A colonoscopy is a procedure that allows a doctor to examine the inner lining of the large intestine (colon and rectum) using a flexible tube with a camera. It is commonly performed to investigate symptoms such as rectal bleeding, changes in bowel habits, abdominal pain, or abnormal stool test results.

Through colonoscopy, a colorectal surgeon can detect a range of conditions affecting the lower digestive tract and, in some cases, perform treatment during the same procedure (for example, removing certain types of polyps).

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Colorectal Polyps

Colorectal polyps are growths that develop on the inner wall of the colon or rectum. Many polyps are non-cancerous, but some types can develop into colorectal cancer over time.

A colonoscopy can:

• Detect the presence, size, and number of polyps
• Allow the doctor to remove polyps (polypectomy) for analysis
• Help assess a patient’s future surveillance or screening schedule

Identifying and removing polyps is an important part of colorectal cancer prevention strategies.

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Colorectal Cancer

Colonoscopy is one of the main tests used to detect colorectal cancer. During the procedure, the doctor can:

• Visualise suspicious lesions or tumours
• Take tissue samples (biopsies) for laboratory analysis
• Assess the location, size, and appearance of abnormal areas

Colonoscopy may be recommended if there is rectal bleeding, unexplained anaemia, persistent changes in bowel habits, or a strong family history of colorectal cancer.

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Inflammatory Bowel Disease (IBD)

Inflammatory bowel disease mainly refers to:

• Ulcerative colitis – inflammation and ulcers in the colon and rectum
• Crohn’s disease – inflammation that can affect any part of the digestive tract, including the colon

Colonoscopy helps:

• Confirm the diagnosis of IBD
• Assess the extent and severity of inflammation
• Monitor response to medical treatment over time
• Screen for dysplasia (abnormal cells) in long-standing IBD, which may carry an increased cancer risk

Findings may include redness, ulcers, erosions, friable mucosa, or strictures.

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Diverticular Disease

Diverticular disease involves small pouches (diverticula) that form in the colon wall. It can present as:

• Diverticulosis – the presence of diverticula, often without symptoms
• Diverticulitis – inflammation or infection of the diverticula

Colonoscopy can help identify diverticula and exclude other causes of symptoms such as bleeding or altered bowel habits. However, colonoscopy is usually not performed during the acute phase of diverticulitis due to concerns about bowel perforation; it may be done after the episode has settled.

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Colitis and Infective Colitis

Colitis refers to inflammation of the inner lining of the colon. It may be due to:

• Infections (bacterial, viral, or parasitic)
• Ischaemic colitis (reduced blood supply to the colon)
• Other inflammatory conditions

Colonoscopy allows the doctor to:

• Directly inspect inflamed areas
• Take biopsies to identify the cause
• Distinguish between different forms of colitis, which may influence treatment decisions

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Vascular Lesions (Angiodysplasia and Others)

Certain vascular abnormalities in the colon, such as angiodysplasia (fragile, dilated blood vessels), can cause chronic or intermittent bleeding.

Colonoscopy can:

• Help identify these vascular lesions as a potential source of blood loss
• Guide possible endoscopic treatment such as cauterisation, where appropriate

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Haemorrhoids and Other Anorectal Conditions

Although haemorrhoids are often diagnosed by physical examination and anoscopy, a colonoscopy may still be performed to:

• Exclude other causes of rectal bleeding higher up in the colon
• Assess the overall health of the lower digestive tract when symptoms are unclear

Other anorectal conditions, such as fissures or rectal lesions, may also be seen during the procedure, depending on the scope used and the extent of examination.

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Screening in High-Risk Individuals

In addition to investigating symptoms, colonoscopy is used as a screening tool in people with:

• A strong family history of colorectal cancer or polyps
• Genetic syndromes associated with colorectal cancer
• Long-standing inflammatory bowel disease involving the colon

In these groups, colonoscopy helps to detect early changes in the lining of the colon and rectum, including small polyps or precancerous lesions that may not cause symptoms yet.

