Ask Your Doctor These When Ordring a Colonoscopy

Cancer is the number one killer in Singapore with 9324 reported incidences of diagnosed colorectal cancer between 2014 and 2014.

Affecting the large intestine and rectum, colonoscopy is the most obvious for detection and diagnosis. It involves the insertion of a flexible tube, with a miniature camera and light source, into the anus, rectum, and colon for examining the walls for any abnormalities and mostly done under sedation.

Before undergoing the procedure one must enquire if the colonoscopy doctor is a gastroenterologist. This is because they specialize in gastroenterological disease and are more likely to spot abnormalities.

Although colonoscopy is associated with the risk of perforation in the colon, for expert doctors it is very rare.  So, one should also ask the number of colonoscopies performed and incidences perforations.

Polyp removal is another important matter than one should ask. Polyps of reasonable sizes are removed by expert doctors during the process.

The article by the American College of Gastroenterology covers this in every detail. Read more here!

A Guide to Colonoscopy

The incidence of Colorectal Cancer is steadily increasing and it has turned to be the most common cancer in Singapore in recent years making colonoscopy vital for examining the internal organs.

Preparing for a colonoscopy involves a minimum of six hours fasting before the procedure and medication are given to clear up bowels. Generally, there is no ban on taking regular medicines except diabetes medicines during fasting. Mild sedation is also administered to make the patient sleepy.

The patient is asked to lie on the side, with the legs curled up. The colonoscopy doctor inserts the colonoscope into the anus, rectum and through to the colon. Generally, the procedure does not take more than 30 minutes and the patient does not feel anything. If required, biopsy, polypectomy, argon-plasma-coagulation, etc are performed by passing instruments through the gastroscope.

Colonoscopy is a safe procedure with very rare incidences of perforation in the intestinal wall. The patient is kept in the recovery room for some time before release.

The article by gutCARE discusses everything about colonoscopy in an elaborate fashion. Read more here!

Is colonoscopy painful?

A colonoscopy is the most effective way of managing colorectal cancer, and most of the Singaporeans are now undergoing the procedure for screening and prevention of the dreaded condition.

In case you are having second thoughts about whether it hurts, the reality is that the patients are usually given sedatives before starting the procedure. It makes them so drowsy that they do not feel or remember anything after the procedure is completed. 

A colonoscopy doctor or a gastroenterologist performs this as they specialize in GI tract issues. A flexible tube is inserted through the anus for examining the internal organs. If polyps are present, they are removed during the process.

Some patients have a feeling of headache and nausea after colonoscopy. Very few of them complain about bloating and mild abdominal cramping. Mild discomfort and little bleeding are experienced if a biopsy is performed during a colonoscopy.

The article written by Rebecca Joy Stanborough discusses many aspects of colonoscopy in great detail. Read more here!

Colonoscopy: Procedure, Effectiveness, and Risks Involved

Colonoscopy is the procedure of examining the lining of the internal walls of the large intestine or colon and the rectum. The colon doctor inserts a flexible with a light source and a camera through the anus and to the colon to perform this procedure. This is recommended, when someone has persistent problems in the bowel, to check for colorectal disorders.

This is a simple procedure and takes about 15 minutes usually. The patient is required to fast for about 6 to 8 hours and also administered medication on the previous day for cleaning up the bowel thoroughly. It is done under mild sedation. So, the patient cannot feel anything. In most cases, polyps are also removed during the procedure. Samples for biopsies are also collected if required.

Although a simple procedure, colonoscopy is more effective than an x-ray of the colon when it comes to the detection of polyps. As both the detection and removal of polyps can be done simultaneously it is a better option than the Barium enema. This is also a very safe procedure with only less than 0.5% risks of colon wall perforation.

The article by Singapore General Hospital explains the things one needs to know about colonoscopy. Read more here

Colonoscopy – what it is

The term colonoscopy means a visual examination of the large intestine including its meeting point with the small intestine, and the rectum through an endoscopic procedure. The procedure is performed by a colon doctor or Gastroenterologist by inserting a flexible tube, with a fiber-optic camera, through the anus.

Other than the detection of abnormalities like polyps and ulcers, it also helps the removal of polyps and suspected lesions for biopsy. Persistent gastrointestinal hemorrhage, changes in bowel habit calls for this procedure. This is highly effective for screening and prevention of colorectal cancer.

