Dr Jason Lim

If you have booked an advanced date for your colonoscopy, it would be ideal to keep to a low fibre diet 3 to 5 days prior to the date of your colonoscopy. This reduces the fibrous debris in the colon and allows a better clean during the bowel preparation. Furthermore, the remnant stools, if any, would often be liquid, which can be sucked out by the colonoscope itself. It is important also to be compliant to the prescribed timing and the volume of the bowel preparation to take.

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).

Hi Yvette, A colonoscopy is the most accurate screening test for colon cancer in Singapore. However, there are risks and costs involved with the procedure. As such, the stool tests offered (FOBT, FIT) are alternatives for patients who want a low-cost screening tool that determines their need for a colonoscopy. If a stool test is positive, one should undergo a colonoscopy as soon as possible. To understand more about getting a colonoscopy in Singapore, read The Complete Guide To Colonoscopies In Singapore (2018).

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!

If you are above the age of 45, or have a positive family history, it is important to consider a colonoscopy as part of your routine health screening. This is because colorectal cancer is the number 1 cancer in Singapore and more often than not begins as a polyp. Polyps are small and have no symptoms. The only way to remove polyps is through a colonoscopy.

Piles’ bleeding often occurs after passing motion and typically presents with bright red blood. It should be noted that colon cancer seldom bleeds with visible blood in the stools until it is very advanced (that is why the stool tests are used to detect unseen blood in the stools), or if the tumour is situated very near the anus. A very common scenario faced by patients is that of an “asymptomatic” colon cancer (i. e. no obvious symptoms and no visible blood seen in the stools) with piles.

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.

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.

The patient is often asleep throughout the procedure due to the sedation administered so essentially the patient often has no recollection of the entire procedure. If a patient chooses to undergo the procedure without sedation, the common sensation will be that of abdominal cramps and bloating due to the air pumped into the colon during the procedure. This can be very uncomfortable. Get a complete breakdown of what happens during your colonoscopy in Singapore here.

Hi Hui Yi, There is actually no recovery period from the scope itself. However, if you had sedation administered during the procedure, you might suffer a loss of memory or experience drowsiness for up to 12 hours after the procedure depending on the dose and type of sedative used. I would not advise you to return to work, drive, operate machinery or make important life decisions until at least 12 hours after the procedure. To understand more about getting a colonoscopy in Singapore, read this to get complete breakdown of what happens during your colonoscopy.

Hi, The description of your symptoms appear to be proctalgia ani. While it literally translate to "pain in your anus", the persistence of your symptoms warrants a physical examination by a doctor. The causes can range anywhere from an anal fissure (tear in your anus), to deep anal infections, to referred pain from somewhere else e. g. coccydynia / pelvic floor strain (from your weight lifting), and stress.

Hi Bing Qi, A colonoscopy often begins with the administration of a mild sedative which renders the patient unconscious or drowsy for the duration of the procedure. After which, the colonoscope is inserted into the anus, gas is pumped into the colon and the scope is advanced to the caecum. This is done by a series of maneuvers executed by the endoscopist’s right hand which twists, pulls and pushes the scope, while the left hand manipulates the up-down-left-right controls on the scope handle. This allows the scope to wriggle its way through the bends and corners of the colon.

I am sure you have done some research by now and know that CA19-9 is possibly elevated in conditions related to the stomach, liver, intestines (small and large) and commonly, the pancreas and biliary system (gallbladder and it's related structures). The common scenario nowadays is that most health screening packages would include cancer markers and abnormal results in these markers naturally lead to alarm and worry. I would however like to reassure you that based on one blood test result alone, we do not know whether you have cancer or not until we have done the necessary tests.

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).

The current local guideline is for Singaporeans to undergo colorectal cancer screening at the age of 50, or earlier if they have a positive family history of the disease. The American Cancer Society recently reduced the screening start age to 45 years old. While our local authorities have not adopted this yet, it should serve as a reminder for one to consider some form of screening for colorectal cancer when they are approaching 50 years of age. Speak to your physician on when you should start screening for colorectal cancer if you have a positive family history.