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When to Speak to a Doctor

If you experience symptoms such as persistent changes in bowel habits, blood in the stool, unexplained weight loss, abdominal pain, or prolonged fatigue, it is advisable to consult a doctor or colorectal clinic for assessment. Your doctor can determine whether a colonoscopy is appropriate and discuss the benefits, risks, and preparation steps with you.

Understanding Piles

Piles, also known as haemorrhoids, are swollen or enlarged blood vessels in the rectal or anal region. They may cause symptoms such as discomfort, pain, itching, and bleeding during bowel movements. Depending on their location, piles can be classified as internal or external.

When Is Piles Removal Surgery Needed?

Doctors may recommend piles removal treatment when:

• The piles are large or prolapsed (protruding from the anus)
• There is persistent bleeding despite treatment
• There is severe pain or thrombosis (clot formation)
• Outpatient or medical treatments have not relieved symptoms

The decision depends on the severity and grade of the piles, as well as the patient’s overall health condition. A medical consultation is required to determine the most appropriate management plan.

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Non-Surgical Alternatives to Piles Removal Surgery

1. Lifestyle and Dietary Modifications

Small or early-stage piles may improve with changes in daily habits. These include:

• Eating a high-fibre diet (whole grains, fruits, vegetables)
• Drinking sufficient water throughout the day
• Avoiding straining during bowel movements
• Exercising regularly to maintain bowel regularity
• Using stool-softening medication when advised by a piles doctor

These measures aim to reduce constipation and ease pressure on the veins in the rectal area. While they may not remove piles completely, they can help control symptoms.

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2. Topical and Oral Medications

Doctors may prescribe or recommend topical creams, suppositories, or oral medication to relieve symptoms such as itching, swelling, and discomfort. These products may contain ingredients that reduce inflammation or soothe irritation.

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3. Outpatient Procedures

If conservative measures are insufficient, minimally invasive outpatient treatments may be suggested. These are generally performed in a clinic setting without the need for hospital admission.

Common outpatient procedures include:

• Rubber Band Ligation: A small band is placed around the base of the internal pile, cutting off its blood supply. The pile usually shrinks and falls off after several days.
• Sclerotherapy: A chemical solution is injected into the affected tissue, causing the pile to shrink.
• Infrared Coagulation (IRC): Heat or light energy is used to close the blood vessels that supply the piles.

These treatments may relieve symptoms for many patients. However, in cases of large, prolapsed, or recurrent piles, surgical removal may still be required.

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Surgical Management of Piles

When non-surgical options are not sufficient, piles removal surgery may be considered. Common surgical methods include:

• Haemorrhoidectomy: Surgical removal of the piles.
• Stapled Haemorrhoidopexy: Repositioning of prolapsed haemorrhoidal tissue using a stapling technique.
• Haemorrhoidal Artery Ligation (HAL): Ligation of blood vessels feeding the piles under ultrasound guidance.

The choice of surgery depends on the type and grade of haemorrhoids, and should be discussed thoroughly with a qualified medical practitioner.

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Post-Treatment and Preventive Measures

After treatment—whether surgical or non-surgical—patients are often advised to:

• Maintain a fibre-rich diet
• Stay hydrated
• Avoid straining or sitting for prolonged periods
• Follow medical advice on wound care or medication
• Attend follow-up consultations as recommended

These steps can support recovery and help reduce the likelihood of recurrence.

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Consult a Doctor for Personalised Advice

Every patient’s condition is unique. While there are alternatives to piles removal surgery, the most suitable treatment depends on the severity of the condition, symptoms, and medical history.

Consult a qualified doctor to discuss available options, understand potential risks, and make an informed decision about your care.

A colonoscopy is a diagnostic procedure that allows doctors to examine the inside of the large intestine (colon and rectum) using a flexible tube with a camera. In Singapore, colonoscopy is commonly performed to investigate symptoms that may be related to conditions such as polyps, inflammation, or colorectal cancer. Recognising when to seek medical evaluation can support early detection and timely management.