Colonoscopy is a very safe procedure with an overall risk of 0.35% serious complications including perforation of the intestinal wall and bleeding. Since it is done under mild sedation the patients do not feel any pain. However, some experience nausea and bloating caused due to inflation of the colon by gas.

Written by Wikipedia this article everything one should know about colonoscopy. Read more here!

These Questions Can Reveal All About Colon Cancer

Talking with the cancer care team, especially the colon doctor is essential, necessary and vital to make informed decisions. Only a frank discussion can help you understand the colon and its functions. Moreover, they build up the foundation to learn more about colon cancer and the quality of life you can expect.

  • What is colon cancer and how it starts?
  • Who gets this and what are the rates?
  • What are the risk factors?
  • What signifies a colon cancer?
  • How colon cancer is diagnosed?
  • What is colonoscopy all about?
  • Why it is important?
  • How colonoscopy is performed?
  • How to prepare for a colonoscopy?
  • What to expect during colonoscopy?
  • What are polyps?

The article by Doctors Community Health System includes these questions with answers that reveal everything about colon cancer. Read more here!

Acute Complications to Watch Out for After Anal Surgery

Patients can face different kinds of complications during their postoperative period. Some common situations are given in the following part of the article. Read more about the anal surgery offered at Mark Wong Surgery here.

Postoperative hemorrhage

In this relation, minor bleeding is common to happen. It is expected that patients will continue to have normal bowel movements. The patient can experience bleeding due to disturbed movement of bowel and irritation.  It is also common to have bloody discharge during a bowel movement. Therefore, patients should know what activities to avoid such can reduce the chance of anxiety in the patient.

All these can have an impact in smooth bowel movement of the patient. Though major bleeding problem is not common patients may experience small blood clot during the first bowel movement after the surgery.

Common problems of infection

Infection problems are also common, and along with this, swelling is also common after anal surgery. Even one may suffer from problems of fever that can worsen the pain after some improvement during the postoperative period. As part of warning sign, delayed urination is a common sign. However, soon after experiencing the symptoms, the patient should visit a doctor before the complication become worse.

In this case, computerized tomography is a suitable option in case of deeper abscess or similar problems. If there is an infection problem after anal surgery, the surgeon should be careful enough to suggest suitable measures for infection control and treat the problem carefully. 

Problems of urinary retention

Urinary retention is a common problem among patients after anal surgery that should be treated carefully by the physicians. The problem of urinary retention occurs from multifunctional problems like irritation in pelvic nerves or pain. Therefore, it is known that the multifactorial type of urinary infection makes it difficult to endure after anal surgery.

Having pain during the post-operative period is common and when planning to find strategies to deal with it, it can aggravate other problems related to anal surgery.

Other than this, severe constipation is common to take place after anal surgery. The problem of functional constipation can also happen due to fear of bowel movement along with the related pain.

What are the reasons for anal surgery?

Hemorrhoids are a problem that causes the disruption of anchoring of the anal cushions. These are common in the right interior position and this is related to straining and difficulty in bowel habits. During defecation, it is known that the straining engorges the cushions and it gets displaced. Eventually, when the replacement continues to offer, it results in stretching of anal cushions resulting in problems like hemorrhoids.

Therefore, when suffering from anal problems, without any further delay, it is better that you consult the physician to get rid of the problem soon. Make sure that you get in touch with the right physician who is experienced enough to suggest you whether you need to undergo anal surgery or not. An experienced doctor can also help you during the post-operative period properly.   

Possible Conditions to Expect After Anal Surgery

During anal surgery, it is diagnosed whether anal cancer is present or not. It is an exhaustive process. When you start to face anal problems, it is suggested to see a doctor. This shall prevent the disease from getting worse. It is better to treat the disease before there are many other diseases that take place in your body. It is usually seen that it takes 2 to 3 weeks to recover from the surgery.

It can also depend on the severity of the problem. However, in this regard, it is better to consult an experienced doctor who can make it easy for the patient to recover from anal surgery operation. Some important symptoms to look after are as follows.

Proper bowel function

You might have some discomfort in bowel movements after anal surgery. Adding to the post-surgery discomfort, diarrhoea and constipation make the situation worse and painful. It can result in anal wounds due to hard bowel movements in the post-operative period that eventually affects the healing procedure.

Preventing constipation from aggravating surgical pain

It is normal to have a bowel movement every other day. If bowel movements skip two days, take milk of magnesia. In case, it does not have any results, try to take milk of magnesia every six hours. Instead of this, you can try to have phosphate or tap water enema.

