Officer supports the overall activities of the Department and works in conjunction with the CNC, to develop and coordinate public health strategies that promote participation and equitable access to bowel cancer screening within the Metro South Health catchment area. Health Promotion Officers provide key program updates for community, GP’s and other health care providers on the NBCSP.
The Princess Alexandra Hospital is committed to improving the delivery of services and the quality of care our patients receive. Patient satisfaction initiatives allow us to implement changes that will result in improved care and better patient outcomes. One of the ways we can explore the patient’s experience is through a so-called ‘Mirror Meeting’. The contents of this brochure will provide more information on the Mirror Meeting process.
The experience of patients within the hospital and with our team of healthcare professionals often remains unspoken. These are missed opportunities to gain valuable insight into your experience as a patient and can impact the level of care we deliver. To insure we deliver the quality of care you expect and deserve, it is important for our staff to hear firsthand about your patient experience. These experiences can be captured through conducting a Mirror Meeting. Under the guidance of a moderator, you will be given the opportunity to speak about the experience you had with our service. We place great value on your experience as a patient in our hospital. Your contributions to this process assist us to improve and provide better care for future patients.
What are Mirror Meetings?
During a Mirror Meeting approximately 10 patients will be guided to discuss their experiences within the Department, both positive and negative. Healthcare professionals will attend this meeting via video. The healthcare professionals viewing the discussions can be nurses, administrative staff, allied health and doctors of our department. This will allow our staff to learn directly through your experience with our service.
We will keep a video recording of the Mirror Meeting. This will assist in implement any identified areas that require changes or improvements within our Department. Your participation in this Mirror Meeting is on a voluntary basis only and will in no way have an impact on your future healthcare within a Queensland Health facility.
How can I participate in a Mirror Meeting?
Healthcare professionals around the department may invite you to participate or register your interest in this quality improvement initiative. If you are interested in participating, we will take your details and be in touch shortly with more information. You can also register your interest by contacting us via email: PAHemail@example.com.
How can I prepare?
The period between your discharge from our care or visit to our clinic and the Mirror Meeting is an ideal time to reflect on your personal experience. Try to recall the care you received and how the experience impacted your time at the hospital. You can write down any ideas or points that you believe will help us improve our delivery of care.
On the day
Details on the time and location of the Mirror Meeting will be emailed to you in an official Mirror Meeting invitation. On the day we will welcome you with tea, coffee and nibbles before we officially commence the Mirror Meeting. We will ask you to arrive 30 minutes before the start of the meeting to meet the other patients and the moderator. Feel free to ask the moderator any question before the meeting officially starts. Staff support and assistance will be in place should you feel overwhelmed at any stage during the Mirror Meeting. We hope the Mirror Meeting will be a pleasant and informative experience for all involved and we will take great care in evaluating your comments with the Department’s health care professionals. Following this evaluation, you will receive a short report delivered to the home address or email supplied. Your feedback and involvement in the Mirror Meeting are very much appreciated and will result in improved healthcare delivery for future patients of the Department of Gastroenterology, Hepatology and Digestive Health.
If you want to participate in one of the Mirror Meetings, please get in touch with us via email: PAHfirstname.lastname@example.org.
