Know What Your Stools Are Telling You About Your Health

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October 4, 2019 Blog0

Bowel movement is a natural process that all humans undergo to eliminate wastes from the body. While some may dismiss it as a daily inconvenience, the appearance of one’s stools can be a useful indicator of one’s gastrointestinal health. Thus, it is good to have an idea of the different kinds of stools and what they tell you about your health.

What are stools?

Faeces excreted from the body consist of undigested food, proteins, bacteria, salts, and various other chemicals from the intestines. The appearance and smell of stools differ from person to person, although there are some characteristic trends for healthy and unhealthy faeces.

  •    Healthy stools

Healthy bowel movement should be easy and painless to pass. Normal stools should be log-shaped, brown to greenish in colour, and soft to firm in consistency.

Between 3 times a week up to 3 times a day is considered a normal frequency for passing stools. As this frequency varies from person to person, anything out of one’s usual routine can be a sign of something being amiss.

  •    Hard, lumpy stools

Small, pellet-shaped stools that require straining to pass is usually an indication of constipation. Constipation can be caused by a number of issues, such as stress, irritable bowel syndrome (IBS), and certain medications. However, in otherwise healthy individuals, hard, lumpy stools are likely to be a consequence of a lack of fibre. This problem can be solved by increasing the intake of dietary fibre and drinking more water.

  •    Very loose stools

Formless or watery stools, otherwise known as diarrhoea, can be a symptom of various conditions, such as food poisoning and stomach flu. Prolonged diarrhoea lasting more than a few days can be a sign of more serious issues like IBS, Crohn’s disease, or celiac disease.

Aside from getting to the root cause of diarrhoea, persons suffering from it should take extra care to stay hydrated by drinking water and electrolyte drinks, to counter dehydration and malabsorption of nutrients.

  •    Strange-smelling stools

Faeces naturally smell unpleasant due to the fermentation process that occurs in the intestines. However, stools that smell exceptionally foul may signal malabsorption of nutrients, causing excessive fermentation of undigested food. This could be a warning sign for conditions such as celiac disease, bacterial infections, or food intolerances.

  •    Blood in stools

Blood in stools can appear as red or black stools. Red stools may indicate bleeding in the lower intestinal tract, or bleeding due to hemorrhoids. A less alarming cause of red-tinted stools may be coloured foods consumed recently, such as beetroot, cranberries, or tomato juice.

Similarly, black stools may indicate bleeding in the upper gastrointestinal tract, or be due to foods such as licorice, iron supplements, or bismuth medications. To ascertain if it is blood in your stools, first rule out the possibility of these foods being the cause of your red or black stools.

While the occurrence of hemorrhoids in Singapore is common and usually non-serious, blood in stools may signal a more serious problem that is worth a visit to your doctor sooner rather than later.

  •    Fatty, oily stools

Stools sometimes appear stinky, yellowish, and greasy due to high fat content. As a result, these oil-slicked stools tend to float rather than sink. This type of stools is a sign that the body is not absorbing fats from food properly, which may be contributed by pancreatic conditions, a gastrointestinal infection, or cystic fibrosis.

If these symptoms last for more than a few days, a visit to the doctor will be helpful to ascertain the cause of oily stools. While acute pancreatitis is usually short-lived and treatable, chronic cases cause prolonged discomfort and may increase the chances of contracting pancreatic cancer. You doctor will be able to advise you on relevant information such as options for pancreatitis or pancreatic cancer treatment in Singapore.

What should you do if you detect unusual changes in your stool?

Fleeting changes in stool appearance are normal in healthy persons, dependent on the day-to-day activities and diet of the individual. It only becomes a cause for concern when these unusual symptoms persist for more than a few days, or occurs alongside pain or other symptoms. A more urgent case is blood in stools – these should be checked out by your doctor if the bleeding lasts for more than two days without an apparent cause.

The first course of action when investigating unusual stools is to consult your doctor, who may refer you to a gastroenterologist specialist. To diagnose your condition, you may be required to provide a stool sample for clinical testing. Further examinations like an endoscopy may also be performed. After diagnosing the state of your health, the gastroenterologist can then dispense you advise for suitable treatments.


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September 26, 2019 Blog

Alcohol abuse is commonly associated with liver problems because the liver is the organ mainly responsible for metabolising alcohol in the body. When there is excessive alcohol intake, the liver is unable to keep up with processing of the alcohol and causes it to remain in the body. The more alcohol is consumed, the greater the risk of damage to the liver. These damages can occur in the form of fatty liver, alcohol hepatitis, and cirrhosis.

