Colonoscopy and Gastroscopy are scope procedures used to assess the large intestine (colon and rectum) and stomach for common symptoms like blood in stools, irregular bowel habits, abdominal pain and bloatedness. The interior of the intestine and stomach is visualised with a high definition camera at the end of a flexible fibre-optic scope tube which is manoeuvred by the expert endoscopist for diagnosis and treatment.
Piles, also known as haemorrhoids, are naturally occurring anal cushions that help with stool control. Haemorrhoids cause bleeding, pain and swelling when they are diseased, often as a result of hard stools, straining and constipation. Treatment of piles include use of medications, rubber band ligation and surgery by a specialist.
Polyps: EMR, TEO
Colon polyps are growths from the intestinal lining and are precursors of colon cancer. They are commonly detected during colonoscopy and removal of polyps is the best means of cancer prevention. Polyps are usually removed by the use of instruments during colonoscopy; this is called polypectomy. Large colon and rectal polyps may require the use of specialised techniques called Endoscopic Mucosal Resection (EMR) and Trans-anal Endoscopic Operation (TEO), respectively.
Anal Fistula, Abscess, Fissure
Anal fistula, abscess and fissures are common problems causing anal pain. Anal fistula and abscesses are caused by infection within the glands of the anal canal, that often require surgical treatment by the colorectal surgeon for cure. Anal fissure is an anal tear that can result from constipation and hard stools, which results in severe pain on passing motion with muscular spasm. Non-healing fissures will need minor surgery to relief pain and aid healing.
Laparoscopic, Robotic Surgery
Laparoscopic or key-hole surgery involves the use of a camera and instruments inserted into the abdominal cavity via a few small incisions to visualise and treat common conditions like appendicitis, gallstones, and colon cancer. There is less pain, and faster post-operative recovery compared to traditional open surgery. Robotic surgery uses small robotic instruments which mimics the action of the human hand, and a robotic camera that can visualise the surgical field in 3D. Robotic rectal cancer surgery can enhance the surgical precision and minimise the potential side effects of surgery.
Colorectal cancer is the most common cancer in males and females in Singapore. It is one of the few cancers for which a cure is possible when diagnosed early. The key is in early detection by colonoscopy screening and assessment of symptoms like blood in stools and change of bowel habit. The current standard of treatment is surgery to remove the cancer, with addition of chemotherapy and/or radiotherapy for more advanced cancers.
Appendicitis is an inflammation of the appendix which can progress to severe infection of the abdomen if left untreated. Treatment involves surgery to remove the appendix to minimise the chances of perforation and abscess (pus) formation. Appendicectomy can be done usually with laparoscopic (key-hole) technique with fast recovery. Diverticulitis is the inflammation of colonic diverticulum, which are outpouching of the colonic lining due to age, inherited factors and propulsive force of the colon. This can often be treated with antibiotics and a short hospital stay for mild cases.
Constipation is characterised by hard stools or a decrease in stool frequency to less than 3 times per week. This can be a chronic (long-term) condition related to gut movement disorders and inability for pelvic and anus muscles to coordinate and relax. Persistent or sudden constipation should be evaluated by specialist to exclude colorectal tumours causing blockage, especially in the older age group.
Irritable Bowel Syndrome (IBS)
Irritable Bowel Syndrome (IBS) is a spectrum of gut movement disorder that exhibits a variety of symptoms from abdominal pain, irregular stools frequency and stool forms which affect patients’ quality of life and can mimic the same symptoms as gastrointestinal cancer, ulcers and abdominal inflammation. Diagnosis of IBS requires a thorough assessment by a specialist which can include endoscopy and abdominal scans.
Common hernias seen in surgical practice include inguinal and abdominal wall hernias. Inguinal hernia starts as a lump in the groin and is usually a result of inguinal wall weakness that can be related to heavy work and lifting. The intestines can be pushed out of the abdominal cavity into the hernia sac, causing pain and discomfort. Surgery for hernia repair is done to treat the wall weakness, and prevent strangulation of the intestines in the hernia opening. Specialised techniques used include use of soft hi-tech synthetic mesh or nets to strengthen the wall, as well as the use of key-hole techniques in selected patients.
Gallstones are formed in the gallbladder from bile, cholesterol and calcium deposits. They are a common cause of upper abdominal pain, usually on the right side, and after a heavy meal. Gallstones can also cause infection of the gallbladder, called cholecystitis, as well as blockage if the bile ducts. Laparoscopic cholecystectomy is a commonly performed key- hole operation to remove the gallbladder and associated stones once a patient develops recurrent pain and infection or blockage.
Common skin lumps that appear on the body include sebaceous cyst, lipoma, skin infections or abscesses. Sebaceous cysts are collections of sebum (secretions which keep hair follicles moisturised) formed from blockage of sebaceous ducts. They can be removed with minor surgery to prevent recurrent infection. Lipoma is a benign (non- cancerous) growth of fat cells that commonly occurs in the arms, legs and trunk of the body. They are soft,usually painless and can be left alone when small. Surgery to remove large or symptomatic lipomas can be done in safe and simple fashion. Skin abscesses and infection will require surgical drainage for faster healing.