Gastroenterology and Hepatology medical staff
Professor Gerald Holtmann, MD, PhD, MBA, FRACP, FRCP
Clinical Director Endoscopy
Dr Luke Hourigan, MBBS, FRACP
Director of Hepatology
Dr Katherine Stuart, PhD, MBBS, FRACP
Associate Professor Graeme Macdonald, PhD, MBBS, FRACP
Professor Elizabeth Powell, PhD, MBBS (Hons), FRACP, PhD, FRCP (Lond), FAASLD
Dr Alex Huelsen-Katz, MBBS, FRACP
Dr Andrew Taylor, MBBS, FRACP
Dr Ayesha Shah, PhD, MBBS, FRACP
Dr Bradley Kendall, MBBS, PhD, FRACP
Dr Caroline Tallis, BPhty (Hons), MBBS (Hons), FRACP
Dr Che-yung (Jeff) Chao, MBBS, FRACP
Dr Daniel Burger, BSc, MBBS (Hons), FRACP
Dr James Thomas, MBBS, FRACP
Dr Kate Forgan-Smith, MBBS, FRACP
Dr Lara Kane, MBBS, FRACP
Dr Laurence Britton, MBChB, PhD, FRACP
Dr Melita Andelkovic, MBBS, FRACP
Dr Montri Gururatsakal, MBBS, FRACP
Dr Neal Martin, BSc, MBBS, FRACP
Dr Paul Clark, PhD, MBBS (Hons), MPH & TM, FRACP
Dr Sam O'Connor, MBBS, FRACP
Dr Terrance Tan, PhD, MBBS, FRACP
Dr Zaki Hamarneh, MBBS, FRACP
Clinics are held for patients with general gastroenterological problems as well as for inflammatory bowel diseases (IBD), motility or functional gastrointestinal disorders and pancreato-biliary diseases. In addition, Specialised Gastroenterology and Hepatology clinics have been established for a number of disease conditions including:
- General Gastroenterology
- Inflammatory Bowel Disease
- Gastrointestinal Motility Disorders
- Diagnostic and Interventional Endoscopy.
Motility and Functional Testing
The department provides comprehensive services in the field of motility and GI function testing. The procedures include:
- Oesophageal manometry and pH monitoring
- Ambulatory oesophageal pH monitoring
- Hydrogen Breath testing for small bowel bacterial overgrowth and lactose intolerance
- 13C Breath testing (using IRIS) for gastric emptying, pancreatic function, H. pylori infection
- Wireless Capsule pH-Metry (BRAVO)
- Anorectal manometry.
The Hepatology Department is committed to providing high quality patient centered care to all patients with a Hepatology condition including advanced liver disease/cirrhosis, hepatocellular carcinoma, metabolic liver diseases including fatty liver and chronic viral hepatitis. These clinics provide for the integrated management of patients with liver disease in close liaison with specialist nursing team, general practitioners, nutrition and dietetics, exercise physiologists, psychologists, pharmacists, hepatobiliary surgical unit, and the alcohol and drug unit, as required. Liver transplant clinics are also held within the Burke Street Centre. We have on offer several methods of non-invasive assessment of liver disease including FibroScan®.
The General Hepatology clinics are attended by Dr Katherine Stuart, Associate Professor Graeme Macdonald, Professor Elizabeth Powell, Dr Lara Kane, Dr Caroline Tallis, Dr Laurence Britton, Dr James Thomas, Dr Melita Andelkovic and Dr Paul Clark.
- Liver transplantation
- Advanced liver disease/cirrhosis
- Chronic viral hepatitis
- Hepatocellular carcinoma
- Metabolic liver diseases including fatty liver disease
- General hepatology
- Liver biopsy, Transient elastography, Indocyanine green testing.
Patients with the following problems can be referred to this clinic via the Central Referral Hub. Details on referral information can be found on Metro South Refer your patient.
- Abnormal liver tests/jaundice
- Autoimmune liver disease (AIH, PBC, PSC)
- Elevated iron studies
- Hepatic steatosis/Non-alcoholic fatty liver disease (NAFLD)
- Hepatitis B Virus
- Hepatitis C Virus
- Liver cirrhosis
- Space occupying liver lesion
- All other Hepatology conditions.
Liver Transplant Clinics
Several Hepatologists are senior members of the Queensland Liver Transplant Service and work closely with their liver transplant surgical colleagues. Pre-liver transplant assessment, integrated post-liver transplant and Hepatoma clinics are held at the Burke Street Centre. The Hepatobiliary surgeons attending these clinics include Dr Peter Hodgkinson and Dr Nicholas Butler.
The Endoscopy Unit provides an inpatient and outpatient endoscopic service with daily sessions starting at 0800h and concluding at 1800h. The unit exists of an admission area, 4 procedure rooms, 8 recovery beds, a discharge area and an endoscope reprocessing unit. Weekly, the Endoscopy Unit has 4 procedure rooms running, all with a dedicated anaesthetic team. There is an on-call service provided by the Endoscopy Unit nursing and medical staff covering 24 hours a day for urgent procedures that require immediate intervention.
