Blog | gutCARE - Part 2

Here’s What Might Be Causing Your Stomach To Bloat


September 16, 2020 Blog0

We’ve probably all felt that familiar swell, discomfort, and fullness before, especially after a particularly heavy meal. Stomach bloating is very common and often not a cause for worry.

However, there are days when we feel bloated and we just can’t seem to figure out why. Or perhaps, your bloated stomach symptoms have become more frequent, and you’re not sure what’s causing it. Explore the causes of bloating below to find out what may be causing your bloat.

Why tummies bloat

Your stomach may feel bloated for a number of primary reasons. The bloating sensation may be a result of:

  • Gas: Gas is produced as a part of the natural digestion process. Excess gas that is unreleased can lead to bloatedness. Occasionally, gas may also be introduced by swallowing air.
  • Constipation: Having trouble emptying the bowels can lead to a feeling of fullness and incomplete evacuation.
  • Fluid retention: When the body retains more fluid than usual, it can be experienced as bloating.

While most of us experience the occasional bloat and stomach discomfort, most of these usually go away quickly and do not pose a health threat.

Diets that cause bloating

It is common knowledge that eating certain foods like garlic, onions, and beans leads to a gassy tummy and increased flatulence. This is due to certain sugars in foods, which the body finds difficult to digest. Undigested sugars end up in the large intestine, where bacteria ferments them, producing gas.

These food triggers have a label called FODMAPs, which stands for ‘fermentable oligosaccharides, disaccharides, monosaccharides, and polyols’. Other examples of FODMAP foods include wheat, rye, legumes, apple, mango, honey, cherry, and lychee.

Aside from the food itself, an individual’s sensitivity to certain foods may also cause more severe bloating. For example, persons with lactose insensitivity or intolerance may bloat more seriously than other persons without, after consuming dairy products like milk or cheese.

High-fat foods are also bloat triggers as they are challenging to digest. In addition, foods high in salt content might lead to water retention, causing not just a bloated tummy, but also general puffiness.

Medical conditions that cause bloating

In some cases, gas, constipation, or fluid retention may also be symptoms of more serious underlying health conditions that warrant a doctor’s examination. The list of conditions that may cause bloating is long, and here are just some of them:

  • Irritable bowel syndrome (IBS): IBS is a condition where one experiences intestinal symptoms like cramping, abdominal pain, diarrhoea, constipation, and bloating, often in combination, for a period of 3 or more months for at least 3 days per month. These symptoms are classified as IBS if they are unrelated to other bowel conditions.
  • Inflammatory bowel disease (IBD): Not to be confused with IBS, IBD is caused by inflammation of the gastrointestinal lining, and includes Crohn’s disease and ulcerative colitis. Bloating may be caused by poor digestion, or in some instances, blockage or narrowing of the intestinal tract due to swelling or scarring.
  • Celiac disease: Persons with celiac disease experience an immune response in their small intestines when they consume gluten. Due to the weakened functions of the small intestine, undigested food ferments for longer in the digestive tract and causes more gas production.
  • Gastroparesis: Usually occurring as a symptom of other conditions like diabetes or hypothyroidism, gastroparesis is the reduced rate of motion of food from the stomach into the small intestine due to weak or damaged stomach muscles.
  • Ascites: This is a serious condition in which fluids accumulate in the peritoneal cavity (the abdominal space which contains the stomach, intestines, and liver). This situation may occur due to liver cirrhosis, cancer, or tuberculosis.


The occasional stomach bloatedness is normal, but in some cases, it can also be caused by underlying medical conditions. In the event you notice any changes to your health, persistent bloating, or bloating accompanied by other symptoms, don’t wait to visit your health professional for a checkup.


September 11, 2020 Blog

In talking about colon health, polyps pop up frequently as a topic of relevance. You may have heard that colon cancer virtually always begins from colonic polyps, or perhaps your doctor has detected some polyps growing in your colon, and you’re now worried about what this means.

What exactly are colonic polyps, and should we be worried about them? Learn more about these growths below.

What are colonic polyps?

Colonic polyps are cell growths that occur on the lining of the colon (the large intestine). They develop due to abnormal cell growth, when cells multiply more rapidly than normal.

