Ask a Colorectal Surgeon: Dr Teoh Tiong Ann from Mount Elizabeth (Orchard) Hospital Singapore

Ask a Doctor ForumCategory: General SurgeryAsk a Colorectal Surgeon: Dr Teoh Tiong Ann from Mount Elizabeth (Orchard) Hospital Singapore
dr. Teoh Tiong Ann asked 2 years ago
I am Dr Teoh Tiong Ann, Consultant Colorectal Surgeon and General Surgeon at Teoh Colon Rectum & General Surgery based in Mount Elizabeth (Orchard) Hospital Singapore. I specialise in the treatment of colon and rectal cancers, as well as anal conditions such as piles, fistulae (abnormal connections) and fissures (tears). I specialise in the treatment of colon and rectal cancers, as well as anal conditions such as Haemorrhoids (piles), key-hole Surgery for Gallstones, Appendix, Hernia and Colonoscopy and Gastroscopy and investigation of abdominal problems. I trained in General Surgery at the National University of Singapore and attained my fellowships from the Royal College of Surgeons of Edinburgh, UK and the Academy of Medicine of Singapore. I was subsequently awarded a Singapore Government Health Manpower Development Plan (HMDP) scholarship to pursue subspecialty training in colorectal surgery at the world-renowned Cleveland Clinic in Florida, USA. I am a founding member of the Endoscopic and Laparoscopic Surgeons of Asia and of the Society of Colorectal Surgeons in Singapore, and was a member of the American Society of Colon and Rectal Surgeons (ASCRS). Besides treating colon and rectal cancers, and anal conditions such as piles, I also perform keyhole surgeries such as gallstones, appendix removal, Hernia, Colon (large intestine) surgery, and endoscopic procedures such as gastroscopy and colonoscopy. Learn more about Mount Elizabeth Hospital here: https://patients.smarterhealth.my/hospital/mount-elizabeth-hospital-singapore/ Learn more about me here: https://patients.smarterhealth.my/specialist-doctor/teoh-tiong-ann/ I am excited to be here and I will be actively answering questions. Whether you've got questions about general, stomach, gallbladder, colorectal or pernianal surgery, ask me anything! === Want to ask a question? Submit your question at the bottom of this page. Don’t forget to include your name and email address to get notified when the doctor answers your question. Please also include your age and gender in your question to aid the doctor in providing you with an answer.
147 Answers
Achmad Sunarto Sabdo answered 2 years ago
Is it true that piles are incurable?
dr. Teoh Tiong Ann replied 2 years ago

Piles or hemorrhoids are natural structures in the anus that we all have. However, in some people, piles cause problems and symptoms. There are different degrees or severity of piles. Not all piles need to be treated and many can be left alone. Depending on the type of piles, there are different types of treatment and piles can be cured. However, piles can recur also if the patient does not change his or her lifestyle. I would suggest a consultation so that more accurate assessment of the piles can be made.

Many patients are afraid that piles eventually can become cancer. This is not true. However, it is important to see a doctor to make sure that the symptoms are due to piles. In some patients, further investigations are necessary to make sure that there is no other cause of the symptoms.

Thank You.

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Aditya Utomo answered 2 years ago
Doctor, my grandmother is 80 years old and she was diagnosed with a rectal tumor 6 months ago. Now she is having problems with her bowel movement. She complains about feeling so much pain every time she defecates, and she has to take laxatives to help. Should my grandma undergo surgery in her old age? Could taking too much laxatives be dangerous for her?
dr. Teoh Tiong Ann replied 2 years ago

Your grandmother should be seen by a Colorectal Surgeon as soon as possible. From your description of pain and difficulty in moving her bowels and the requirement to take laxatives, the tumor may be obstructing her rectum and she may need urgent treatment or surgery. If the tumor blocks the rectum completely then there will be obstruction and an emergency procedure may be necessary.

Age, as a single factor, does not mean that she should not have surgery. Many other factors are taken into consideration. I have performed surgery on 97 year old patients who have recovered. I urge you to bring her to a Colorectal surgeon to discuss the options available to her. Please do not be afraid purely because of age.

I would be happy to see her but, unfortunately, the present, and indefinite, travel restrictions due to the Covid virus do not make this possible and your grandmother also needs urgent treatment and cannot wait. Taking laxatives will not solve the problem.

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Sunarti answered 2 years ago
Doctor, my father who is 50 years old, has had haemorrhoids since 4 years ago. It used to get better without taking any medication. But as time goes by, it keeps recurring again and again. His doctor suggested a surgery. Can it be totally cured by having surgery? Is there any chance of recurrence?
dr. Teoh Tiong Ann replied 2 years ago

If the hemorrhoids are not too big, simple procedures like 'Rubber Band Ligation' may be performed. This procedure may be performed in the office without any need for anesthesia. There are also newer procedures like HET (Heat Energy Therapy for Hemorrhoids). This procedure, however, will require some sedation.

Simple procedures, however, can only be used for smaller hemorrhoids. Recurrence rates are also higher. However, the procedure is not major and recovery time is faster and with little pain.

Larger hemorrhoids require Surgical procedures like 'Excision Hemorrhoidecomy' where the hemorrhoids are surgically removed and 'Stapled Hemorrhoidectomy' where hemorrhoids are removed using a stapling device. Both these procedures require anethesia, either regional or general anesthesia. Recovery is also longer and ther is some associated pain and discomfort in the recovery phase. Although after surgery, there is a chance of recurrence, recurrence rates are reduced if good bowel habits are maintained. So there is a possibility of 'curing' hemorrhoids with surgery.

If your father has bleeding, as he is 50 years old, I would also recommend a Colonoscopy to exclude other causes of the bleeding and also for screening for Colorectal Polyps and Cancers.

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rayhan answered 2 years ago
Doctor, I am 26 years old. These two weeks I spotted blood in my feces. Not everyday though, maybe 3 times a week. But it is without pain, not even in my stomach. Do I need to be worried and see a doctor?
dr. Teoh Tiong Ann replied 2 years ago

If the blood is fresh red in color and you do not have any change in bowel habits and the stools are normal and you do not have a family history of Colon Cancer, it is likely that the bleeding is from either hemorrhoids or an anal fissure. Hemorrhoids may not cause any pain in the anal region. Anal fissures, however, are usually associated with pain in the anus on defecation.

However, it would be best that you consult a doctor and ensure that the doctor does an anal examination and proctoscopy. If no cause of the bleeding is found and if the symptoms persist, although the suspicion level is low given your age, I may consider advising a Colonoscopy to exclude other causes of bleeding.

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Ajeng Karina answered 2 years ago
Doctor, I have a 15 day old child. This morning when I gave him a bath, I noticed a hole above his anus. What is it, Doc?
dr. Teoh Tiong Ann replied 2 years ago

I do not see 15 day old children. Perhaps an opinion from a Paediatric Surgeon would be best.

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Ibu Rahmi answered 2 years ago
Hello Doctor, I had a normal birth 6 months ago. This past week, I think there are dregs in my urine and they are as smelly as stool. I read online that it might be an anal fissure. Is there any chance I tore my anus when I gave birth so my urine is contaminated with stool? What should I do?
dr. Teoh Tiong Ann replied 2 years ago

Can I confirm that you are experiencing fluid or something coming from your urine or vagina that smells like stool?

It is possible that you may simply have a urinary tract infection. This can be easily treated with antibiotics and drinking more water. You could also have a vaginal infection which is also easily treated. Your Doctor should be able to diagnose this.

However, if the symptom that you are feeling is a smelly discharge like stool from your vagina, I would encourage you to see a Colorectal Surgeon urgently. There is a rare condition called a recto-vaginal fistula where there is a connection between the rectum and vagina. This can occur in normal childbirth especially when the baby is big or there is a 'tear of the vagina' during delivery.

As stated, this a rare condition but you will need to be sure that you do not have this with your stated symptoms. Please see a doctor.

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Maryati answered 2 years ago
Doctor, I have been having haemorrhoids for these 2 years. It used to be cured by its own, but recently it hurts so bad, as if there is a piece of flesh stuck in my anus. Should I have surgery, or will herbal medicines help?
dr. Teoh Tiong Ann replied 2 years ago

There are different grades of hemorrhoids. Depending on the grade, type and your tolerance of symptoms of the hemorrhoids, there are different treatment options available. It is also important to see a doctor to make sure that it is only hemorrhoids and not something else. However, it is possible to ‘cure’ some hemorrhoids with appropriate treatment. I am not certain about ‘herbal medicines’ as there are also many different types of herbal medicines with different components. Some of these components may be harmful if they are not properly registered or prepared.

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Ika sulistiani answered 2 years ago
Doctor, my mother is 50. She complained that she can’t hold in her defecation when she coughs and laughs. Is this normal for someone who is 50?
dr. Teoh Tiong Ann replied 2 years ago

This sounds like ‘stress incontinence’. Stress incontinence is more common for the urine but it can happen for the anus, though it is less common. Your mother will need assessment and further tests including ‘Anorectal Physiology Studies’ and also a consultation with a Colorectal Surgeon and also a Gynecologist.

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Mardiono answered 2 years ago
Doctor, I am a 36 year old male and have anal fissure. I went for a surgery but it failed. What procedure should I undergo? I am not comfortable with this condition.
dr. Teoh Tiong Ann replied 2 years ago

This is a difficult question to answer without more information from you and also examining you. It would be best if you can be examined and then more information to your question can be provided. I would be most happy to see and examine you when the travel restrictions have been lifted. Thank you.

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panji answered 2 years ago
Doctor, I am 20 years old. Since I was in high school, there has been a lump in my anus and it has grown bigger now. That lump presses out when I defecate, and I have to push it back afterwards. It doesn’t hurt, but it bothers me. How to treat this, Doc?
dr. Teoh Tiong Ann replied 2 years ago

Thank you for your question.

It is likely that you have a hemorrhoid that is large enough and has prolapsed (come out). It could also be a skin tag or a fibroepithelial polyp. All these conditions are not serious. However, to be sure, I would have to examine you. With your young age, the suspicion of you having a serious condition is very low.

If it is a hemorrhoid, this can be left alone and observed. However, if it causes discomfort, then surgery may be required to remove it. If it is not too large, a rubber band ligation may be attempted, but it may not be successful if it is too large.

Please do see a doctor to confirm the diagnosis or please feel free to make an appointment to see me in Singapore when the travel restrictions are lifted.

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Alce Manuhuruapon answered 2 years ago
Good evening, Doctor. I have been having piles for 1 year. It also makes my breath short and makes me exhausted and cough. Please give me your explanation about my condition, Doc?
dr. Teoh Tiong Ann replied 2 years ago

Thank you for your question. ‘Piles’ or hemorrhoids do not usually affect your breathing or coughing or make you exhausted. Rarely, if you have a lot of bleeding from your piles and the hemoglobin (blood count) is low, it can cause tiredness, shortness of breath. But the haemoglobin would have to be very low and your hemorrhoids have bled a lot to cause that. You did not give your age, but you should see a doctor to find another cause of your symptoms and you should not assume that it comes from hemorrhoids. Heart conditions, lung conditions may all cause shortness of breath, exhaustion and cough.

