Blog | gutCARE

Signs Your Constipation Is Not Just A Passing Problem


June 3, 2020 Blog

Most people would have experienced constipation at least once or more in their lives. Being unable to pass stools for more than a few days, or needing to strain to pass stools is a common issue that is usually easily resolved with home remedies or an over-the-counter laxative.

Most cases of constipation have causes that can be easily addressed. For example, lack of fibre, lack of fluids, lack of exercise, or ignoring the urge to go to the bathroom can all lead to constipation. However, chronic constipation or constipation that is accompanied by other worrying symptoms can also be a sign of more troubling problems, such as physical conditions in the gastrointestinal tract.

Thus, the question is, how does one tell apart the innocuous bout of constipation from constipation as an indicator of something more serious? Here are some clues you should look out for:

1. Persistent or intense abdominal pain

Constipation symptoms often include some abdominal pain. This pain is usually due to a build-up of gas or the need to pass stools. However, if the pain is debilitating or persistent, it could signal other issues with the gastrointestinal tract. If this occurs with the inability to pass gas or stools, you should seek medical help immediately.

Some possible causes of persistent, intense abdominal pain accompanied by constipation are:

  • intestinal obstruction
  • perforated intestine or stomach
  • pancreatitis
  • appendicitis
  • mesenteric ischemia (blockage of blood flow to the intestine)

2. Blood in your stool

Finding bright red blood in your stools seems like a worrying sign, but it is not always the case. Small bright red stains are often due to a scratch in the rectal area from straining or wiping too hard, or sometimes due to haemorrhoids (piles). These symptoms and conditions are relatively minor and you can find relief with home and over-the-counter remedies.

However, having large amounts of bright red stains or spots, or dark red or black stools may indicate problems in your intestinal tract itself. For these cases, it is best to consult a doctor to examine the source of bleeding.

Some possible causes for blood in stools are:

  • ulcerative colitis
  • diverticulosis
  • Crohn’s disease
  • colorectal cancer

3. Vomiting

If constipation and vomiting come together, you should suspect a case of faecal impaction or other forms of bowel obstruction. Faecal impaction is when a large, dry mass of stool becomes stuck in the colon or rectum. The blockage causes a build-up of waste, and is highly dangerous and potentially life-threatening. Learning to recognise the signs of faecal impaction can allow the sufferer to get prompt help and save them from this medical emergency.

4. Bloating

When constipation is accompanied by bloated stomach symptoms, it can be a sign of bowel obstruction. Bowel obstruction can also present itself with vomiting. Most cases of bowel obstruction require immediate attention, as it can become dangerous and life-threatening if left untreated. Obstructions in the small or large intestine can be caused by a variety of factors, including:

  • Scar tissue from previous surgery
  • Inflammation (e.g. due to Crohn’s disease, inflammatory bowel disease, etc.)
  • Tumour
  • Hernia

What to expect when seeing a doctor for constipation

If you experience any of the above symptoms, you know it’s time to visit your doctor or a gastroenterology specialist. The doctor will typically ask you a series of questions about your bowel movements, diet, lifestyle, and family history of digestive issues. Don’t feel embarrassed about answering them, but try your best to be as accurate as possible, as this will help your doctor pinpoint the cause of your constipation.

The doctor may conduct a physical examination by inserting a gloved, lubricated finger into your anus to check for blockage or bleeding. If further diagnostic tests are required, the doctor may advise you to undergo procedures like a colonoscopy, CT scan, or barium enema X-ray.


May 27, 2020 Blog

People often dismiss the occasional stomach discomfort, such as bloating, flatulence, or cramps. However, if these symptoms persist for longer than usual, or is significantly affecting your daily life, it is definitely worth it to get it checked out by a doctor. Yet, some people may avoid going to a specialist in gastroenterology for their symptoms, due to the hassle and costs involved.

Doing due research to find the best doctors and reasonable rates is thus of utmost importance. Let us help you make a more informed decision with some benchmarks and breakdowns of the costs typically involved in getting a colonoscopy and gastroscopy – two common methods for diagnosing gastrointestinal (GI) symptoms.