Several types of polyps exist. Non-neoplastic polyps, which include hyperplastic polyps, are usually non-cancerous. In contrast, neoplastic polyps such as adenomas and serrated polyps have a greater risk of turning into cancer.

What are the chances of polyps turning cancerous?

The size and type of the polyp influence the likelihood of it developing into cancer.

Generally, the larger the polyp, the higher the chances of it turning cancerous. An estimated 1% of polyps with a diameter of smaller than 1cm are cancerous. This percentage sees a striking jump to 50% for polyps that are larger than 2cm.

Adenomas and serrated polyps present a more significant chance of developing into cancer as compared to hyperplastic polyps. The most common polyps are adenomas, which make up two-thirds of polyps found during colonoscopies. For this type of polyp, about 14% become cancerous after 10 years.

Do polyps cause any symptoms?

Most people with colonic polyps don’t feel any symptoms, which is why many don’t know it until the polyps are discovered during routine screening.

However, some people may experience symptoms of gastrointestinal discomfort similar to colon cancer symptoms, such as:

  • Blood in stools or rectal bleeding
  • Persistent change in bowel habits (e.g. prolonged constipation or diarrhoea)
  • Abdominal pain
  • Iron deficiency anaemia
  • Nausea or vomiting

How can I screen for polyps?

Routine colonoscopy is where most polyps are discovered. Other colon screening tests may also detect the presence of polyps, including sigmoidoscopy, barium enema, and CT colonography. However, only colonoscopy allows for the removal of polyps.

A stool test like faecal occult blood test (FOBT) or faecal immunochemical test (FIT) can also detect bleeding in the intestines, which may indicate the presence of larger bleeding polyps or colon cancer. A faecal occult blood stool test may not be able to pick up non bleeding polyps or cancer, but this is widely recommended as community colon cancer screening test due it’s cost effectiveness for large population screening. A positive FOBT test requires a follow-up colonoscopy to confirm the presence of polyps.

You are advised to undergo regular screening, especially if you have an increased risk of developing colonic polyps or colon cancer. Some risk factors that may necessitate more frequent testing include:

  • Old age (50 years or older)
  • Being overweight
  • Smoking heavily
  • Personal or family history of colonic polyps, colon cancer or other related intestinal conditions
  • Symptoms such as abdominal pain, bloody stools, or change in bowel habits

Should I remove a non-cancerous polyp?

Most doctors recommend removing polyps even if it’s not cancerous now, this is because colonic polyps will continue to grow over years, and the risk of cancer developing increases the bigger the polyps get.

In many countries, If a polyp is found during a colonoscopy, the doctor usually removes it during the procedure itself. In certain countries, In some instances where the polyp is too large, keyhole surgery (laparoscopy) can be performed to remove the polyp.

After removal, the polyp can be analysed for the presence of cancer cells.


Discovering a polyp might feel alarming, but understanding what it is can help you allay your fears and worries. It is always best to ask your doctor any specific questions you have, be it about the type of colonic polyp you have, or the potential costs of colon cancer treatment. The good news is, with regular screening, polyps can usually be nipped right in the bud before they have a chance to turn cancerous.


September 1, 2020 Blog

There are few things more annoying than getting an upset stomach, even worse if it is accompanied by vomiting or constipation symptoms. When you are stuck with stomach pain or bloated stomach symptoms, the most important thing is to focus on your recovery, so that you can resume your daily activities.

To that end, controlling your diet can be of help. By eating appropriate foods, you can give your digestive system a chance to recover, or even soothe some of the unpleasant symptoms. As such, you need to be smart about your food choices in the face of stomach pain. Here are some foods that you can consider eating when dealing with stomach pain symptoms.

Bland foods

As with most conditions causing gastrointestinal distress, a bland diet can help to smoothen recovery from stomach pain. This diet is also sometimes referred to as the BRAT diet, which stands for bananas, rice, apples, and toast.

As these examples suggest, the diet generally consists of foods that are soft, low in dietary fibre, and usually cooked. These include low-fibre fruits, processed grains, lean poultry, seafood, and eggs. These foods are easy to digest and minimise irritation to the digestive tissues.

In contrast, fried and fatty foods are generally avoided, as these can be harder to digest and can irritate your gut. Food that can cause gas, such as broccoli, beans, and chicken skin, should also be avoided to prevent bloated stomach symptoms.