If you have bleeding when you move your bowels, it may be important to make sure that the bleeding is not from another more serious cause. A Colonoscopy may sometimes be required to make sure that there is no other serious condition like a cancer present causing low hemoglobin and tiredness.

My advice is for you to see a doctor to find out what the cause of your symptoms are as It is not likely to be due to piles. This is unless the piles have been bleeding a lot, especially when you have defecation or a bowel movement.

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Bayu Mahendra answered 2 years ago
Doctor, is there any chance for the gallstones to recur after we undergo a surgery? I had a surgery to remove my gallstones, but now I feel pain exactly at the same spot. Please give your advice, Doc.
dr. Teoh Tiong Ann replied 2 years ago

Usually, surgery to remove gallstones is to remove the Gallbladder and not just the stones. The surgery is called a ‘Laparoscopic Cholecytectomy’ or common layman terms are ‘keyhole surgery to remove gallbladder and gallstones’ or ‘Laser Gallbladder or Gallstone removal’ even though we do not use lasers for this anymore.’ Thus, it is unlikely that there are still gallstones in the gallbladder as the gallbladder has already been removed.

However, sometimes, gallstones can recur in the bile duct. Bile duct stones will cause pain and jaundice (yellow skin) due to obstruction of the common bile duct.

You can go for a blood test and an ultrasound of the biliary system. The blood test are to check the liver enzymes and bilirubin. If the ultrasound is not clear, an MRCP (Magnetic Resonance Cholangio- Pancreatogram) can be performed. This is an MRI of the bile ducts.

If these tests do not show any bile duct stones or bile duct blockage, then you should do other tests to find another cause.

If the pain is epigastric in position, you may do a Gastroscopy (Endoscopy) to check the stomach. A CT scan may also be performed to check the pancreas and other organs nearby. If the pain is in the lower abdomen, you may also benefit from Colonoscopy.

I hope this answers your question. Please do feel free to ask more questions after you have undergone the tests. Thank You

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Laksmi Munawar answered 2 years ago
My husband went for a surgery for his hernia, but he still complains about having the pain and he said he also feels the pain when he urinates, and his urine flow is not smooth. Why is this Doctor?
dr. Teoh Tiong Ann replied 2 years ago

I assume that you are referring to an inguinal hernia. An inguinal hernia is a hernia in the groin and is the most common hernia in males. Hernia surgery or hernia repair is usually performed either by the conventional surgery or by a Laparoscopic Hernia Repair. Laparoscopic hernia repair uses smaller incisions and is also known as the keyhole hernia surgery repair. This is a very common surgery now. Presently, in most hernia repairs, whether conventional or laparoscopic, the surgeon will place a hernia mesh to do the repair. The hernia mesh is usually very soft and thin.

If the hernia surgery has recently been performed, I suggest that you ask your husband to observe it for now. You can ask him to do some simple stretching exercises. It may sometimes take about 2 to 3 months for the discomfort to get better after surgery. The pain when he is urinating may be due to scar formation. The bladder is situated quite close to the inguinal hernia site. After 2 to 3 months, the scar may soften and the pain will get better.

Unfortunately, about 20% of patients do feel some sort of long-term pain after hernia repair. The pain is usually mild, like a discomfort, but in a very small number of patients, it can be quite painful. This is especially after strenuous exercise or lifting heavy weights.

It will be useful to ask a doctor to examine him or obtain an ultrasound of the groin to check if there is a recurrent inguinal hernia. If there is a recurrent hernia, this may be repaired again by surgery. Thank you.

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Cindy answered 2 years ago
Hello Doctor. Why does my stomach cramp up if I bend over, even only for a few seconds? But after that, it will be normal again?
dr. Teoh Tiong Ann replied 2 years ago

This is an unusual symptom. I apologise but I am unable to answer your question with asking you more questions and examining you. It is likely that some other tests may be performed. If the pain is severe, I would recommend you to see a doctor and discuss the symptoms to see if further tests are necessary.

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juwita answered 2 years ago
Dear Dr Teoh. Can colorectal cancer be passed on genetically to grandchildren? My grandmother was diagnosed with colorectal cancer, but her children were not. However, I am worried about myself. My lower stomach hurts, especially if I stand up for too long or bend my body. It has been like this for around 2 months. Honestly, I am afraid to see a doctor knowing about the history of my grandmother’s condition. Please give me your advice, Doc. What are the signs of severe conditions that you think I must go and see a doctor?
dr. Teoh Tiong Ann replied 2 years ago

Colorectal Cancer can occur in anyone, even if they do not have any relatives with Colorectal Cancer. That is the reason why doctors recommend screening even for patients without any family history of Colorectal Cancer.

Screening means to do checks like stool tests or colonoscopy on patients who are well and do not have any symptoms. The usual recommendation is to have a colonoscopy by the age of 50 years old. For patients who have first degree relatives with colorectal cancer, the first colonoscopy is recommended when the patient reaches 40 years old and for it to be performed every 5 years.

For patients who have symptoms, it is best to consult a doctor/colorectal surgeon and further tests like a colonoscopy can be performed depending on the symptoms. In this scenario, the type of symptoms are more important than age.

Not all lower abdominal pain is die to colon cancer. It may be due to other causes. As your symptoms have already been present for 2 months, it is best to see a doctor or colorectal surgeon. Further tests can then be carried out. It is likely that a colonoscopy and CT scan can be performed depending on your symptoms, clinical examination and your age.

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Ilham N answered 2 years ago
What is the effective way to treat haemorrhoids, Doctor? Especially the type that occurs after eating spicy food.
dr. Teoh Tiong Ann replied 2 years ago

There are several ways to treat haemorrhoids depending on the size and type of haemorrhoids. A simple way is to avoid eating spicy food as it causes your symptoms! I am sure that you will not like my answer! LOL!!!

As there are different type of haemorrhoids, there are also different treatments available. Some treatments are simple and painless like injection sclerotherapy or rubber band ligation and can be performed in the office without any need for anesthesia.

Larger haemorrhoids may need surgery. There are also different types of surgery available. It would be best if I can examine you to explain what your options are. If the haemorrhoids do not bother you very much, they can also be observed without any need for treatment.

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Kia answered 2 years ago
Doctor, these few months I have problems in my bowel movement. If I eat something solid, the stool is a bit hard, I sometimes even have to force it out with my fingers. But if I eat something soft, like a bowl of porridge, the stool is easy to come out and is only finger-sized. The (small) size of the stool leaves me feeling dissatisfied, as if there is something obstructed and cannot come out. Why is this so, Doc?
dr. Teoh Tiong Ann replied 2 years ago

Thank you for your question. Change in diet may affect the type of stools. It is always important to drink adequate water also. A healthy diet comes with taking adequate fiber. Natural fiber can be found in vegetables, fruit, cereals. However, too much fiber is not advisable as the stools become hard and you may also feel ‘gassy’ and bloated’. The key is to eat everything in moderation. Drinking sweet drinks, tea or coffee is not a substitute for water and it is best that you drink water.
It is not good to use your fingers to force your stool out. You should try to stop doing this. It may cause local injury like tears and bleeding. If you get too used to doing this, you will also lose sensation.

You did not state your age. However, if you are 40 years old and above, it might be reasonable to undergo a colonoscopy to ensure that the recent change in bowel habits is not due to anything serious. The recent change of a few months and the feeling of ‘dissatisfaction’ of incomplete defecation are symptoms that need further investigation. The best method is a Colonoscopy.

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Utari answered 2 years ago
Doctor, my eldest brother is 69 years old and was diagnosed with colon cancer. He had chemotherapy. Now he is very weak and cannot eat normally because he is nauseous and vomits when he eats. Meanwhile, there is a thick yellow liquid coming out of his anus. Is this normal for a post-chemo colon cancer patient? Or is there any food we should give him to improve his digestion? Thank you for your answer doc
dr. Teoh Tiong Ann replied 2 years ago

Thank you for your question. I am sorry to hear that your brother has colon cancer. It would be better if I have more information to answer your question better. I am uncertain why he has this yellowish liquid but if your brother only had chemotherapy without surgery, it is possible that the yellow liquid could be from the Rectal Cancer. The nausea and vomiting could be due to the chemotherapy side effects. The oncologist can give him some medicine for this.

It is important for patients with cancer and those undergoing chemotherapy to have adequate nutrition. He will need to be able to eat nutritious meals. If he is unable to eat, dietary supplements can be given. Sometimes liquid meals like ensure can be given. For patients who really cannot tolerate any fluids or food, sometimes they can admitted for a short period of TPN. TPN is giving nutrition by a special infusion to build up strength until he can eat better.

On another note, it is very important for you and your other brothers and sisters to undergo a screening colonoscopy. When your brother’s children reach 40 years of age, they should also be encouraged to undergo a screening colonoscopy. First degree relatives (e.g. brothers, sisters, children) have an increased risk of developing colon cancer. So it is best to undergo Colonoscopy to look for and to remove colon polyps, if any are found. If colon polyps are found and removed, the risk of developing colon cancer may be reduced. You will also need to do a colonoscopy every 5 years to look for new colon polyps.

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Rukmana Trijaya answered 2 years ago
Doctor, what are the causes of gallstones? How to prevent and avoid it?
dr. Teoh Tiong Ann replied 2 years ago

Gallstones are quite common. Previously, doctors thought that Gallstones were caused by increased cholesterol, fat, hormone imbalances. However, nowadays, Gallstones are so common that we do not really know why some people have them. There is no sure way to prevent gallstones.

Many times Gallstones are only diagnosed when there is acute symptoms like epigastric pain. They can also be found incidentally when patients undergo an ultrasound for other reasons. Usually, if there are no symptoms (asymptomatic gallstones) they can be observed. However, if symptoms like pain develop, then surgery is recommended.

Surgery for gallstones is usually by ‘keyhole surgery’. The operation is called a Laparoscopic Cholecystectomy or Laparoscopic Removal of the Gallstones together with the Gallbladder. Because of the small incisions, patients recover quite quickly.

There are several remedies that you may read about on the internet. Many patients ask me if by taking olive oil and apple or grape juice the stones can disappear. This is not proven at all.

If you like to check if you have gallstones, you can have an ultrasound of the Gallbladder performed. However, if you do not have any symptoms, it might be a better option to observe it and undergo surgery only if you develop symptoms.

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Alimta Boekit answered 2 years ago
What are the symptoms of gallstones, Doctor?
dr. Teoh Tiong Ann replied 2 years ago

There are basically 4 types of presentations of Gallstones.