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1. Blood in the Stool

Noticing blood in your stool should not be ignored. The cause may range from minor issues such as haemorrhoids to more serious conditions like colorectal polyps or cancer. A colorectal surgeon may recommend a colonoscopy to identify the source of bleeding and determine appropriate management.

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2. Persistent Changes in Bowel Habits

Changes in bowel patterns — including prolonged diarrhoea, constipation, or alternating between the two — may indicate underlying intestinal problems. If these changes persist for more than a few weeks, a colonoscopy may help assess the lining of the colon for inflammation, narrowing, or abnormal growths.

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3. Abdominal Pain or Bloating

Recurrent abdominal discomfort, cramping, or bloating can be associated with digestive conditions. When such symptoms persist despite lifestyle or dietary adjustments, your doctor may suggest a colonoscopy to investigate potential causes such as diverticular disease, inflammatory bowel disease, or obstruction.

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4. Unexplained Weight Loss or Fatigue

Significant, unintended weight loss or persistent fatigue may be warning signs of an underlying digestive issue. In some cases, these symptoms can be linked to chronic bleeding from the colon or rectum, leading to anaemia. A colonoscopy may be advised to determine whether there is a bleeding source within the large intestine.

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5. Family History of Colorectal Cancer or Polyps

Individuals with a family history of colorectal cancer or colon polyps are generally advised to undergo screening earlier and more regularly. A colonoscopy enables the doctor to identify and remove polyps before they develop into cancer. Discussing your family history with your doctor can help determine an appropriate screening schedule.

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6. Positive Stool Test Results

If you have taken a stool test — such as a faecal occult blood test (FOBT) or faecal immunochemical test (FIT) — and received positive results, your doctor may recommend a colonoscopy to identify the source of bleeding or confirm the findings.

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When to See a Doctor

If you experience any of these symptoms, it is advisable to consult a colorectal clinic in Singapore for assessment. While not all symptoms indicate serious disease, a colonoscopy can help provide clarity and guide further medical care. Early evaluation supports timely management and can help detect potential problems before they progress.

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Conclusion

A colonoscopy is an important diagnostic tool used to evaluate a range of intestinal symptoms and support preventive care. If you have noticed any persistent digestive changes or warning signs, speak to a qualified colorectal surgeon in Singapore for medical advice on whether a colonoscopy may be appropriate for you.

Understanding the Colonoscopy Test Procedure

A colonoscopy is a medical examination that allows a doctor to view the inner lining of the colon and rectum. The colonoscopy test procedure is used to identify and assess conditions such as colorectal polyps, inflammation, or other abnormalities in the large intestine. It is also an important screening method for colorectal cancer.

In Singapore, colonoscopy is commonly recommended for individuals who experience symptoms such as rectal bleeding, unexplained weight loss, persistent abdominal discomfort, or changes in bowel habits. It is also used for routine screening among those with risk factors, including age or family history.

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Purpose of the Colonoscopy Test

The colonoscopy test serves both diagnostic and screening purposes. It helps detect early changes in the colon that might not cause symptoms. Early detection allows doctors to remove polyps before they develop into more serious conditions.
A doctor may recommend a colonoscopy if a patient has:

• Blood in the stool or unexplained anaemia
• Chronic diarrhoea or constipation
• Abdominal pain that persists despite treatment
• A family history of colorectal cancer or polyps
• Previous findings of polyps or inflammatory bowel disease

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Preparation Before the Procedure

Proper preparation is essential for a clear view of the colon. Patients are typically advised to:

• Follow a low-fibre or clear-liquid diet one to two days before the procedure
• Take a prescribed bowel-cleansing solution to empty the colon
• Avoid certain medications temporarily, if instructed by the doctor

It is important for patients to follow these instructions carefully so that the colon is fully cleansed for accurate visualisation during the colonoscopy test procedure.

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What Happens During a Colonoscopy

The colonoscopy is usually performed as a day procedure. The patient lies on their side while the doctor inserts a thin, flexible tube called a colonoscope into the rectum. The colonoscope is equipped with a camera that transmits live images to a monitor, allowing the doctor to examine the colon lining in real time.

