Gastroenterology in Kuala Lumpur: Expert Care

In order to treat this condition, various drugs may be prescribed to reduce inflammation and suppress the immune system that is causing the inflammation, using antibiotics to treat any related infections. Pain relief as well as anti-diarrhoea medication may also be prescribed.

As bowel rest may reduce inflammation, nutrition through feeding tube inserts or via intravenous injections may be recommended for more severe cases.

For drastic measures, surgery to remove diseased parts of the large and/or small intestine may sometimes be required for much more severe cases.

Stage 1 and 2 hemorrhoid development may require lifestyle changes and minor medical treatment which may include diets with high fibre foods, the usage of topical treatments, warm water soaks and anal area cleanliness. Haemorrhoid symptoms often go away within one or two weeks.

However, if persistent bleeding and painful haemorrhoids occur, our specialist team may perform rubber band ligation, in which one or two small bands are placed at the base of the haemorrhoid to cut off blood circulation. Alternatively, injections (sclerotherapy) and coagulation via infrared and/or lasers may be recommended for haemorrhoid size reduction.

If surgery is recommended, the two main options include:

• Haemorrhoidectomy - the most effective and complete way to treat severe or recurring haemorrhoids.
• Stapled haemorrhoidectomy or stapled haemorrhoidopexy - where blood flow to haemorrhoidal tissue is blocked off. This process is typically used for internal haemorrhoids. Though causing less pain, this procedure has a greater recurring risk as compared to a regular haemorrhoidectomy

Changes in your diet, or completely removing foods that cause bloating may be recommended by your doctor. Depending on your range of symptoms, fibre supplements, laxative or diarrheal medication may be prescribed to you.

Certain drugs may be prescribed to:

- Ease diarrhea via reduction of muscular contraction and secretion of fluids in the intestine, while increasing rectal muscular tone

- Decrease overgrowth of bacteria

- Increase fluid secretion in small intestines to help bowel movement

The easiest path to treatment for this condition would be diet improvement and sometimes antibiotics. Mild cases of diverticulitis infection may only require rest, a liquid diet, stool softeners and antibiotics. However, surgery may be recommended for more severe cases along with a course of antibiotics and intravenous nutrition.

The typical main treatment method for this would be surgery to remove the cancer. Your doctor may also recommend chemotherapy as well as radiation therapy before and after successful surgery.

Prescription drugs to neutralise, reduce and block excessive stomach acid production may be prescribed. Drastic measures include surgery and procedures such as these listed below may be recommended:

- Fundoplication to tighten the muscle and prevent reflux by wrapping the top of the stomach around the lower esophageal sphincter.

Often used to check faecal occult blood tests for colorectal screening, this test can help assess the patient's gut health by taking into consideration the change in acidity (pH), colour and consistency of stools. The presence of mucus, red and white blood cells, sugar, fat and bile can help further understand the causes of indigestion, constipation, diarrhea, mal-absorption and infection.

This diagnosis allows for the close scrutiny of the stomach and digestive tract. A long instrument resembling a long tube with a camera called an endoscope is used to take images of the inter gastrointestinal environment. For further diagnosis, biopsies may taken to be microscopically examined to help in cancer cell detection.

Sound waves are used to produce dynamic images of organs that may not be accessed via other conventional means such as the gallbladder, pancreas and liver.

Liver function tests, blood counts and pancreatic enzyme tests can help determine conditions such as parasitic, viral or bacterial infections, lactose intolerance, celiac disease and diarrhoea. These blood tests may often help exclude other serious illnesses.

As medical test used to detect polyps and other various abnormal gastrointestinal growth, a camera is embedded at the end of a flexible tube, which is then inserted via the anus. This allows specialists to visually examine the large intestine and parts of the small intestine for any abnormalities.

Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) scans help give specialists a cross-sectional view of the abdominal organs. This then helps them visualize the conditions of the internal structures of the body.

Changes in your diet, or completely removing foods that cause bloating may be recommended by your doctor. Depending on your range of symptoms, fibre supplements, laxative or diarrheal medication may be prescribed to you.

Certain drugs may be prescribed to:

- Ease diarrhea via reduction of muscular contraction and secretion of fluids in the intestine, while increasing rectal muscular tone

- Decrease overgrowth of bacteria

- Increase fluid secretion in small intestines to help bowel movement

Prescription drugs to neutralise, reduce and block excessive stomach acid production may be prescribed. Drastic measures include surgery and procedures such as these listed below may be recommended:

- Fundoplication to tighten the muscle and prevent reflux by wrapping the top of the stomach around the lower esophageal sphincter.

Changes in your diet, or completely removing foods that cause bloating may be recommended by your doctor. Depending on your range of symptoms, fibre supplements, laxative or diarrheal medication may be prescribed to you.

