Colonoscopy Screening in Singapore: Importance, Preparation and What to Expect

Colorectal cancer is one of the significant health concerns affecting adults in Singapore. It can develop gradually, sometimes without noticeable symptoms during its early stages. This makes regular screening important, particularly for individuals who meet recommended age or risk criteria.

A colonoscopy is an important examination that allows a doctor to inspect the inner lining of the large intestine and rectum. It can identify abnormal growths, including polyps, and allow certain abnormalities to be removed or sampled during the same procedure.

Understanding how colonoscopy works, who may need it and how to prepare can help individuals make informed decisions about their digestive health.

What Is a Colonoscopy?

A colonoscopy is a medical procedure used to examine the colon and rectum using a thin, flexible instrument called a colonoscope. It has a small camera and light at its tip, allowing the doctor to view the bowel lining on a monitor.

The examination helps identify abnormalities such as:

• Colon polyps

• Colorectal cancer

• Inflammation and ulcers

• Diverticular disease

• Sources of unexplained rectal bleeding

• Changes associated with inflammatory bowel disease

If a polyp is discovered, the doctor may be able to remove it during the examination. Tissue samples can also be collected for laboratory analysis when necessary.

This makes colonoscopy useful for both screening and investigating existing symptoms.

Why Is Colorectal Cancer Screening Important?

Colorectal cancer can develop from certain types of polyps over several years. These growths are often harmless initially, but some can gradually develop into cancer.

Screening helps identify abnormalities before they progress or cause noticeable symptoms. Removing suitable precancerous polyps can also reduce the likelihood of colorectal cancer developing.

According to Singapore's latest screening recommendations, average-risk individuals should begin colorectal cancer screening from age 50. Depending on individual circumstances, screening options may include annual stool-based testing, such as the faecal immunochemical test (FIT), or colonoscopy.

People with a higher risk may require earlier or more frequent assessment. A family history of colorectal cancer, previous polyps and certain inflammatory bowel conditions can influence screening recommendations.

It is important to discuss the appropriate screening method and interval with a doctor rather than assuming everyone requires a colonoscopy at the same frequency.

Who Should Consider a Colonoscopy?

A colonoscopy may be recommended for routine screening or to investigate symptoms that require further examination.

1. Individuals Aged 50 and Above

Age is an important risk factor for colorectal cancer. Individuals aged 50 and above should discuss suitable screening options with their healthcare provider, even if they feel healthy.

2. People With a Family History of Colorectal Cancer

A close family history, particularly involving a parent, sibling or child, may increase an individual's risk. Depending on the relative's age at diagnosis and other factors, screening may need to begin earlier.

3. Individuals With a History of Colon Polyps

People who have previously had polyps removed may require follow-up colonoscopies. The recommended interval depends on the number, size and type of polyps identified.

4. People With Persistent Digestive Symptoms

A diagnostic colonoscopy may be recommended when someone experiences:

• Blood in the stool or rectal bleeding

• Persistent constipation or diarrhoea

• Unexplained abdominal discomfort

• Changes in bowel habits

• Unexplained iron-deficiency anaemia

• Unexplained weight loss

These symptoms do not necessarily indicate cancer, but they should be evaluated by a medical professional. Screening tests such as FIT should not replace diagnostic assessment when concerning symptoms are present.

How Does a Colonoscopy Work?

A colonoscopy generally takes around 30 to 60 minutes, although the duration depends on the examination and whether additional procedures are required.

The process usually involves several stages.

1. Consultation and Assessment

The doctor reviews the patient's medical history, symptoms, medications and screening requirements. This helps determine whether colonoscopy is appropriate and whether any additional precautions are necessary.

2. Bowel Preparation

The colon must be cleared of stool before the procedure. Patients are given specific dietary instructions and prescribed bowel-cleansing medication.

3. Sedation or Anaesthesia

Sedation or anaesthesia may be administered to improve comfort during the examination. The appropriate approach depends on the patient's medical condition and the clinical team's assessment.

4. Examination of the Colon

The colonoscope is gently inserted through the rectum and guided through the large intestine. The camera transmits images to a monitor, allowing the doctor to inspect the bowel lining.

