Colonoscopy Screening In Singapore

COLONOSCOPY SCREENING SINGAPORE

What is colonoscopy?

In Singapore, a colonoscopy screening is the most effective way for doctors to evaluate the colon (large intestine). Colonoscopy uses a flexible tube about the thickness of a finger, which contains a camera and a light source at the tip. This instrument is inserted through the anus. The scope is then advanced through the rectum and the colon slowly, under visual guidance, usually up to the cecum. There is also the possibility of entering and examining the small intestine's last few inches (terminal ileum).

Sigmoidoscopy Vs Colonoscopy
Why is colonoscopy done, and how much does a colonoscopy cost in Singapore?

There are many reasons to perform a colonoscopy. In most cases, colonoscopies are performed in the context of cancer screening programs. The procedure is usually carried out to determine the cause of blood in the stool, pain in the abdomen or the cause of diarrhea, bowel habits change, or to find out how abnormal the colonic x-ray or CT scan is.

 

The risk of polyps and colon cancer is higher for those with a history of polyps or colon cancer and those with a family history of some types of non-colonic cancers and colonic problems that can resemble colon cancer (such as colonic polyps).

 

The cost of colonoscopy in Singapore can be variable depending on whether it is for screening purposes or therapeutic purposes. It will also depend on whether it is done as an in-patient or outpatient basis. There is also some inter hospital variation in costs. The costs change if additional procedures such as ligation of piles or hemorrhoids, polypectomy or bleeding control etc is done at the same sitting when certain pathologies are found. A patient's health insurance plan also determines their deductible. It is common for Medicare patients to pay around 20 percent of the Medicare-approved amount for physician's services, in addition to copayments for outpatient facility services.

What is the bowel preparation needed before colonoscopy?

The colon needs to be cleaned before colonoscopy, and several preparations are available for colonoscopy. A detailed instruction sheet is provided to the patient before colonoscopy. In addition, laxatives or enemas are generally administered the day before the examination, while a large volume of a particular cleansing solution is consumed the day before the examination. It is essential to follow these instructions carefully. Otherwise, the test may not be accurate (residual stool may obscure the colon lining). If the visibility is poor, the test may have to be repeated, or it may have to be substituted.

 

Additionally, you will probably be advised to avoid certain foods, such as fiber-rich foods or foods that contain seeds.

Before a colonoscopy, will my medications work? Does there have to be a special diet?

It would be best to take most medications as usual, but some may interfere with your examination. Please have all current prescriptions and non-prescription medications available to the colonoscopist or colorectal specialist. The following medications may require special instructions: aspirin products, blood thinners, such as warfarin (Coumadin), arthritis medications, insulin, and iron preparations. A colonoscopist may also want to know if the patient has any allergies or other illnesses that need to be addressed. Furthermore, the colonoscopist should be made aware that the patient has required antibiotics before dental or surgical procedures in the past.

What should you expect during colonoscopy screening in Singapore?


During a colonoscopy screening in Singapore, the patient will have their heart rate, blood pressure, and oxygen levels are continuously monitored. In most cases, sedatives are delivered through an intravenous line to put the patient to sleep and reduce pain. The doctor may give the patient additional medication or Intravenous fluids if necessary during the procedure. When a colonoscopy is performed, one often feels pressure, cramping, and bloating in the abdomen; however, with prescribed medications, most patients tolerate it well, and there is rarely severe pain associated with the procedure.

To advance the colonoscopy, patients lie on their left side or back. A colonoscope is slowly withdrawn after reaching the tip of the colon (cecum) or the ending of the small intestine (terminal ileum), after which the colon's lining is scrutinized. Typically, colonoscopies last between 15 and 60 minutes. In cases where the colon cannot be seen in its entirety, the physician may choose to perform colonoscopy again, possibly with or without a different preparation, at a later date. They may also order a CT scan or X-ray of the colon in these situations.




If abnormalities are discovered during the colonoscopy, what is the next step?


If the specialist finds an abnormal area, it may require further evaluation. Typically, the colorectal specialist will use biopsy forceps to pass through a channel in the colonoscope and a biopsy (a sample of the tissue) will be taken. Under a microscope, a pathologist examines the biopsy in a pathology laboratory. In cases of infection, an examination under a microscope for parasites may be conducted along with a biopsy to culture the bacteria (and occasionally viruses and fungi). It is possible to obtain tissue samples (if necessary) and to control bleeding by several means if colonoscopy is performed because of bleeding. A colonoscopy can work almost permanently on polyps (benign growths that can turn cancerous). However, most polyps do not become cancerous, so removing them is crucial to preventing colon and rectal cancers. No additional pain is usually associated with these procedures. Many reasons can lead to biopsy-taking, and it does not necessarily mean they are testing for cancer.