However, it is less common knowledge that heavy alcohol use also affects the pancreas. In the US, some statistics put the proportion of pancreatitis sufferers who are also heavy alcohol users at 70%. It is well established in the medical field that there is a link between excessive alcohol intake and pancreatic-related health conditions.

Pancreatitis

Pancreatitis is a condition where the pancreas becomes inflamed. It is one of the main pancreatic illnesses that alcohol abuse is associated with. The inflammation of the organ impacts the metabolic functions of the pancreas, which cause further health complications. Clinical records put men in their 40s with a history of heavy alcohol consumption as at highest risk of being diagnosed with pancreatitis.

Although researchers have not confirmed the exact mechanism by which alcohol affects the pancreas, one theory postulates that alcohol induces digestive enzymes to flow back into the pancreas instead of being released into the intestines. As a result, the enzymes attack the pancreas cells themselves. Another theory proposed that alcohol incites a backflow of bile, thus damaging the pancreas.

Pancreatitis occurs in two forms: acute pancreatitis and chronic pancreatitis. While both are inflammations to the pancreas, they differ in the duration and severity of the conditions.

  •    Acute pancreatitis

Acute pancreatitis is a short-term and sudden inflammation of the pancreas. Symptoms include abdominal pain near the back behind the ribs, nausea, vomiting, and fever. Symptoms usually only last a few days, and most patients recover quickly without major complications. However, in rare cases, it can also become fatal. Severe cases of acute pancreatitis can also cause further complications like internal bleeding, irreparable tissue damage, infection, formation of cysts, and damage to other organs.

While most cases of acute pancreatitis usually resolve quickly without leaving lasting damages, continued excessive drinking can cause repeated bouts of acute pancreatitis. Recurring acute pancreatitis can then evolve into a chronic condition of the inflammation of the pancreas.

  •    Chronic pancreatitis

Chronic pancreatitis occurs when there is long-term inflammation of the pancreas, which usually happens only after periods of acute pancreatitis. At this stage, the damage to the pancreas is irreparable, and symptoms are experienced on a long-term basis. Symptoms include recurring pain near the back behind the ribs, weight loss, greasy stools, and jaundice. Chronic pancreatitis typically does not heal, but only gets worse gradually.

While chronic pancreatitis is usually not immediately life-threatening, it can lead to further health complications. For example, the loss of function in the pancreas leads to digestion problems and diabetes.

Complications arising from pancreatitis

  •    Diabetes

Chronic pancreatitis can lead to diabetes because the pancreas can no longer function to produce insulin. About one-third of chronic pancreatitis patients develop diabetes later in life. The onset of diabetes for pancreatitis patients usually occurs only years after the diagnosis of pancreatitis.

  •    Pseudocysts

Chronic pancreatitis can also lead to the growth of cysts or pseudocysts. These growths are fluid-filled sacs that form on the surface of the pancreas. They are formed by localised masses of dead tissue and old blood. Some cases of pseudocysts do not show symptoms, however, some patients report bloating, indigestion, and abdominal pain resulting from these cysts.

Pancreatic cysts may cause infections to the pancreas and nearby organs. In some cases, the cyst may be cancerous or pre-cancerous, developing into malignant tumours later on.

  •    Pancreatic cancer

Pancreatic cancer is when a tumour grows on a part of the pancreas, thus affecting the function of the pancreas. Studies show a link between heavy alcohol usage and pancreatic cancer, and between those with a history of pancreatitis and those who develop the cancer. One pathway for this development is the cysts that form as a complication in chronic pancreatitis.

How can you guard yourself against pancreatic conditions?

Pancreatic conditions are potentially very painful and costly illnesses. Not only might you have to deal with the substantial pancreatic cancer treatment cost, but you will also have to suffer in your quality of life. It will be worth it to reduce your likelihood of developing these pancreatic conditions and complications by regulating your alcohol intake.

Even if you have been diagnosed with acute pancreatitis before, you can lower your chances of suffering from acute pancreatitis again and from developing the chronic condition by keeping a low rate of alcohol intake and a low-fat diet. For those currently battling pancreatitis, abstinence from alcohol will help to reduce pain and allow your pancreas to heal.

If you are a heavy alcohol user, you should consider taking measures to regulate your drinking habits. To find out more about the risks of alcohol drinking to your pancreas health, consult a gastroenterology specialist today.