Colonoscopy is a procedure used to examine the lower GI tract, namely, the large intestine. Thus, it is performed to investigate the cause of digestive issues like chronic diarrhoea, chronic constipation, or blood in stools. Colonoscopy is also a highly effective examination technique for the diagnosis, treatment, and follow-up to patients with colorectal cancer, Crohn’s disease, ulcerative colitis, and more.

Average cost of colonoscopy in Singapore (fees indicate total bill amount)

Public hospital (with government subsidies)Private hospital
Colonoscopy screening$397-*
Diagnostic colonoscopy (day surgery)$576$2,590
Diagnostic colonoscopy (in-patient)$1,365 (Ward C)
$1,827 (Ward B2)

*Average cost unavailable due to insufficient data points

Many factors can influence the cost of colonoscopy. Colonoscopy for general screening purposes is usually kept more affordable. Diagnostic colonoscopy for the purposes of identifying specific conditions is slightly costlier. With the addition of procedures like removing growths, taking biopsies, or other treatments performed using colonoscopy, the fees will increase.

Another consideration to make is the choice of hospital you choose, and whether you decide to undergo the procedure on an out-patient or in-patient basis. Out-patient colonoscopy at a public hospital is the most cost-effective option, especially with government subsidies. However, if you prefer a more private, personalised, and premium experience, you can also opt for a private hospital, for a higher price.


Gastroscopy is a type of endoscopy used to examine the upper GI tract, which includes the oesophagus, stomach, and the upper portion of the small intestine. It is commonly employed to assess the cause of GI symptoms like heartburn, difficulty swallowing, persistent vomiting, and bloatedness. Gastroscopy is also involved in the diagnosis and examination of conditions such as gastroesophageal reflux disease (GERD), stomach ulcer, stomach cancer, gastritis, and more.

Average cost of gastroscopy in Singapore (fees indicate total bill amount)

Public hospital (with government subsidies)Private hospital
Gastroscopy (day surgery)$342$2,139
Gastroscopy (in-patient)$1,387 (Ward C)
$1,655 (Ward B2)

Like with colonoscopy, the cost of receiving a gastroscopy is also influenced by factors such as additional procedures required, the type of medical facility, and whether the procedure is done on an in-patient or out-patient basis.

At the end of the day, how much you spend on your colonoscopy or endoscopy is dependent on your budget, level of service expected, and whether additional procedures are needed. To find out more about Singapore’s cost for various medical procedures, you can also explore the Ministry of Health’s portal for more fee benchmarks based on past transacted bills.


May 15, 2020 Blog

Having occasional upset tummy, bloating, or flatulence symptoms is pretty normal, and many people don’t even see a doctor for it. However, having to see a specialist in gastroenterology for symptoms like these probably mean it is adversely affecting your life. In addition to following doctor’s orders for treatments, what else can you do to improve your general gut health?

What if we told you that breathing can affect your gut health? It’s a relation that few people think about, but is in fact quite significant. Understanding the link between your breathing and your digestive system can be a tremendous breakthrough if you are seeking to improve your gut health.

Stress, breathing, & gut health

It’s popular knowledge that stress is a trigger for countless health issues. From headaches to asthma, stress can make it worse. That familiar anxiety, tight feeling, and restlessness we experience during a busy work-week, right before a test, or when faced with an emergency is accompanied by quick, shallow breathing, which isn’t ideal for our digestive system.

Shallow breathing occurs due to the fight or flight response, when adrenaline in the body kicks in. Breathing quickens to channel more oxygen to the muscles in preparation to attack or run – but the drawback is that blood flow to other systems, like the digestive system, becomes compromised.

As a result, prolonged or frequent periods of stress can interfere with the digestive system, hampering its normal functions, and increase the chances of inflammation. Overall, the immune system also weakens, and causes the body to be more vulnerable to various infections and illnesses.

Two ways to breathe

While stress is unavoidable – and even good for you at moderate levels – there are some ways you can teach your body to counter it.

To begin with, many people don’t breathe optimally to encourage deep breathing. Instead, they employ chest breathing, which is a shallow breathing method. As can be imagined, during times of stress, this breathing becomes even more shallow, and incurs more damage to health.

A better way to breathe will be to practice abdominal breathing. This is the natural breathing method of babies and people when asleep. Rather than having the chest move up and down when breathing, the motion engages the abdomen instead.

Abdominal breathing doesn’t just help our organs take in more oxygen for improved health; it also has a relaxing effect, which helps to chase off the feelings of stress and anxiety.