What to expect when my Colonoscopy is done?


After Colonoscopy, patients will be kept in an observation area for an hour or two to let the medications take effect. During or before Colonoscopy, or even immediately after, patients may be given sedatives, which prevent them from driving. Driving or riding a motor vehicle or operating machinery for the rest of the day may be dangerous, as their reflexes and judgment may be impaired. Upon returning home, patients who have cramps or bloating should find it better with passage of gas and should be able to eat upon regaining their normal appetite. It may be necessary to restrict patients' activity levels or diet after removing polyps or other manipulations.

Patients can discuss the findings of their colonoscopic examination before leaving. However, it may be necessary to wait for microscopic analysis of biopsy samples before a definitive diagnosis can be made. It usually takes a few days.




What are the risk factors, complications, and alternatives to colonoscopy?


It is rare for colonoscopies to cause complications when performed by trained physicians with experience in colonoscopy.

During biopsy or polyp removal, bleeding may occur; however, the bleeding is typically minor and self-limited or can be managed using a colonoscope. Therefore, it is possible that you will need transfusions or surgery after a colonoscopy. In very rare cases, there may be delayed perforation of the colonic wall. Sometimes, this can be managed conservatively and occasionally one may require surgery.

Another possible complication is an adverse reaction to the sedatives used and the localised irritation of the vein where medications were injected (which may cause a tender lump to form). Heart and lung problems can also occur. Together, these problems account for less than 1% of all complications.

These complications are seldom seen, but patients should recognize early signs of difficulties and go to their physicians or the emergency department as soon as possible. For example, if a patient experiences severe abdominal pain or rectal bleeding, or fever and chills, we recommend calling the colonoscopist who performed the procedure.

For detecting, diagnosing, and treating disorders within the colon, colonoscopy is the best method. However, quite a few other options exist such as a barium enema. It is less accurate than a colonoscopy. There is a higher tendency for it to miss abnormalities compared to a colonoscopy, and even if it detects an abnormality such as a polyp, one may need to remove it via colonoscopy or biopsy. A barium enema may reveal an abnormality or lesion when stool or leftover food hasn't been thoroughly removed from the colon. For clarification, a colonoscopy may be necessary. Flexible sigmoidoscopy involves using a shorter colonoscope, and just the last third of the colon is examined.




Virtual colonoscopy screening in Singapore: What is it??


It is possible to perform virtual colonoscopies instead of colonoscopies. CT scanning is a technique used to obtain virtual colonoscopies that reproduce actual colonoscopic images like an actual colonoscopy. They are created using CT images, so they do not represent authentic images. They are digital images.

A virtual colonoscopy calls for the colon to be cleansed the day before the examination. This examination involves injecting air into the colon through a tube placed in the anus. A CT scan of the colon is then carried out with it inflated; then, the images are analyzed and manipulated to create a virtual image of the colon. Virtual colonoscopy is effective if it is performed correctly. However, virtual colonoscopy often misses polyps that are "hiding" behind folds.



The virtual colonoscopy method, however, has several limitations.

Although small polyps (less than 5 mm) are indeed less likely to be cancerous, virtual colonoscopy does not appear to detect these when they are discovered at colonoscopy.

When flat lesions, for example, that are not polyp-like, are not protruding, virtual colonoscopy has incredible difficulty identifying them.There is no way to remove polyps found during a virtual colonoscopy. Thirty to forty percent of people have colon polyps. Virtual colonoscopies can reveal polyps, which need to be released via colonoscopy. Therefore, many people who have virtual colonoscopies will also need to undergo colonoscopy.

There is mild radiation exposure associated with virtual colonoscopy. It is impossible to differentiate between lesions that need to be biopsied and those that do not comply with virtual colonoscopy.

Virtual colonoscopy has not replaced colonoscopy for individuals at a high risk of polyps or colon cancer due to these limitations. In addition, a colonoscopy may not be suitable for people with common risk factors for polyps or colon cancer that are unable or unwilling to have one.