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September 4, 2019 Blog

Pancreatic Cancer Treatment Cost Singapore, Vomiting Symptoms

Pancreatic cancer is the 5th and 6th most common cancer to take lives in men and women in Singapore, respectively. More than 80% of cases cannot be fully treated by the time of diagnosis. About 5% of pancreatic cancer patients live beyond five years, but only 1% survive beyond ten years. What is pancreatic cancer, and why is it so lethal?

What is pancreatic cancer?

The pancreas is an organ located in the upper abdomen, in between the stomach and the spine. The organ has two functions, which is to secrete enzymes to digest fats, proteins, and carbohydrates (exocrine function); and to produce insulin and glucagon to regulate blood sugar levels (endocrine function).

Pancreatic cancer occurs when a tumour grows in part of the pancreas, hindering the normal function of the pancreas. In advanced stages of the illness, the growth of the tumour can also metastasise (spread) to other parts of the body, which makes total removal of cancer cells close to impossible.

There are two main types of pancreatic cancer, depending on which part of the pancreas the tumour begins to grow in. The more common and also more aggressive type is the exocrine pancreatic cancer, wherein the tumour affects the exocrine function of the pancreas. The less common variant is the endocrine pancreatic cancer, in which the tumour affects the endocrine function of the pancreas.

Why is pancreatic cancer so lethal?

Pancreatic cancer is said to be an aggressive and deadly illness because most of the patients who are diagnosed have little chance of survival. Here are some of the reasons why pancreatic cancer offers little hope for patients:

  • There is no known cause: There is no known cause for pancreatic cancer, making it difficult to identify people who are at-risk. While there are some factors found to have correlations to pancreatic cancer, such as a family history of pancreatic illness, smoking, and obesity, these are still much too general to effectively predict or narrow down people at risk of developing pancreatic cancer, such that early diagnosis can be made.
  • Symptoms are non-specific: Doctors list the symptoms of pancreatic cancer to be upper abdomen pain, jaundice, poor appetite, nausea, vomiting, weight loss, malnutrition, and pale greasy stools, amongst others. However, these symptoms vary from case to case and are not specific to pancreatic cancer. This makes it difficult to immediately pinpoint the cause of symptoms to pancreatic cancer.
  • Symptoms arise when its already too late: Most cases of pancreatic cancer are diagnosed when it is already too late to be cured. This is because symptoms of pancreatic cancer often only arise at the later stages of cancer when the tumour has already grown quite large. At this point, the growth would have infiltrated nearby organs such as biliary ducts, liver, surrounding lymph nodes, blood vessels and bones, making it impossible to remove at the time of diagnosis.
  • There is no reliable screening method: Unlike breast cancer or colon cancer where diagnosis tests are relatively reliable and accessible, pancreatic cancer lacks a reliable and widely available test for the masses to conduct regular checks. This makes it difficult to detect pancreatic cancer at the early stages when it is still curable.

Unfortunately, pancreatic cancer continues to take lives with warnings that are too little and too late. What you can do is to maintain a healthy lifestyle to reduce the risk factors of pancreatic cancer, and keep a lookout for warning signs. If you would like to know more about pancreatic cancer, you can consult a gastroenterologist specialist to tell you more about its symptoms, diagnosis methods, and treatment options.


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August 15, 2019 Blog

 

Have you been experiencing pain when passing stools, itching in your anal area, swelling or soreness in your bottoms, or bleeding in your stools? These are common symptoms for hemorrhoids, or piles, and can make the everyday affair of defecation a painful one. Hemorrhoids are the medical condition of swollen veins in or around the anus and lower rectum. Most cases of piles are minor and go away without further medical intervention. However, if the symptoms persist beyond 1-2 weeks, it is advisable to visit a gastroenterologist to rule out other serious problems and consider appropriate medical treatment to deal with the hemorrhoids.

Whether you are awaiting further treatment, or are advised to wait out the symptoms, it can be agonising living with the pain and discomfort of having piles. Measures that prevent hemorrhoids are also effective methods for piles treatment. These include having sufficient water intake, and not resisting the urge to empty your bowels. Apart from these, there are also numerous home remedies for piles you can try if you are already suffering from painful hemorrhoids: 

  • Soothing wipes

Toilet paper tends to be rough and may further irritate the tender sores on your bottom. Instead, try using soothing wet wipes to clean up after bowel movement. The moisture of the wipes serves as lubrication, so they are gentler on the skin. Look for wipes with witch hazel or aloe vera, as these have soothing and anti-inflammatory properties. However, keep away from wipes containing alcohol or perfume, as these are irritants that may exacerbate your condition.