The first are patient with no symptoms. The Gallstones are diagnosed incidentally when an ultrasound is performed for other reasons. Asymptomatic Gallstones can be observed and surgery may not be necessary unless the patient develops symptoms.

A second type of presentation is biliary Colic. This is a severe sudden pain that occurs in the upper abdomen. Sometimes, the pain can radiate (move) to the right side and to the back. Some patients may mistake these symptoms for ‘gastric’. However, gastric pain (maag) is usually not as severe. It is bet to undergo an ultrasound if a patient has severe upper abdominal pain. Surgery with a Laparoscopic Cholecystectomy is recommended for this patient with biliary colic and the pain (colic) should be cured and should not happen again, unless there are additional stones in the bile duct.

A third type of presentation is upper abdominal pain and mainly on the right upper part of the abdomen. Sometimes there is fever and when an examination is performed the right upper quadrant of the abdomen is very tender. An ultrasound may show a swollen gallbladder with thickened walls and gallstones. This is named ‘Acute Cholecystitis’ or Acute Gallbladder inflammation. Surgery with a Laparoscopic Cholecystectomy is recommended for patients with acute cholecystitis (acute gallbladder inflammation) and the inflammation would be cured and should not happen again.

The last type of presentation is a patient who feels ‘indigestion’ especially when eating oily food. The patient may burp a lot also after a fatty meal. In patients with these symptoms, other checks like an Gastroscopy (endoscopy) should be performed to ensure that there is nothing wrong with the stomach. Usually, a trial of some ‘maag’ medicine would be given first. If tis does not improve the symptoms, surgery may be discussed. However, in this type of patients, Laparoscopic Cholecystectomy may not relieve the symptoms and the patient should be made aware of this.

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Budi Drajat answered 2 years ago
There is a lump in my anus. It doesn’t hurt but it disturbs my bowel movement. People say that if it was haemorrhoids, then it should be painful, and if it doesn’t hurt, it is likely a tumor. Is that right, Doctor? Is surgery the only solution?
dr. Teoh Tiong Ann replied 2 years ago

There are different causes of a ‘lump in the anus’. It is difficult for me to give you a good answer unless I see you and examine your anus. It could be haemorrhoids or sometimes it can be thickened skin.

However, not all haemorrhoids are painful. Many people have haemorrhoids which are not painful. It is also important to know that haemorrhoids that do not bother you may not need any treatment. It may not be necessary to have surgery.

However, I would suggest that you see a Colorectal Surgeon to get a proper diagnosis and ensure that this lump is not anything more serious.

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Mutia Zahra answered 2 years ago
What should I do to cure diarrhoea that has been ongoing for 3 days, Doctor? The last time there was blood in the stools. 
dr. Teoh Tiong Ann replied 2 years ago

Bleeding with diarrhea can arise from a few causes. You did not state your age.

If the blood is fresh red blood, the bleeding can be arising from hemorrhoids or an anal fissure. These occur as the diarrhea irritates the anal canal and the hemorrhoids and fissure may bleed.

If the blood is darker in color and mixed with the stools, then a source of bleeding from the Colon will need to be considered. There may be inflammation of the colon causing the blood. The commonest cause of inflammation is usually an infection like ‘food poisoning’ or ‘gastroenteritis’. Usually, the patient may also feel unwell with an infection and have other symptoms like fever and nausea

Blood that is mixed in the stools may also be a sign of bleeding from diverticuli or possibly a tumor.

If you are young, it is unlikely that there is a tumor.

My suggestion is that you should see a Gastroenterologist or Colorectal Surgeon for an assessment and let them discuss with you whether further tests like a Colonoscopy are required.

Thank You

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Leli Iskandar answered 2 years ago
Doctor, can a rectal tumor recur after surgery?
dr. Teoh Tiong Ann replied 2 years ago

Unfortunately, the answer to your question is Yes, rectal tumors/cancer can recur after surgery.

However, with careful pre-operative assessment, possible pre-operative radiotherapy and chemotherapy in some patients, and most importantly, an experienced Colorectal Surgeon performing the surgery, and with newer techniques in surgery, the recurrence rates have reduced from previously.

It is important to get an experienced Colorectal surgeon to perform the surgery, especially for rectal cancer. With experienced colorectal surgeons and a multidisciplinary team of oncologists and radiotherapists, many patients have been cured after treatment.

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Rediansyah answered 2 years ago
Good afternoon, Doctor. I like playing basketball. This week, I have been feeling a sudden pain in my lower abdomen, sometimes I can’t stand up because of it. Some say it may be due to hernia. They said people who jump a lot or lift weights are at risk of hernia. Is that true? But sometimes I don’t feel the pain all day.
dr. Teoh Tiong Ann replied 2 years ago

It is possible that with your intense activity like basketball, you may have strained some muscles. It may not necessarily be a hernia. As you have only had pain this week, maybe you can observe it first and you can take some pain-killers for the pain. You can also rest for a week from your basketball.

If the pain persists, it would be wise to consult a doctor. The doctor will examine you and see if there is a hernia present. Sometime, an ultrasound may be useful in helping to diagnose a hernia, but sometimes the results of an ultrasound may not be accurate. An examination by a surgeon is important.

When lifting weights, it is best to learn the proper technique of lifting weights. This will reduce chances of a hernia and muscle and back strains.

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mirna siregar answered 2 years ago
I feel pain in my stomach when I cough, the pain goes through my thigh. I googled and found an article about hernia femoralis. The article said this hernia is likely experienced by a woman, especially if she is obese. I am scared because I am fat, doctor. Is there any chance I have that problem? If so, should I undergo surgery? I am worried if I have to undergo surgery.
dr. Teoh Tiong Ann replied 2 years ago

Femoral Hernia are quite uncommon. Inguinal Hernia is the more common type of hernia and is situated in the groin or inguinal region. Usually, on examination, there is a swelling in the groin region or in the upper thigh near the groin crease. An ultrasound of the area may help to diagnose a hernia, inguinal or femoral.

There may be other causes of the symptoms that are not due to a hernia. It would be best to consult a doctor who can examine you and advise the necessary tests/scans to diagnose the condition.

Thank You.

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Yakobus answered 2 years ago
Hello doctor, these 3 days, I feel my bowel movement is not finished every time I defecate. My stomach hurts, but there is no stool that comes out anymore. It makes my stomach bloat and hard. Is this a sign of obstruction? Thank you
dr. Teoh Tiong Ann replied 2 years ago

Thank You. You did not state your age. If you are of an older age, this may be a serious symptom and I would suggest that you see a Colorectal Surgeon or Gastroenterologist for a consultation and an examination. The doctor may also advise you to undergo a Colonoscopy to ensure that there are no serious causes like a tumor.

However, if you were previously well without symptoms, and you are young, the cause is likely to be not serious. Many people experience some constipation or change in bowel habits from time to time. However, it may be best if you went for a consultation with a doctor.

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Fikri Ariansyah answered 2 years ago
I am 22 years old. I am experiencing white pus coming out of my anus and it itches and hurts a bit. Along with this, I feel pain on my back and on the right side of my stomach. Now, there is a small growth near the anus. How to treat this, Doc?
dr. Teoh Tiong Ann replied 2 years ago

Thank You. From your description, I think that you may have an Anal Fistula. This is a discharging nodule with a path that leads into the anal canal. The usual treatment for Anal Fistula is surgery. However, it is important to ensure that it is properly assessed and performed by an experienced Colorectal Surgeon. There is a chance of recurrence and sometimes some degree of loss of control of the anus if the surgery is not properly performed. Some fistula are situated ‘higher up’ in the anal canal and surgery even by the most experienced colorectal surgeon may result in recurrence.

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Pratiwi Nurendah answered 2 years ago
Doc, I have haemorrhoids that produce fresh blood when I defecate. The pain radiates to my butt. Is there any suggestion as to how to treat this condition, Doc? I am a 56 year old male.
dr. Teoh Tiong Ann replied 2 years ago

At 56 years old, it is important to ensure that the bleeding is not due to more serious conditions. You are encouraged to undergo a Colonoscopy, both to look for other causes of the bleeding and also to screen for Colon Polyps and Cancer. With the pain on defecation, it is possible that you may have an anal Fissure rather than haemorrhoids. Patients with Anal Fissures experience quite some pain on defecation. A Colorectal Surgeon can examine you and diagnose a fissure. The treatment for fissures is different for haemorrhoids. Thus it is important to get an accurate diagnosis so that the appropriate treatment can be given.

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Gilang Anshari answered 2 years ago
Good evening, Doctor. I have been feeling pain in my stomach these past two days. But when I defecate, there are only a few stools coming out, and the color is white, like chalk. Why is this so, Doc? I am a 28 year old male.
dr. Teoh Tiong Ann replied 2 years ago

Chalk (Pale) coloured stools may be a serious problem. It usually occurs in patients with obstructive jaundice. This is a situation when the bile ducts are obstructed and the bile that causes the usual colour of stools cannot flow into the intestines. I would suggest that you see a doctor for further investigations. A Liver Function Blood tests and an Ultrasound of the Liver and Bile ducts or a CT scan may be necessary.

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Fatmah answered 2 years ago
Hello doctor, I've been having bloody stools this last week, although I don’t feel any pain. Why is that so, Doc? What should I do? Thank you.
dr. Teoh Tiong Ann replied 2 years ago

You did not state your age. However, the commonest cause of painless blood during defecation are Haemorrhoids. If you are young, that will likely be the cause. However, if you are older, it would be important to make sure that the blood is not from any other more serious cause in the Colon and Rectum. You may wish to consult a doctor to see if further investigations are necessary.

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Vian nabil answered 2 years ago
Doctor, my father has a rectal tumor. His doctor suggested he undergo radiotherapy and chemotherapy, because he said my father’s tumor is stage 4. Is there any other solution doctor, besides chemo and surgery? My father doesn’t want to do chemotherapy and surgery.
dr. Teoh Tiong Ann replied 2 years ago

For Rectal Cancers, the main treatment is Surgery, Radiotherapy and Chemotherapy. Often, it is a combination of these three treatments. There are no other good options. Please speak to your father and encourage him to seek and accept the doctor’s advice. However, in stage 4, you should have a good discussion with the treating doctors to discuss risks, benefits, side effects and expectations of treatment.

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Bambang GH answered 2 years ago
Doctor, these past 3 days, there is liquid coming out of my anus, even when I don’t defecate. What disease is that, Doc? I don’t feel any pain, but the liquid is disturbing and smelly. I am 43 years old.
dr. Teoh Tiong Ann replied 2 years ago

This is an unusual symptom. If it is of small amounts, this may be due to an anal fistula. There may be a smelly discharge of pus from the fistula opening. I would suggest that you consult a Colorectal Surgeon for a more accurate diagnosis.