Sedation is typically given to help the patient relax and remain comfortable. The procedure generally takes between 30 and 60 minutes, depending on what is found during the examination.
If polyps or abnormal tissues are detected, they may be removed or biopsied during the same procedure for further evaluation.

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Recovery and Aftercare

After the colonoscopy test procedure, patients are monitored until the effects of sedation wear off. Most individuals can return home the same day, although driving is not recommended for the next 24 hours. Mild bloating or discomfort may occur but usually subsides shortly.

The doctor will discuss the findings and advise on any follow-up steps, depending on the outcome of the examination and biopsy results (if taken).

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Frequency of Colonoscopy Tests

The frequency of colonoscopy screening depends on individual factors such as:

• Age and general health
• Family medical history
• Previous colonoscopy results
• Presence of polyps or other findings

In Singapore, individuals aged 50 and above are generally encouraged to discuss routine colorectal screening with their doctor. Those with higher risk factors may be advised to undergo screening earlier or more frequently.

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About Dr Ho Kok Sun

Dr Ho Kok Sun
Colorectal & General Surgeon
MBBS (Singapore), M Med (Gen Surg) (Singapore), FRCSEd (Gen Surg), FAMS

Dr Ho Kok Sun is a Ministry of Health-accredited colon surgeon in Singapore who manages colorectal conditions and performs colonoscopy procedures.
He obtained his Master of Medicine in Surgery from the National University of Singapore in 1998 and became a Fellow of the Royal College of Surgeons of Edinburgh in the same year. He completed his general surgery training in 2002 and pursued a fellowship at the Cleveland Clinic Florida, where he specialised in colorectal surgery.

Dr Ho’s previous appointments include:

• Former President, College of Surgeons, Singapore
• Former President, Society of Colorectal Surgeons (Singapore)
• Former President, ASEAN Society of Colorectal Surgeons
• Former Senior Consultant, Department of Colorectal Surgery, Singapore General Hospital
• Former Visiting Consultant, Department of Surgical Oncology, National Cancer Centre Singapore
• Former Clinical Senior Lecturer, Yong Loo Lin School of Medicine, National University of Singapore
• Former Assistant Professor, Duke-NUS Graduate Medical School

For more information, visit Colonoscopy Clinic Singapore.

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When to Consult a Doctor

If you experience rectal bleeding, persistent abdominal discomfort, or unexplained changes in bowel habits, it is advisable to seek medical consultation. A colonoscopy test procedure can help identify the underlying cause and guide appropriate medical care.

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Key Takeaway

The colonoscopy test procedure is a safe and effective way to evaluate colon health and detect potential issues early. Discussing your screening needs with a qualified specialist ensures that you receive appropriate medical advice based on your individual risk profile.

Piles, also known as haemorrhoids, are swollen blood vessels in the rectal or anal area. They may cause discomfort, itching, pain, and occasionally bleeding during bowel movements. The condition is common among adults and may vary in severity depending on the size and location of the affected veins.

In many cases, piles can be managed with lifestyle adjustments and medical treatment. However, if symptoms persist or significantly affect daily life, piles removal surgery may be considered.

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When Is Piles Removal Surgery Recommended?

A doctor may discuss surgical options if:

• Non-surgical treatments (such as dietary changes, medication, or rubber band ligation) do not relieve symptoms
• The piles are large, painful, or recurrent
• There is persistent bleeding or prolapse (piles protruding outside the anus)
• There are complications such as thrombosis (clotted blood within the piles)

The choice of treatment depends on the type, grade, and severity of the piles, as well as the patient’s general health and preferences.

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Outpatient Treatment Options

For many patients, minor procedures can be performed on an outpatient basis — meaning hospital admission is usually not required. These include:

1. Rubber Band Ligation

A small rubber band is placed around the base of the pile, cutting off its blood supply. The pile shrinks and typically falls off within a few days. This procedure is suitable for internal piles and is done under local anaesthesia or mild sedation.