  • Take warm baths

Warm baths are a quick and easy way to soothe skin irritations. Harvard Health recommends a 20-minute warm bath after each bowel movement for effective results. A fuss-free way is to use a sitz bath, a small plastic tub that attaches over your toilet seat, by filling it with a few inches of water to soak your bum. After every bath, make sure to dry off thoroughly by gently patting with a soft towel or using a hair dryer. This prevents the accumulation of moisture that promotes the development of unwelcome bacterial or fungal infections.

  • Cold compress

Application of ice packs or cold compresses are known to aid in pain relief and shrinking of sores. Hold the cold compress or ice pack against the affected area for up to 15 minutes at a time. To minimise the risk of ice burn, always wrap any frozen objects in a towel before applying to the skin.

  • Stool softeners

To make stool less painful to pass, stool softeners can help to make bowel movements smoother and quicker. Stool softeners, also called emollient laxatives, come in various forms like powders, capsules, or liquids, and are readily available as over-the-counter medications.

  • Increase fibre intake

Dietary fibre and fluids intake are crucial for promoting bowel movement, which reduces the need to over-strain when passing stool. Simple dietary changes or supplements can help to increase dietary fibre intake and relieve constipation. Some high-fibre foods to add to your diet include wholegrain-based foods, fruits and vegetables, peas, beans, and nuts. Take care to make these dietary adjustments gradually, as sudden overconsumption of fibre may cause excessive gas and bloating.

What to do if your symptoms persist

Piles are a common and usually mild affliction, but in rare cases where your symptoms persists, it could signal something more serious. Your doctor may recommend performing further checks such as a digital rectal examination and possibly a colonoscopy to give a more detailed diagnosis. If the condition requires, your gastroenterologist will advise you on appropriate medical procedures available to you, which may include rubber band ligation, or hemorrhoid stapling. It is recommended you make an appointment with a specialist in gastroenterology to access the needs of your condition.


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August 7, 2019 Blog

Endoscopy Symptoms

An endoscopy is a nonsurgical procedure that involves inserting a long, thin tube directly into the body, commonly through the mouth or anus, to make observations on an organ or tissue in detail. The flexible tube has a camera and light attached to it so the doctor can visually examine your digestive tract on the TV monitor.

Through the endoscopy procedure, the doctor can evaluate and diagnose certain the cause of symptoms and therefore, recommend the appropriate treatment. It can also be used to carry out treatment directly and avoid the need for further surgery.

Different types of endoscopy

Gastroenterology specialists are specialized in endoscopy and they are the ones who will perform it. It can be a useful procedure to help in a broad array of medical conditions related to all parts of the digestive tract. There are generally 2 groups of digestive endoscopies.

General endoscopy helps to evaluate most digestive symptoms and recommend treatment, including procedures like:

  • Gastroscopy: Esophagus, stomach and small intestine (duodenum)
  • Colonoscopy: Large intestine and colon

Advanced endoscopy includes more complicated endoscopy types with higher risks of complications but often help patients avoid a more invasive surgery, namely:

  • ERCP (Endoscopic Retrograde Cholangio-Pancreatography): Bile ducts and pancreatic ducts
  • Endoscopic ultrasound (EUS): The gastrointestinal (GI) tract and neighbouring organs

When will you need an endoscopy

There are mainly three reasons when endoscopy will be recommended to you.

1. Investigate symptoms and signs

Your doctor can take a look and investigate digestive signs and symptoms like persistent abdominal pain, difficulty in swallowing (dysphagia), change of bowel habits, blood in stools and gastrointestinal bleeding.

2. Diagnose

A biopsy can be carried out using endoscopy to collect tissue samples and test for conditions and diseases such as ulcers, digestive tract bleeding, polyps or growths in the colon to prevent the development of colon cancer.

3. Treatment

It may also be used to treat problems in the digestive tract. Special tools and devices can be passed through the endoscope to remove bile stones, for example. If polyps are found in the colon, they can also be removed through endoscopy with standard polypectomy techniques. for the prevention of colon cancer development.

How to prepare for the procedure

Your doctor will share specific instructions in preparation for the endoscopy. Typically, you will need to fast for about 8 to 12 hours before the endoscopy so your stomach will be empty for the effectiveness of the procedure. Laxatives may also be taken on the previous night to clear your system for procedures investigating the gut. Remember to mention the supplements and medications you are currently taking so your doctor will advise you accordingly to stop taking or continue as per normal.

