Home arrow FAQs
Some Common GI Problems

Gastroesophageal Reflux 
Gastroesophageal Reflux or GERD is a common cause of gastric pain. In Singapore, it is more frequent cause of gastric pain than traditional peptic ulcer disease. It is a physical condtion in which acid from the stomach flows backward up into the esophagus. Unlike the stomach, the esophagus does not have a protective lining against stomach juices, so prolonged exposure can lead to pain, inflammation and ulceration. Common symptoms include heartburn, a bitter taste in the mouth, sensation of bloatedness and often backache. The gastric pain can be quite distressing and affects the patient the whole day long. Prolonged GERD can lead to ULCERATION, strictures, mucosal changes like Barret’s esophagus which can ultimately result in a higher incidence of gastro-esophageal cancer.

GERD can be accurately assessed with gastroscopy. It is important to investigate this condtion if it is prolonged and symptoms do not respond to treatment.

Cancer of the Colon
The most feared diagnosis is cancer of the colon. This is the most common cause of cancer in males in Singapore and second most common in females. It is increasing in developed countries and this is thought to be related to diet. Symptoms include change in bowel habits, anemia(lack of blood), Bleeding and loss of weight. Unfortunately, when these symptoms occur, the cancer is very often advanced and though amenable to treatment, often requires prolonged chemotherapy and multiple operations. This has lead to the concept of SCREENING where people without symptoms are stratified according to their risk factors and screening done. The best form of investigation is still colonoscopy as it is accurate and has a therapeutic potential as it can also remove polyps. Polyps are precursors to cancer.

Presently, anybody above 50 years of age should prefably have some form of screening. The screening should be carried out earlier, usually at the age of 40 or 5 years younger than the index case in people at risk. These include those with :

a) A family history of colorectal cancer or adenoma(polyp)

b) A history of ulcerative colitis or other inflammatory bowel disease.

c) Personal history of cancer or polyps or other related tumors/cancers 

It is important to remember that it is never too late to treat cancer of the colon as the newer chemotherapeutic agents give hope to even the most advanced patients.

Hepatitis B
Hepatits B results in chronic liver disease and liver cancer. It is spread by 2 means- via blood or sexual transmission. In this region, it is commonly transmitted from the mother to the child at birth. Other common sources of transmission include the sharing of toothbrushes, combs and shavers. IN the older age group, it is often sexually transmitted. While there are many modes of transmission, we should realise that hepatitis B is not spread through breast feeding or sharing of food. The use of vaccination has dramatically reduced the incidence of hepatitis B. All children should be vaccinated as they are at birth in Singapore. Adults at risk should also be vaccinated.

There is treatment for hepatitis B. It can control the condition but there is no medication which can cure it. Some 30-40 % of Hepatitis B carriers develop cirrhosis of the liver. The overall incidence of cancer of the liver is 100 times normal population. However the incidence of cancer in patients with liver cirrhosis is 20 times that without liver cirrhosis. Hence, short of curing the hepatitis B, our main aim is to identify those patients who will most likely develop liver cirrhosis and treat them. Not everybody needs treatment and it is important to pick who needs treatment and who does not. This is because long term treatment has its problems with resistance. 

Patients with hepatitis B should also make sure they see their doctors at least 6 monthly.

Hepatitis C
This is a condtion which in the long term results in liver cirrhosis and liver cancer. This virus is transmitted principally via blood- the use of transfusion, dirty razors, I/V drug abusers/dirty contaminated needles.

There is no vaccination for hepatitis C. Detection of hepatitis C is by blood tests.

Not everybody develops liver cirrhosis/cancer. Only those with potential to develop progressive liver disease/cirrhosis need treatment. It is estimated that about 20-30% of patient do not need treatment . There is effective treatment for hepatitis C (it can be cured) and the duration varies from 6 months to a year. It depends on the Genotype and the degree of damage the liver has. Generally, the worse the underlying liver diease, the longer the treatment. The effective cure rate is between 50-90% depending on the genotype and underlying liver disease. 

New drugs are now available for the treatment of Hepatitis C. They are especially useful for patients with genotype 1 infection.

The treatment can be quite trying on the patient; hence it is important to decide who needs treatment at onset and for the patient to expect the side effects. 

 (C) 2018 RC Gastro Liver
6 Napier Road
Gleneagles Medical Centre
Singapore 258449
Tel : (65) 6476 7555
Fax : (65) 6476 2555
Ans. Service (After Off. Hrs):
6533 0088

Opening Hours:
Mon - Fri: 9.00am - 1.00pm
2.00pm - 5.00pm
Saturdays: 9.00am - 1.00pm