Spices and herbs

Several spices may be able to relieve or reduce stomach pain symptoms. One of the most popular ones, especially in Singapore, is ginger. Ginger has been shown to aid in treating nausea and vomiting, among other gastrointestinal symptoms.

Some studies have shown that pregnant women who took 1g of ginger daily saw a significant reduction in nausea and vomiting. It has also been shown to relieve these symptoms in individuals that underwent chemotherapy or surgery.

Other spices and herbs have been suggested to aid in reducing stomach pain as well. For example, some studies suggest that chamomile supplements could reduce intestinal spasms. It has also been shown to reduce vomiting after chemotherapy treatments. Similarly, peppermint oil has been shown to reduce stomach pain, gas, and diarrhoea in adults with irritable bowel syndrome.

While the studies on these herbs are limited, the herbs are generally safe for consumption in appropriate amounts. As with all supplements, do observe the recommended contraindications and dosage before consuming them.

Probiotic-rich foods

At times, stomach discomfort can be caused by an imbalance of the bacteria in your gut, a condition known as dysbiosis. Eating foods that are rich in probiotics, which are bacteria that are beneficial to the health of your gut, can help to correct dysbiosis. This may relieve symptoms of bloating, diarrhoea, or irregular bowel movements.

One of the most well-known of these foods is yoghurt. Yoghurt often contains live bacterial cultures that are good for the gut. Studies have shown that eating it can reduce diarrhoea and constipation symptoms. Fermented milk beverages like Yakult, Vitagen, and kefir are also convenient sources of such probiotics.

There are several other foods that contain probiotics, such as kimchi, natto, miso, sauerkraut, and kombucha. While the evidence supporting the benefits of these foods on the gut is less robust, it is widely accepted that they are healthy in moderation.


Being stuck with stomach pain may be an unpleasant experience, but you can support your gut on its road to recovery with smart dietary choices. That being said, additional treatment may be necessary if your stomach pain is severe, or lasts for an extended period. In such cases, it would be best to consult a doctor or gastroenterology specialist for professional medical advice.


August 25, 2020 Blog

Diarrhoea can be irritating and inconvenient, but chances are that most people will experience it at some point in their lives. It can be a symptom of several conditions, ranging from allergies to irritable bowel syndrome. But more often than not, it occurs because you ate something that just did not sit well with your body.

In any case, knowing how to manage your diet while you are down with diarrhoea can help you on the road to recovery. Certain types of food can aid your digestive system in regaining its normal function, while others could easily aggravate the condition. Here are some of the foods that you should and should not eat while suffering from diarrhoea.


Your body loses water from passing out watery stools. This makes you especially vulnerable to dehydration. So, it is imperative to drink plenty of water to replace the fluids that are being lost. You can also get hydrated through other fluid-rich foods and drinks. Some of these include electrolyte-enhanced water, weak tea, and clear broths (with grease and oil removed).

Bland foods

When someone has diarrhoea, the intestinal lining may be irritated and inflamed. As such, you will want to be gentle on your digestive system while it is in the process of recovering. For this purpose, experts recommend that you adopt a bland diet.

Here, the ‘bland’ in bland foods does not refer to a lack of taste. Indeed, many bland foods can be quite flavourful. It is actually a term used to describe foods that are easy on the digestive tract.

Bland foods are usually softer in texture and low in fibre. This makes them easier to stomach and minimises irritation to your digestive tract. The low fibre content also reduces bowel stimulation, making the food easier to digest.

One popular example of a bland food diet is the BRAT diet, which stands for bananas, rice, apples, and toast. The diet does not only consist of these four types of food; they simply serve as a guideline for the food you should consume. It chiefly consists of bland foods like cooked cereal, plain crackers, and applesauce. As such, the diet can be helpful for those experiencing diarrhoea in the short term.

However, due to the low protein and fat content of these foods, it is crucial to reinclude these nutrients in your diet after recovery, such that you get a well-balanced diet. Other bland foods that you can eat include boiled potatoes, porridge, and skinless baked lean chicken.