2. Sclerotherapy

A chemical solution is injected into the haemorrhoid tissue, causing it to shrink. It is often used for smaller internal piles and can be performed quickly in a clinic setting.

3. Infrared Coagulation (IRC)

This method uses infrared light to seal the blood vessels supplying the pile, leading to its gradual reduction. It is usually used for mild to moderate internal piles.

These outpatient methods are generally associated with shorter recovery times, although patients may still experience temporary discomfort or minor bleeding after the procedure.

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Surgical Procedures for Piles Removal

When non-surgical or outpatient methods are insufficient, piles removal surgery may be advised. The main surgical options include:

1. Haemorrhoidectomy

This is the surgical removal of piles. It is typically recommended for larger or severe haemorrhoids. The procedure is performed under anaesthesia, and recovery may take a few weeks. Patients are usually advised on wound care and pain management following the operation.

2. Stapled Haemorrhoidopexy

This procedure repositions prolapsed haemorrhoidal tissue and reduces blood flow to the affected area using a circular stapling device. It is often considered for internal haemorrhoids causing prolapse.

3. Haemorrhoidal Artery Ligation (HAL)

In this approach, the surgeon ties off the blood vessels feeding the piles using ultrasound guidance, reducing their size over time. It is typically performed under general or spinal anaesthesia.

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Aftercare and Recovery

Post-operative care following piles removal surgery focuses on promoting healing and reducing discomfort. Doctors may recommend:

• A high-fibre diet and adequate hydration to prevent constipation
• Avoiding straining during bowel movements
• Regular sitz baths (soaking the anal area in warm water)
• Prescribed pain relief or stool-softening medication

Patients should attend all follow-up appointments and contact their doctor if they experience heavy bleeding, severe pain, or signs of infection.

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Consultation and Individualised Care

Every patient’s condition is unique. Before deciding on piles removal, it is important to have a thorough consultation with a qualified medical practitioner. The doctor can discuss the different treatment options, assess suitability for surgery, and explain potential benefits and risks in detail.

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Conclusion

There are several treatment options for piles, ranging from outpatient procedures to surgical interventions. The appropriate method depends on the severity of the condition and the patient’s health status.

If you are experiencing persistent symptoms, seek medical evaluation to determine whether piles removal surgery may be suitable for you.

Understanding Piles Surgery

Piles, also known as haemorrhoids, are swollen veins in the lower rectum or anus. While mild cases may be managed with lifestyle adjustments or non-surgical procedures, surgery may be considered for more severe or persistent cases.
Piles surgery aims to remove or reduce haemorrhoidal tissue and alleviate symptoms such as bleeding, swelling, or prolapse.

Like all medical procedures, piles surgery carries potential risks and complications. Understanding these helps patients make informed decisions and prepare for recovery with realistic expectations.

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Common Types of Piles Surgery

In Singapore, several types of piles surgery are performed depending on the severity and nature of the condition:

• Conventional Haemorrhoidectomy: Surgical removal of haemorrhoidal tissue.
• Stapled Haemorrhoidopexy: Repositions prolapsed haemorrhoidal tissue using a stapling device.
• Laser Piles Surgery: Uses focused laser energy to remove or shrink haemorrhoidal tissue.
• Ultrasound-Guided Haemorrhoidal Artery Ligation: Reduces blood flow to the haemorrhoids by tying off feeding arteries.

A colorectal surgeon will determine which method is most appropriate based on the patient’s condition and medical history.

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Common Risks Associated with Piles Surgery

All surgical procedures involve some degree of risk. The following are potential risks linked to piles surgery:

1. Pain and Discomfort

It is common to experience pain or discomfort in the anal area after surgery. The intensity varies depending on the type of procedure performed and the individual’s pain tolerance. Medication may be prescribed to manage discomfort.

2. Bleeding

Some bleeding may occur during or after piles surgery. Minor bleeding is generally expected, particularly during bowel movements in the first few days.

Persistent or heavy bleeding should be reviewed by the attending surgeon.