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Andika Restu answered 2 years ago
Doctor, I have haemorrhoids and if I defecate there is fresh blood. I feel the pain on my spine as well, radiating to my anus. Is there any way to treat this? I am 30 years old.
dr. Teoh Tiong Ann replied 2 years ago

It is possible that you have hemorrhoids or an anal fissure. Usually, hemorrhoids are not very painful but can cause some anal discomfort. Patients with an Anal fissure experience pain on defecation and bleeding. The pain feels like a tearing pain as the stools come through the anus. The treatment of anal fissures is different from hemorrhoids. It is important to avoid hard stools.

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Anindita answered 2 years ago
Good afternoon, Doctor. I am a 28 year old female. There is a growth in my anus - it was small but is growing bigger over time. I feel a throbbing sensation when I defecate. What treatment should I seek, Doc? Should it be a surgery? I feel uncomfortable and it hurts when I sit.
dr. Teoh Tiong Ann replied 2 years ago

It is possible that you may have a prolapsing haemorrhoid or an anal fistula. It is possible also that the growth is a skin tag that is associated with an anal fissure. Anal Fissures can cause quite a bit of pain when one defecates. You should consult a Colorectal Surgeon for an accurate diagnosis so that the appropriate treatment can be recommended. The treatment for these three conditions are different so it is important to get an accurate diagnosis.

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M. Darwis answered 2 years ago
This one month I have a problem defecating. Yesterday night I just realized there is a lump around my anus. Is this dangerous, Doctor? I am a 39 year old male.
dr. Teoh Tiong Ann replied 2 years ago

If the ‘lump’ occurred suddenly, it is possible that you may have thrombosed External Haemorrhoid. These are usually not serious and should get better by itself in a couple of weeks. It is also possible that there may be an abscess but abscesses are usually painful. You should consult a Colorectal Surgeon for an accurate diagnosis so that the appropriate treatment can be recommended.

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Mardiansyah answered 2 years ago
Doctor, my mother is 53 years old. She can’t hold her bowel movement. When she laughs hard or cries, the stool comes out. It is disturbing and uncomfortable. What is the cause of this condition, Doc?
dr. Teoh Tiong Ann replied 2 years ago

It is likely that she has some degree of Anal Incontinence. In women, this is commonly due to childbirth. She will need specialised assessment by a Colorectal Surgeon. There are several tests that should be performed. This will include a physical examination, Colonoscopy, Anorectal Physiology tests like manometry, Endoanal Ultrasound and nerve conduction studies. After these tests, a recommendation for appropriate treatment can be discussed. The treatment for Anal Incontinence can be difficult.

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Dila answered 2 years ago
Doctor, I am 40 years old and was diagnosed with stage-2 colon cancer. My doctor suggested me to undergo surgery, but I am afraid. Is there any other way?
dr. Teoh Tiong Ann replied 2 years ago

The best treatment for Colon Cancer is Surgery. Nowadays, if you have a good well trained and experienced Colorectal Surgeon, Surgery is performed very safely with good results. I perform most of the surgery with Laparoscopic Colorectal Surgery. This is using small incisions (lobang kunci) to do the colon cancer surgery. Because of the small incisions, patients recover faster and with less pain. It is also important to perform a radical operation to remove the tumour and the lymph nodes for best results. In present day, many Stage 2 Colon Cancers can be cured!

I would encourage you to follow your doctor’s advice and undergo surgery as it is your best chance for a cure. I would be happy to see you and advise you but the present Covid Travel restrictions do not allow travel into Singapore.

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Annissa Rachmawati answered 2 years ago
Doctor, my brother was diagnosed with anal fistula. He complained about pain in his anus and pus and blood coming out of it. Can he be totally cured? What is the proper treatment?
dr. Teoh Tiong Ann replied 2 years ago

Anal Fistula is a condition where there is an ‘origin or source or head’ which is usually located within the anal canal. The part that can be seen on the skin around the anus is the ‘tail’. It is important to get to the ‘head or source’ of the fistula. If the source is not dealt with, the fistula is likely to recur.

To treat a fistula, accurate assessment must be made. ‘Low fistula’ can be treated fairly easily. However, ‘high fistula’ are difficult to treat. If an endoanal ultrasound is available, it is a good guide to the type of the fistula.

The best treatment of an anal fistula is surgery. There are different types of surgery that can be performed, depending on the type of fistula. The most important factors that are taken into consideration when treating anal fistula are preserving continence (control of the anus) and reducing chances of recurrence.

Anal fistula can be cured with surgery, but the difficult or high anal fistula may be difficult to cure.

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Hijrah Nurani answered 2 years ago
A lot of blood comes out of my anus when I defecate and I have a stomach ache everyday. I also feel weak, nauseous, and vomit frequently. What treatment should I undergo? Can I be cured?
dr. Teoh Tiong Ann replied 2 years ago

The commonest cause of bleeding on defecation is hemorrhods. However, with the other symptoms that you describe like stomach ache, feeling weak, nausea and vomiting, it is very important to have a proper assessment by a Colorectal Surgeon or Gastroenterologist and undergo investigations like a Colonoscopy, Blood tests and possibly a CT scan. The bleeding may be due to more serious causes. Please see a Colorectal Surgeon or Gastroenterologist as soon as possible.

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Nadia answered 2 years ago
Doctor, why does my anus feel hot after defecating? I am a 32 year old female.
Evan Elvianto Solin answered 2 years ago
On June 2nd 2020 I had appendicitis, but the lower right abdomen and groin are still aching and painful when I engage in activities and thinking. I have consulted a neurologist and have gotten X-ray photos but the results are not clear.
dr. Teoh Tiong Ann replied 2 years ago

Did you have surgery for your appendicitis? Appendicitis is best treated with early surgery to remove the appendix. Usually, this can be performed with key-hole surgery. Laparoscopic Appendicectomy or Laparoscopic Removal of the Appendix is very commonly performed.

If you have had surgery already, it might be worthwhile to get a CT scan of the abdomen performed to see if there are any postoperative problems. A plain X-Ray is unlikely to provide useful information.

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Renata answered 2 years ago
Hello doctor. I am a 29 year old female. Every morning I have a stomach ache after breakfast, but there is only a little amount of stool. My stomach bloats because I have problems with my bowel movement. What should I do? Are there any tips to maintain good bowel movement habits?
dr. Teoh Tiong Ann replied 2 years ago

It is good to maintain good bowel movements. You do not need to move your bowels daily. However, if you have hard and dry stools, it is best that you change your diet.

It is good to drink adequate water and take adequate fiber in your diet. However, too much fiber is also not recommended. You can also look at the type of foods that make you bloat and avoid those foods.

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Wartono answered 2 years ago
Hi Doctor. I am 30 years old and have inflammation of the intestine. What should I do to get it fully cured? Are there any recommended foods I should consume?
dr. Teoh Tiong Ann replied 2 years ago

There are a few causes of inflammation of the intestine. The commonest cause is an infection. If the bacteria causing the infection can be identified, anti-biotics can be given to treat the inflammation.

However, there are some types of inflammation of the intestines that are not caused by infection. Two of the more types are Ulcerative Colitis and Crohns’ Disease. Treatment of these inflammatory bowel diseases need specialist treatment and special medication. You will likely need a colonoscopy to make a diagnosis. You are advised to see a Gastrointestinal Specialist for a proper assessment, diagnosis and treatment.

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Adib answered 2 years ago
Doctor, what should I do to treat a growth in my anus that makes my bowel movement painful? I am a 25 year old male.
dr. Teoh Tiong Ann replied 2 years ago

It is possible that you have an anal fissure. This is a tear in the lining of the anal canal. It is usually quite painful, especially when the stools are coming through the anus and the pain continues for a period after that. The growth may be a sentinel pile which is usually associated with an anal fissure. However, it is best to see a doctor for an accurate diagnosis and then the appropriate treatment can be advised.

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Husnaini answered 2 years ago
My father is 56 years old and has had a boil in his anal folds since 3 months ago. First, he complained about pain when he sat down. Is this dangerous? What should I do?
dr. Teoh Tiong Ann replied 2 years ago

A ’boil’ is an infection. If it has been present for 3 months, it is likely that he requires surgery. It is best to see a Colorectal Surgeon for a proper diagnosis and possible surgery.

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Heru answered 2 years ago
Doctor, what causes haemorrhoids? Can people who sit for too long have haemorrhoids?
dr. Teoh Tiong Ann replied 2 years ago

There is no definite cause for hemorrhoids. However, common associated factors are excessive straining during a bowel movement, hard stools, pregnancy and childbirth. Having a good bowel movement helps to reduce the incidence of hemorrhoids. Sitting for long periods may make the flare-ups of hemorrhoids worse.

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Nink gani answered 2 years ago
Doctor, I have a gastric acid reflux problem and chronic ulcer. Sometimes I have constipation, but on the other hand I also often have pain in my lower abdomen. My doctor said it is due to urinary tract infection. I have irregular menstruation that lasts only one day. I also have problems with my bowel movement - there's only a few pieces of stool but I defecate at a high frequency, and sometimes with pain in the vagina. There is vaginal discharge but not much, and it is not itchy or smelly. What disease could this be, Doctor? I've lost a lot of weight.
dr. Teoh Tiong Ann replied 2 years ago

From your description, you have symptoms of a few organ systems. I am unable to think of a condition that would have all the above symptoms. It would be best to consult a doctor for a proper assessment.

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Resihafsah answered 2 years ago
Doctor, I am 6 months pregnant but I have grade-3 haemorrhoids. I feel very uncomfortable when I defecate. My bowel movement is not hard, but after I pass motion, there is a lump coming out of my anus and it hurts so much because I have to push it back in. Now, I worry about defecating and I have constipation. Can I undergo haemorrhoids surgery while I am pregnant?
dr. Teoh Tiong Ann replied 2 years ago

Haemorrhoids are quite common during pregnancy. As the pregnancy progresses, the haemorrhoids may become worse. What you are doing by pushing the haemorrhoids back after defecation is the correct thing to do. It is best to use some gloves and lubricant like to do this as using your fingers may cause damage. Surgery is possible but it is best not to have surgery unless it is unavoidable for example if the haemorrhoids are thrombosed or infected. Sometimes, a few months after delivery, the haemorrhoids do become smaller and less troublesome.

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ratih answered 2 years ago
Doctor, I have hernia. Is it only curable by surgery? Or is there oral medicine I can take?
dr. Teoh Tiong Ann replied 2 years ago

The only treatment for a Hernia is surgery. No medication can cure this as it is a mechanical defect. However, hernia surgery is quite common and many patients can be cured. Hernia surgery can also now be performed by the ‘key-hole Hernia Repair’ or Laparoscopic Hernia Repair. With smaller incisions, recovery may be faster with less pain.