Tips for deep breathing

For those of us who have un-learnt how to breathe abdominally, you can pick it up again by practising regularly. Here’s how you can perform abdominal breathing:

1. Sit or lie down comfortably with one hand on your chest and another on your stomach.
2. Breathe in comfortably through your nose for two seconds, and let the air ‘enter’ your stomach. You should feel the hand on your stomach rising, and minimal movement for the hand on your chest.
3. Exhale slowly from your mouth for two seconds. You should feel the hand on your stomach lowering as your abdomen deflates.
4. Repeat for 10 minutes.

Getting started with abdominal breathing may feel weird if you are not used to it, but you will become more used to it as you practise. The good thing is, you can easily practise as you go about your day – while sitting in your commute to work, as you are watching TV, or as part of your cooling down routine after a work-out.

The effects of abdominal breathing will be well worth picking up this simple habit. In future, your body will be able to respond more calmly during moments of stress, and reduce the impacts to your gut health.


May 8, 2020 Blog

Getting a colonoscopy is not something most people will look forward to. However, it is a very useful procedure for keeping up with your gut health. Widely regarded as the best procedure for colon cancer screening, colonoscopy is also frequently used to check out various gastrointestinal symptoms like piles, blood in the stools, constant stomach bloating or cramping, and more.

When the time comes to get your first colonoscopy, it is normal to feel nervous and worried about it. Yet, knowing that you have an experienced doctor with a wonderful track record can give you more confidence and help to allay your fears. Talking to your doctor and making sure you know what to expect can also go a long way in preparing yourself mentally for the procedure.

To make your colonoscopy experience as comfortable and worry-free as possible, here are some questions you should definitely ask your doctor before the colonoscopy:

  • What is their adenoma detection rate?

Adenoma detection rate (ADR) is often taken as a strong indicator of how effective a doctor’s colonoscopies are. A doctor’s ADR is defined as the proportion of patients with at least one adenomatous polyp detected out of all the first-time colonoscopy patients over 50 years old that are screened by the doctor in a given time period.

A lower ADR may mean a higher chance of missed polyps or cancers, while higher ADRs are an indication of effective colonoscopy. A general guideline for a ‘good’ ADR is 20% or higher for women patients, and 30% or higher for men. However, you should also note that the demographics of a doctor’s patient base also affect their ADR. For example, a doctor who sees relatively higher numbers of young and female patients may have a lower ADR, but it might not mean they are any less competent in performing colonoscopies – rather, their patients are just less likely to have polyps in the first place.

  • What is their average withdrawal time like?

A doctor performs colonoscopy by first inserting the scope fully into the colon, then conducting examinations as the scope is being withdrawn. Thus, common sense will have it that doctors who are more thorough in their examinations will take longer in their withdrawal time.

It is during this withdrawal time that precancerous polyps and other lesions are typically found, and studies show that doctors with a longer withdrawal time often also have higher ADRs. Experts recommend looking for a doctor with a withdrawal time of at least 6 minutes.

  • What is their cecal intubation rate?

The cecum is the furthest point of the colon from the rectum, which is where the large intestine meets the small intestine. A total colonoscopy means that the cecal intubation rate is 100%, where the scope reaches all the way to the cecum. Having a lower cecal intubation rate will mean a higher chance of missing any polyps that are in the colon.

The average cecal intubation rate is about 90%, so if your doctor has a rate above that, you are likely to be in good hands. However, in some cases, low cecal intubation rates can be due to incomplete bowel preparation by the patient, which prevents the doctor from advancing the scope fully.

  • What is the preparation process like?

Following the right preparation steps will help ensure that your bowels are completely cleared for the procedure. Inadequate clearing will affect the cecal intubation rate, and in the worst case, will mean you have to postpone your colonoscopy appointment – and go through the bowel prep again.

Different doctors may have slightly different instructions and colon-clearing solutions for their patients. So, make sure you hear it from your doctor on the right steps to follow, and commit to it diligently. Just remember, colonoscopy can save your life, so putting up with a few days of inconvenience will be worth it!

  • What will the procedure be like?

Being nervous about an upcoming medical appointment can be truly nerve-wracking, but knowing what to expect at the procedure can at least help you prepare your mind for it. You can ask people you know who have gone through colonoscopy before on what to expect.