3. Swelling or Inflammation

Mild swelling or inflammation around the surgical area is part of the body’s natural healing process. This usually subsides gradually with proper post-operative care.

4. Infection

As with any surgical procedure, there is a risk of infection. Maintaining good hygiene and following medical advice reduces this risk. The doctor may prescribe antibiotics if necessary.

5. Difficulty Passing Urine

Some patients may experience temporary difficulty urinating after surgery due to swelling or discomfort. This generally resolves with time.

6. Constipation

Pain during recovery may cause some patients to delay bowel movements, leading to constipation. A fibre-rich diet, adequate fluids, and stool-softening medication can help prevent straining.

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Possible but Less Common Complications

While uncommon, certain complications may occur following piles surgery:

1. Anal Stricture (Narrowing of the Anal Canal)

Scar tissue may occasionally form during healing, causing narrowing of the anal passage. This may require further medical management.

2. Recurrence of Haemorrhoids

Haemorrhoids can sometimes return, especially if underlying factors such as constipation or prolonged straining are not addressed. Lifestyle changes and regular follow-ups help reduce recurrence risk.

3. Faecal Leakage or Incontinence

Rarely, some patients may experience temporary difficulty controlling bowel movements. This is usually mild and improves with recovery.

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How to Reduce the Risk of Complications

Patients can take several steps to support recovery and minimise the risk of complications after piles surgery:

• Follow all post-operative instructions provided by the doctor.
• Take prescribed medication as directed.
• Eat a fibre-rich diet to prevent constipation.
• Drink plenty of fluids daily.
• Avoid heavy lifting or straining during recovery.
• Attend scheduled follow-up appointments.

Adhering to medical advice plays an important role in promoting smooth healing and early return to normal activities.

If you experience persistent bleeding, swelling, or pain following piles surgery, it is advisable to contact your surgeon for assessment. Early follow-up helps ensure proper recovery and identify any potential complications promptly.

Hernia surgery is performed to repair a weakened area in the abdominal wall and prevent tissue from protruding through it. While most hernia repairs are successful, there is a small chance that a hernia may return after surgery. Understanding why this happens and what factors contribute to recurrence can help patients manage their recovery effectively.

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Why a Hernia May Recur

A hernia can reappear in the same location if the repaired area becomes weak again or if another defect forms nearby. Common reasons a hernia might come back include:

• Strain on the surgical site during recovery, such as from lifting heavy objects too soon
• Persistent coughing or constipation, which increases pressure inside the abdomen
• Obesity, which places additional stress on the repaired tissues
• Smoking, which can slow tissue healing
• Infection at the surgical site, which may weaken the repair

Even after successful repair, the surrounding tissue may still be vulnerable to stress, particularly if lifestyle factors that cause abdominal strain are not managed.

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How Common Is Hernia Recurrence?

While recurrence can occur, it is generally uncommon when proper recovery and post-operative care are followed. The likelihood of a hernia coming back depends on several factors, including:

• The type and size of the original hernia
• The location of the hernia (inguinal, incisional, or umbilical)
• The method of repair used
• The patient’s overall health and healing response

Following the doctor’s recovery instructions — such as avoiding heavy lifting and maintaining a healthy weight — helps reduce the risk of recurrence.

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Recognising the Signs of a Recurrent Hernia

If a hernia returns, it may produce similar symptoms to the initial condition. These can include:

• A visible or palpable bulge near or at the previous surgical site
• Pain or discomfort when coughing, bending, or lifting
• A dragging or heavy sensation in the abdomen or groin
• Swelling or tenderness in the affected area

Any of these signs should be evaluated by a hernia specialist. Diagnosis usually involves a physical examination and, if needed, imaging such as ultrasound or CT scan.

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What Can Be Done If a Hernia Comes Back

If recurrence is confirmed, the doctor may recommend hernia surgery to reinforce the weakened tissue. The approach depends on factors such as the type of hernia, the method of the previous repair, and the patient’s overall condition.

Some cases may require a different surgical technique from the initial repair to strengthen the area and reduce the risk of future recurrence.