Certain drugs may be prescribed to:

- Ease diarrhea via reduction of muscular contraction and secretion of fluids in the intestine, while increasing rectal muscular tone

- Decrease overgrowth of bacteria

- Increase fluid secretion in small intestines to help bowel movement

Stage 1 and 2 hemorrhoid development may require lifestyle changes and minor medical treatment which may include diets with high fibre foods, the usage of topical treatments, warm water soaks and anal area cleanliness. Haemorrhoid symptoms often go away within one or two weeks.

However, if persistent bleeding and painful haemorrhoids occur, our specialist team may perform rubber band ligation, in which one or two small bands are placed at the base of the haemorrhoid to cut off blood circulation. Alternatively, injections (sclerotherapy) and coagulation via infrared and/or lasers may be recommended for haemorrhoid size reduction.

If surgery is recommended, the two main options include:

• Haemorrhoidectomy - the most effective and complete way to treat severe or recurring haemorrhoids.
• Stapled haemorrhoidectomy or stapled haemorrhoidopexy - where blood flow to haemorrhoidal tissue is blocked off. This process is typically used for internal haemorrhoids. Though causing less pain, this procedure has a greater recurring risk as compared to a regular haemorrhoidectomy

Colonoscopy is an essential procedure for maintaining digestive health and preventing serious conditions. At Gleneagles Hospital Kuala Lumpur, our experienced gastroenterologists use advanced techniques to examine the inner lining of the colon and rectum. This procedure helps detect polyps, tumors, and other abnormalities early, allowing for prompt intervention.

We prioritize patient safety and comfort at every step of the process. Our dedicated team ensures a sterile and controlled environment, adhering to stringent safety protocols to minimize any risk of infection or complications. Regular colonoscopies are key to early detection and treatment, providing you with peace of mind and better health outcomes.

Commitment to International Quality Benchmarks

At Gleneagles Hospital Kuala Lumpur, achieving international benchmarks for several important quality indicators underscores our dedication to providing top-tier colonoscopy services:

1. Cecal Intubation Rate

   The cecal intubation rate refers to the percentage of colonoscopies reaching and visualizing the whole cecum and its landmark. A complete bowel examination is a prerequisite for thorough and reliable inspection of the mucosa in search of suspicious lesions. A low cecal intubation rate is commonly associated with increased risk of interval colorectal cancer. An incomplete colonoscopy causes an increase in treatment cost and patient comfort as the examination needs to be repeated [1].

2. Adequate Bowel Preparation Rate

   Past studies have demonstrated that the quality of bowel preparation affects the cecal intubation rate and detection of adenoma (benign tumours). An inadequate bowel preparation causes increased costs and patient inconvenience as the procedure needs to be rescheduled to a later date. An adequate bowel preparation rate is defined as achieving a Boston Bowel Preparation Rate Scale (BBPS) score of ≥ 6, with each segment of the bowel (ascending, transverse and descending) registering a score of ≥ 2 [1].

3. Adenoma Detection Rate for patients ≥ 50 years old

   The aim of colonoscopy is to reduce the complications and death from colorectal cancer via early detection of tumours at an earlier and more treatable stage and through removal of pre-cancerous adenomas [2]. Adonomas are non-cancerous (benign polyps) that have the potential to develop into cancerous adenomas (adenocarcinoma) [3]. Hence, the Adenoma Detection Rate (ADR) is utilized to gauge the sufficient inspection at screening or diagnostic colonoscopy in patients aged 50 and more. ADR is defined as the proportion of colonoscopies that detect at least one histologically confirmed colorectal adenoma or adenocarcinoma [1,2].

Inclusion factors of Colonoscopy are as follow: 

• Colonoscopy procedures (fiber optic colonoscopy plus/ minus excision/ destruction lesion and colonoscopy with polypectomy)
• Patients who are going through gastroscopy and colonoscopy in the same session
• Elective/ daycare colonoscopies

Exclusion factors of Colonoscopy are as follow: 

• Inpatient referrals
• Emergency Colonoscopy
• Patients less than 18 years old
• Patients with hemicolectomy
• Absconded/ AOR (“at own risk’) discharge

Colonoscopy: Overview of 2023 Data Analysis

Reference

1. Kaminski MF, Thomas-Gibson S, Bugajski M, Bretthauer M, Rees CJ, Dekker E, Hoff G, Jover R, Suchanek S, Ferlitsch M, Anderson J. Performance measures for lower gastrointestinal endoscopy: a European Society of Gastrointestinal Endoscopy (ESGE) quality improvement initiative. United European gastroenterology journal. 2017 Apr;5(3):309-34.
2. Corley DA, Jensen CD, Marks AR, Zhao WK, Lee JK, Doubeni CA, Zauber AG, De Boer J, Fireman BH, Schottinger JE, Quinn VP. Adenoma detection rate and risk of colorectal cancer and death. New england journal of medicine. 2014 Apr 3;370(14):1298-306.
3. UpToDate. Patient education: Colon polyps (Beyond the Basics). [Online].; 2019 [cited 2022 August. Available from: https://www.uptodate.com/contents/colon-polyps-beyond-the-basics