Getting to Know… Adele Sayers

Adele SayersAdele Sayers is a colorectal surgeon working in Exeter whose medical research has been supported by funding from the charity. From October, Adele will be joining Sam Alexandra Rose, Nigel Horwood and Eric Douglin as a new regular blogger for Bowel Research UK.

What’s your current job and where did you train?

I’m a consultant colorectal surgeon based at the Royal Devon and Exeter Hospital. I joined Hull York Medical School in September 2003, graduating five years later in July 2008. I started my foundation training in Hull, with my first job being in Colorectal Surgery. I thoroughly enjoyed working in this unit and I believe the team I worked with during this time, really cemented my desire to become a colorectal surgeon.  I started my surgical training in August 2010 in Yorkshire and rotated through a number of different hospitals, including Hull and Sheffield. In September 2020, I was awarded my Certificate of Completion of Training (CCT) in colorectal surgery, allowing me to start work as a consultant.

From August 2012 to 2014, I took time out of my surgical training to studying for an MD under John Hartley and Andy Hunter in Hull. This was my first real experience of surgical research, and whilst it was daunting at first, I had a supportive team around me, making the transition from clinical to academic working much easier.  My MD research topic was the biomechanics of the anterior abdominal wall, looking into various techniques to help reduce parastomal hernia rates.

After obtaining my CCT in 2020, I completed an ACP and RCS fellowship in complex inflammatory bowel disease (IBD) surgery with Professor Steve Brown at the Sheffield Teaching Hospitals.

Why did you decide to get involved with BRUK?

My links to the charity go back to 2014/5 when fellow trainee Matt Lee and I were part of the steering group for the National Audit of Small Bowel Obstruction (NASBO), which was being led by colorectal surgeon Nicola Fearnhead who at the time was the Chair of the ACP. Our research was funded by the Bowel Disease Research Foundation [which merged with Bowel & Cancer Research to become Bowel Research UK in September 2020]. The main report was published in 2018.

What motivates me is my passion for how education and information can play a crucial role for people with bowel disease, enabling them to cope better with their conditions.

During my research I came to see just what a positive role social media performs for people with bowel disease, helping to reduce the stigma associated with bowel-related illnesses.  This is especially noticeable among younger people, as social media can provide a platform, allowing them to share experiences and offer support to each other. As someone who is already regularly on social media, I thought I was well placed to help.

BRUK is known for its niche funding of early stages of research with small proof of principle grants and getting the careers of new researchers started through funding PhDs. Could you tell us why you think this particular kind of approach to research funding is important?

It’s hugely important. From my experience with NASBO we needed these grants as they allowed our ideas to get off the ground and provided a great structure for collaborative studies. This funding also helped with advertising the project, allowing us to work collaboratively with other researchers across the UK, resulting in much more robust data.

What’s more, the availability of ‘start up’ funding inspires people to conduct the research that genuinely excites and interests them. And what’s great is that BRUK continues to support the next stages of research through continuation grants that help studies advance beyond the proof-of-concept stage and towards clinical trials.

This funding drives breakthroughs that simply wouldn’t have happened without it. But I would go even further and argue that the funding broadens access to the research world and makes it far more attractive to people who might never have been involved.

How important is it to challenge the stigma about talking about our bowels?

It’s so important we break the stigma. In my job I see stigma at play all the time with people resisting talking about their bowel problems, even apologising to me in clinic for talking about their bowel habit, despite taking about poo being my job. We know this stigma prevents patients discussing symptoms of bowel disease, such as bowel cancer with a medical professional. We must normalise talking about poo and bowels so people can get the treatment they need and in good time.

Because I specialise in IBD surgery, many of my patients are relatively young.  I’ve been very impressed by all the ‘body positive’ social media campaigns that have done so much to normalise living with surgical scars and living with a stoma for younger people.