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Rustam Gofar answered 2 years ago
Hello Doctor. I have been experiencing a cramp in my stomach lately. My stomach bloats because I have problems with my bowel movement. What problem is this likely, doc?
dr. Teoh Tiong Ann replied 2 years ago

Your symptoms are not specific enough and there is not enough information for me to provide a reasonable answer. Various factors have to be considered. If you are older in age, if your symptoms are recent, if there are other associated factors, then it is important for you to see a doctor and undergo a proper consultation, examination and possibly further tests.

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Muhammad answered 2 years ago
I have a hernia. I'm 45 years old. My right scrotum seed is enlarged and when I press on it, the size goes back to normal. I've suffered this for 20 years. What is the solution?
dr. Teoh Tiong Ann replied 2 years ago

It sounds like you may have an inguinal hernia. This is reducible as it becomes normal sized when you press it. There is only one way to cure hernia and this is by surgery. Hernia Repair can be performed by key-hole or laparoscopic surgery. Laparoscopic Hernia repair is commonly done nowadays. Usually, the hernia is repaired with a mesh that is placed at the hernia defect in the inguinal region.

Some patients do not want surgery. Unfortunately, there is no medication to treat this. One of the dangers of having a hernia is a strangulation. This is when the intestine cannot be pushed back and when you press the scrotum, it will not become normal and it will be painful and swollen. This is when the hernia contents which could be intestines are stuck in the hernia and the blood supply to the intestines is reduced. The intestine may die. This condition requires urgent surgery and the surgery may have to be more major and more complicated than when it is performed when the hernia is not strangulated or ‘stuck’.

As you are still young, it is recommended that you consider surgery.

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Lim mung hai answered 2 years ago
How much does surgery for anal fistula cost?
dr. Teoh Tiong Ann replied 2 years ago

The cost depends on the type of fistula and the complexity of the operation. It is difficult to predict without seeing the patient.

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Maulana Fajri answered 2 years ago
Good afternoon, Doctor. My wife is 28 years old and has just delivered our first born. She's been complaining about the pain in her anus and about her murky urine. She said her bowel movement is not complete and she has lost her appetite. Please give us your advice.
dr. Teoh Tiong Ann replied 2 years ago

You should bring your wife to consult a Colorectal Surgeon. She could be suffering from an anal fissure or haemorrhoids that will cause pain. If your wife had an episiotomy, which is a cut at the vagina during Childbirth for bigger babies to be delivered, it is important to ensure that there is no infection of the wound and there is no tear into the anal sphincter. Another less common, but serious, possibility is a recto-vaginal fistula. This is a tear from the vagina into the rectum. Her urine should also be checked to ensure there is no urine infection.

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Yanto answered 2 years ago
Doctor, how do we treat constipation? I have not defecated for 1 week and my stomach aches and is hard. I am a 40 year old male.
dr. Teoh Tiong Ann replied 2 years ago

It is important to ensure that you do not have an intestinal blockage from other causes. You should consult a doctor to assess this. The doctor may require you to undergo further investigations like XRays, Scans and a Colonoscopy. If there is no other cause that is found, then you can take some steps to improve your bowel movements. Drinking adequate fluids like water is important together with adequate fiber. Excessive fiber is not good as it causes bloating. Natural fiber like vegetables and fruit is good. Fiber supplements can be purchased at the pharmacy. Try not to take medication like laxatives. If you have to, start with the most gentle types. Avoid strong laxatives as after a while, the strong laxatives may not work anymore and you will have to take increasing doses and it would still not work. It is best to seek a doctor’s assessment for advice.

It is also important to know, that many people do not have a bowel movement daily and some people move their bowels every 2 to 3 days and this is normal for them. However, it is important that the stools are not hard. Natural remedies are better than medication.

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Ajat sudrajat answered 2 years ago
Doctor, if someone has a distended stomach, does it mean his feces are obstructed in his colon? Is it dangerous to consume laxatives to normalize one's bowel movement in order to not have a distended stomach? What is the laxative you would recommend? Thank you
dr. Teoh Tiong Ann replied 2 years ago

A ‘distended stomach’ or ‘distended abdomen’ can be due to may different causes. Intestinal obstruction is just one of them.It is not common for feces to block a colon. Usually, there is another cause. Sometimes, it is just the feeling of being distended and it is not really distension when examined by a doctor or when investigations are performed. ‘Distended abdomen’ should be investigated especially in an older person. A good clinical history taking and examination by a doctor is important. After that some sort of scan and perhaps endoscopy like gastroscopy and colonoscopy.

As a general guideline, I feel that natural ways are better than laxatives. Taking a laxative is an easy way out but it may lead to being dependent on laxatives which is not good. Adequate fluid intake, a good diet and exercise is the best way.

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Chalida H answered 2 years ago
Doctor, my mother has been complaining lately about the pain in her stomach. She is 69 years old. When she was 40, she was diagnosed with colon inflammation. But at that time, she just took medications and eventually her condition got better. Sometimes the pain recurred, but if she let it be for 1-2 days, the pain would be relieved. It was only lately that she feels pain almost every day and is in quite a worrisome condition. Is this still related to her previous inflammation? Is there any chance for colon inflammation to turn into a more dangerous disease?
dr. Teoh Tiong Ann replied 2 years ago

It is unlikely that your mother’s present symptoms are due to what happened nearly 30 years ago. Her symptoms are recent and recent symptoms must be properly investigated, especially at her age. I would strongly recommend that you bring her for a proper consultation with a colorectal surgeon or a gastroenterologist. She would likely have to undergo some scans like a CT scan and Endoscopy like Gastroscopy and Colonoscopy. It is important to ensure that she does not have any serious condition causing the symptoms.

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Rizky Andriano answered 2 years ago
Doctor, my mother had a colon tumor 7cm from her anus. There are two tumors: one is as big as a corn kernel, the other is as big as a grain of rice. Her doctor suggested surgery and a stoma in her stomach. My question: are there any alternatives besides having a stoma, Doc?
dr. Teoh Tiong Ann replied 2 years ago

You must bring your mother to an experienced Colorectal Surgeon. I have not examined your mother to give an accurate diagnosis. However, at 7 cm it is possible to join back the rectum after removal of the tumor and avoid a permanent stoma. Often a temporary stoma is required and as smaller surgery is performed after a few months to close the stoma and the patient can pass motion through the anus after that. This operation of removing the rectal tumor can also be performed with laparoscopy. Laparoscopic Colorectal Surgery is now commonly performed.

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Pahlevi answered 2 years ago
Doctor, is a stomachache/stomach pain that spreads to the crotch normal for someone who had surgery for appendicitis? I had surgery a week ago and now my stomach hurts. I am a 29 year old male.
dr. Teoh Tiong Ann replied 2 years ago

It is common to have some sort of pain one week after surgery. However, it is best that you go back to see your surgeon to ensure that there are no complications from surgery.

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Antun Nugroho answered 2 years ago
Doctor, my left stomach hurts, to the point it sometimes makes my breath short. When I press on it, I feel something hard and eel-shaped. The pain sometimes radiates to the lower side of my left rib. Some people say it is intestinal inflammation. What should I do?
dr. Teoh Tiong Ann replied 2 years ago

You should consult a gastroenterologist or colorectal surgeon. It would be best if you undergo some tests like an ultrasound or CT scan of the abdomen and an endoscopy or gastroscopy and colonoscopy to ensure that there are no serious causes.

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Muskud answered 2 years ago
Doctor, when should someone undergo surgery for his/her piles?
dr. Teoh Tiong Ann replied 2 years ago

The treatment of piles is the treatment of tolerance of symptoms or it depends on how much the symptoms bother the patient. Some patients who have symptoms are not overly bothered by them and do not want surgery. This is possible and not wrong.

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Tinasuri JH answered 2 years ago
Can hernia recur after surgery?
dr. Teoh Tiong Ann replied 2 years ago

Hernia can recur after surgery. The reported recurrence rates range from 1% to 20%. As in all surgical procedures, it would be best to consult an experienced surgeon to perform the surgery. The common type of surgery performed nowadays is Laparoscopic Hernia Repair. This is the key-hole method where a few small incisions are made and a hernia mesh is used to repair the hernia. It is also important that the patient has adequate rest and restrain from carrying heavy weights and strenuous physical exercise for a few weeks after surgery to allow the wound to heal and for the repair to be strong. This can also help to reduce the recurrence.

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Wati Endah answered 2 years ago
Doctor, my mother’s stools are watery, and she always defecates after eating. I gave her medicines for diarrhoea but her condition persists. Please give me your advice on what happened to her. She is 68 years old.
dr. Teoh Tiong Ann replied 2 years ago

At 68 years old with recent bowel symptoms, it is important to get an accurate diagnosis and ensure that there are no serious conditions causing her symptoms. I would suggest that you bring her to consult a gastroenterologist or colorectal surgeon for assessment. She may require tests like blood tests, stool tests and a colonoscopy.

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Victor Pan answered 2 years ago
Doctor, my left stomach hurts so much and my bowel movement is hard and hot. Why is this so? I am a 32 year old male.
dr. Teoh Tiong Ann replied 2 years ago

At 32 years old, it is unlike that you have a serious disease. Chronic constipation is a relatively common condition. It usually arises out of poor habits. It is important to drink adequate water, have a healthy diet with adequate fibre, exercise regularly. It is also important not to hold your stool for too long as the stools will harden and it makes it more difficult to defecate after that. It is also best not to consume laxative medication. If your symptoms are recent, it would be better to see a gastroenterologist or colorectal surgeon to ensure that there are no other serious causes.

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Agill answered 2 years ago
I often find it hard to defecate, I feel a stomach ache, but when I go to the toilet I will be squatting for long durations of time but the feces does not emerge. I feel bloated because of this issue.  I can always hold back when I want to defecate, up to 12 hours. Do you know why and is it dangerous?
dr. Teoh Tiong Ann replied 2 years ago

Chronic constipation is a relatively common condition. It usually arises out of poor habits. It is important to drink adequate water, have a healthy diet with adequate fibre, and exercise regularly. It is also important not to hold your stool for too long as the stools will harden and it makes it more difficult to defecate after that. It is also best not to consume laxative medication. If your symptoms are recent, it would be better to see a gastroenterologist or colorectal surgeon to ensure that there are no other serious causes.

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mamad answered 2 years ago
I am a 39 year old male. I have suffered from haemorrhoids for a long time but in the past year, I had trouble defecating. There was a lump in my anus during defecation and I inserted it back in afterwards. The feces that came out were flat, sometimes dark brown. Could this possibly mean I have cancer?
dr. Teoh Tiong Ann replied 2 years ago

The symptoms that you describe suggest a prolapse of the hemorrhoids. This is when the hemorrhoids ‘pop out’ or ‘prolapse of the anus. Hemorrhoids do not affect the size of stools as hemorrhoids are usually soft and do not obstruct the anal canal. It would be best to consult a colorectal surgeon to examine your anus properly to find any causes of the change in calibre of the stools. You may require a colonoscopy to ensure that there are no other serious causes.