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Summary

Although hernia recurrence after surgery is possible, it is not common when recovery guidelines are followed and risk factors are managed. Recognising symptoms early and consulting a colorectal surgeon in Singapore allows timely evaluation and, if necessary, discussion of options for hernia surgery. Regular follow-up and maintaining a healthy lifestyle play an important role in supporting long-term recovery.

Understanding Colonoscopy Screening

A colonoscopy is a medical procedure used to examine the inner lining of the colon (large intestine) and rectum. It plays an important role in identifying potential abnormalities such as polyps, inflammation, or other changes that may require further medical attention.

In Singapore, colonoscopy screening is commonly recommended for individuals as part of preventive health checks or when symptoms such as rectal bleeding, changes in bowel habits, or persistent abdominal discomfort are present.

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Purpose of Colonoscopy Screening

Colonoscopy screening allows doctors to directly view the inside of the colon and rectum using a flexible tube with a camera at the end, called a colonoscope. This enables the detection of early changes that may not be visible through other diagnostic tests.

The procedure is frequently advised for:

• Individuals aged 50 and above as part of routine colorectal cancer screening
• Those with a family history of colorectal cancer or polyps
• Patients who have previously been diagnosed with inflammatory bowel disease, such as ulcerative colitis or Crohn’s disease
• People experiencing unexplained gastrointestinal symptoms

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Preparing for a Colonoscopy

Preparation is essential for a successful colonoscopy screening. The colonoscopy doctor will usually provide instructions to ensure the colon is clean for accurate examination. This typically involves:

• A special diet for one to two days before the procedure (usually avoiding solid foods)
• Drinking a prescribed bowel-cleansing solution to empty the colon
• Avoiding certain medications if advised by the doctor

Following the preparation guidelines closely helps ensure a clear view of the colon, allowing for a thorough and safe examination.

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What to Expect During the Procedure

During a colonoscopy, the patient lies on their side while the doctor inserts the colonoscope through the rectum into the colon. The procedure generally takes about 30 to 60 minutes. Sedation is often administered to ensure comfort.

If any polyps (small growths) or suspicious tissues are found, they can often be removed or biopsied during the same session. The removed tissue is then sent to a laboratory for further analysis.

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After the Colonoscopy

Patients are usually observed for a short period after the procedure until the effects of sedation wear off. Mild bloating or cramping may occur, which typically resolves within a few hours.
The doctor will review the findings and discuss follow-up steps if required, based on the results of the examination and biopsy (if performed).

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Colonoscopy Screening in Singapore

Colonoscopy screening in Singapore is performed by trained specialists such as colorectal surgeons or gastroenterologists. The procedure is available at hospitals, specialist clinics, and day surgery centres.
The frequency of follow-up screenings depends on factors such as age, family history, and the results of previous colonoscopies. Patients are encouraged to discuss their individual screening schedule with their doctor.

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About Dr Ho Kok Sun

Dr Ho Kok Sun
Colorectal & General Surgeon
MBBS (Singapore), M Med (Gen Surg) (Singapore), FRCSEd (Gen Surg), FAMS

Dr Ho Kok Sun is a Ministry of Health-accredited colon surgeon in Singapore with a focus on colorectal disease management, including colonoscopy and minimally invasive colorectal procedures.
He obtained his Master of Medicine in Surgery from the National University of Singapore in 1998 and became a Fellow of the Royal College of Surgeons of Edinburgh in the same year. After completing his general surgical training in 2002, Dr Ho pursued a fellowship at the Cleveland Clinic Florida, where he subspecialised in colorectal surgery.

He has served in various professional roles, including:

• Former President, College of Surgeons Singapore
• Former President, Society of Colorectal Surgeons (Singapore)
• Former President, ASEAN Society of Colorectal Surgeons
• Former Senior Consultant, Department of Colorectal Surgery, Singapore General Hospital
• Former Visiting Consultant, Department of Surgical Oncology, National Cancer Centre Singapore
• Former Clinical Senior Lecturer, Yong Loo Lin School of Medicine, National University of Singapore
• Former Assistant Professor, Duke-NUS Graduate Medical School

For further information on Dr Ho Kok Sun’s clinical services, visit Colonoscopy Clinic Singapore.

