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Colonoscopy

Dr Thng Yongxian

Hepatopancreatobiliary & General Surgeon
MBBS • MMed • MRCS (IRE) • FRCSED • FAMS

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What Is Colonoscopy?

A colonoscopy is a diagnostic procedure that visually examines the interior of the colon and rectum using a flexible, camera-equipped tube called a colonoscope. This procedure is important for detecting colon polyps, cancers, and other conditions, affecting the large intestine.

 

Colonoscopy is recommended as a routine screening tool for colorectal cancer starting at age 45 for people at average risk. It can also help diagnose symptoms such as unexplained changes in bowel habits, rectal bleeding, and abdominal pain. The procedure not only aids in diagnosis but can also be therapeutic, allowing for the removal of polyps and tissue sampling.

Indications for Colonoscopy

Colonoscopy is a diagnostic and therapeutic tool used in various clinical scenarios. Here are the primary reasons for undergoing this procedure:

Cancer Screening

Routine screening for colorectal cancer is recommended for all people starting at age 45 or earlier for those with a family history of colorectal cancer or other risk factors.

Investigation of Symptoms

Colonoscopy is performed to explore the cause of gastrointestinal symptoms such as persistent diarrhea, rectal bleeding, unexplained abdominal pain, or changes in bowel habits.

Monitoring and Surveillance

For patients with a history of polyps or colorectal cancer, regular colonoscopies are used to monitor the colon and rectum for recurrence or new growth.

Inflammatory Bowel Disease

Patients with chronic inflammatory conditions such as ulcerative colitis or Crohn’s disease often undergo colonoscopies to assess the extent of disease activity and response to treatment.

Preparing for a Colonoscopy

Successful colonoscopy relies on proper preparation. Here are the key steps involved:

Dietary Restrictions

  • Patients are usually required to follow a special diet in the days leading up to the procedure. This often includes consuming only clear liquids like broths, teas, and clear juices for at least 24 hours before the procedure.

Bowel Preparation

  • Patients must take a laxative preparation to ensure the colon is clean and free of obstructions. This may come in the form of large-volume liquids or pill forms that induce diarrhea to empty the colon.

Medication Adjustments

  • Discuss all medications, as some may need to be adjusted or temporarily discontinued, especially blood thinners and diabetes medications.

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The Colonoscopy Procedure

A colonoscopy is a comprehensive procedure aimed at examining the interior of the colon and rectum. Here’s what happens during a typical colonoscopy:

Pre-Procedure Setup

Upon arrival at the clinic or hospital, you will be required to complete the necessary paperwork and change into a gown. You’ll then be taken to the procedure room.

Sedation

Most colonoscopies are performed under sedation to ensure comfort throughout the procedure. You will receive sedatives intravenously, which will make you feel drowsy.

Insertion of the Colonoscope

A long, flexible tube called a colonoscope will be inserted into the rectum and gently advanced through the colon. The colonoscope has a light and camera that sends images to a monitor, allowing it to examine the intestinal lining.

Examination and Intervention

As the colonoscope is manoeuvred through the colon, it is used to identify abnormalities like polyps or signs of inflammation. Tools can be passed through the colonoscope to remove polyps, take biopsies, or perform other necessary interventions.

Withdrawal and Inspection

The colonoscope is slowly withdrawn while the lining of the colon is inspected for any additional findings.

Recovery and Aftercare Following Colonoscopy

It is important to follow specific aftercare instructions to ensure a smooth recovery. Here’s what you can generally expect:

  • Immediate Post-Procedure Care: After the colonoscopy, you will be taken to a recovery area, where nurses will monitor you as the effects of sedation wear off. This usually takes about 1 to 2 hours.
  • Observation for Complications: Although complications are rare, it’s important to monitor for any signs of trouble, such as severe abdominal pain, fever, bloody stool, or heavy bleeding from the rectum.
  • Resuming Diet and Activities: You can usually eat and drink normally soon after the procedure unless advised otherwise. Most people can return to normal activities the following day.
  • Managing Discomfort: You might experience mild cramping or bloating due to air introduced into the colon during the procedure. Walking and moving around can help dispel gas and alleviate discomfort.

Dr Thng Yongxian

Senior Consultant

HEPATOPANCREATOBILIARY & GENERAL SURGEON

MBBS (SG) • MMed (Surg) • MRCS (Ire) • FRCSEd (Gen) • FAMS (Surg)

Dr Thng Yongxian is a dual fellowship-trained Hepatopancreatobiliary & General Surgeon who has performed over 6000 surgical procedures.

  • Bachelor of Medicine & Bachelor of Surgery
  • National University of Singapore
  • Membership of the Royal College of Surgeons, Ireland
  • Master of Medicine, General Surgery, Singapore
  • Fellow of the Royal College of Surgeons, Edinburgh
  • Fellow of the Academy of Medicine, Singapore

He pursued his subspecialty training in Hepatopancreatobiliary surgery first in the Department of Hepatopancreatobiliary Surgery, Singapore General Hospital. Following this, he completed a clinical fellowship in Minimally Invasive Hepatopancreatobiliary Surgery at Seoul National University Hospital in Bundang, South Korea.


Dr Thng set up and pioneered the Minimally invasive surgery program for his hospital in complex liver and pancreas cases. His surgeries were featured on live national television. His surgical videos have also been presented at international surgical conferences. He also pioneered the use of capsule colonoscopy for colorectal screening.


Dr Thng has served on various committees at hospital, cluster and ministry level. Dr Thng served as a member of the Ministry of Health (MOH) Laparoscopic cholecystectomy Clinician workgroup for value-driven care (VDC).

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Nexus Surgical @ Mt. Alvernia

Nexus Surgical @ Mt. Elizabeth Orchard

Nexus Surgical @ Mt. Elizabeth Novena

Nexus Surgical @ Parkway East

Nexus Surgical @ Gleneagles Medical Centre

Nexus Surgical @ Mt. Alvernia

Nexus Surgical @ Mt. Elizabeth Orchard

Nexus Surgical @ Mt. Elizabeth Novena

Nexus Surgical @ Parkway East

Nexus Surgical @ Gleneagles Medical Centre

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