Having patients who already have some insight into life after surgery, thanks to social media, has been a huge help in the care we are able to give. When counselling patients about surgery, some patients are already well informed and have a variety of specific questions, thanks to what they have already learnt through social media.

Have you ever been on the other side of the fence and been a patient in hospital?  How horrible was it and what did you learn from it?

I’ve been admitted to hospital twice, once as a very young baby when I went to hospital with septic arthritis and needed urgent shoulder surgery at the age of 10-days old. This was performed by orthopaedic surgeon Professor Michael Bell at Sheffield Children’s Hospital, and I believe it was during the first year of his consultancy. He essentially saved my life and I saw him every six to twelve months, from a being a baby right up to the age of 15.

My positive experience under Professor Bell’s care definitely inspired me to become a surgeon and he was instrumental in shaping my career choice. Thanks to Professor Bell, I was able to have full use of my right arm, without which I certainly wouldn’t be able to do the job I do today! I believe he has retired now but I’d love to see him and thank him personally, so if he’s reading this, please get in touch!

Less positively, whilst studying for my MD, I had a nasty bout of food poisoning. I knew I was really quite unwell, and should have gone to hospital sooner but I put it off until I’d reached the point of collapse from dehydration. At hospital, I learnt some valuable lessons about the patient experience. I was stuck on a ward in a cubicle and felt ignored because the ward was so understaffed. There was a real lack of communication between the ward doctors, nursing staff and me. The buzzer for my cubicle wasn’t even working, and due to my contagious nature, I wasn’t allowed to leave my room to ask for help. It made me feel very isolated.

I learnt that we must do better when it comes to communicating with our patients. While I’d say communication is probably better than, say, 35 years ago, today there are barriers that didn’t exist to the extent they do today. For example, the levels of admin all allied healthcare professionals can face today can sometimes result in us not having enough time to spend with patients as we would like.

Trying to explain the details of major abdominal surgery and help patients to make an informed decision about their management in a 15-minute appointment, is simply not long enough. This is a life changing operation and patients deserve longer. Thankfully in Exeter we have special 30-minute appointments with this group of patients, but that does understandably impact on how many patients I can see during one clinic.

Do you think social media is the way to change the conversation around bowels?

Yes. It’s hugely beneficial for reaching different audiences. From experience, the big brand social media (SM) platforms cover broadly different demographics. For example, older SM users are mostly on Facebook and professionals tend to use Twitter and LinkedIn, while younger generations favour Instagram and Tik Tok. Whichever SM platforms people use, it’s important we normalise conversations about IBD and bowel disease. We’ve all seen how Adele Roberts and Dame Deborah James have shown great courage in sharing their stories over social media. This can help to raise awareness of what symptoms and signs to look out for and can encourage others to break this stigma and report symptoms to doctors.

What part can patients play in our research work, and how can their experiences shape research which improves future care and treatment?

Patients are what our research is all about, being able to improve their care and increasing our understanding of their disease processes. We are not just talking about physical support but also emotional. As a patient you don’t just want to know how certain medications or treatments work, you want to know how quickly your life can get back to normal.

The work with the PaRT network is essential. It helps us focus on patient needs and design research studies that will work practically. For example, no PPI volunteer wants to plough through hundreds of questions on a lengthy questionnaire or be asked to fill forms every week. Working with research group patients we are able to ask the right, most important questions for our patients.

Doctors are notorious for not following the advice they dispense to others.  Guilty or not guilty as charged?

I’m probably guilty of a couple of things! I’m pretty good about my diet and my five a day, and I’ve now cut out refined sugar, but I don’t exercise as much as I should do. I have also previously been guilty of drinking too much alcohol on a Saturday night whilst at medical school. However, this is now not much of an issue as I don’t really drink much now, mainly because I have reached the age where a hangover takes 3 days to get over! However, I’d say my worst health habit is not getting enough sleep. I average around five to six hours a night which is definitely not enough and I’m very guilty of playing computer games late into the evening!

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