Most of all, ask your doctor directly about what will happen at the procedure. They will know best about how long the process will take, what kind of discomfort you will feel, and what sedation methods are available.

As with any medical procedure, it is always good to pick a doctor you are comfortable with and confident in. Asking the right questions can help you make the right choice!

Experiencing piles, flatulence, or blood in stool symptoms? If you have persistent gastrointestinal symptoms or a high risk of colon cancer, it might be time to set a colonoscopy appointment with your doctor.


April 22, 2020 Blog

You know that feeling all too well, when you’ve had a heavy or spicy meal, and this itching, stabbing sensation crawls up your chest. If you’ve experienced this before, you have encountered heartburn. Also known as acid reflux, it is a common occurrence that can happen to anyone.

The occasional bout of acid reflux is perfectly normal, and often goes away by itself, or can be relieved with over-the-counter antacids. However, some people experience heartburn symptoms that are frequent enough to interfere with their lives. When heartburn occurs regularly over a long period of time, it is diagnosed as gastroesophageal reflux disease, or GERD.

Whether you have sporadic incidents of acid reflux, or a persistent GERD, it has been found that a significant trigger of heartburn is the food we eat. Some foods directly trigger increased acid production, while others help to fight and control excess stomach acids. Read on to find out which of these foods you should eat and avoid if you want to stay away from heartburn.

Foods to avoid

Foods that are acid-triggering can be a cause for heartburn, although every individual may have different tolerances. Here are some foods notorious for inciting that burning feeling:

  • High-fat foods: Fatty foods can cause the lower esophagal sphincter (LES) to relax, which allows the backflow of stomach acids. High-fat foods to avoid include red meat, full-fat dairy, deep-fried foods, processed foods, as well as desserts and sweets.
  • Chocolates: The culprit is not just the fat or milk content in chocolates, but also a component called methylxanthine, which has been found to relax muscles of the LES and worsen heartburn symptoms.
  • Caffeine: The major component of a lot of coffees and teas, caffeine, can also contribute to the relaxation of the LES. You can opt for decaf coffees or non-caffeinated teas if you find that caffeine is a trigger for your heartburn.
  • Citrus fruits: Tangy fruits like orange, lemon, pineapple, and limes are high in citric acid, which can increase the chance of an acid reflux flare-up. Other plant-based common triggers are tomato, garlic, onions, and mint.
  • Spicy foods: Spicy foods are commonly thought to aggravate heartburn due to the capsaicin and their ability to irritate the esophagus and stomach.

Acid-fighting foods to eat

Some foods are considered ‘acid-fighting’ and recommended for those suffering from frequent bouts of heartburn. Here are some foods you can consider adding to your diet:

  • Lean meats: Low-fat cuts of turkey, chicken, and fish are ideal protein sources without the reflux-inducing fats. Avoid fried versions of these, and enjoy them baked, steamed or grilled instead.
  • Healthy fats: Omega-3 fatty acids are a healthier alternative to saturated fats from meat. Some examples of healthy fat sources are avocados, salmon, walnuts, flaxseed, olive oil, and sesame oil.
  • Wholegrains: Fibre-rich grains like oatmeal, wholegrain bread and brown rice have been found to lower the risk of acid reflux.
  • Ginger: Widely used for its anti-inflammatory properties, ginger is a natural remedy for a variety of gastrointestinal problems, including heartburn. You can easily add it to juices, soups, as a garnish, or steeped as tea.
  • Vegetables: Most vegetables are low in fat and sugar, and can help with regulating stomach acids. Some great choices are broccoli, cauliflower, leafy greens, cucumbers, and long beans.

The bottom line

While what we know of acid-triggering foods come from a combination of anecdotal evidence and scientific research, there are still a lot of inconclusive results as well as individual variation. Some foods can be triggers to some individuals, but have no effect on others.

What experts recommend is to keep a food journal to keep track of what you eat, and when symptoms occur. This way, you can figure out what foods your body reacts to, and avoid those foods accordingly.

If your GERD symptoms persist, you may also want to have it checked out thoroughly by your doctor or a gastroenterology specialist.


April 9, 2020 Blog

Colorectal cancer is the most prevalent cancer in Singapore, which makes regular screenings for it extra important. Early detection is key to effective colon cancer treatment, a higher chance of recovery, and a better quality of life.