The patient process
Colonoscopy and Endoscopy
To learn about preparing for your colonoscopy or endoscopy, a range of video resources are available.
The Colonoscopy: What you need to know fact sheet specific for Aboriginal and Torres Strait Islander peoples provides useful information on each step of the colonoscopy procedure. It discusses each stage from referral to discussion of the colonoscopy results.
Diagnostic and therapeutic procedures
The Endoscopy Unit provides state-of-the-art endoscopic diagnostic and therapeutic procedures:
- Upper gastrointestinal endoscopy
- Capsule and balloon enteroscopy
- Colonoscopy and sigmoidoscopy
- Endoscopic ultrasound and guided biopsy
- Endoscopic retrograde cholangio pancreatography (ERCP)
- Oesophageal dilatation
- Variceal sclerotherapy/banding
- Gastric variceal glue
- Oesophageal stenting
- Ulcer injection
- Argon plasma coagulation of mucosal lesions
- Removal of foreign bodies
- Percutaneous endoscopic gastrostomy and jejunostomy (PEG/PEJ)
- Endoscopic mucosal resection of polyps and early mucosal tumours (Endoscopic submucosal dissections)
- Gastric or enteric feeding tubes
- Abdominal paracentesis
- Haemorrhoid treatment
- Endoscopic sphincterotomy – common bile duct stone removal
- Biliary or pancreatic stent insertion
- Biliary or pancreatic stricture dilation
- Biliary electrohydraulic lithotripsy
- Colo-rectal stricture dilation
- Placement of oesophageal, duodenal or colonic stents
- Peroral endoscopic myotomy (POEM)
- Endoscopic sleeve gastroplasty
- Endoscopic treatment of varices
- Endoscopic treatment of Barrett's lesions
- Bariatric endoscopic gastric sleeve.
The Department of Gastroenterology and Hepatology has a strong research track record. The collocated Translational Research Institute provides and outstanding opportunity and has a stellar international reputation that attracts trainees and senior investigators from overseas. Members of the Department have laboratory space in this facility and we have created a hospital-research laboratory pipeline where research samples are collected during specialised procedures and transported to the research laboratories for cutting edge experimentations which will ultimately lead to new treatment options.
A number of research projects related to various aspects of Gastroenterology and Hepatology are currently conducted in our Department, including drug therapies for functional and inflammatory bowel diseases, pathophysiology of functional gastrointestinal disorders, efficiency and safety of interventional endoscopic techniques, drug therapies for viral hepatitis and pathophysiological mechanisms of non-alcoholic steatohepatitis, liver repair and regeneration and innate immune function in chronic liver disease.
Basic scientific experimental research is conducted at adjacent Translational Research Institute and research collaborations exist with the QIMR Berghoffer Medical Research Institute (QIMR) and Centre for Advanced Imaging, University of Queensland.
