Gastroenterology Services | Meet the Best Gastroenterologists in Penang

Colorectal cancer includes cancers of both the colon and rectum, often beginning in the large intestine (colon) or the rectum, which forms the final section of the digestive tract. While it’s more common in older adults, colorectal cancer can develop at any age.

• Change in bowel habits – Persistent diarrhea, constipation, or changes in stool consistency.
• Blood in stool or rectal bleeding – May appear as bright red or dark blood.
• Abdominal discomfort – Cramps, pain, or gas that does not subside.
• Incomplete bowel movement – A feeling that your bowel doesn’t empty fully.
• Unexplained weight loss – Losing weight without changes in diet or activity.
• Fatigue and weakness – General feeling of low energy.

Some people may not experience symptoms in the early stages, and symptoms can vary by individual. Regular screening is the most effective way to detect colorectal cancer early, especially for those with risk factors like a family history of the disease.

These symptoms may vary in intensity and duration.

• Persistent diarrhea – Lasting more than four weeks.
• Abdominal pain – Frequent or chronic discomfort in the abdomen.
• Blood or mucus in stool – Presence of blood or a clear, slimy substance.
• Rectal bleeding – Bleeding from the anus.
• Chronic fatigue – Feeling consistently tired or low on energy.
• Unintentional weight loss – Losing weight without diet or exercise changes.

Hemorrhoids or Piles are swollen lumps in and around the anus that often improve on their own within a few days. However, certain treatments and preventative measures can help manage and reduce symptoms.

• Bright red blood after bowel movements.
• Itchy anus
• Feeling of incomplete bowel movement 
• Mucus on toilet paper or in underwear after wiping.
• Lumps around the anus 
• Pain or discomfort around the anus.

If symptoms persist or worsen, consult a healthcare provider for appropriate treatment options.

Irritable Bowel Syndrome (IBS) is a chronic condition affecting the digestive system, characterised by episodes of discomfort without causing changes to bowel tissues or increasing the risk of colorectal cancer. Symptoms can vary in intensity and may be triggered by food or stress, with some days being better than others.

1. Stomach Pain or Cramps – Often worsens after eating and typically relieved by a bowel movement.
2. Bloating – Persistent feeling of fullness and abdominal swelling.
3. Diarrhea or Constipation – May alternate, with diarrhea causing urgency and watery stools, and constipation involving straining or incomplete bowel movements.
4. Excess Gas (Flatulence) – Increased gas production, leading to discomfort.
5. Mucus in Stool – Presence of mucus without blood.
6. Nausea and Fatigue – General feelings of tiredness and occasional nausea.
7. Back Pain – Often associated with abdominal discomfort.

• Urinary issues, such as frequent urination or urgency.
• Bowel incontinence in severe cases.

While IBS typically involves manageable symptoms, certain signs may require immediate care:

• Unexplained Weight Loss
• Nighttime Diarrhea
• Rectal Bleeding
• Unexplained Vomiting
• Iron Deficiency Anemia
• Persistent Abdominal Pain 

If you experience these symptoms, consult a gastroenterologist for further evaluation and guidance on managing IBS.

Gastroesophageal Reflux Disease (GERD) occurs when stomach acid flows back into the esophagus, leading to acid reflux and irritation of the esophageal lining.

• Heartburn – A burning sensation in the chest, often after eating and typically worse at night.
• Chest pain
• Difficulty swallowing
• Sensation of a lump in the throat
• Regurgitation – Sour liquid or food coming back up into the mouth.

• Laryngitis
• Chronic cough
• Asthma symptoms
• Sleep disruptions

If you experience frequent or severe GERD symptoms, consult a healthcare provider for effective management options.

• Pain in the abdomen 
• Abdominal discomfort 
• Constipation or diarrhea
• Blood in stool
• Bloating

If an infection or inflammation occurs, this condition is known as diverticulitis, which may also cause:

• Severe, constant abdominal pain
• Fever (high temperature)
• Rectal bleeding or mucus discharge from the rectum

Colonoscopy is a 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.

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.

Stool analysis 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.

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

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 gastroenterology 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

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.

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 or procedures, such as Fundoplication may be recommended to tighten the muscle and prevent reflux by wrapping the top of the stomach around the lower esophageal sphincter.

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.

In order to treat this IBD condition, various drugs may be prescribed by your gastroenterologist 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.