In their efforts to make colorectal cancer screenings more accessible to Singaporeans, the Singapore Cancer Society (SCS) has partnered up with pharmacies and clinics around Singapore to give out free screening kits. Recently, gutCARE has also officially tied-up with the SCS in this initiative, and we will be offering these free screening kits at all of our clinics!

Want to know more about this screening kit? Below are some quick things you need to know:

What is this screening kit for?

This screening kit is for the Faecal Immunochemical Test, a non-invasive screening method that helps to detect colorectal cancer. It is a preliminary test that detects the presence of trace amounts of blood in your stools. If there is blood found, it may indicate the presence of polyps or cancer.

Who is this test for?

The Singapore Cancer Society is making FIT kits available free-of-charge to individuals with higher risk of contracting colorectal cancer, namely, older persons. You are eligible to collect a FIT kit if you:

  • are a Singaporean citizen or PR
  • are 50 years old and above
  • haven’t done a FIT in the last 12 months
  • haven’t done a colonoscopy in the last 10 months

You should take the test even if you don’t display any symptoms, as many cases of early colorectal cancer don’t come with symptoms. However, noticing any emerging symptoms of colorectal cancer is even more reason for you to take the test. Some common colorectal cancer symptoms include:

Apart from age, some other factors put individuals at higher-than-average risk of developing colorectal cancer as well. Some of these factors include:

  • Moderate to heavy alcohol use
  • Obesity
  • Diet high in processed foods and red meat
  • Smoking
  • History of gastrointestinal diseases (e.g. colon cancer, polyps, inflammatory bowel disease)
  • Family history of colorectal cancer

If you feel that you are at a high risk of getting colorectal cancer, but are not eligible for the FIT kits, do consult your doctor for alternative options.

How does the test go?

Unlike other methods of colorectal screening that will require you to visit a clinic or hospital, FIT can be done in the comfort of your own home.

All you have to do is use the FIT kit probe to poke into your stool to collect a sample. After sealing the specimen back into the given kit, fill in your particulars on the reply slip and mail it together with the FIT kit to SCS.

You will have to collect and send a second sample on a separate day, within 7 days of the first. This ensures more reliable results.

Once you have sent out both kits, the stool specimen will be tested at the lab. You will receive the results by post in about 6-8 weeks.

How do I collect my FIT kit?

If you are eligible for the free FIT kit, and would like to get tested, simply head to any participating clinic or pharmacy with your NRIC or passport and request for the kit. You may also collect a kit on behalf of your family member if you present their NRIC or passport. Every eligible person is entitled to one kit per calendar year.

For a full list of participating outlets or more information about these FIT kits, you can head on to SCS’s official website to learn more.


March 31, 2020 Blog

Iron deficiency occurs when the body lacks enough iron for the formation of haemoglobin, a protein in red blood cells that helps transport oxygen. This can happen in two ways:

  • absolute iron deficiency is said to occur when the body has abnormally low levels of iron; in contrast,
  • functional iron deficiency is when the body has sufficient iron supplies, but for some reason, the body cannot make use of iron at normal rates of efficiency.

When the body doesn’t have enough iron to form haemoglobin, it leads to a low red blood cell count, and insufficient oxygen in tissues and muscles. The lack of haemoglobin is termed anaemia, and this often results in adverse effects on one’s quality of life.

How do you know if you have iron-deficiency anaemia?

Some of the effects and symptoms of anaemia are described below. If you observe any of these signs in yourself, you might want to get checked out for iron-deficiency anaemia.

  • Constant tiredness

A lack of oxygen reaching the tissues and muscles in the body deprives them of energy. As a result, the heart has to work harder to deliver oxygen-rich blood to various parts of the body, leading to a feeling of tiredness. It might be difficult to pinpoint iron deficiency as the cause from fatigue alone, but if you are iron-deficient, you will most likely experience this persistent sluggishness along with weakness, crankiness, poor concentration, and low productivity.

  • Pale skin

Haemoglobin is what gives blood its red colour, and what gives colour to lips, the insides of the eyelids, and rosy cheeks. Hence, low levels of haemoglobin make people appear paler. People with iron deficiency may lose their healthy, rosy colour, or exhibit pale lips, inner eyelids, gums, or nails. Also known as pallor, paleness is more common in moderate to severe anaemia cases.

