Colonoscopy

What is a Colonoscopy?

A colonoscopy is a common medical procedure in Singapore that allows specialists to examine the inside of the large intestine, including the colon, rectum, and anus. The primary goal of a colonoscopy is to screen for colorectal cancer, one of the most commonly diagnosed cancers in Singapore.

Colonoscopies can also help investigate gastrointestinal symptoms such as abdominal pain, bloating, rectal bleeding, chronic constipation, chronic diarrhoea, and other gastrointestinal issues. If needed, your doctor can remove polyps and/or take tissue samples (biopsies) for further examination during the procedure.

How does a Colonoscopy work in Singapore?

Before the procedure, you must cleanse your bowel to ensure clear visualisation of your lower digestive tract. You will be provided with some oral laxatives to aid in this process. You will also be advised to avoid fruits and vegetables, brown rice, and red meat for three days before your colonoscopy. Consume a soft diet the day before your procedure and stick to clear liquids. You will need to fast for at least 6 hours on the day of your procedure. These steps help ensure greater visualisation and accuracy of your colonoscopy.

You may be required to avoid certain medications like blood-thinning medicine.

On the day of the colonoscopy, sedation will be administered for comfort. Next, your specialist inserts the colonoscope, a flexible tube with a light and camera attached, into the colon and rectum through the anus. Live images are transmitted to a monitor as the device navigates the colon, enabling detailed inspection of the colon lining for signs of disease. To enhance visibility, air or carbon dioxide may be introduced through the scope to expand the colon.

If polyps or suspicious growths are found, your specialist may remove them or obtain a sample using specialised tools. The samples are then sent to a laboratory for further analysis to determine their nature and whether you will require additional treatment.

After the procedure, you will be monitored as the effects of the sedation wears off. You may experience mild bloating, but these typically subside shortly after.

Benefits of a Colonoscopy procedure in Singapore

• Early detection of colon cancer: colonoscopies play a crucial role in detecting colon cancer at its earliest stages. Early detection of colorectal cancer allows for prompt treatment and enhances the chances of successful recovery.
• Decreased risk of colon cancer: during a colonoscopy, your specialist may identify precancerous polyps and perform a polypectomy. Removing these polyps can reduce your chances of developing colon cancer in the future.
• Improved diagnosis: colonoscopies provide a more thorough colon examination than other diagnostic procedures. This allows for a more accurate diagnosis and effective treatment plan.
• Reduced mortality risk: early detection of colon cancer can lower the risk of death associated with the disease.
• Prevention of other health conditions: colonoscopies can detect signs of inflammation or infection in the colon, which, if left untreated, could lead to other health issues.
• Improved symptom management: colonoscopies help identify underlying causes of symptoms such as abdominal pain or rectal bleeding. By addressing these root causes, symptom management and relief can be improved.
• Better quality of life: early recognition of colon-related problems can enhance an individual's quality of life and decrease the likelihood of complications and severity of symptoms.

What conditions can Colonoscopy treat/diagnose in Singapore?

A colonoscopy can be used to treat or diagnose the following gastrointestinal conditions: 

• Colon polyps
• Crohn's disease
• Colon infection
• Diverticulosis, diverticular bleeding, and diverticulitis
• Colorectal cancer
• Ulcerative colitis
• Irritable Bowel Syndrome (IBS)
• Gastrointestinal bleeding
• Anal itching
• Anaemia
• Constipation
• Unexplained diarrhoea
• Abdominal pain
• Ulcerations
• Inflammation

What results can I expect from a Colonoscopy?

The results from a colonoscopy will vary, but they will provide important insights into the health of your colon. The outcomes of this diagnostic procedure can be categorised based on what is found during the examination.

• Normal results: if your colonoscopy reveals no abnormalities, this is considered normal. In such cases, your gastro specialist may not need further tests and will recommend the next screening in 5 to 10 years, depending on your risk factors and family history.
• Positive result: a colonoscopy is deemed positive if polyps or abnormal tissue are discovered in the colon. Most polyps are benign (non-cancerous); however, some can evolve into cancer. These are usually removed during the procedure for further analysis. The presence of these growths or any abnormal tissue may require a closer examination through laboratory analysis to determine their nature.
• Biopsy and laboratory analysis: if any suspicious areas are identified during the colonoscopy, a biopsy may be conducted for further examination. The results from these biopsies can take up to 2 weeks. Your specialist will communicate these findings to you, detailing whether any precancerous or cancerous cells were found and outlining the next steps if any follow-up care and/or treatment is necessary.
• Finding cancer: in rare cases, a colonoscopy may reveal a cancer diagnosis. If cancer is detected during the procedure, your specialist will discuss the best course of action. This may include additional tests to determine the stage of the cancer and the development of a treatment plan tailored to your specific condition.
• Follow-up care: depending on what is found during your colonoscopy, your specialist in Singapore will advise you on the appropriate follow-up care. This ranges from simply scheduling another screening in several years to more immediate actions if any concerning findings are made.

It is important to note that the detection of polyps or other abnormalities during a colonoscopy allows for early intervention, which can significantly improve treatment outcomes, especially in the case of colorectal cancer.

How many Colonoscopy sessions are needed?

The number of colonoscopy sessions required varies widely among individuals, mainly based on initial screening results, personal and family medical history, and specific risk factors. Generally, individuals in Singapore with normal colonoscopy results and no additional risk factors may be advised to have a follow-up colonoscopy in 7-10 years. This longer interval is due to the reduced risk of developing significant changes or conditions in the colon that could lead to cancer.

If polyps are discovered during the colonoscopy, the future screening schedule is based on the number, size, and type of polyps detected. For example, finding one or two small polyps may lead to a recommendation for another colonoscopy in 5 to 10 years. However, discovering more and larger polyps or polyps with high-risk features could shorten the interval to just one year for a follow-up. This personalised approach aids in the early identification and removal of potentially precancerous conditions, significantly lowering the risk of developing colorectal cancer.

Additionally, individuals in Singapore with specific conditions that increase the risk of colorectal cancer, such as inflammatory bowel disease, or those with a strong family history of colorectal cancer may require more frequent colonoscopy and monitoring .

Frequently asked questions

Is a colonoscopy painful?

While some individuals may experience discomfort, colonoscopies are typically not painful procedures. Sedatives and pain relievers may be administered to help alleviate any discomfort during the examination.

Are there risks associated with a colonoscopy?

In rare cases, potential complications may involve reactions to the sedative, bleeding from the biopsy site  (where a polyp was removed), and colon wall perforation (0.1%).

Can I eat before a colonoscopy?

Yes, however, the clinic staff will advise you of some diet restrictions and instructions. Your specialist will prescribe a clear liquid diet to prepare your colon for the procedure.

How accurate is a colonoscopy?

Colonoscopies are widely regarded as the top choice for detecting colon cancer and polyps. However, while the procedure is considered highly accurate, no test is truly 100% foolproof.

What signs of complication should I watch for after a colonoscopy?

While complications are rare, it is important to reach out to your doctor if you have severe abdominal pain, fever, chills, heavy bleeding, or persistent nausea and vomiting.