Dr. CH Poh Digestive & Liver Clinic PTE. LTD.
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#09-46, Mount Elizabeth
Novena, 38, Irrawaddy Road,
Singapore 329563

Email : doctor@chpohgastroliver.com
Tel : +65 6694 6988, +65 6535 8833 (24 hours)
Fax : +65 6694 5510

© Copyright Dr. Poh Choo Hean 2018
REFLUX DISEASE EVALUATION

Reflux is common chronic condition that normally present with heartburn and regurgitation (sour and bitter taste in the mouth). It can also sometimes affect the sleeping pattern (interrupted sleep) and hence the wellbeing of patients.

Conventional endoscopy can be normal in up to 70% of the patients. Hence the above test is used to measure the acidity within the food pipe and how frequently acid/non-acid is moving into your gullet from your stomach. It is used to investigate patients with persistent reflux symptoms despite taking acid suppression medications. Moreover, it is also used to evaluate patients with chest pain (not due to heart disease), atypical symptoms like chronic cough and hoarseness.

HIGH RESOLUTION MANOMETRY (HRM)
HRM is used to assess the function of esophagus (food pipe). Manometry measures the strength and co-ordination of the contractions in the oesophagus during swallow. Usually performed for the following reasons:
a) Difficulty in swallowing
b) Heartburn/reflux
c) Chest pain

How Is Oesophageal Manometry Performed?
Nose is anaesthetised with topical anaesthetic spray and a small flexible tube is passed through the nose down the food pipe. The tube contains pressure sensors will be connected to a computer which records the contractions of the food pipe. Patient will be asked to swallow on around 10 occasions usually with small sips of water. The tests last about 10 minutes before the tube is removed.

Potential discomfort (uncommon):
• Nose bleed due to trauma to lining of the nose.
• Short, slight discomfort around throat area.
• Nausea or coughing.

CAPSULE ENDOSCOPY
Capsule endoscopy is a technology that uses a swallowed video capsule to take photographs of the inside of the esophagus, stomach, and small intestine. It is commonly used to investigate small intestinal bleeding and sometimes unexplained iron deficiency anaemia.
ENDOSCOPIC GASTROSTOMY FOR FEEDING

A percutaneous endoscopic gastrostomy (PEG) is a procedure for placing a feeding tube directly into the stomach with the assistance of an instrument known as an endoscope. The procedure is performed as a means of providing nutrition to patients who cannot take food by mouth because of underlying condition like stroke. Assessment is usually done prior to insertion to assess if PEG tube placement is suitable for patient.

GASTROINTESTINAL ENDOSCOPY DIAGNOSTIC

OGD (oesophageal gastroduodenoscope) – Gastroscopy is a common procedure performed to allow direct visualization of the upper gastrointestinal tract (food pipe, stomach and duodenum) using a flexible instrument through which a live image passes. A gastroscopy is performed to evaluate symptoms like difficulty swallowing, stomach or chest pain, nausea and vomiting and anemia (low blood count). It can also be used to control bleeding from food pipe, stomach or duodenal ulcer.

Colonoscope – Colonoscopy is an investigation to evaluate inside the large intestine. It is used to investigate symptoms like abdominal pain, blood in the stool, change in bowel habit and screening for colon cancer in those above 50 years of age or those with strong family history of colon cancer. Colonic polyps can be removed during colonoscope.

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