  • Shortness of breath

When the body is not receiving enough oxygen for energy, everyday activities like walking or climbing the stairs can feel more strenuous than usual. This leads to an increased breathing rate and shortness of breath as the body tries to inhale more oxygen. Less commonly, persons with iron-deficiency may experience heart palpitations due to the heart having to work harder to move oxygen-rich blood around.

  • Swollen, pale tongue

Myoglobin is another protein in the blood, and it helps to support the structure of the muscles. Apart from low haemoglobin levels causing the tongue to look pale, low myoglobin levels can cause the tongue to feel sore, abnormally smooth, and swollen. Having dry mouth, cracks in the mouth or on the tongue can also be a sign of iron deficiency.

  • Spoon-shaped fingernails

A rarer symptom of iron deficiency is koilonychia – brittle or spoon-shaped fingernails. You may first notice that your nails chip and crack more easily than usual. As koilonychia worsens, the nails’ contours dip from convex to concave, giving it a spoon-like appearance. Koilonychia is less common, and usually occurs only in more severe cases of anaemia.

What does it mean if you have iron deficiency?

Iron deficiency is an indicator that something is wrong in the body – it could be a diet with insufficient iron, or excessive bleeding from menstruation or internal injury. It is also often an indicator of other health conditions, some of which include cancer and gastrointestinal diseases.

In particular, people with iron-deficiency anaemia are across the board more likely to develop cancer, and the converse is true as well – people with cancer are more likely to get iron-deficiency anaemia. One study showed that iron deficiency was most often associated with patients of pancreatic cancer, colorectal cancer, and lung cancer. Another research found that 6% of iron-deficiency anaemia cases were linked to colorectal cancer (which is often accompanied by bleeding in the colon).

So, being alert to symptoms of iron deficiency is not enough – if you also notice additional signs like persistent diarrhoea or constipation, bloated stomach, blood in stools, nausea, vomiting, and stomach pain, it is highly recommended you get tested for cancer or other gastrointestinal conditions as well. Your general practitioner may refer you to a colon cancer specialist if your risk of contracting colorectal cancer is high.


March 23, 2020 Blog

Diet is a huge factor in maintaining a healthy body, but did you know it could also go as far as to keep you cancer-free?

In particular, experts have found certain food types that increase one’s risk of contracting colorectal cancer – the most common cancer in Singapore – while some foods help to reduce the risk.

While diet won’t guarantee a fool-proof defence against cancer, studies show that the association between diet and colorectal cancer incidence is strong. Thus, reducing your chances of contracting colorectal cancer can be as simple as making a few dietary adjustments.

Foods associated with increased colorectal cancer risk

For a start, here are some foods you should cut down on if you wish to guard yourself against colorectal cancer:

  • Alcohol

Studies show that having about 50g of alcohol a day (or three and a half drinks) can increase one’s risk of contracting the cancer by 50%. To minimise the effects of alcohol on one’s cancer risk, limit drinks to no more than two a day.

While the mechanism of alcohol intake to cancer remains unclear, some suggest that the responsibility lies with acetaldehyde, a DNA-damaging chemical that results from the breakdown of ethanol. Alcohol consumption is also linked to numerous other health conditions like liver disease and pancreatic cancer.

  • Red meats

Red meats like beef, pork, and lamb have been found to be associated with up to 20-28% increased risk of colorectal cancer, and is linked to higher risks of other cancers like that of the pancreas and prostate. While red meats are a good source of iron and proteins, the American Institute for Cancer Research recommends limiting intake to not more than 510g of red meat per week, and complementing it with other iron and protein sources.

Experts say the culprit behind red meat’s link to cancer may be the high levels of saturated fat. This leads to an increased emission of bile acids (chemicals that break down fats), of which excess turns into secondary bile acids, a carcinogen. Other possible contributors are Heterocyclic Amines (HCAs) and Polycyclic Aromatic Hydrocarbons (PAHs) – carcinogenic chemicals formed from cooking meats at high temperatures, as well as nitrites and N-nitroso compounds (NOCs) – suspected carcinogens.