Food to avoid

Contrary to bland foods, some foods can travel through your bowels quickly, agitating your digestive system. These foods can worsen your diarrhoea or prolong it. Here are some of the worst offenders:

  • Fatty foods: Some people’s digestive systems have difficulty digesting fried or creamy foods. If the fats are not absorbed normally, they are broken down into fatty acids in the colon. This stimulates the colon to secrete fluid, causing diarrhoea.
  • Dairy products: Many Asian individuals are lactose intolerant. This means that they cannot digest lactose well (lactose being the sugar found naturally in milk). Diarrhoea due to lactose intolerance is usually accompanied by bloated stomach symptoms. In any case, it is best to stay away from butter, cheese, and ice cream while you are recovering.
  • Alcohol: Alcohol is a diuretic, which is a substance that causes your body to increase the production of urine, and thus lose water. Considering that you want to minimise fluid loss, avoiding alcohol is advised.
  • Artificial sweeteners: Artificial sweeteners like Sorbitol can have a laxative effect on some people. They can also stimulate your intestines to produce more water, loosening bowels and triggering diarrhoea.


While diarrhoea will always be an unpleasant experience, you can aid your digestive system in recovering through proper dieting. However, if your diarrhoea persists for an extended period, or you are also dealing with additional symptoms like vomiting or stomach pain, you should see a doctor or gastroenterology specialist for further advice.


August 17, 2020 Blog

Not being able to pass stools for more than a few days is a sign of constipation. But fewer people recognise that having hard and dry stools is also a form of constipation. With this definition in mind, it would mean that almost everyone has had experienced constipation some time in their lives, and needless to say, it can be quite an unpleasant experience often accompanied by bloated stomach symptoms, a loss of appetite, stomach pain, and flatulence.

One well-known and natural way to relieve constipation symptoms is to increase one’s intake of fibre and fluids. Thus, drinking up and having foods like prunes, figs, leafy greens, sweet potato, and beans are highly recommended for anyone experiencing constipation.

However, do you know that some foods you eat may be causing your constipation instead? Few people consider that foods can also be the trigger of their constipation in the first place. If you are prone to getting constipation without knowing why, it would be worthwhile to examine your diet for these potential culprits.

  • Gluten

Gluten is commonly present in grains such as wheat, rye, and barley. Some people who are sensitive or allergic to the protein may suffer from constipation after consuming it.

Gluten intolerance is most commonly associated with celiac disease, but people with non-celiac gluten sensitivity or irritable bowel syndrome may also experience reactions like constipation after ingesting gluten.

  • Red meat

Red meat is a huge offender when it comes to constipation-triggering foods, as it is high in several of the compounds that are difficult for the body to digest. These include fats, tough protein fibres, and iron.

Indirectly, red meat may also cause a reduced intake of other fibre-rich foods, as it is very filling and takes up a big portion of the meal.

  • White bread & white rice

If you are prone to having constipation, a high intake of processed grains may be a factor. White rice and white bread are made from grains which have had their husk, bran, and germ removed – parts of the grain which contain a lot of fibre. This means you lose out on a lot of fibre – which is good for bowel health – when you consume a large proportion of processed grains.

Instead, people with constipation may benefit from switching over to brown rice and other whole-grain foods.

  • Alcohol

Those nights out at the bar or club may be making your constipation worse without you knowing. Alcohol is very dehydrating, and slows down the body’s digestion process. All these may aggravate constipation symptoms, especially if alcohol is consumed in large amounts.

Beside limiting alcohol intake, drinkers can ease the effects on their body by drinking a glass of water in between each alcoholic beverage.

  • Chocolate

Many anecdotal reports and surveys by people with constipation suggest that chocolate is a trigger for constipation. While there have not been firm empirical evidence to suggest this, the ingredients of chocolate do pose a possible risk. The high fat content, caffeine, and milk in many chocolate bars are potential aggravators of constipation.

  • Health supplements

Certain health supplements like calcium and iron tablets may cause constipation as a side effect. Wherever possible, it is still best to obtain your nutrients from a balanced diet. However, if your doctor prescribes these supplements to you, you can reduce the chances of experiencing constipation by increasing your dietary fibre intake.


If you experience constipation often, consider ruling out these possible aggravators one at a time to pinpoint the trigger. Not all these foods may be constipation-triggering in every person, and some are worsened only by underlying health conditions (e.g. celiac disease or irritable bowel syndrome).