Can diarrhea make the situation worse?

Yes, there is a chance that you may suffer from diarrhoea after anal surgery. It can take place when you have watery bowel movement more than three times in 24 hours span. In this, you should not take milk of magnesia or any other laxatives. In case the situation persists, it is better to consult a physician without further delay.

Careful bathing process

After anal surgery, you have to be careful about bathing and use wet cloth, toilet paper, cotton, perianal pads for suitable cleaning process. Also try to take a tub bath and it should take 10 minutes to 15 minutes. Make sure that you take a bath in warm water to make it comfortable. Every day, try to take three baths that shall help to keep away from problems of infection and during the post-surgery period. 

Following a proper diet 

Maintaining proper diet during post-surgical period is important. Therefore, you should try to have high-fibre diet that includes plenty of vegetables and fruits. Adding to this, drink plenty of water almost up to eight glasses that shall help in easy stool movement.

After the surgery, you can get involved in different activities like walking, climbing, riding a car and the like. It is better not to get involved in any strenuous activity or lift heavy things for a week or two. 

The following problems can occur:

  • Difficulty in urination
  • Severe bleeding
  • Constipation
  • Increased pain, redness or drainage problems 
  • Nausea or vomiting 
  • Chills 

When suffering from any of the following problems do not delay and consult the doctor immediately. Proper medications can help get rid of the problems soon.   

What Should I Expect After a Meniscus Surgery?

Modern technology currently allows for low-risk meniscus surgery. It requires only a small incision at the knee area and by using an instrument called arthroscope, a doctor can inspect the extent of the injury and at the same time do necessary repair.

Three types of treatment can be done using arthroscope, i.e. arthroscopic repair, and partial or total meniscectomy. However, after the meniscus surgery is complete, patients should know what to expect until full recovery. This is important to avoid any untoward incidents that may cause issues in the just operated area.

What Happens Right After Surgery?

The doctors may perform meniscus surgery under general or spinal anesthetic. Administration of local anesthesia is also possible at the area of the knee in combination with spinal anesthetic. Depending on whether you choose a general or spinal anesthetic, or what the doctors see as more suitable for you if you have other conditions, then you may be wide awake during the surgery, or completely unconscious.

Once the surgery is over, you will be resting in the hospital for a while because the doctor would like to check on your progress. When the doctor finds that you are doing well, you will be allowed to return home, but maybe with braces or cast to stabilise your knee. The doctor may supply you with some pain relievers to swallow, in case the pain is too much to bear.

You also need to take antibiotics for a few days to prevent infection at the incision area and inside it. To avoid risk of blood clots, which is normal precaution after any types of surgery, the doctor may suggest that you wear compression stockings. It will keep your feet warm and encourage healthy blood flow.

How Long Does It Take to Recover from a Meniscus Surgery?

Expect to find swelling and feel stiffness at your knee area for quite some time. However, the after-effect may differ from one patient to another. In some cases, patients complained that their leg still did not regain its full capability and smoothness of movement after two weeks post-operation.

This situation is quite normal, taking into consideration the usual recovery period of one month for those who underwent partial or total meniscectomy. For those who went through repair surgery, unfortunately it can take longer, up to 3 months for full recovery.

Hence, it is important to abide by all the advice given by doctors. Other than taking the medication properly, try to cool down the swelling area with ice packs and put your feet higher than your head while resting. This is to reduce the swelling and help you feel more comfortable over time. Avoid any forceful movement during recovery process.

You must also attend physical therapy sessions. This therapy session is essential because it can help your knee to regain its elasticity and strengthen tissues and muscles in the affected area.

In the end, most of the patients who ever had a history of meniscus surgery can go back to playing their favourite sports and participate again in any activities they enjoyed. If you have any concerns about your situation before or after a meniscus surgery, please do not hesitate to discuss it with your healthcare provider, because their experience can help eliminate any worries that you may have.

Non-Surgical Remedies for Trigger Finger

When faced with known medical conditions, it is usually easy to come up with a home remedy. However, when first faced with trigger finger, the first reaction may be panic. This is because many people don’t understand why a finger that has been bending and straightening easily, suddenly gets stuck temporarily. Fortunately, several non-surgical trigger finger treatments can be explored, of course, depending on how long it takes before the finger unfolds.

In the following article by Arush Patel in, non-surgical treatments of trigger finger are discussed. Knowing what to do once when you have trigger finger will help you reduce the inflammation in the tendons of your finger quickly.