5. Removal of Polyps or Tissue Sampling

If suitable polyps or suspicious abnormalities are identified, they may be removed or sampled during the same procedure.

6. Recovery and Results

After the examination, patients are monitored in a recovery area until they are ready for discharge. The doctor discusses the findings and explains whether further investigations or follow-up appointments are required.

Preparing for a Colonoscopy

Proper preparation is essential because the doctor needs a clear view of the bowel lining. Inadequate bowel cleansing can make it difficult to identify smaller polyps or other abnormalities.

Preparation instructions vary, but commonly include the following:

Several Days Before the Procedure

• Follow the recommended dietary changes.

• Reduce high-fibre foods if instructed.

• Inform the doctor about existing medical conditions.

• Review medications, particularly blood thinners, diabetes medication and iron supplements.

• Follow any individual preparation instructions.

The Day Before the Procedure

Patients are generally advised to follow a clear-liquid diet for a specified period and take the prescribed bowel preparation medication.

The medication causes frequent bowel movements to clear the colon. Drinking appropriate clear fluids helps maintain hydration during this process.

On the Day of the Procedure

Follow the clinic's instructions regarding fasting, medication and arrival time. Do not independently stop prescribed medication unless the doctor has advised you to do so.

Following the preparation instructions carefully improves the quality of the examination.

Are There Any Risks Associated With Colonoscopy?

Colonoscopy is a commonly performed procedure, but it is not entirely risk-free.

Possible complications include:

• Bleeding, particularly after polyp removal

• Perforation or a small tear in the bowel wall

• Reactions or complications associated with sedation or anaesthesia

• Abdominal bloating or temporary discomfort

• Incomplete examination if bowel preparation is inadequate

Serious complications are uncommon, but patients should understand the potential risks before proceeding.

After the procedure, severe abdominal pain, heavy bleeding, fever or dizziness should be reported to a healthcare professional promptly.

Choosing a Colonoscopy Specialist in Singapore

When selecting a clinic, patients should consider the specialist's qualifications, endoscopy experience, diagnostic facilities and approach to follow-up care.

Continuity is also valuable. Having the same specialist involved in consultation, examination and discussion of results can make it easier to understand the findings and plan further treatment when necessary.

Colonoscopy screening with Advanced Colorectal, led by Dr Leong Quor Meng, provides patients with access to specialist colorectal assessment and diagnostic endoscopy in Singapore.

Dr Leong Quor Meng is a general and colorectal surgeon with more than two decades of clinical experience. His background includes diagnostic and therapeutic colonoscopy, as well as minimally invasive colorectal surgery. According to the clinic, he has performed more than 10,000 endoscopic procedures.

Advanced Colorectal and General Surgery offers colonoscopy for routine screening and investigation of symptoms. Where clinically suitable, the practice also provides same-day consultation and colonoscopy arrangements.

The clinic is based at Mount Alvernia Hospital in Singapore. Patients can discuss their screening needs, preparation requirements and available appointment arrangements with the medical team.

Understanding Colonoscopy Results and Follow-Up

After the examination, the doctor explains whether the colon appears normal or whether any abnormalities were identified.

If polyps have been removed, their samples may be sent for laboratory examination. The results help determine whether further treatment or an earlier repeat colonoscopy is necessary.

A normal result does not mean everyone requires the same follow-up interval. The next screening date depends on factors such as personal risk, examination quality and previous findings.

Patients should follow the specialist's recommendations and keep records of their colonoscopy reports for future reference.

Making Colorectal Screening a Priority

Colorectal cancer screening is an important part of preventive healthcare, particularly for adults approaching or above the recommended screening age. Colonoscopy allows direct examination of the large intestine and can identify abnormalities that may otherwise remain unnoticed.

For individuals considering Colonoscopy screening with Advanced Colorectal, led by Dr Leong Quor Meng, a consultation can help establish whether the procedure is appropriate and what preparation is required.

By understanding personal risk factors, following screening recommendations and seeking medical advice when symptoms arise, individuals can take practical steps towards protecting their long-term colorectal health.