Besides food, other lifestyle factors that may be causing your frequent constipation may be:

  • Inactive lifestyle
  • Old age
  • Stress or mental health conditions
  • Pregnancy

Chronic constipation without an immediately identifiable cause may also be a sign of other health issues such as a blockage in the colon, weakened pelvic muscles, or neurological problems. Do consult a gastroenterology specialist to rule out any of these conditions.


August 12, 2020 Blog

Hemorrhoids often cause discomfort like pain or itching near the anal area, especially when sitting or during bowel movements. However, experiencing an irritated anus is not just a sign of hemorrhoids. Sometimes, this pain could be something else altogether – and it is important to be able to tell the difference.

If the pain comes from hemorrhoids, there is usually nothing much to worry about. Hemorrhoids, also known as piles, are swollen veins either in the rectum or around the walls of the anus. More often than not, they subside by themselves with home care. Only in some rare cases does a case of hemorrhoids become severe or have complications.

It is more worrying when pain around the anal area is a result of some other serious health issues. Here are some conditions that may include signs of pain and discomfort similar to hemorrhoid symptoms:

  • Colorectal cancer: Colorectal cancer occurs in the lower intestine or rectum area, and sometimes causes bleeding which may be mistaken as a sign of hemorrhoids. While finding fresh red blood in the stools can point to either colorectal cancer or hemorrhoids, the presence of other symptoms can help to distinguish between them. If there are other digestive symptoms like stomach pain, change in bowel movements, bloated stomach, and unexplained weight loss, it is probably not just hemorrhoids you should be worrying about.
  • Inflammatory bowel disease (IBD): IBD encompasses ulcerative colitis and Crohn’s disease, which can cause hemorrhoid-like symptoms like rectal bleeding and discomfort. These two conditions are chronic diseases, which means if you experience symptoms that persist for more than a few days, it may be one of these conditions rather than hemorrhoids. IBD may also be accompanied by abdominal cramping, diarrhoea, and fever.
  • Anal fissures: Similar to hemorrhoids, anal fissures are localised conditions that directly affect the anal region. Anal fissures are small tears or cuts in the anal canal that can feel painful, with some experiencing a burning sensation. Bleeding may also occur. Often, the cause is over-straining due to constipation. Anal fissures are generally non-serious and can be treated much in the same way as hemorrhoids.
  • Pruritus ani: Pruritus ani refers to anal itching and is a symptom rather than a condition by itself. However, it deserves a spot on the list as many people mistake anal itching for hemorrhoids. Feeling irritation and the urge to scratch the anus area can be caused by numerous conditions, such as psoriasis and fungal infection. Hemorrhoids, anal fissures, or the use of harsh soaps and irritants can also trigger itching.
  • Genital warts: Caused by the human papillomavirus (HPV), genital warts are signs of a sexually transmitted disease (STD) that affects the genital and anal area. Bleeding, itching, and discomfort is common with genital warts and many other STDs. Unlike hemorrhoids which subside quite quickly, genital warts often get worse unless it receives medical attention.

Hemorrhoid-like symptoms alone may make it difficult to pinpoint the exact cause, but you can narrow down your condition by also assessing other accompanying symptoms and your risk factors for certain diseases.

When should you visit the doctor?

If you are unsure of what your anal discomfort is caused by, or if it is causing significant pain, a trip to the doctor is recommended to get a thorough examination of your symptoms. Additionally, you should consult a doctor if:

  • there is heavy rectal bleeding
  • symptoms do not subside within a few days
  • there are other symptoms, e.g. fever, stomach pain, weight loss


August 4, 2020 Blog

Hepatitis is an inflammation of the liver, and it comes in numerous forms such as hepatitis A, hepatitis B, and hepatitis C. Often caused by viruses, hepatitis infections cause damage and impedes the normal functions of the liver. Although all hepatitis types affect the liver, they differ in the viruses that cause them and the effects they have.

Hepatitis B is one of the more common types of liver inflammation. The estimated prevalence of chronic hepatitis B infection in Singapore is about 3-4%. In adults, most hepatitis B infections recover by itself within a few weeks. In fact, many cases go undetected because of the lack of symptoms. However, in some cases, especially in young children, hepatitis B may progress into a chronic infection, and cause long-term health effects like liver damage, cirrhosis, or liver cancer.