Steps to Take When You Get Trigger Finger

Trigger finger is a condition in which a finger or thumb becomes temporarily “stuck” in a bent position due to inflammation in the tendon sheaths. The goal of treatment is to reduce inflammation in the tendon and sheath to allow unimpeded tendon movement.

Specific treatments for trigger finger are described below. The best course of treatment for patients depends on the severity of trigger finger and the number of fingers affected. Read more here

When you choose to do something about your trigger finger matters a lot. It is important to seek treatment when you first see signs of trigger finger. Some of the non-surgical therapies include the use of a splint for a few weeks, ice therapy, and the use of anti-inflammatory medication. If you don’t have diabetes or an inflammatory condition, may decide to use cortisone injection to reduce the inflammation of the tendon.

Unfortunately, if your condition is severe, the only option may be surgical treatment. This article by William Morrison discusses what you should expect from after a surgery to correct trigger finger.

Types of Surgery for Trigger Finger

Trigger finger can leave the finger or thumb stuck in a crooked position. It causes pain and stiffness and makes it hard to move the affected digit.

If other treatments are not successful or the condition is severe, surgery is usually successful in restoring full movement.

The recovery time for trigger finger surgery is quick, and the procedure has a high chance of success. Read more here

When your doctor confirms that the only solution to your trigger finger is surgery, you need to find out which surgery he finds most viable for .your condition. Open surgery involves an incision and the cutting of the tendon sheath. This will give the tendon space to move easily. Percutaneous release surgery involves the use of a needle to improve your finger’s flexibility. This surgery leaves no wound. If these surgical options do not yield the desired result, your doctor may recommend Tenosynovectomy. This surgical treatment is best for people with rheumatoid arthritis and involves the removal of part of the tendon sheath.

In the next article on, the Mount Elizabeth Medical Centre specialists discuss some of the common questions patients ask.

Concerns Many Patients Have Regarding Trigger Finger

Trigger finger (also known as stenosing tenosynovitis) is a condition in which one experiences pain and swelling over the base of the thumb or finger. This is associated with a jerking, snapping or clicking when one extends the affected digit from a fully clenched position, much like how the trigger of a gun clicks when one pulls on it to fire, hence the name “trigger finger”.

This happens due to a disparity of the size of the flexor tendon with its surrounding retinacular sheath of the affected digit. This is most common at the A1 pulley region. It is caused by a swelling of the flexor tendon synovium, which can be felt as a nodule, and/or thickening of the retinacular pulley. Read more here


Questions many people with trigger finger ask is “why me? Did I do anything to contribute to this?” It is natural to imagine you are the exception, especially if you don’t see many people complaining about trigger finger. However, trigger finger is associated with age and existing medical condition. Trigger finger is as unique as any other medical condition. Understanding the possible cause and solutions will help you to manage it better.

Treatment for Meniscus Tears

When any part of our body gets injured, it is best to seek immediate evaluation of its seriousness and obtain early treatment. This is very true also when we talk about meniscus tear. The truth is, this type of injury is one of the most common knee injuries to happen and it can affect anyone, regardless of age or activity.

Types of Meniscus Tear

Types of meniscus tear determines the type of treatment a patient must undergo. Discuss it in-depth with your healthcare provider before deciding on the best kind of treatment because healing process can differ based on which meniscus tear treatment we choose.

As patient, we should know that meniscus tear injury can be categorized into either degenerative or normal tear. Degenerative tear happens to older patients and it is not repairable with normal surgery but must be treated by knee replacement procedure. During MRI, degenerative tear shows lots of fraying, compared to normal tear, which is straight-lined and clean-cut. Normal tear tends to happen to younger people who play vigorous sports or whose knees received strong force due to some accident.

The doctor may also check how deep is the injury. If it is at the outer part of the meniscus, chances for self-recovery is high because blood flow is more extant here. But if it is deeper and towards the middle, then the chances are lower. Any healing process requires more vitamins and nutrients. Without constant blood flow, healing process can take longer, which means more pain and side effects in one of the most important areas to human to support their movement.

Treatment for Meniscus Tears

Treatment for meniscus tear varies, depending on where it is situated at the meniscus, how big the injury is, and what kind of injury it suffers.

When you suspect that you have meniscus tear and meet your doctor for treatment, during the first stage usually the doctor will suggest that you take proper rest, take some pain-killers and apply ice to cool down the area around your injury so the swelling is reduced.