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Billy Pangestu answered 2 years ago
I had digestive problems, diarrhoea, blood in my feces, and am experiencing bloating and sudden weight loss for about 1 month. I’ve consulted with the doctor, and consumed some medicines but I’m not getting better. Does this condition usually require surgery?
dr. Teoh Tiong Ann replied 2 years ago

From the combination of symptoms as well as the one month history without any improvement, I strongly suggest that you consult a specialist like a gastroenterologist or colorectal surgeon for proper assessment and more tests. You may require blood tests, stool tests and a colonoscopy. Many conditions do not require surgery and can be treated with medication.

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Rima Marwanti answered 2 years ago

My anus itches after hemorrhoids surgery. Is this normal?

dr. Teoh Tiong Ann replied 2 years ago

It is common for itch after surgery while the surgical wounds are healing. Give it some time and it will get better once the wounds are fully healed.

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Sadam Farizzi answered 2 years ago

Good afternoon, Doctor. My anal canal is red and swollen, and there is a lump inside it. What is the cause? It hurts and it is uncomfortable.

dr. Teoh Tiong Ann replied 2 years ago

You may have hemorrhoids or an abscess. Both can be treated easily with surgery. Please consult a Colorectal Surgeon for advice.

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Dewi answered 2 years ago

Doc, my name is Dewi, 49 years old (female). I have piles and had undergone surgery once but it recurred. And then I treated it with ointment but it made me allergic, red spots appeared and made my anus itch. Lately the piles have been bleeding again. Should I undergo surgery again? But what if it recurs again? Are there any tips so it doesn’t recur after surgery?

dr. Teoh Tiong Ann replied 2 years ago

It is best that you have a proper assessment. If you are sensitive to the ointments, then you can consider other options like surgery or other procedures. It would be best to consult a colorectal surgeon to discuss your options. There many options available and even a repeat surgery may give you good relief of symptoms.

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Hendro answered 2 years ago

I am a 27 year old male. My stomach hurts after eating spicy foods, and I always defecate afterwards. But the stools are always a few and red. And it makes my anus feel hot. It is always like that. What is likely the cause, Doc? And is it true spicy foods cause appendicitis?

dr. Teoh Tiong Ann replied 2 years ago

Spicy foods can irritate the stomach and also trigger a bowel movement in some people. The spicy foods can also cause itch and irritation in the anus. My suggestion is to avoid spicy foods for a few weeks and see if your symptoms improve. If the symptoms improve, then you will know that it is the spicy foods that are the cause. With that knowledge, you can then make a decision of whether or not to avoid spicy foods or that if you enjoy your spicy foods, then you must be prepared to suffer and tolerate the symptoms.

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Mila answered 2 years ago

I am 31 years old. I have gallstones and my laboratorium test shows I have a high level of SGOT and SGPT. But I don’t feel any symptoms. I also get tired easily. What should I do, Doc?

dr. Teoh Tiong Ann replied 2 years ago

It would depend on how high the SGOT and SGPT levels are. Gallstones do not usually cause a high liver enzymes unless there is infection or there is blockage of the bile duct. The elevated SGOT and SGPT levels may be due to another cause. Gallstones also do not cause tiredness. It would be best to see a surgeon or gastroenterologist to make a proper assessment.

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Fran Ardinanto answered 2 years ago

When I strain while defecating, I feel the left side of my stomach, from my navel downwards, is hard and painful. When I stand up after that, it also hurts. I have to take a rest, sitting or lying down for a few minutes. Is this a sign of hernia?

dr. Teoh Tiong Ann replied 2 years ago

Usually, there is a swelling (or lump) associated with a hernia. This becomes more obvious when you are straining, coughing or standing up. This swelling also usually gets smaller or disappears (reduces) when you lie down. These are the typical signs of a hernia. It would be best to consult a surgeon to see if you actually do have a hernia. Most hernia can be repaired. Presently, a Laparoscopic Hernia Repair is performed. This is a ‘key hole’ surgery. It would also be best if you stop straining so hard when you defecate.

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Manda answered 2 years ago

Good afternoon, Doc. My little brother had surgery for appendicitis last month. Now, in that area, he feels pain again. And his feces is watery. What is the cause?

dr. Teoh Tiong Ann replied 2 years ago

There are some possibilities that I can think of. The pain can be the common post-operative pain from the wounds. This occurs when the patient is starting to get active. However, there are also more serious possibilities. One of the possibilities is a post-operative infection. Especially, in patients where the appendix was severely inflamed, there may be some residual inflammation/infection. Occasionally, there may be another cause of the original pain that has not been addressed.

The diarrhea can be because of prolonged use of antibiotics. This is an antibiotic associated diarrhea where the antibiotics have replaced the ‘good bacteria’ in the intestine allowing an overgrowth of ‘bad bacteria’.

As in any symptoms that occur after an surgery. It would be best to bring your brother back to see the surgeon who performed the surgery on him. This surgeon would be in the best position to advise you.

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Deddy Ramadhona answered 2 years ago

Doc, my mother was diagnosed with intestinal disease 7 months ago. She complains about pain in the stomach everytime she eats, and sometimes there is blood in her stools. She had undergone endoscopy and colonoscopy. The result shows rectal polyp. What is the good medicine for this?

dr. Teoh Tiong Ann replied 2 years ago

It would be best to provide more accurate report of her endoscopy and colonoscopy results. Pain after eating can sometimes be due to gallstones. An ultrasound of the Gall Bladder can easily be performed to check for gallstones. There are several causes of bleeding in the stools. Simple causes like hemorrhoids can cause bleeding. But it is important to make sure that there are no other causes. I assume that the rectal polyp has been removed in the colonoscopy. If the histology result shows a non-serious result, there should be no cause for worry. Depending on the exact result, a repeat colonoscopy may be required in a couple of years.

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Ardika Pratama answered 2 years ago

Doc, I want to ask. I have recurring constipation. When it recurs, I cannot defecate for around two weeks. Papaya juice with lemon usually helps. But when I don’t drink the juice, the constipation recurs again. Is it okay to keep drinking the juice? I am worried that the main problem is actually in my colon.

dr. Teoh Tiong Ann replied 2 years ago

Fruit juices like papaya and lemon can be consumed regularly. However, depending on your age, it may be a good idea to consult a colorectal surgeon or gastroenterologist to assess why you have constipation. If your constipation is of a recent onset, you may require further investigations like a colonoscopy.

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Riswanto answered 2 years ago

Doc, I had undergone surgery for my piles, but it recurs again and gets worse. The lump is stuck and cannot be pushed back in. Some people suggest that I undergo bipolar tech surgery. Can I still undergo surgery for the second time?

dr. Teoh Tiong Ann replied 2 years ago

If the piles recur, it is still possible to undergo surgery again. However, it is important not to remove too much anal mucosa as it may give rise to a scar and stricture. I am not familiar with a ‘bipolar tech surgery’. However, it sounds like using a bipolar forceps to cut the piles. This is just another mode of a surgical device but the basic principle remains – and that is not to remove too much anal mucosa. It would be recommended that you consult an experienced Colorectal Surgeon.

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Risdiyanto Eko answered 2 years ago

Doc, I want to ask. I have undergone surgery for piles but these 2 months I have been having liquid and mucus and sometimes blood discharge from my anus, like a watery stool and I cannot control it, especially when I fart. Please give me your explanation, Doc. Thank you

dr. Teoh Tiong Ann replied 2 years ago

The symptoms are not common symptoms. I would suggest that you consult a Colorectal Surgeon to examine you properly to get an accurate diagnosis. It is possible that the wound has not healed or there is another cause of the symptoms.

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Faiz answered 2 years ago

I have very painful hemorrhoids. I had surgery 3 years ago. Can I undergo surgery twice?

dr. Teoh Tiong Ann replied 2 years ago

Yes, surgery can be performed twice, if necessary. If the hemorrhoids are not too big, simple procedures like ‘Rubber Band Ligation’ may be performed. This procedure may be performed in the office without any need for anesthesia. There are also newer procedures like HET (Heat Energy Therapy for Hemorrhoids). This procedure, however, will require some sedation. Simple procedures, however, can only be used for smaller hemorrhoids. Recurrence rates are also higher. However, the procedure is not major and recovery time is faster and with little pain. Larger hemorrhoids require Surgical procedures like ‘Excision Hemorrhoidecomy’ where the hemorrhoids are surgically removed and ‘Stapled Hemorrhoidectomy’ where hemorrhoids are removed using a stapling device. Both these procedures require anesthesia, either regional or general anesthesia. Recovery is also longer and there is some associated pain and discomfort in the recovery phase. Although after surgery, there is a chance of recurrence, recurrence rates are reduced if good bowel habits are maintained. So there is a possibility of ‘curing’ hemorrhoids with surgery.

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Laeliana answered 2 years ago

What food is good for curing constipation?

dr. Teoh Tiong Ann replied 2 years ago

Chronic constipation is a relatively common condition. It usually arises out of poor habits. It is important to drink adequate water, have a healthy diet with adequate fibre, and exercise regularly. It is also important not to hold your stool for too long as the stools will harden and it makes it more difficult to defecate after that. It is also best not to consume laxative medication. If your symptoms are recent, it would be better to see a gastroenterologist or colorectal surgeon to ensure that there are no other serious causes.

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Santi answered 2 years ago

Hello, Doctor, I want to ask, my husband has been having constipation for a long time. He had undergone colonoscopy but there was no disease found. And then my husband took laxative. When the stools came out, there was blood in it and my husband complained about pain in his anus after defecation. Please give suggestions, Doc, is this normal? What should he do?

dr. Teoh Tiong Ann replied 2 years ago

It is possible that the bleeding is due to hemorrhoids or an anal fissure. Tis is due to straining and hard stools. He should drink adequate fluids and ensure that he does not have hard stools. If necessary, gentle laxatives like lactulose may help. It is best to avoid strong laxatives. Seek an opinion from a Colorectal surgeon.

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Nurandini answered 2 years ago

Good afternoon, Doc. I want to ask, does hernia come with cough and fever? There is a red lump on my husband’s stomach. It hurts him when he stands or moves. I worry about hernia. But he also has cough and fever. Please give me your answer, Doc.

dr. Teoh Tiong Ann replied 2 years ago

A hernia is a swelling through a defect in the abdominal wall. It usually does not come with fever and cough. A cough, however, may cause the hernia to protrude and get bigger. Your husband may have two different illnesses. He may actually have an abscess that needs urgent attention. It would be best to consult a surgeon to get an accurate diagnosis.