During the procedure

The procedure is usually an hour-long duration and won’t require an overnight hospital stay. A local anaesthetic is applied to numb a specific area of your body, such as the back of your throat. The endoscope will be inserted into your body openings, which depends on the examined area, i.e. throat, anus, or urethra. For insertion through the mouth, you will be asked to wear a mouth guard to protect the lips and teeth, and hold your mouth open.

You may feel some pressure during the insertion but generally, you shouldn’t feel pain. Images will be transmitted to the monitor for your doctor to view and look for abnormalities. Gentle air pressure may be added into your esophagus to allow the endoscope to move freely and examine your digestive tract easily.

A sedative will also be given to patients to help them to relax and be more comfortable, and have a good experience when going through the endoscopic examination. During the procedure, patients will not feel or remember the process but your doctor will ensure it is performed safely with adequate monitoring.

Due to the sedative, your judgement, reaction times, and memory may be impaired. Thus, arrange for someone to drive you home afterwards and plan for an additional 24 hours for the sedative effects to wear off before resuming work or other activities.

The risks and possible side effects

After endoscopy, you may experience mildly uncomfortable symptoms such as sore throat, cramping, bloating and gas. It is a relatively safe procedure with a low risk of serious complications. However, if you experience symptoms like shortness of breath, chest pain, vomiting blood, severe and persistent abdominal pain, it should be reported to a doctor.

Possible complications can include a minor infection in the area of investigation, persistent pain experienced in the endoscopy area, perforation (tearing) of an organ or internal bleeding.


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July 23, 2019 Blog

Fatty Liver Symptoms, Singapore Fatty Liver

Many adults enjoy drinking a few alcoholic beverages – beers, wines and spirits on a regular basis. While the occasional drinking of alcoholic beverage is less likely to pose harm to your health, excessive drinking can bring about significant negative effects on your body and overall well-being.

Too much of a good thing can be bad. In general, more than or equal to 3 units for a male and 2 units for a female (a day) is too much on a long-term basis. Drink binging is not suggested, even once a while.

How many alcohol units are in each drink?

A shot of spirits (25ml): 1 unit

A standard glass of wine (175ml): 2.1 units

A large glass of wine (250ml): 3 units

A pint of 4% beer: 2.3 units

A pint of 8% strong cider: 4.5 units

What are the health risks?

Our liver plays an important role in the body to metabolise and process the alcohol consumed. The liver cells may not be able to keep up if alcohol is consumed too much too fast, thus increasing the alcohol level in the bloodstream.

Exceeding the recommended limit for moderate alcohol use will introduce risks of excessive drinking. Binge drinking can be defined as consuming 5 or more drinks within 2 hours for men, and 4 or more drinks within 2 hours for women.

Too much alcohol consumption can cause a number of health problems including

  • Obesity
  • Problems managing conditions like high blood pressure and diabetes
  • Cancers of the mouth, throat and esophagus, liver, colon, and breast
  • Digestive problems
  • Liver disease
  • Diabetes complications

Health impacts on different organs of our body

  • Pancreas

Heavy alcohol drinking is another big cause to chronic pancreatitis, a condition where the pancreases is severely inflammed. It occurs mostly after an episode of acute pancreatitis. The damage from heavy alcohol use to the pancreas may not develop symptoms for many years and one day, suddenly develop severe pancreatitis symptoms such as diarrhoea, constant upper abdominal pain, and weight loss caused by malabsorption of food. 

  • Brain

Drinking alcohol brings about depressant effects such as slurred speech and poor limb coordination that prevents the ability to walk properly, which can be seen in any occasional or moderate drinker. However, heavy drinkers may develop deficits in brain functioning and shrinkage of the frontal lobes of your brain over an extended period of time, that continue despite attaining sobriety.  Cognitive problems can persist due to the long-term alcohol abuse that negatively impact the brain’s “hard wiring”, such as poor decision-making, mild to moderate impairment of intellectual functioning, confused or abnormal thinking and loss of inhibitions.

  • Heart

The more you drink alcohol at one time, the higher your heart rate gets. According to researchers, it is thought that overconsumption of alcohol creates an imbalance between the parasympathetic (rest and digest) and sympathetic (fight or flight) nervous systems, thus raising your heart rate. For people with heart conditions, experiencing a sudden spike in heart rate is potentially dangerous as it could trigger arrhythmias (irregular heartbeats). Regularly drinking too much alcohol also raises your blood pressure, and over time high blood pressure (hypertension) can place a strain on the heart muscle, increasing your risk of heart attack, stroke and heart failure.

  • Stomach

Too much alcohol consumption can irritate your digestive system and over time, damage your intestines leading to bouts of diarrhoea or stomach pain. It can also cause stomach distress with symptoms like bloating, gas and painful ulcers.