To help with the pain, the doctor may also encourage physical therapy later. Therapy can strengthen the injured area and give further support to an already weakened muscles and tissues.

So, it is not an emergency scenario where you will be led into the operation theatre right away. There are many steps involved before the doctor finally resort to surgery.

Afterwards, if the pain and swelling does not go away, the doctor will suggest further treatment including surgery. A non-invasive surgery is possible with two small incisions made near the meniscus area and treatment is administered through these incisions.

Surgery is always the final option, though it may still be the best solution for the patient in the long run.

However, it is essential for a patient to understand that meniscus surgery is not high risk. Of utmost importance is the support that we can obtain during treatment and recovery period which can take up between one to three months. With ample support and understanding from the dearest and the nearest, all obstacles can seem small.

Different Process Involved In Project Management – Related Certifications

What are these processes?

In general, any project has to be managed in multiple numbers of features involving a minimum of 4 to 5 management processes of the project management, along with a system to control and monitor the entire project. There might be a different name in different industries and a different software to approach but the main concept and the stages involved in the development of a product or service to achieve the desired outcomes will be same.

The stages are the Initiation, Plan, Execute, Monitor & Control and the Closing of the project. At the workplace, the team engaged in researching and developing the stages is supplemented by making decisions of Yes/No with which it can be decided if the project can continue or suspend. The project management certification helps in detail to understand every aspect in a real time scenario.

In detail

Initiation –€“ This is the preliminary phase where the result of the project is decided and the scope of continuing is finalized. The demands of the business should decide the goals of the project, understanding current process. An analysis should be made from a finance perspective to estimate the cost and fix a budget. Support personnel should be involved in the project with a charter to decide the tasks.

Planning –The importance of planning is that it helps in estimating adequately and approximately the time of completing this project, cost and budget, resources required, risk management and finally proper execution. This, being the second phase, makes it essential to plan perfectly, failing in which results in decreasing the chance of success of project completion and achieving goals.

Execution –€“ All the deliverables are ensured to be executed as planned. This is the crucial and implementation stage of all that is planned with the project. It includes the right allocation of the work to right person, managing the resources and human skills, material and cost. The main idea is to run the project by submitting deliverables.

Monitoring & Controlling – This phase is the essential phase to check for corrections, monitor the work and its execution. The main idea of this process is the smooth functioning of the project and head towards completion without any barriers. All the measures are taken at this level to notice the variance from the plan to execution and set things right.

Closing –€“ This is the final phase where it is officially accepted from both the parties that the project is completed, with files and documents of the project.

A System That Needs Awareness And Transition – EMS

In a formal manner environmental management system can be referred as a database and system that integrates processes and procedures to train personnel, summarize, monitor, report and safeguard the special environmental performance to all the stakeholders at a firm. The EMS is based on the standard that is used widely – the ISO – International Organization for Standardization – 14001. Few other times it might include this standard called EMAS.

What is this Awareness & Transition?

Awareness and Transition are the ISO 14001 certified courses to gain better knowledge on the environment industry and solve the real time problems with an ease. The reason for this training is, managing proper environment is not a choice made morally but has become much a business requirement. Organizations with structured EMS are reaching places in making a better environment. The ISO 14001:2015 acts as a guide to stable growth, making innovations and accessibility to markets. Learning the need of what exactly has to transition in meeting the standards of EMS comes with identifying the new changes happened and how will they affect the organization.

Who must take-up this course and why?

* To understand the working process of ISO 14001

* A responsible EMS staff who works on implementing these processes

* An interest in EMS

* To those who is actively seeking a prospective career in EMS

In short this course is for all those who are directly or indirectly, partially or fully involved with the entire operations of planning, supervising, and implementing the awareness programs and transitions with respect to ISO 14001:2015 for converting the old policies to new standards required.

What is the learning taken?

The course helps in gaining better knowledge on ISO structure of high level EMS standards and gives a chance of exploring the changes that took place from 2004 to 2015 in ISO 14001. The gaps can be bridged by planning a proper transition to the new standards. The key terminology and definitions of the new ISO can be learned which incorporates the common framework of EMS. Many interesting concepts like PDCA – Plan, Do, Check and Act.


* Knowledge on the changes happened from ISO 14001 of 2004 to 2015 & Introduction to the current needs of Annex SL in organizational context

* Learning the plan and implementation of the approach that is risk-based and to revise the current EMS from the old one and making necessary transitions.