Symptoms of hepatitis B

With such an elusive infection having such great potential to harm the body, it is crucial to get an idea of how to tell if you have been infected with hepatitis B. Unfortunately, some hepatitis B patients don’t experience any symptoms at all, or exhibit flu-like symptoms that are easily dismissible. In countries with high hepatitis B prevalence, hepatitis B screening is recommended as part of the health screening.

If there are any symptoms at all, a person affected by hepatitis B may experience signs such as:

Symptoms, if any, typically occur between 2 to 5 months after exposure to the virus. Acute conditions usually last for a few weeks.

Risk factors for hepatitis B

Knowing when you have been placed in a vulnerable situation that increases your risk is another way to be on guard against hepatitis B. Along with your awareness of possible exposure, you can suspect a hepatitis B infection, especially if the symptoms begin 2 to 5 months after exposure.

Here are some situations that put people at higher risk of contracting hepatitis B:

  • Accidental pricks from used needles (e.g. injection syringes)
  • Sharing of unsanitary needles (e.g. tattoo needles)
  • Sexual contact with infected persons
  • Infants born to infected mothers
  • Direct contact with blood or open wounds of an infected person

Hepatitis B does not spread through sharing of food or water, eating utensils, coughing, sneezing, and other forms of skin-to-skin contact like hugging, holding hands, or kissing. Different hepatitis types are transmitted differently as well, so it’s important not to get confused.

Testing for hepatitis B

While looking out for symptoms and risk exposure are vital steps in spotting a possible hepatitis B infection, the only way to confirm an infection is to get tested for it. If you have observed any symptoms and have recent suspected exposure to the virus, it is best to visit a doctor to receive a blood test.

There are a few different blood tests used to detect the hepatitis B virus. Make sure to consult with your doctor about the options before making the most appropriate choice.

Guarding against hepatitis B requires vigilance in looking out for symptoms, risk exposure, and taking action to receive testing. That way, you can be assured of receiving timely and suitable care to keep the infection under control.


If you have concerns about hepatitis B infection or it’s related problem. Speaks to our gastroenterologist who is expert in this field today.


This article is written by our liver expert Dr Chong Chern Hao from gutCARE Mount Elizabeth Hospital Orchard. He has extensive experience in diagnosing, treating and managing  all viral hepatitis B condition.


July 28, 2020 Blog

Pancreatic cancer is a cancer of the pancreas, an organ that lies between the stomach, liver, and intestine. The pancreas is made out of two glands, one that produces insulin, and the other which produces enzymes to aid with digestion. These enzymes drain into ducts before entering the small intestine. While cancer rarely develops in the gland tissue, the ducts are where cancer most commonly develops.

A majority of pancreatic cancer cases go undetected until the cancer worsens. Often, the disease does not cause any symptoms until it has progressed to the later stages, when the cancer has spread to other organs. It is no surprise then that pancreatic cancer is often referred to as the silent killer.

Symptoms of pancreatic cancer

Unlike other types of cancer like breast, prostate, or colorectal cancer, there is no routine screening test for pancreatic cancer. This makes it all the more crucial that you understand the symptoms of the disease, so you can get it diagnosed as soon as possible. Due to the location and function of the pancreas, pancreas cancer symptoms range widely from digestive issues to hormonal conditions.

  • Belly or back pain

Tumours that grow in the body or tail of the pancreas may apply pressure on nearby organs, resulting in stomach pain. The tumour could also press on nerves around the pancreas, leading to back pain. However, abdominal and back pain can also be caused by many other conditions besides cancer, including musculoskeletal and digestive issues. 

  • Unexplained weight loss

Sudden and unexplained weight loss can occur in pancreatic cancer cases for several reasons. Cancer steals nutrients from the body to grow and multiply, depriving the body of energy. A tumour pressing on the stomach can also cause nausea and vomiting, making it difficult to keep food down. Even while maintaining a healthy diet, the body may not be able to properly digest the food due to the pancreas failing to make sufficient digestive fluids.

  • Jaundice

A tumour at the head of the pancreas can cause blockage of the liver’s bile duct. In these cases, the body is not able to effectively get rid of bilirubin, a waste product from the breakdown of blood cells.

