Best Gastroenterologist in Kuala Lumpur | Expert Gastroenterology Services

Treatment for Inflammatory Bowel Disease (IBD) may involve various drugs that 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.

The treatment of Stage 1 and 2 hemorrhoid development may require lifestyle changes and minor medical treatment, which may include:

• A high-fiber diet to ease bowel movements
• Topical treatments to reduce swelling and discomfort
• Warm water soaks for soothing relief
• Maintaining anal area cleanliness to prevent further irritation

In many cases, symptoms of haemorrhoids improve or resolve within one to two weeks with these basic measures.

However, if persistent bleeding and painful symptoms occur, more advanced treatments may be required:

• Rubber Band Ligation: A procedure where small bands are placed at the base of the haemorrhoid to cut off its blood supply, leading to shrinkage.
• Sclerotherapy: An injection therapy that helps shrink haemorrhoids.
• Coagulation: Infrared or laser treatment to reduce haemorrhoid size.

For severe or recurring haemorrhoids, surgery might be recommended:

• Haemorrhoidectomy:The most effective and complete treatment for large or recurring haemorrhoids.
• Stapled Haemorrhoidectomy or Stapled Haemorrhoidopexy: It is a less invasive option, 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.

Treatment for Irritable Bowel Syndrome (IBS) typically involves 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.

Depending on your specific symptoms, certain drugs may be prescribed to:

• Anti-diarrheal drugs to ease diarrhea via reduction of muscular contraction and secretion of fluids in the intestine, while increasing rectal muscular tone.
• Antibiotics to Decrease overgrowth of bacteria.
• Medications to increase fluid secretion in small intestines to help bowel movement.

The most effective treatment for this diverticulitis typically involves dietary improvements and, in some cases, 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 primary treatment for colorectal cancer is usually surgery to remove the cancerous tissue. Additionally, 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 to treat GERD. Drastic measures include surgery, and procedures such as those 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.
• Insertion of a LINX device, a string of magnetic beads, around the stomach, allowing for the magnetic elements of the beads to draw the junction closer together yet still enable food to move through.

Diverticulitis occurs when small pouches (diverticula) in the digestive system become inflamed or infected, typically in the colon.

Common Symptoms of Diverticulitis:

• Abdominal pain on the lower left side, starting mild and worsening
• Constipation or diarrhea (less common)
• Nausea, vomiting, and abdominal tenderness
• Fever and chills
• Rectal bleeding in some cases

Irritable Bowel Syndrome (IBS) is a digestive disorder that causes discomfort but does not affect bowel tissue or increase colorectal cancer risk.

Common Symptoms of IBS:

• Stomach cramps and pain, typically worse after eating and relieved after a bowel movement
• Diarrhea, constipation, or alternating between both
• Bloating, excess gas, and mucus in stool

Serious Signs to Seek Immediate Treatment:

• Unexplained weight loss
• Nighttime diarrhea
• Rectal bleeding
• Unexplained vomiting
• Iron deficiency anemia
• Persistent stomach pain even after a bowel movement

GERD occurs when stomach acid flows back into the oesophagus, causing irritation and acid reflux.

Common GERD Symptoms:

• Heartburn or burning sensation in the chest, often after eating and worsened at night
• Chest pain and difficulty swallowing
• Lump sensation in the throat and regurgitation of sour liquid or food

Nighttime GERD Effects:

• Laryngitis, chronic cough, and asthma
• Sleep disruptions

IBD includes chronic inflammatory disorders of the digestive tract, such as ulcerative colitis and Crohn’s disease. If left untreated, IBD can lead to severe, life-threatening complications.

Common IBD Symptoms:

• Diarrhea and blood in the stool
• Abdominal pain or cramps
• Fatigue, weakness, and loss of appetite
• Unintended weight loss

IBD symptoms vary based on the severity and location of inflammation. People with IBD may experience remission periods and flare-ups when the disease is active.

Haemorrhoids (or piles) are swollen veins in the lower rectum or anus, which can develop inside the rectum or around the anus.

Common Haemorrhoid Symptoms:

• Itching or irritation around the anus
• Swelling and bleeding
• Discomfort or pain near the anus
• Lumps around the anus
• Feeling of incomplete bowel movement after using the toilet
• Mucus on toilet paper or underwear

Seek immediate medical help if you experience heavy rectal bleeding, dizziness, or light-headedness.

Colon cancer begins in the large intestine and is part of colorectal cancer, which affects both the colon and rectum. While more common in older adults, colorectal cancer can develop at any age.

Common Symptoms of Colorectal Cancer:

• Changes in bowel habits, including diarrhea, constipation, or altered stool consistency
• Blood in the stool or rectal bleeding
• Abdominal discomfort (cramps, pain, or bloating) that persists
• A sensation of incomplete bowel emptying
• Unexplained weight loss and fatigue

Many individuals may not experience symptoms in the early stages, and symptoms can vary. Regular colorectal cancer screenings are crucial, especially for those with a family history or other risk factors.

Colonoscopy is a crucial procedure for maintaining digestive health and preventing serious gastrological conditions. At Gleneagles Hospital Kuala Lumpur, the 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 prioritise 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.

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.