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Asra Anindito answered 2 years ago

My father has hernia. He is 63 years old. Currently he regularly undergoes dialysis. Is it safe for him to undergo hernia surgery?

dr. Teoh Tiong Ann replied 2 years ago

In view of his dialysis, this may not be a straightforward answer. If the hernia is strangulated or obstructed, surgery should definitely be performed. If the hernia is easily reducible, it would be best to consult a surgeon and you can discuss both the pros and cons of having surgery and the risks involved.

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Nurhasanah answered 2 years ago

I have gallstones, but they are small and only a few. I want to ask, Doc. If it is not severe, what can I do to reduce the size and the amount of them? I worry they will get bigger and more if I leave them untreated

dr. Teoh Tiong Ann replied 2 years ago

Gallstones that do not give symptoms or have never given pain or other symptoms are quite common. Many times, asymptomatic stones do not need to be treated unless there are symptoms. The size of stones is not important. In fact, small stones tend to give more problems than big stones. Small stones can travel out of the Gallbladder and cause blockage of the bile duct. This becomes more complicated to treat. It will then require two operations – An ERCP which is a special scope to remove Bile duct stones. This is followed by a Laparoscopic Cholecystectomy or Gallbladder removal using key-hole surgery to remove the Gall Bladder together with the stones. Gallstones cannot usually be cured with medicines alone.

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Meisy answered 2 years ago

Doc, can megacolon disease be cured so the patient doesn’t need to use stoma?

dr. Teoh Tiong Ann replied 2 years ago

Megacolon is not a common disease. There are a few different types of megacolon. If it is a toxic megacolon, the patient is very ill and needs emergency surgery. Many times a stoma may be necessary but this may sometimes be reversed when the acute illness has improved. There are patients with chronic constipation and megacolon. Surgery for these may not require a stoms.

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David answered 2 years ago

Lately I have been feeling my stomach twisting at night. I feel like wanting to defecate but the feces doesn’t come out. I am a 34 year old male. What should I do?

dr. Teoh Tiong Ann replied 2 years ago

There may be several reasons for these symptoms. What you have described is intestinal colic. This can be due to mild infections. However, mechanical causes like obstruction from adhesions may have to be considered if you have had surgery before. If you have the urge to defecate but no stools come out, you may require a colonoscopy. It would be best for you to consult a digestive surgeon.

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Ismarsiah answered 2 years ago

My name is Iis, a 48 year old woman. I have very big piles and it bleeds. It has been troubling me for 2 weeks. I have had surgery for piles before. Please give me information, Doc, what is the more effective surgery?

dr. Teoh Tiong Ann replied 2 years ago

Piles can sometimes recur after surgery. It would be best to consult a Colorectal Surgeon. Sometimes when it is inflamed, it can be treated with medication first. Surgery can be performed again even if you have had surgery before. The haemorrhoids need to be examined before accurate treatment options are discussed with you.

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Anton answered 2 years ago

I have been having diarrhea for 3 weeks. My stomach is hot and my anus hurts. Please give me your advice, Doc, what should I do? Is there any food I should avoid?

dr. Teoh Tiong Ann replied 2 years ago

Diarrhoea will irritate the anus due to the repeated usage. I would advise you to avoid oily food and spicy food. It is best to eat bland food like porridge for a few days until your diarrhoea gets better. You may also wish to try some probiotics. If your diarrhoea persists and your symptoms worsen, it is best to consult a doctor.

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Meta answered 2 years ago

Not only blood, there is also pus from my piles. It hurts, itches, and is smelly. Please give me your advice, Doc, what should I do to treat this? I have taken medicine but it doesn’t get better.

dr. Teoh Tiong Ann replied 2 years ago

It is possible that you have an anal abscess and an anal fistula. This may not be haemorrhoids. Anal abscess usually requires surgery for treatment. I would advise you to consult a Colorectal Surgeon for a proper diagnosis.

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Mesi answered 2 years ago

Doc, I am 22 years old and have 2 children. Three years ago, I had piles. I had surgery 3 weeks ago and it has been 3 days since the lump grew back. It is small. Should I undergo surgery again? Would a repeated surgery stop the piles from growing back?

dr. Teoh Tiong Ann replied 2 years ago

I would advise you to wait for a while and not rush into surgery. Sometimes after surgery, there is swelling that will get better after a few weeks without surgery before you decide your next course of action.

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Sri Wahyuni answered 2 years ago

Doctor, I have grade 3 hemorrhoids. My friend said grade 3 needs surgery. Is that true? If so, does this surgery have side effects? How long does it take to recover?

dr. Teoh Tiong Ann replied 2 years ago

The treatment of haemorrhoids is the treatment of tolerance of symptoms. If a patient has grade 3 haemorrhoids, and it does not bother him, no treatment is necessary. If the haemorrhoids do bother him, then he can consider surgery. There are a few surgical treatments available like a stapled haemorrhoidectomy or an excision haemorrhoidectomy. It is best to consult a colorectal surgeon and obtain the appropriate advice after he examines you.

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Rasmi answered 2 years ago

Doc, it has been almost a week since I have had difficulties defecating. Sometimes I feel weak and vomit. Why is this so, Doc? I am a 49 year old female

dr. Teoh Tiong Ann replied 2 years ago

The symptoms are very general. Constipation does not cause weakness. It is possible that you might have a mild infection. It would be best for you to consult a doctor so that the doctor can assess your symptoms and arrive at a proper diagnosis.

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Leyllanii answered 2 years ago

My father is 58 years old and it has been 3 days since he has blood in his stools. What is the medicine?

dr. Teoh Tiong Ann replied 2 years ago

Bleeding with a bowel movement can arise from a few causes. If the blood is fresh red blood, the bleeding can be arising from hemorrhoids or an anal fissure. These occur as the stools irritate the anal canal and the hemorrhoids and fissure may bleed. If the blood is darker in color and mixed with the stools, then a source of bleeding from the Colon will need to be considered. There may be inflammation of the colon causing the blood. The commonest cause of inflammation is usually an infection like ‘food poisoning’ or ‘gastroenteritis’. Usually, the patient may also feel unwell with an infection and have other symptoms like fever and nausea. Blood that is mixed in the stools may also be a sign of bleeding from diverticuli or possibly a tumor. At 58 years old with recent bowel symptoms, it is important to get an accurate diagnosis and ensure that there are no serious conditions causing his symptoms. I would suggest that you bring him to consult a gastroenterologist or colorectal surgeon for assessment. He may require tests like blood tests, stool tests and a colonoscopy.

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Aini answered 2 years ago

I have a lump outside my anus after giving birth to my first child. Lately, when my stools are hard, that lump is hard as well. Sometimes it hurts, sometimes it gets better but then the pain recurs when I have another hard defecation. Is this a severe hemorrhoid or what, Doc? Please give me your explanation

dr. Teoh Tiong Ann replied 2 years ago

It is possible that you may have either a haemorrhoid or an anal fissure with a sentinel pile. You will need to see a Colorectal Surgeon to examine you and to arrive at a proper diagnosis. It is also important to avoid hard stools by drinking adequate fluids and consuming adequate fibre.

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Yanah Ajh answered 2 years ago

I want to ask, my mother in-law has not been able to defecate since a long time ago. We took her to the hospital on an outpatient basis. The last check up result showed everything is fine. But at home, she feels there is a lump in her stomach. It gets bigger. She cannot hold her urine too and the amount of her urine is excessive. What condition is this? What should we do?

dr. Teoh Tiong Ann replied 2 years ago

You did not provide any information of what check up she had. Did she have a colonoscopy, CT scans etc? It would be best to bring her back to the doctor, preferably a colorectal surgeon, so that a proper assessment can be performed. This may include a colonoscopy and CT scans.

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Indah answered 2 years ago

Doc, after having surgery to remove his colon tumor, my husband complains about pain in the stomach and he has diarrhea. It has been a week. What should we do? What condition is this?

dr. Teoh Tiong Ann replied 2 years ago

If the surgery is recent (about a week), it is expected to have a change in the stools. This will improve after a while. This will also depend on how much intestine was actually removed during the surgery. I would wait for a couple of months and the stools are likely to improve. This may also improve after he has started eating normally.

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Abdallaah answered 2 years ago

I have a small bump in my anus. It slightly hurts. Is this dangerous?

dr. Teoh Tiong Ann replied 2 years ago

If this occurred suddenly and recently, you could have a thrombosed external hemorrhoid. This is a blood clot and it usually will resolve in a few weeks without any need for treatment. It is also possible that this is an abscess. An abscess will need surgical treatment. It would be best to consult a colorectal surgeon for a proper diagnosis.

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Femi answered 2 years ago

Doc, after giving birth, I always feel a burning sensation after defecating. Why is that? Is that dangerous? I am a 32 year old female

dr. Teoh Tiong Ann replied 2 years ago

It is possible that you may have an anal fissure. This is a wound in the anal canal. You could als have some hemorrhoids. It would be best to consult a Colorectal surgeon for a proper diagnosis and treatment.

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Yadi answered 2 years ago

Hello, Doctor. My name is Yadi, a 58 year old male. I have undergone surgery for colon polyp 2 years ago. In the middle of this year, I feel the same symptoms like when I had polyp. But my defecation is normal (when I had polyp, I had severe constipation). Please give me your advice, Doc, should I check now? Can colon polyp recur?

dr. Teoh Tiong Ann replied 2 years ago

A polyp can recur. It would be best to consult a colorectal surgeon or gastroenterologist and have a colonoscopy performed.

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Harun answered 2 years ago

Doc, can a grade 2 hemorrhoid be cured with medicine?

dr. Teoh Tiong Ann replied 2 years ago

Grade 2 hemorrhoids can even be cured with a proper diet, adequate fluid intake and good bowel habits. Medication or minor procedures like injection or ligation of the hemorrhoids may also help.

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Pritania answered 2 years ago

What food should be avoided when we have blood in our stools, Doc?

dr. Teoh Tiong Ann replied 2 years ago

It is important to establish the cause of the bleeding first. Suspicious bleeding should be further investigated. If no other cause is found, having adequate fiber and fluid to ensure good bowel habits is important.

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Danu Hadi answered 2 years ago

Can colon inflammation turn into colon cancer, Doc?

dr. Teoh Tiong Ann replied 2 years ago

There are specific Colon Inflammations like ulcerative colitis that may predispose to cancer. Common colon inflammation like from food poisoning or infections do not usually predispose to cancer.

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Indra answered 2 years ago

If my father had colorectal cancer when he lived, what can I do to prevent it? I am a 29 year old male.

dr. Teoh Tiong Ann replied 2 years ago

First degree family members of a patient with colorectal cancer are at an increased risk of developing cancer. This is especially if the patient had colorectal cancer before the age of 60 years old. The recommendation is for first degree family members to undergo a screening colonoscopy starting at age 40 years. This should be repeated every 5 years if no polyps were found, or earlier depending on how many and the type of polyps. If there are symptoms, then consideration will be made whether or not to have an earlier colonoscopy.