Bilirubin then builds up in the body, causing jaundice. Signs of jaundice include yellow skin and eyes, pale-coloured stools, and dark-coloured urine. An excess of bilirubin in the skin can also cause itching and irritation. Aside from cancer, jaundice also occurs in liver-related diseases.

  • Diabetes

Once pancreatic cancer has progressed, it may destroy the insulin-making cells in the pancreas. This could cause one to experience symptoms of diabetes, as the body cannot produce enough insulin to maintain healthy blood sugar levels. Such symptoms include excessive hunger or thirst, frequent urination, weight loss, and fatigue.

  • Enlarged gallbladder

When the tumour blocks the common bile duct, bile can get trapped and accumulate in the gallbladder. This results in a swollen gallbladder. Doctors may be able to feel this as a lump on the right side of the belly, under the ribs. Apart from cancer, gallstones can also cause the gallbladder to swell if it blocks the cystic duct or bile duct.

  • Blood clots

Pancreatic cancer increases the risk of deep vein thrombosis (DVT), which is when a blood clot forms in a large vein, often in the leg. This can cause several uncomfortable symptoms in the leg, including pain, redness, swelling, and warmth.

In some cases, the blood clot can dislodge and travel to the lungs, causing a pulmonary embolism (PE). When this happens, the patient usually experiences shortness of breath or chest pain. Blood clots can be caused by a variety of conditions as well, so discovering them in one’s body is not a sure sign of cancer.

  • Pale and greasy stools

Blockage of the common bile duct can cause a few changes in the stool. A lack of bilirubin from bile causes the stools to appear lighter in colour. Stools can also contain undigested fat, causing it to appear greasier and float. This is because the body is unable to break down fat well due to the lack of digestive juices from the damaged pancreas.

What to do if you are experiencing symptoms

If you are experiencing one or more of these symptoms, it does not necessarily mean that you have pancreatic cancer. There are several other possible causes for most of them. Still, it would be best to consult a gastroenterology specialist who can advise you on the best course of action.


July 23, 2020 Blog

Colon cancer is a cancer that forms in the cells lining the inside of the large intestine. It is usually grouped together with cancer of the rectum and referred to collectively as colorectal cancer.

Colorectal cancer is one of the most common cancers among Singaporeans. According to the Singapore Cancer Registry, between the years 2011 to 2015, colorectal cancer was the most common cancer among men in Singapore, and second most common among Singaporean women. It is also the second-largest cause of cancer-related deaths among men, and the third-largest among women.

Recognising colon cancer

The symptoms of colon cancer can sometimes be overlooked or unnoticed. This is especially so in the early stages of the disease, when the symptoms may be milder, or not even be present. Yet, early diagnosis is crucial as it can expedite life-saving treatment.

As such, colorectal cancer screening tests like the faecal immunochemical test (FIT) or lower gastrointestinal endoscopy are recommended for Singaporeans above 50 years old. Regular screening should be accompanied by vigilance in looking out for early warning signs of colon cancer. Here are some of the noticeable symptoms that you should look out for.

  • Rapid, unexplained weight loss

A sudden drop in weight could be a cause for concern. If you experience a loss of about 4.5kg or more in six months or less without any marked change in your diet or lifestyle, you should consult a doctor about it. Cancer cells tend to use a lot of the body’s nutrients to grow and multiply, which can lead to weight loss.

  • Fatigue and lethargy

Fatigue is a feeling of tiredness that does not go away even with rest. Like unexplained weight loss, this could occur due to the cancer cells depleting the energy stores in the body. This is a rather common symptom shared across many conditions, like diabetes and heart disease, so it should be considered alongside other symptoms.

  • Persistent changes in bowel habits

A tumour that has grown large enough can cause blockage in the colon. This could result in narrower stools or more frequent trips to the bathroom. It could also affect the ability of the large intestine to absorb water, leading to more watery stools. One may experience this as diarrhoea or constipation. If unrelated to another condition, these can be symptoms of colon cancer.

  • Stomach pain

Long-lasting and severe stomach pain that began recently can be a symptom of colon cancer. Colon cancer often causes changes in bowel habits, which can result in cramping and bloated stomach symptoms. Irritable bowel syndrome (IBS) can cause these symptoms as well, in addition to diarrhoea and constipation.

  • Blood in stool

A tumour can lead to bleeding in the colon and blood in the stool. One may notice this from blood on the toilet paper after wiping, or blood in the toilet bowl water. Alternatively, stool could appear very dark or even black due to dried blood. Bloody stool is also observed in cases of ulcerative colitis (UC) or inflammatory bowel diseases, like Crohn’s disease.


While one of these symptoms alone may not be sufficient to determine the underlying condition, multiple symptoms can give your doctor a better idea of the possible causes.

Frequent screening and knowledge of the symptoms of colon cancer could allow for early diagnosis and the provision of life-saving treatment. If you are experiencing these symptoms, want to explore your colon cancer screening options, or find out more about colon cancer treatment costs in Singapore, you can consult a gastroenterology specialist or a general practitioner.


July 8, 2020 Blog

Vomiting is an unpleasant symptom that most people have probably experienced in their lives. But as with most gastrointestinal issues like constipation or bloated stomach symptoms, it often signals fleeting issues in one’s digestion – like indigestion, reflux, or eating something ‘wrong’. Most vomiting symptoms go away within a day. However, in rarer cases, vomiting can also be a sign of more serious health problems.

Vomiting can point to many different kinds of health issues. These are not just limited to gastrointestinal problems, but also conditions that affect the brain, central nervous system, cardiovascular system, and so on. Often, the other symptoms that vomiting occurs with can be a helpful indication of the underlying health issue. Here are some symptoms that commonly occur with vomiting, and what they could mean:

  • Vomiting with abdominal pain

Food poisoning often leads to vomiting with abdominal pain, cramping, nausea, and diarrhoea. However, this is usually easily traced back to food. In cases where certain foods are not the issue, these symptoms can signal an underlying problem in the gastrointestinal tract. This could be due to chronic illnesses like Crohn’s disease or irritable bowel syndrome (IBS), or signal an emergency condition like intestinal blockage. If the onset of vomiting is sudden, with sharp, escalating abdominal pain, it could also point to a case of appendicitis.

  • Vomiting with headache

Feeling nauseated, vomiting, and suffering painful migraines sometimes come together. In these cases, it is usually the pain from the headache that triggers the nausea and vomiting. Migraine may also be accompanied by sensitivity to light, noise and odours. Some people find relief that their migraine is relieved after vomiting. It is also possible for these symptoms to be linked to emotional stress, like anxiety.

  • Vomiting with fever

Common problems like food poisoning and stomach flu (gastroenteritis) may be accompanied by fever. A huge cause of concern would be if vomiting occurs with sudden high fever, a stiff neck and severe headache. These are signs of meningitis – inflammation of membranes in the brain and spinal cord. It is an extremely serious, but relatively rare condition that can be caused by viral, bacterial, or fungal infection.

  • Vomiting with blood

Vomit with blood is often a worrying sign. If the blood appears as red streaks, it may indicate the presence of a tear in the oesophagus or stomach lining. In some cases, vomit with blood takes on a coffee grounds appearance, which happens when stomach acids and blood congeal. Peptic ulcers, gastroesophageal reflux disease, stomach cancer, or liver cancer, may all result in this kind of vomiting.

When does vomiting become a cause for concern?

When vomiting comes and goes within a day, it is usually not a cause for concern. However, certain combination of symptoms can be signs that the problem is more serious, and requires a thorough examination by the doctor. Here are some signs you shouldn’t ignore vomiting:

  • Repeated vomiting beyond 1 or 2 days
  • Moderate to severe dehydration
  • Vomit with blood
  • Significant loss of weight since onset of vomiting
  • On and off vomiting that occurs for over a month
  • Vomiting accompanied by severe pain

On top of these symptoms, you should be getting emergency medical attention if you experience vomiting with any of these signs:

  • Chest pain
  • Sudden, severe headache
  • Sudden, severe stomach pain
  • Shortness of breath
  • Blurred vision
  • Confusion
  • Stiff neck and high fever

Knowing how to identify your health symptoms is an important step in getting timely and appropriate care. Don’t wait until it is too late to visit your health practitioner or the ER.

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