Colorectal cancer is the number 1 cancer in Singapore, rank first in men and second only to breast cancer in women. The presentation ranges from abdominal pain to change in bowel habit, and overlaps with many benign condition, such as piles and anal fissure.
This is the commonest condition that brings a person to consult a doctor. The presenting symptoms include lump in the anus, blood in the stool and anal pain. Most piles can be managed conservatively with medication and rubber band ligation. Prolapsed piles will usually require surgical removal of the piles.
Anal fissure or tear usually results from excessive straining during constipation. The main presentation is anal pain, usually accompanied by fresh bleeding noted on cleaning up. Conservative Treatment include stool bulking and stool softening agent. Medication will usually aid in the recovery of this condition. Chronic anal tear will require surgical intervention, in addition to medications.
Colonic polyps are overgrowth of lining of the colon, which carry a small cancer risk. Most polyps are symptomatic, and usually detected on colonoscopy. Some polyps can present as blood in stool or iron deficiency anemia from occult bleeding. As polyp carries a small risk of malignant change, it is usually removed during colonoscopy.
This is the dreaded condition that everyone worries about whenever they have any bleeding during bowel movement. In additional to bleeding, other symptoms include recent onset of constipation, alternating constipation and diarrhoea, pencil-thin stool caliber as well as abdominal pain. When these symptoms occur, it usually means that cancer has grown. Colorectal cancer is easier to treat if it is asymptomatic, and the prognosis is better at that stage. This belies the important of colonic screening for early detection of colorectal cancer.
This is an examination that allow the inner lining of the large intestine and distal part of small intestine to be evaluated using a flexible fibre optic tube connected to a camera. It helps to find problem such as ulcer, polyps, inflammation or bleeding. Colonoscopy is also a therapeutic procedure where polyps can be removed and bleeding can be stopped if visualized.
Colonoscopy procedure starts with bowel preparation where the colon is cleansed to allow detection of small polyps. During the procedure, sedation will be administered intravenously so that the patient will not feel any discomfort or feel stress about the procedure. After the process, the patient will be allowed to eat and be discharged on the same day.