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When to Seek Medical Advice

Anyone experiencing rectal bleeding, unexplained changes in bowel habits, or persistent abdominal discomfort should consult a doctor for evaluation. A timely colonoscopy screening may help detect and manage potential colorectal conditions effectively.

Colonoscopy screening is a vital component of colorectal health management in Singapore. Discussing your individual risk factors and screening needs with a qualified specialist can help ensure timely and appropriate medical care.

Understanding Piles and When Surgery Is Needed

Piles, or haemorrhoids, are swollen blood vessels in the lower rectum or around the anus. They may cause symptoms such as bleeding, pain, itching, or swelling.
In mild cases, piles may improve with lifestyle changes and non-surgical treatments. However, when symptoms are severe, recurrent, or not relieved by non-surgical methods, piles surgery may be considered.

Surgery is generally recommended for patients with large haemorrhoids, prolapsed piles, or complications such as thrombosis. A colorectal surgeon will assess the condition to determine which surgical approach is suitable.

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Common Types of Piles Surgery in Singapore

1. Conventional Haemorrhoidectomy

A haemorrhoidectomy involves surgically removing the haemorrhoidal tissue. This procedure is typically used for large or severe haemorrhoids that do not respond to non-surgical treatments.

The surgery is performed under anaesthesia, and recovery usually takes a few weeks.

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2. Stapled Haemorrhoidopexy

Stapled haemorrhoidopexy, also known as stapled haemorrhoid surgery, is performed to treat internal haemorrhoids that have prolapsed. During the procedure, a circular stapling device is used to reposition the haemorrhoidal tissue and reduce blood flow to it.

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3. Doppler or Ultrasound-Guided Haemorrhoidal Artery Ligation

This procedure uses ultrasound or Doppler guidance to locate the arteries supplying blood to the haemorrhoids. The surgeon then ties off these arteries to reduce blood flow, allowing the haemorrhoids to shrink over time.

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4. Laser Piles Surgery

Laser piles surgery uses focused laser energy to remove or reduce haemorrhoidal tissue. The laser seals the blood vessels while targeting the affected tissue, which may help minimise bleeding.

This type of piles surgery is often considered for selected cases based on the doctor’s assessment.

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5. Haemorrhoid Energy Therapy (HET)

Haemorrhoid Energy Therapy is a minimally invasive procedure that uses controlled thermal energy to treat internal haemorrhoids. The energy is applied to the affected tissue to reduce bleeding and discomfort.

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What to Expect Before and After Piles Surgery

Before piles surgery, the doctor will review your medical history and may recommend diagnostic procedures such as a digital rectal examination or proctoscopy.
These tests help confirm the diagnosis and rule out other causes of bleeding or discomfort.

After surgery, patients may experience mild discomfort or temporary swelling. It is important to follow the doctor’s post-operative advice, which may include:

• Taking prescribed medication for pain or swelling
• Maintaining a fibre-rich diet to soften stools
• Drinking adequate fluids daily
• Avoiding prolonged sitting or straining

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About the Piles Clinic in Singapore

Dr Ho Kok Sun is consultant colorectal & general surgeon in Singapore who completed his surgical training at the National University of Singapore and a fellowship at the Cleveland Clinic Florida. He has also served as Assistant Master of the Academy of Medicine Singapore and President of the College of Surgeons Singapore.

His piles treatment clinic offers assessment and management of piles and other colorectal conditions, including both non-surgical and surgical piles surgery options such as haemorrhoidectomy, artery ligation, and laser procedures.

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When to Consult a Doctor

If you have persistent rectal bleeding, discomfort, or swelling that interferes with daily activities, it is advisable to seek medical evaluation from a colorectal surgeon. Early assessment helps determine whether piles surgery or other treatments are appropriate for your condition.

To learn more or schedule a consultation, visit piles.com.sg.