  • Processed foods

According to research by the International Agency for Research on Cancer (IARC), every 50g of processed meat (about one hotdog) eaten daily raises one’s chances of contracting colorectal cancer by 18%. Processed foods like ham, bacon, and sausages should be only eaten occasionally.

The components suspected to be involved in contributing to the higher cancer risk are similar to that of red meat: saturated fats, HCAs, PAHs, nitrites, and NOCs.

Food recommendations for preventing colorectal cancer

On the flip side, researchers have found that certain diets are favourable in reducing the risk of colorectal cancer. These tips will help you maintain a diet that is low-risk and beneficial to overall health.

  • Try the Mediterranean diet

In their studies of diet and colorectal cancer, researchers noticed that people with diets high in fruits, vegetables, whole-grains and fish were less prone to getting colorectal cancer. The cancer risk is reported to be up to 45% less than those who had a meat-based diet.

The high fibre content of fruits, vegetables, and whole-grains are thought to be beneficial for gut health as it reduces the amount of time that potentially cancer-causing compounds can stay in the digestive system and wreak havoc on the body. Additionally, fish offers the body healthy fats while providing it with the proteins it needs.

  • Eat in moderation and go low-fat

Obesity is also a risk factor for colorectal cancer. Studies find that people who are obese have about 30% higher risk of developing colorectal cancer than people of healthy weight, and this effect is higher in men than in women.

Eating in moderation, watching one’s consumption of fatty foods, and regular exercise will be helpful for maintaining a healthy weight.

How to stay vigilant against colorectal cancer

Indeed, there are many steps you can take to maintain a low-risk, cancer-free lifestyle. Apart from a healthy diet, regular physical activity and abstaining from smoking are some other steps you can take.

It is also crucial to be aware of the common colorectal cancer symptoms like blood in stools, persistent diarrhoea or constipation, bloated stomachstomach pain, nausea and/or vomiting. If you have any known risks or symptoms, be sure to keep up with regular colon screenings at your nearest health facility, or with a colon cancer specialist in Singapore.


March 16, 2020 Blog

How much do you know about colorectal cancer? Given that colorectal cancer is the most common cancer in Singapore, it will be worth your while to understand a little bit more about it so that you can better guard against it.

Unfortunately, many people have misconceptions about colorectal cancer, which could lead to unwarranted fear or misled complacency. Here, we address some of the most commonly heard misconceptions our doctors hear from patients regarding colorectal cancer, and correct them with the facts.

Myth: Only men get colorectal cancer.

Fact: Colorectal cancer can affect both men and women.

Colorectal cancer is amongst one of the top 3 cancers diagnosed in Singapore, and it affects people across both genders. According to research from the Singapore Cancer Registry based on figures from 2011 to 2015, colorectal cancer makes up 1 in 7 of cancers diagnosed in women, making it second only to breast cancer, with lung cancer following closely behind.

In men, colorectal cancer makes up 1 in 6 cancers, making it the top cancer diagnosis amongst men in Singapore, followed by lung and prostate cancer.

Myth: People under 50 years of age don’t need to be worried about colorectal cancer.

Fact: Colorectal cancer can affect persons of any age.

The risk of contracting colorectal cancer rises as one grows older, but it does not mean that young people are safe from it. In fact, the incidence of colorectal cancer in younger people is on the rise. 10 years ago, only about 1 in 10 cases of colorectal cancer were in persons below the age of 50, but in the years 2011 to 2015, this rate has increased to 1 out of 5.

While age is one risk factor, young people also need to be aware of other factors that put them in risk, like their family history, existing or history of bowel-related conditions, a diet high in red meats and/or processed foods, a sedentary lifestyle, smoking, and heavy alcohol consumption.

Myth: Persons without symptoms do not need colorectal cancer screening.

Fact: Screening can detect cancer before symptoms arise, and offers a higher chance for effective treatment.

As many as half of colorectal cancer patients don’t display the common symptoms like blood in stools, diarrhoeaconstipation, bloated stomach or stomach pain before the cancer is discovered. Screening tests help to detect cancers before symptoms surface, and allows for early intervention, which increases the chances of effective treatment and full recovery.

Some screening tests also detect pre-cancerous growths like polyps. Colonoscopy is one screening method that also offers the possibility of removing small polyps before they develop into tumours.

Myth: I must get a colonoscopy to screen for colorectal cancer.

Fact: There are several tests available for colorectal screening.

Colonoscopy stands as the most reliable method for detecting colorectal cancer. However, for those who prefer not to undergo colonoscopy, there are various alternatives available as well.

Stool tests like the faecal occult blood test or the faecal immunochemical test are non-invasive methods to detect blood in the stool. One can also opt for CT-assisted virtual colonoscopy to let the doctor examine the colon without a physical colonoscopy.

While these tests are good for preliminary testing, it should be noted that any abnormal results are still best checked out through a colonoscopy.

Being informed about your risks and options when it comes to your health is one of the best ways to guard against diseases like colorectal cancer. If you would like to know more about your risk for colorectal cancer, don’t hesitate to consult a colon cancer specialist in Singapore to walk you through a thorough health history examination and give you advice on screenings recommended for you.


March 10, 2020 Blog

When it comes to colorectal cancer, early detection is the key to successful treatment. However, colorectal cancer is notorious for not having many symptoms – in fact, over half of the cases do not present symptoms at all.

Thus, knowing when to start screening for colorectal cancer is paramount to early cancer detection. People at higher risk should begin getting screened at an earlier age, with higher frequencies of screenings.

What are the risk factors for colorectal cancer?

To determine if you are at higher-than-average risk of colorectal cancer, these are some signs you should take note of:

  •    Family history

If you have an immediate family member who has had colorectal cancer, you are considered to be at higher risk for the cancer, as it means you likely share genetic, environmental or lifestyle factors that predispose you to it.

  •    Inherited syndromes

Some inherited conditions have been associated with a higher risk of colorectal cancer. These include: Familial adenomatous polyposis (FAP), hereditary non-polyposis colorectal cancer (HNPCC), Lynch Syndrome, Turcot Syndrome and Peutz-Jeghers Syndrome.

  •    Diet

Studies have shown an increased risk of colorectal cancer in persons with diets high in red and processed meats. Frequent consumption of meats cooked at very high temperatures through methods like frying or grilling is also thought to be a risk contributor.

  •    Smoking

Tobacco in cigarettes contains known carcinogens that may be ingested during smoking. Thus, smokers or non-smokers with frequent exposure to cigarette smoke are reportedly at increased risk of developing colorectal cancer.

  •    Alcohol use

A meta-study found that every 10g of alcohol consumed per day gives you a 7% rise in risk of getting colorectal cancer. This is attributed to acetaldehyde, which is a chemical formed during the break down of alcohol in the body. The compound can lead to DNA damage or the formation of polyps in the colon.

  •    Age

Colorectal cancer can strike individuals of any age, but the risks are significantly higher in older persons. Over 90% of colorectal cancer cases were diagnosed in people above the age of 50.

  •    History of colorectal cancer or polyps

Persons who have had colorectal cancer previously have a higher chance of developing cancer in the colon or rectum again. Having a history of polyps – even benign or removed ones – may also increase one’s chances of getting colorectal cancer as it means there is a potential for more polyps to form.

  •    History of inflammatory bowel disease (IBD)

People with chronic or recurrent conditions like ulcerative colitis and Crohn’s disease, which involve the inflammation of the colon, may be at increased risk of colorectal cancer. The risk may increase according to the length of time one experiences IBD, as well as the percentage of colon affected.

  •    Obesity

Overweight or obese persons have an estimated 30% higher risk of contracting colorectal cancer than a person of healthy weight. A variety of factors may cause this, such as the tendency of obese persons to have chronic low-level inflammation, or the increased production of adipokines, which are the hormones responsible for cell growth.

What are some symptoms of colorectal cancer?

Majority of patients with colon cancer in Singapore do not show symptoms at their early stages. However, if present, these symptoms may include:

  • A permanent change in bowel movement (diarrhoea or constipation)
  • A feeling of incomplete emptying of bowels
  • Blood in stools (appearing as bright red or dark-coloured stools)
  • Bloated stomach with frequent abdominal pain
  • Rapid weight loss with for no apparent cause
  • Persistent fatigue
  • Nausea or vomiting

If you tick the boxes for having a high risk of colorectal cancer, and/or experience any unusual symptoms with your bowel system, it is best you consult your doctor or a colon cancer specialist for a medical examination. Regular screening in the form of colonoscopy is also a good measure to guard yourself against the cancer.

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