  • Liver

Chronic heavy drinking of alcohol can also lead to alcohol-related liver diseases such as fatty liver, cirrhosis and hepatitis. A person can have any of the conditions at a time, or all, if the disease is part of a progression.

Alcoholic fatty liver disease occurs as the early stage of liver damage induced by alcohol. It develops over time when too much alcohol consumption leads to a build-up of fat in the body’s liver cells, thus hindering liver function. This condition can be followed by inflammation in the liver (alcoholic hepatitis) and may progress to a build-up of scar tissues in the liver, leading to alcoholic cirrhosis.

Symptoms may not be present in the early stages. As you continue drinking alcohol over time, the performance and health of your liver declines and symptoms may begin to appear, which often can be too late.

They may develop gradually and include:

  • Jaundice
  • Abdominal pain and swelling
  • Encephalopathy or confusion
  • Severe itching of the skin
  • Wasting of muscles
  • Gastrointestinal bleeding

Moderation is key

By drinking lightly and in moderation, you can probably continue your drinking habits responsibly. Alternate alcoholic drinks with soft drinks. Before or during a drinking session, eating a snack or meal can help slow down the absorption of alcohol. Avoid eating salty food as they make you thirstier and reach out for more alcohol to drink and quench your thirst.

For those taking prescription and medication, they should also ask their doctor if they can drink alcohol while taking them. Individuals with health conditions like heart failure, liver or pancreatic disease and uncontrolled high blood pressure should also check with their doctor about drinking as alcohol can worsen pre-existing health conditions.

Diagnosis and treatment

 Alcoholic liver cirrhosis can be diagnosed by gastroenterology specialists using blood tests and imaging procedures, including Fibroscan that will give a comprehensive assessment of a person’s liver health and determine disease severity. Patients in early stages of alcoholic hepatitis and fatty liver can reverse the condition, however, cirrhosis damage is irreversible and might require a liver transplant to survive.

You will need to abstain from drinking completely or gradually reduce your alcohol intake to see an improvement in your liver over time. Dietary and lifestyle modifications will be recommended to improve your well-being, and you can seek advice from a dietician for a balanced diet.


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July 16, 2019 Blog

Heartburn Singapore, GERD Symptoms

Spicy food isn’t the only thing that can make your insides feels like burning. Heartburn is a burning sensation that is felt from the top part of the stomach, going down the throat and chest. The sensation is caused by stomach acid travelling back up into the esophagus. It is usually a symptom of gastroesophageal reflux disease (GERD).

How and why does it happen?

The issue lies with the lower esophageal sphincter (LES), where the esophagus meets the stomach. When it is functioning well, the LES relaxes to allow food into your stomach or to let you burp, and then tightens or closes again. If the LES weakens or relaxes abnormally, stomach acid can back up into the esophagus and cause a burning discomfort in your upper stomach or lower breastbone also known as heartburn.

There are several causes to heartburn. Often, it is due to overeating. Being overweight or pregnant can also potentially increase your risk of experiencing heartburn as there is too much pressure on the stomach. Certain foods and beverages can also trigger heartburn such as coffee (caffeine), acidic juices (grapefruit, orange, pineapples), spicy foods, carbonated drinks and consuming alcohol that can relax your LES too much or increase stomach acid. Studies also show that smoking cigarettes relaxes the LES.

How serious is heartburn? 

Heartburn can be usually identified by feeling a burning pain in the chest especially after food or at night, pain that can worsen when you lie down or bend over, and experiencing an acidic or bitter taste in the mouth. If it occurs more than just occasionally, it is not just a small inconvenience. It can affect what you eat and keep you from doing your daily activities and how you sleep at night.

You can find relief with over-the-counter medications such as antacid or prescriptions like proton pump inhibitor which also helps to lower the acid in your stomach and heal the esophageal lining. Other remedies include drinking ginger tea, wearing loose clothing to avoid compressing your stomach, and elevating your upper body to put less pressure on your LES.

The severity of heartburn depends on how frequent it occurs. Too often and it is considered as GERD, where there may be a dysfunction of the LES and the amount of stomach acid brought up from the stomach. It can lead to serious problems such as laryngitis, ulcers or inflammation of the esophagus, narrowing or scarring of the esophagus and Barrett’s esophagus, a complication that increases your risk of developing esophageal cancer.

When to seek treatment for heartburn?