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Nurhayati Athied answered 2 years ago

Lately my bowel movement is hard. If I don’t strain, the stools won’t come out. But if I do, there is blood in my stools. And after defecation, my anus hurts. Is this a severe hemorrhoid or what, Doc?

dr. Teoh Tiong Ann replied 2 years ago

Bleeding with a bowel movement can arise from a few causes. If the blood is fresh red blood, the bleeding can be arising from hemorrhoids or an anal fissure. These occur as the stools irritate the anal canal and the hemorrhoids and fissure may bleed. If the blood is darker in color and mixed with the stools, then a source of bleeding from the Colon will need to be considered. Blood that is mixed in the stools may also be a sign of bleeding from diverticuli or possibly a tumor. You did not specify your age. If you are above 50 years of age with recent bowel symptoms, it is important to get an accurate diagnosis and ensure that there are no serious conditions causing your symptoms. I would suggest that you consult a gastroenterologist or colorectal surgeon for assessment. You may require tests like blood tests, stool tests and a colonoscopy.

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Diana dee answered 2 years ago

Good evening. My husband had surgery for piles 7 months ago. Why does he have an uncomfortable small lump? Is that skin tag?

dr. Teoh Tiong Ann replied 2 years ago

These could be residual skin tags. Skin Tags are sometimes difficult to remove completely. It is best to consult the surgeon who performed the surgery for his/her opinion.

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Rifan Ibrahim answered 2 years ago

Doc, can stage 1 colorectal cancer be cured with surgery only, without chemotherapy? And what can be done to prevent the cancer from recurring after surgery?

dr. Teoh Tiong Ann replied 2 years ago

Yes, Stage 1 Colorectal Cancer can be cured by surgery alone, without any need for chemotherapy or radiotherapy. The cure rate exceeds 95% to 98%. The chance of recurring is very low (<2% to 5%). However, new cancers can appear. Thus, it is advisable that close follow-up for up to 5 years with Colonoscopy and Scans would be useful. After 5 years, regular Colonoscopies are advised, at least once every 5 years.

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Egi answered 2 years ago

Doctor, my name is Egi, a 40 years old female. I have Autoimun Sjogren and now I have a chance to have Autoimun IBD or Autoimun Chron too (currently observed by an internist - allergy and immunology subspecialist, because there is a lump in my rectum. If it is measured with a finger, it is located 7cm inside my anus. I haven’t undergone colonoscopy. This morning my stools are red, at 7 and 9 AM. I am about to undergo a complete feces test. I want to ask, if I have rectal lump 7cm away from my anus surface (it is almost as long as surgeon’s pointing finger), should I undergo colon removal surgery?

dr. Teoh Tiong Ann replied 2 years ago

It is most important to establish exactly what this ‘lump’ is. A feces test may not give you the answer. A Colonoscopy and biopsy would give the best idea of what the ‘lump’ actually is. If it is a cancer, there are options to treatment.

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Risti answered 2 years ago

Good morning, Doc. My husband has hernia. It started in his lower abdomen. We went to a traditional massage to treat it. He got better for a while. But now, one of his testicles gets bigger and prolapses. I am convincing him to undergo surgery. He worried that his testicle will be removed in surgery. Is that true? Is there any recurring chance after surgery?

dr. Teoh Tiong Ann replied 2 years ago

The testicles and cord are the structures that surgeons strive to preserve with hernia surgery. It is not the intent to remove the testes. However, in rare circumstances, for example recurrent large herniae in an older man, there may be consideration for removing the tests. I stress again, this is a rare circumstance and usually the testes are preserved. Unfortunately, hernia can recur after surgery. The rate of recurrence will depend on several factors including size of hernia, persisting aggravating factors after surgery like recurrent coughing, carrying heavy weights etc. The type of procedure and experience of the surgeon are also factors to consider.

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Ishadi answered 2 years ago

Doc, my name is Ishadi, a 39 years old male. I have been having constipation since two weeks ago. When I defecate, it hurts a lot. Why is that? How to treat it?

dr. Teoh Tiong Ann replied 2 years ago

It is possible that you may have an anal fissure. This is a painful condition that is caused by hard stools in constipated patients. To prevent hard stools, drinking adequate fluids like water is important together with adequate fiber. Excessive fiber is not good as it causes bloating. Natural fiber like vegetables and fruit is good. Fiber supplements can be purchased at the pharmacy. Try not to take medication like laxatives. If you have to, start with the most gentle types. Avoid strong laxatives as after a while, the strong laxatives may not work anymore and you will have to take increasing doses and it would still not work. It is best to seek a doctor’s assessment for advice. If the constipation persist, it is important to ensure that you do not have an intestinal blockage from other causes. You should consult a doctor to assess this. The doctor may require you to undergo further investigations like XRays, Scans and a Colonoscopy. If there is no other cause that is found, then you can take some steps to improve your bowel movements.

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Izza Limiq Almunir answered 2 years ago

Doc, I want to ask. My friend has fresh blood when she defecates, but it comes from her vagina. Why is that so?

dr. Teoh Tiong Ann replied 2 years ago

This is unusual. It is best to bring your friend to see a Gynecologist or Colorectal Surgeon. If the symptom is correct, there is an unusual condition called a Recto-Vaginal Fistula. This is not a common condition and is difficult to treat. However, it is most important to get an accurate diagnosis.

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Liza answered 2 years ago

Doc, my father is 55 years old. He was diagnosed with grade 2 hemorrhoids and abscess. He has blood in his stools and pain when he sits. My question is, if he undergoes surgery for his abscess, should he also have surgery for his hemorrhoids?

dr. Teoh Tiong Ann replied 2 years ago

The immediate issue is the abscess and a possible anal fistula which is commonly associated with an abscess. It is best to address these two conditions first. Hemorrhoid treatment can be addressed later.

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Dian answered 2 years ago

Good morning, Doc. My name is Dian, a 36 years old female. I have been having blood in my stools for 2 weeks. The blood is dark red. And when I defecate, my stomach hurts so much, it makes all of my body weak. I have taken painkiller but it only lasts for a few hours. I have been trying to avoid oily and spicy food, but when I defecate, the pain persists. Please give me your advice, what should I do?

dr. Teoh Tiong Ann replied 2 years ago

Dark red blood with abdominal pain are symptoms that you should consultation with a Gastroenterologist or Colorectal Surgeon. This may indicate an issue in the Colon or Rectum. Further tests like a colonoscopy may have to be performed. If thee blood is fresh red in color and you do not have any change in bowel habits and the stools are normal and you do not have a family history of Colon Cancer, it is likely that the bleeding is from either hemorrhoids or an anal fissure. Hemorrhoids may not cause any pain in the anal region. However, it would be best that you consult a doctor and ensure that the doctor does an anal examination and proctoscopy. If no cause of the bleeding is found and if the symptoms persist, although the suspicion level is low given your age, I may consider advising a Colonoscopy to exclude other causes of bleeding.

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Maya answered 2 years ago

My name is Maya, 30 years old. I am currently 4 months pregnant. It would be my first born. It has been more than 10 days. I haven’t been able to defecate. It feels like the stools are blocked. I have seen my obgyn and my pregnancy is just fine. I read about colonoscopy but I am worried to undergo it due to my pregnancy. Please give me your advice, Doc.

dr. Teoh Tiong Ann replied 2 years ago

Constipation is quite common during pregnancy without any serious cause. Rarely, it may be due to more serious conditions. Generally, a colonoscopy would not be advised if there is constipation during pregnancy unless there are suspicious factors in the history and clinical presentation. I would suggest that you consult your gynecologist or a gastroenterologist or Colorectal surgeon for advice. Sometimes, just drinking adequate fluids and a gentle laxative may relieve your symptoms

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Aris answered 2 years ago

Hello, Doc. My name is Aris, 40 years old. These 2 weeks, I have been having constipation and feeling a burning sensation inside my stomach although I don’t eat spicy food. I try to eat fruits but it only makes me bloat. My stomach is as hard as a stone. What should I do, Doc?

Zami answered 2 years ago

My name is Zami, a 49 year old male. I have been having diarrhea for more than 2 weeks. Everytime I defecate, my stomach cramps so much. My feces is dark. Please give me advice on how to treat it.

Kartika answered 2 years ago

Doc, does menstruation affect the piles? When I am on my period, my piles hurt and I have blood in my stools. I am 33 years old. Should I cure my piles?

Ryan Cheukok answered 2 years ago

I have a rectal tumor. Can it be cured?

Nuki answered 2 years ago

After having surgery for piles, I feel heat in my anus when I defecate. Why is that, Doc?

Maysaroh answered 2 years ago

My husband has a colon tumor. Can it be cured after surgery?

Rani answered 2 years ago

Hello, Doc. It has been a long time since I have constipation. There are only a few stools coming out and my defecation feels unfinished. It gives me a stomach ache. Like I want to defecate but nothing comes out. The pain is below my navel. The pain is relieved after watery stools, but then it will recur again. What should I do? Am I having piles?

Siska answered 2 years ago

Doc, two months ago I underwent treatment for piles. These two months after treatment, I don’t feel pain anymore in my anus. But this morning, when I had a bowel movement, I saw fresh blood in my stools. But it doesn’t hurt. Does this have something to do with my piles?

Ningsih answered 2 years ago

My son is 25 but he already has bleeding piles, Doc. Is this normal? Would it get severe as he grows up later?

Dede Raihani answered 2 years ago

My husband had surgery for colon polyp. Is there any food he should avoid to prevent the polyp from recurring, Doc?

Dedi Hasmi answered 2 years ago

Doc, my wife, 54 years old, has colon polyp. She has undergone surgery but I am afraid, can it turn into cancer?

Iskandar answered 2 years ago

Doc, my son is 17 years old. After having surgery for gallstones, he often has stomach ache. Please give me solution, Doc

syarifudin answered 2 years ago

My wife was diagnosed with colon inflammation. Is there any food she should avoid to prevent it from recur?

Adrian Maaruf answered 2 years ago

Doc, what stage is a pile which discharges pus? And how to treat it?

Febi Oktari answered 2 years ago

I have had pain in my lower abdomen since last week and my bowel movement is hard. Why is that, Doc?

Ranti Diah Novemelia answered 2 years ago

Hello, Doc. I am an 18 years old girl. I want to ask. I have hemorrhoids. There is a small growth in my anus and it prolapses when I defecate. I can push it back in with my finger. I once treated it with a bullet medicine. When I was about to push the medicine, I saw the growth prolapse although I have pushed it back in after defecation and I didn’t do any strenuous activities. But when I wanted to push the medicine, the growth prolapsed and it happened several times. What should I do, