How useful is a colonoscopy, and are colonoscopies really necessary?

Hi Cai Shum, A colonoscopy is one of the investigative tools we have to examine the colon, rectum and in some cases the terminal ileum. The alternatives are a computed tomography scan of the colon (also known as a CT Colonography) and a barium enema. The key benefit of performing a colonoscopy is the ability to directly visualize the colonic lumen through a high definition lens and biopsy the lesion if necessary. This cannot be done with the other imaging options.

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Dr Jason Lim

Colorectal Surgeon

How often do doctors miss polyps on colonoscopies, and why does this happen?

It is not uncommon for doctors to miss polyps during a colonoscopy. There are no figures locally on how often this happens but these can be due to three main factors: Poor bowel preparation causing the polyp to be obscured by stools Small polyps behind the corners or folds of the colon, which are not visualized well during the colonoscopy Inexperienced endoscopist To find out more about getting a colonoscopy in Singapore, you can read my Complete Guide To Colonoscopies In Singapore (2018).

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Dr Jason Lim

Colorectal Surgeon

How can I find the best doctor for my colonoscopy in Singapore?

Hi Adorra, My advice is to gather direct feedback from trusted friends and relatives who have undergone a successful colonoscopy on whom to consider as your endoscopist. In this era of fake news and social media marketing, it is even more important now to distil reviews accurately. When you speak to your endoscopist, remember that you are not obliged to undergo the procedure unless you are comfortable with the doctor and accept the risks involved with the procedure. Finding a good doctor for your colonoscopy in Singapore should not be that complicated!

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Dr Jason Lim

Colorectal Surgeon

Is colonoscopy a simple procedure that can be performed well by a junior doctor?

A colonoscopy carries a 1 in 1000 risk of perforation. Should a perforation occur, it often requires immediate surgery to repair the perforation. In some instances, a stoma is required to allow the damaged colon to heal. As such, a colonoscopy should not be considered a “simple” or “risk-free” procedure as the consequences of a complication from the scope can be morbid, with the need for multiple surgical procedures to treat. To understand more about colonoscopy in Singapore, you can refer to The Complete Guide To Colonoscopies In Singapore (2018).

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Dr Jason Lim

Colorectal Surgeon

Is surgery necessary for an abdominal hernia?

It sounds like your cousin has an abdominal hernia. A hernia occurs when the “inner organs” pushes through the weakened layers of the abdominal wall, forming a bulge. This bulge often gets bigger over time. It can also cause abdominal pain, nausea and vomiting, which could explain the stomach discomfort your cousin has experienced. An abdominal hernia can be exacerbated by heavy lifting or straining. There are several different types of abdominal hernias – the most common type is an inguinal hernia.

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Human

What could be the cause of black stools and dull ache at my pelvic area?

Black tarry and unformed stool may represent the passage of altered blood - also known as melena. The most common cause of melena is internal bleeding from peptic ulcers, usually originating from a point higher up in your gastrointestinal (GI) tract like the stomach or duodenum. Risk factors for peptic ulcer disease include presence of Helicobacter pylori (a bacteria found in the stomach) and consumption of certain medications such as aspirin and non-steroidal anti-inflammatory drugs (NSAIDs).

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Human

Which will give the best results between a standard colonoscopy, a virtual colonoscopy and a capsule endoscopy?

To find out more about getting a colonscopy in Singapore, you can read my Complete Guide To Colonoscopies In Singapore (2018). A standard colonoscopy’s sensitivity is in the range of 95 – 98% accurate, while a CT Colonography’s sensitivity can range from 90 – 95%. However, it is imperative to note that the sensitivity and accuracy of either investigation is highly dependent on the quality of the bowel preparation before the procedure. The poorer the bowel preparation, the lower the accuracy.

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Dr Jason Lim

Colorectal Surgeon

What could be the cause of blood clots on passing motion?

Seeing blood in the toilet, or with wiping after passing motion is common, especially when you are passing hard stools or constipated. Most of the causes of such bleeding are not life-threatening; common causes include hemorrhoids and anal fissures. However, the only way to be certain of the cause is to be evaluated with a proper history and examination by a doctor. This is especially so in light of your most recent problem of blood clots. You should definitely highlight it as soon as possible to the doctor whom you are seeing.

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Human

When should I see a doctor regarding rectum bleeding if I’m worried about colon cancer?

Great question. Bleeding from the back passage is actually one of the most common questions that get asked by friends. In short, the answer is you should see a GP. He 'll be able to determine the source of the bleeding by examining your back passage, and if it' s unclear where the blood is coming from, or if your history is to be able to decide on the necessary further investigations. In your shoes, I would not be overly concerned. As you mentioned, pain and bleeding in your 20s is most commonly due to anal fissures, caused by passing hard stools.

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Human

Do I need a colonoscopy for tailbone and anal pain to rule out cancer?

From the sounds of it, you're most worried about cancer (which I can understand, given your father' s colorectal cancer) so let's address that first. Dull pain near tailbone -> anal pain - could it be cancer?

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Human

What should I do next if I experience abdominal bloating and discomfort?

Abdominal bloating commonly originates from conditions in the stomach, gallbladder, small intestines, or the large intestines. Sometimes, it can be due to less common causes from the gynaecological organs or other organs within the abdominal cavity. As you probably know by now, Nexium only addresses bloating due to gastritis from excessive acid in the stomach. It does not address other causes of bloating from the stomach e. g. helicobacter pylori associated gastritis, much less from the other organs in the abdominal cavity.

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Dr Jason Lim

Colorectal Surgeon

Could stomach pain and difficulty passing motion be a sign of cancer?

Cancer of the digestive tract is not very common in your age group (36 years). However, there can at times be exceptions, especially if you have a family history of cancer. Perhaps you may need to consult a doctor with the view to a gastroscopy and colonoscopy if the attending doctor is of the opinion that your symptoms are serious.

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Human

When is blood in the stools a cause for concern?

Bleeding from the back passage is actually one of the most common complaints seen by doctors. The good news is that most of the time, the bleeding is caused by something non-worrying. For example, most people who experience bleeding, as well as a bump around their butt crack may have a haemorrhoid (your doctor can easily confirm this during his examination). The appearance, colour and smell of the blood can sometimes help doctors distinguish between causes. As a general rule: 1. Bleeding from the anus – the blood tends to be bright red and fresh.

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Human

How do I make the preparation for a colonoscopy easier?

It depends greatly on what bowel preparation regime is used for the colonoscopy. Different centres and endoscopists have their own regimes, which can range from just 3 small cups of laxative fluid, to over 3 Litres of a bowel cleansing agent. Speak to your endoscopist on their advice regarding mitigating the experience of bowel preparation with respect to the chosen preparation regime. You can also find out more about colonoscopies in Singapore here.

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Answered By

Dr Jason Lim

Colorectal Surgeon

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