“Keep Your Gut Well – Improve Your Colon Health”

Dr Kam Ming Hian, Visiting Consultant​ from the Division of Surgical Oncology at National Cancer Centre Singapore,​ gives detailed answers to your questions.

Question by anonymous

I’m a DVT (deep vein thrombosis) patient, with pacemaker implant. I’m taking warfarin. I have heavy bleeding in my stools and was told to go for colonoscopy. Does colonoscopy interfere with a pacemaker? Can colonoscopy cause internal bleeding?

Answered by Dr Kam Ming Hian Visiting Consultant Department of Colorectal Surgery Singapore General Hospital

Colonoscopy per se does not interfere with a pacemaker. However, if an electrical current is passed during snare removal of a polyp, this may cause problems to the pacemaker. It is routine to ask for an alteration of pacemaker settings before colonoscopy and to revert to the original settings after the scope is done. There is a small risk of bleeding with colonoscopy. This risk is usually higher for patients on warfarin, who may require alternate forms of anti-coagulation for colonoscopy.

Question by anonymous

What is the difference between cysts and polyps? Can cysts be found in the colon? Can cysts become cancerous?

Answered by Dr Kam Ming Hian Visiting Consultant Department of Colorectal Surgery Singapore General Hospital

Cysts are fluid-filled sacs while polyps are abnormal growths of tissue protruding from the mucosa (inner lining) of the intestines. Cysts can occur in the colon but these are very rare. Most colonic cysts are benign but some rare cancers have been reported.

Question by​ anonymous

I used to have bloody stools on a daily basis, so I went for a colonoscopy and gastroscopy. I was cleared of polyps and had my piles taken care of using the rubber band method. I was given medication for inflammation of the stomach wall. One year later, my bleeding has resumed. I noticed that the bleeding stops when I eat more leafy vegetables and recurs when I don't. Is there a link?

Answered by Dr Kam Ming Hian Visiting Consultant Department of Colorectal Surgery Singapore General Hospital

The bleeding may be due to piles. With a high fibre intake from vegetables, the passage of stool is usually easier. There is less straining and less likelihood of bleeding from piles. However, even with treatment, piles can recur. Other possible causes of rectal bleeding include anal fissures, diverticular disease and colorectal cancer. If bleeding persists, I would suggest a consultation with a medical professional.

Ref: U11