If you find yourself reaching for medication or antacids too often and you are not getting better, seek medical help and see a gastroenterologist in Singapore. This includes symptoms such as heartburn occurring more than twice a week, difficulties in swallowing, persistent nausea or vomiting, and weight loss due to poor appetite.

Your doctor will ask about your medical history and symptoms, and perform a physical examination. Diagnosis tests may also be carried to check for underlying conditions such as 24-hour pH study and gastroscopy, if GERD is suspected. There are specific medication or procedures for proper treatment.

Dietary changes and lifestyle modification can also be helpful when it comes to managing heartburn. Cut down on foods that trigger your heartburn incidents, avoid heavy meals and having a big meal within 2 hours of bedtime. Stress reduction, a modest weight loss and quitting smoking can have significant benefits in improving symptoms.


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July 5, 2019 Blog

Colon Cancer Singapore, Colon Cancer Doctor Singapore

Colonoscopy is one of the primary tools used for colon cancer screening and is widely considered to be the most effective method for it. This procedure takes a look inside the colon and examines its lining using a long, soft and flexible tube with a tiny camera and light attached on the end. This enables live viewing and visual images of the entire large bowel and lower part of the small intestine to be displayed on the screen.

How does this procedure take place?

Colonoscopy helps doctors to directly visualize the colonic mucosa and identify anycolonic polyp growths that occur on the inside wall of the colon or rectum. If detected, pre-cancerous lesions such as tubular adenomas will be removed during the colonoscopy, thus preventing colon cancer.

The bowel preparation is an important component of the colonoscopy as it impacts the success of colonoscopy. It involves fasting for at least 6 hours before undergoing colonoscopy along with medication to help you pass motion. A bowel preparation that is optimal results in increased polyp detection and decreased procedure time. Inadequate prep can lead to variability when interpreting colonoscopy results whereby certain lesions such as polyps or cancers can be potentially missed due to improper bowel cleanliness.

What else is colonoscopy used for?

Apart from colon cancer prevention, this procedure is also a safe and effective method to investigate symptoms in the digestive system and is essential to help in the management of several gastrointestinal illnesses.

Colonoscopy may be used to investigate digestive symptoms such as:

Colonoscopic examination may also be used in some colonic illnesses such as:

  • Ulcerative colitis
  • Colonic polyp
  • Crohn’s disease
  • Angiodysplasia of the colon
  • Diverticulosis

Why does the quality of colonoscopy matter?

Colonoscopy is performed by specialists, specifically gastroenterologists. They undergo specialised training to carry out the procedure and diagnose various diseases skilfully.

The recommended quality colonoscopy is measured by the specialist’s detection of adenomatous polyps at least at a rate above 25% and a cecal intubation rate above 95%. This makes a significant difference in improving outcomes of detecting polyps and increasing diagnostic accuracy.

Cecal intubation rate refers to intubating the cecum whereby the colonoscope is passed through the ileocecal valve to examine the medial wall of the cecum. The rate is determined by the complete examination of the colon – incomplete coloscopies may be caused by poor bowel preparation, severe colitis or other reasons.

Adenoma detection rate (ADR) involves the proportions of patients over 50 years old who undergo screening colonoscopies for the first time in which at least one adenomatous polyp is detected in a given time period for a given specialist. ADR is a relevant quality indicator that is reported to be significantly associated with the risk of interval cancers or post-colonoscopy cancers, and directly measures how effective the colonoscopy that the gastroenterologist offer is.

Aside from proper bowel preparation to provide a clear view of potential problems, knowing the specialist’s ability to find polyps more often than others is crucial. It can mean the difference between detecting an early sign of colon cancer and missing it. A doctor’s effective removal in detecting and removing– pre-cancerous polyps gives patients added confidence to undergo the procedure and reduce the anxiety of potentially developing cancer.

Ultimately, the quality of colonoscopy will increase the colonoscopy value and lead to further decreases in the incidence and mortality of colon cancer. This is dependent on the level of experience and expertise of the gastroenterologist in conducting colonoscopies.


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June 26, 2019 Blog

Flatulence Symptoms

Abdominal pain is generally used to describe discomfort that originates from organs within the abdominal cavity, which includes the stomach, liver, small intestine, colon and gallbladder. The pain can be acute or chronic, and can be felt anywhere from below the ribs to the pelvis. It also ranges in intensity from a mild tummy ache to severe acute pain.

Where is the pain located?

Knowing the location of your abdominal pain is key to a proper diagnosis. It can be helpful in narrowing down what is the cause of the pain and any other symptoms that you are experiencing.