- Dr Natasha Koloski, PhD, Research Fellow and Research Manager
- Dr Marcus Gray, PhD, Advance Queensland Fellow and Senior Lecturer
- Teressa Hansen, Research nurse Research and Clinical Trial Coordinator
- Dr Marguerite Kutyla, BPharm (Hons) PhD, Data Manager and Quality Manager
Translational Research Institute (TRI)
Current Research Projects
Specific research projects with lead investigators in the field of Gastroenterology and Hepatology include:
|Targeting the gut microbiome as a treatment for Primary Sclerosing Cholangitis: The Queensland Clinical Network Study|
|Gut Health Biobank|
|A randomised controlled trial of antibiotic therapy in functional dyspepsia with and without non constipation irritable bowel syndrome|
|A practice change for patients with severe chronic, clinically unexplained gastrointestinal symptoms: A randomised, controlled intervention to assess efficacy and cost-effectiveness|
|Modulation of the Gastrointestinal Microbiome with probiotics and subsequent Methane production as a novel approach to treat constipation|
|Gastroenterology and Hepatology Integrated Care Clinics|
|Effects of STW-5 on intestinal bacterial isolates|
|Structured Assessment of Gastrointestinal Symptoms Scale (SAGIS) study|
|Pathophysiology of Functional Dyspepsia study|
|Yield of same day dual endoscopy for patients referred for assessment of positive Fecal Occult Blood Test|
|ESG Overstitch study|
|Irritable Bowel Syndrome Impact study|
|Smartphone IBS study|
|(AEGIS) Functional Gastrointestinal Disorder Symptom Clusters - A comparative study of Asian and Rome Questionnaire Findings in Asian and Western Patients|
|Feasibility of a new diagnostic device to assess small intestinal dysbiosis in the routine clinical setting|
|Neurobiomarkers for Irritable Bowel Syndrome study|
|A blind study testing the preparation of the Endozime solution used for manual pre-cleaning of flexible endoscopes|
- Dr Vera Meeusen, Email: Vera.Meeusen@health.qld.gov.au
|A randomised controlled trial of patient positioning during Endoscopic retrograde cholangiopancreatography (ERCP) procedures: a comparison between prone and semi-prone positioned patients|
- Dr Vera Meeusen, Email: Vera.Meeusen@health.qld.gov.au
The influence of events and emotions on effective job satisfaction and compassion
- Dr Vera Meeusen, Email: Vera.Meeusen@health.qld.gov.au
|Clinical audit studies|
|Retrospective audit of response to antimicrobial therapy for patients with functional dyspepsia|
|Assessing the impact of COVID-19 on gastrointestinal symptoms|
|An audit of the safety and efficacy of non-anaesthesist - administered sedation using midazolam and fentanyl versus propofol with or without midazolam/fentanyl for low risk endoscopic procedures|
|Patient and clinician satisfaction with alternative modes of service delivery in gastroenterology|
|Small Intestinal Bacterial Overgrowth study|
|Retrospective audit of Clinical Outcomes and the Risk of Vancomycin-resistant Enterococci in Patients with Primary Sclerosing Cholangitis treated with Antimicrobial Therapies|
|Retrospective audit of the diagnostic yield of same day dual endoscopy for patients who have a for positive Fecal Occult Blood Test|
|Investigator initiated sponsored clinical trials|
|A Two-Stage Phase I study to Assess Safety and Efficacy of a Live Microbial Biotherapeutic (SVT-1C469) as Monotherapy in the Eradication of Helicobacter pylori Infection in otherwise healthy adults|
|A Multi-center, Randomised, Double-Blind, Placebo-Controlled Parallel Group Clinical Research of Zhizhu Kuanzhong Capsule in Treating Patients with Functional Dyspepsia-Postprandial Distress Syndrome|
|A Phase I study to Assess Safety and Efficacy of a Live Microbial Biotherapeutic (SVT-1B4911) in the treatment of Functional Constipation in Adult Participants who are otherwise healthy|
Medical students of The University of Queensland are regularly attached to the Unit. International students may apply via the University of Queensland. Other Students are offered placements (e.g. TPN for pharmacists) based upon the availability of positions.
Nursing students from the University of Queensland, Griffith University and TAFE have their clinical placements ranging from several days till weeks and sometimes months. The student nurses rotate through the Gastroenterology outpatient department, Hepatology department and Endoscopy Unit.
The Department of Gastroenterology and Hepatology is fully accredited with the Royal Australasian College of Physicians for advanced training in Gastroenterology and Hepatology. There are three advanced clinical training registrar positions each year. In addition, there is a third-year Fellow position in the field of Gastrointestinal Motility/IBD, a position for an Interventional Endoscopy Fellow and a position for a Hepatology Fellow. Opportunities for further training exist for national or international applicants if they are funded or can attract at least part of the funding.
Direct your expression of interest in writing to either of the following:
Gastroenterology and Clinical/Translational Research
Professor Gerald Holtmann
Dr Katherine Stuart
Basic and Translational Research in Hepatology
Professor Elizabeth Powell
Dr Luke Hourigan