Endoscopy Services

Endoscopy Services

Our clinic provides both diagnostic and therapeutic endoscopic procedures. Dr Ong is one of few paediatric gastroenterologists in Singapore accredited to perform gastroscopy and colonoscopy in children and adolescents. To ensure the best possible care, these procedures are performed in the endoscopy suite or operating theatre in the hospital. In addition, an anaesthetist experienced in paediatric care will be present to provide sedation and/or general anaesthesia to your child during the procedure.

Endoscopy Services

Our clinic provides both diagnostic and therapeutic endoscopic procedures. Dr Ong is one of few paediatric gastroenterologists in Singapore accredited to perform gastroscopy and colonoscopy in children and adolescents. To ensure the best possible care, these procedures are performed in the endoscopy suite or operating theatre in the hospital. In addition, an anaesthetist experienced in paediatric care will be present to provide sedation and/or general anaesthesia to your child during the procedure.

What is Gastroscopy?

Gastroscopy is a test to look at the lining of the upper gut (the swallowing tube or oesophagus, stomach, first part of the small intestine). We use a flexible telescope with a camera, which sends pictures to a screen.

Gastroscopy is a very common test for children and adults with gut problems. It helps us find out if there is a problem with the gut and sometimes we use it to check if the gut is getting better with treatment.

How is Gastroscopy performed?

While you are asleep, your doctor will pass a flexible telescope through the mouth, down the oesophagus and into the stomach. It is usually then passed into the first part of the small intestine (duodenum)

Why do I need this procedure?

Where you have symptoms suggesting possible problems in the upper or lower digestive tract, persistent vomiting, dysphagia (pain or difficulty in swallowing), heartburn, chronic acid reflux, unexplained weight loss or abdominal symptoms, or blood in the stool, your doctor may recommend an endoscopy to:

  • find out if your digestive tract is healthy or diseased
  • screen for ulcers, gastritis, inflammation of intestine, polyps or cancer in the upper digestive tract, and where necessary, take small tissue specimen (biopsy) for further investigation
  • carry out treatment (where possible) through the endoscope at the same examination

What does it involve?

Before the procedure, you must not have anything to eat for about six hours before the test. You are allowed to drink water till 4 hours before the test (or as instructed by your doctor).

You will be put into sleep under general anaesthesia or sedation by an experienced anaesthetist during the procedure. When you are asleep, a flexible telescope will be passed down through the mouth. Tissue samples (biopsy) may be taken for examination during the procedure.

Safety

Gastroscopy is a very safe procedure. Complications are rare.

However despite the best of intention, sometimes, problems do occur and they include:

  • Tear in the lining of the intestinal wall (surgery may be needed)
  • Bleeding from the procedure (rare complication)
  • Allergic reaction to the medication

What can I expect after the gastroscopy?

When you wake up from the anaesthetic you sometimes have a slight sore throat or a sore tummy. You can have some food and a drink as soon as you would like some. You will have to wait for three to four hours in the ward. After you have seen the doctor, you can usually go home.

What is Colonoscopy?

Colonoscopy is a test to look at the lining of the gut mainly the large bowel or colon. We use a flexible telescope with a camera, which sends pictures to a screen. It is a very common investigation for children and adults with gut problems. It helps us find out if there is a problem with the gut and sometimes we use it to check if the gut is getting better with treatment.

How is Colonoscopy performed?

While you are asleep, we will pass a flexible telescope up the back passage (anus) and slowly into the rectum and round the colon. We need to see the lining of the bowel clearly so there has to be no poo in the bowel.

Why do I need this procedure?

Where you have symptoms suggesting possible problems in the lower digestive tract, such as abdominal pain, unexplained weight loss, diarrhea or blood in the stool, your doctor may recommend a colonoscopy to:

  • find out if your digestive tract is healthy or diseased
  • screen for ulcers, inflammation of intestine, polyps or cancer in the digestive tract, and where necessary, take small tissue specimen (biopsy) for further investigation
  • carry out treatment (where possible) through the endoscope at the same examination

What does it involve?

Before the procedure, you must not have anything to eat for about six hours before the test. You are allowed to drink water till two hours before the test. If colonoscopy is recommended, we need to clear the bowel before the procedure. To help the bowel be clean you need to do three things:

  1. Stay in the hospital one day before the test.
  2. For two days before the test you have to eat a special low residue diet that does not leave bits in the bowel. You must also drink plenty of water or juice.
  3. On the day before the test we will ask you to take some laxative medicine. This medicine will make you go for a poo more often and make the poo watery.

It is very important that you take this medicine exactly as told because if your bowel is not clean, the doctors will not be able to do the test.

You will be put into sleep under general anaesthesia or sedation during the procedure. When you are asleep, a flexible telescope will be passed down up through the anus (colonoscopy). Tissue samples (biopsy) may be taken for examination during the procedure.

What are the precautions for colonoscopy?

Let your doctor know if you or your child are currently taking medications like Warfarin or antiplatelet agents, e.g. Aspirin, as these medications may have to be changed or stopped for one week prior to the procedure. This decision will be made by your doctor.

Safety

Colonoscopy is a very safe procedure. Complications are rare.

However, despite the best of intention, sometimes, problems do occur and they include:

  • Tear in the lining of the intestinal wall (surgery may be needed)
  • Bleeding from the procedure (rare complication)
  • Allergic reaction to the medication

What can I expect after the colonoscopy?

When you wake up from the anaesthetic you sometimes have a sore tummy. You can have some food and a drink as soon as you would like some. You will have to wait for three to four hours in the ward. After you have seen the doctor, you can usually go home.

Transit Study

Constipation is a common bowel problem in children. It refers to passing hard stools with difficulty, less frequently than normal. Several factors can result in constipation including lack of fibre and fluid intake in your child’s diet.

The transit study is a study of the motility (movement) of your child’s colon (large intestines).  This study is to check if the movement of stools in your child’s large intestine is normal or slow and evaluate the function of the bowel. Depending on the test results, the specialist will decide on appropriate treatment of your child’s constipation.

The study involves swallowing very small rings or markers. These rings can be mixed with food such as yoghurt or pudding for ingestion. After a few days of taking the markers, your child will need an X-ray. The rings are visible on X-ray. There are no risks involved with swallowing the markers as they are made of inert medical grade plastic material that will be passed out of your child’s body.

The colonic transit result will then be interpreted by your specialist to guide treatment for your child’s constipation.

Impedance pH Monitoring: Why It's Performed

Dr Ong may use a pH Impedance diagnostic test to evaluate your child's reflux. It measures the length of time it takes for your child’s stomach contents (acid or non-acid) come back up into his or her esophagus.

What To Expect

A thin and flexible catheter with an acid-sensitive tip is placed through the nose into the esophagus. Over a 24 hour period, the catheter measures how high the contents come up in the back of the throat. It can also tell if the stomach contents are acid or non-acid.

Minor reflux of stomach contents into the esophagus is normal, but if this happens frequently or for long periods of time, it may cause pain, vomiting or discomfort for the patient.

About Dr. Christina Ong

Senior Consultant
Paediatrician & Paediatric Gastroenterologist

“Dr Christina Ong is a senior consultant paediatrician and paediatric gastroenterologist. Her clinical expertise includes management of children with gastrointestinal conditions as well as performing endoscopic procedures. As an experienced paediatrician with more than 20 years clinical experience, she also specialises in treating children with general medical conditions”

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