Oesophago-gastro-duodenoscopy (OGD)
Oesophago-gastro-duodenoscopy (OGD) is a procedure that allows a doctor to examine the lining of the upper digestive tract. The upper digestive tract includes the oesophagus (gullet), stomach and duodenum (the first part of the small intestine).
The common indications for OGD include persistent or recurrent upper belly pain, swallowing difficulty, persistent ‘acid reflux’ symptom, having black stool or bloody vomit, or weight loss without any obvious reason. Conditions such as inflammation and cancer of the gullet, gastric or duodenal ulcers, bacteria infection and cancer of the stomach can usually be confirmed on OGD.
During the procedure, a thin tube with an attached camera and light source will be introduced through the mouth and down into the stomach and duodenum to examine the lining of the upper digestive tract. Samples of tissues can be taken for further testing under the microscope.
A mouth spray will be given to numb the throat before the procedure. OGD can be carried out with or without additional sedation.
Colonoscopy
Colonoscopy is a procedure that allows a doctor to examine the lining of the entire large intestine. The common indications for colonoscopy include change of bowel habit (such as constipation, diarrhoea, bloody stools), persistent belly pain, or weight loss without any obvious reason. Conditions like colonic polyps (fleshy growth on the lining of the colon which may turn into cancer if left untreated), cancer of the large intestine or infection and inflammation of the large intestine can usually be confirmed on colonoscopy.
During the procedure, a thin tube with an attached camera is introduced through the anus. The doctor will then advance the tube into the large intestine until it reaches the last part of the large intestine called ‘caecum’. The lining of the entire large intestine will be examined. Colonic polyps can be removed if they are found, and samples of intestinal tissues can be taken for further testing under the microscope if needed.
Sedation and pain killer will be given to help you relax and reduce the discomfort during the procedure.
Flexible Sigmoidoscopy
Video Capsule Endoscopy
Video capsule endoscopy (VCE) is a test that allows a doctor to examine the lining of the small intestine (middle part of the digestive tract). The most common reason for doing VCE is to look for a cause of bleeding from the small intestine. It may also be useful for detecting polyps and tumours of the small intestine.
During the test, you will be given a pill sized video camera to swallow. The camera has its own light source and can take images of the small intestine as it passes through. These images are sent to a small recording device worn by the patients for approximately 8 hours. The doctor can then view these images and examine the lining of the small intestine.
Most patients consider the test comfortable and the capsule camera will be eliminated in the stool.
CT Colonography
CT colonography is a test that uses a CT scanner (special X-ray imaging test) to produce images of the lining of the large intestine. For the patients who decline or are not suitable for colonoscopy, this test can be used instead to help detect colonic polyps (fleshy growth on the lining of the colon which may turn into cancer if left untreated), colonic cancer and other bowel conditions.
Urea Breath Test
Urea breath test (UBT) is a test used to identify Helicobacter pylori (H. pylori) infection. H. pylori are bacteria (germ) that can cause the infection of the stomach and duodenum (the first part of the small intestine). In some patients, H. pylori infection does not lead to any problem or symptom. But in others, it may cause gastric or duodenal ‘ulcers’ (sores) on the lining of the stomach or duodenum. H. pylori have been linked to the development of stomach cancer and lymphoma.
This test takes a total of around 15 minutes to complete with minimal discomfort experienced by patients.
Lactose Breath Test
Lactose breath test is a test to confirm ‘lactose intolerance’. It is a condition in which the body has difficulty in handling lactose. People with this condition may get diarrhoea, belly pain and bloatedness after drinking milk or taking other dairy products. Some people are born with a tendency to develop lactose intolerance, whereas others may get it as a result of the infection of digestive tract. The treatment is simply to avoid lactose containing drinks or foods.
Glucose Breath Test
Glucose breath test is a test to diagnose small intestinal bacterial overgrowth (SIBO). SIBO is a condition in which abnormal species of bacteria proliferate in large number in the small intestine. Patients may have belly discomfort, excessive gas, loose stools and weight loss. The common causes include intestinal muscle or nerve disorders associated with diabetes, small intestinal diverticulosis (small pouches on the intestinal wall), intestinal obstruction and surgically created blind loop.
Liver Biopsy
A liver biopsy is a procedure that involves getting a small piece of liver tissue for further examination under the microscope. It is usually done to diagnose and monitor certain liver conditions such as cirrhosis (scarring of the liver) or inflammation of the liver which can be due to various causes.
During the procedure, the patients will lie on a couch on their back. The skin over the liver is cleaned with antiseptic. Some local anaesthetic is then injected into a small area of skin and tissues over a part of the liver. A special needle will then be pushed through the skin into the liver and a small sample of liver tissue will be taken.
A liver biopsy is a very safe procedure. The most common problem is mild pain at the biopsy site. More serious complications such as bleeding, infection and injury to the nearby organs are rare.
CM YEO GASTROINTESTINAL & LIVER SPECIALIST CLINIC
38 Irrawaddy Road #11-57 Mount Elizabeth Novena Hospital Specialist Centre Singapore 329563