  • Upper right abdomen: Hepatitis, liver abscess, kidney stones, pancreatitis, gallbladder disease
  • Upper left abdomen: Gastritis, peptic ulcer, enlarged spleen, kidney stones, hepatitis
  • Lower right abdomen: Appendicitis, kidney stones, right ovary problems, Crohn’s disease
  • Lower left abdomen: Diverticulitis, kidney stones, ovarian cysts, ovarian torsion

In some cases, the abdominal pain you experience may not only occur on one side of your abdomen. If your upper abdomen is causing pain on both sides, it could be stomach issues such as gastritis, pancreatitis and stomach ulcers. For pain in the lower abdomen on both sides, it could be urinary tract infections, uterine fibroids or gynecologic problems.

Abdominal pain can have many potential causes, with some directly linked to the abdomen and others by a non-abdominal disease. When you visit a doctor for abdominal pain, they will ask a variety of questions and examine you carefully, and arrange for tests if necessary.

What are the characteristics of the pain?

Is the pain worse and aggravated by coughing, sneezing or any jarring motions? Does the pain last for no more than several hours or longer than a day? Is the pain sharp, dull, steady, constant or is it intermittent?

Aside from knowing the location of the pain, understanding other factors such as when does the pain occur and how long does it last, will be helpful for your doctor to gain a better understanding on your condition.

There may also be accompanying symptoms like flatulence, bloating, constipation, diarrhoea, indigestion, heartburn and pelvic discomfort.

How is the cause diagnosed?

Doctors will check on the physical signs, characteristic and accompanying systems and conduct a physical examination to pinpoint the source of the pain. This can include pressing different parts of the abdomen for tenderness, a rectal exam, and a pelvic exam.

Other tests may be ordered by the doctor if necessary, including ultrasound, X-ray, CT scan and endoscopy to help diagnose different conditions and diseases. When results are available, the doctor will discuss them with the patient as well as the appropriate treatment following the diagnosis.


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June 13, 2019 Blog

Fatty Liver Doctor Singapore, Gastroenterology Specialist Singapore

Our liver is vital to life and is the largest internal organ in the body. It performs many different functions for the body, including processing digested food and nutrients from the intestine, eliminating toxins from the bloodstream, and manufacturing proteins and enzymes responsible for the body’s chemical reactions. The complexity of the liver makes it susceptible to different diseases such as cirrhosis, hepatitis and fatty liver disease.

Liver disease is an important health issue; liver cancer is one of the most common cancer around the world. It is also a major cause of cancer-related deaths globally.

Benefits of consuming coffee

Studies have proven that having a cup of morning coffee might lower the risks of liver disease. Through epidemiological evidence, studies in patients who suffer from a variety of liver diseases have found that moderate coffee consumption brought a positive effect on limiting the progression rate of the disease.

In essence:

  • Moderate amounts of coffee consumption may help to lessen the risk of liver cancer, and the risk of developing liver cancer reduces as coffee consumption increases.
  • Patients with Hepatitis C who consumes more coffee, have a lower rate of disease progression as compared to those who drink lesser.
  • Drinking coffee moderately may also be related to a slower progression rate of chronic liver disease. Those who drink higher amounts of coffee were found to show a milder course of fibrosis, particularly in patients with alcohol-related liver disease.
  • Consumption of caffeine has been related to slower development of cirrhosis in patients who are scheduled to undergo liver biopsy.
  • The association between moderate consumption of coffee and a slower rate of fibrosis were also seen in patients with cirrhosis, fibrosis, Hepatitis C and non-alcohol related liver disease.

Aside from caffeine, several coffee components are also investigated for their benefits with the liver. Naturally-occurring compounds found in coffee, such as cafestol and kahweol, have revealed anti-carcinogenic properties, while caffeic acids and chlorogenic display anti-viral characteristics.

However you drink coffee, be it espresso, filtered or instant, you should keep in mind to avoid adding too much milk or sugar to prevent any other health complications. It is important to also remember that despite the fact that drinking coffee may provide benefits and reduce the risk of developing liver disease, as well as lower the progression risk for those who already suffer from some degree of liver damage.

The key messages for good liver health continue to be the same, such as reducing the amount of alcohol consumption, keeping to healthy weight, eating a balanced diet, doing regular exercises, and drinking plenty of water.

Cases of fatty liver is also on a rise among the younger population, where there is an abnormal accumulation of fats in the liver cells. It is prevalent in those with high blood pressure and high cholesterol. You can talk to a gastroenterology specialist in Singapore to address any health concerns regarding your liver.


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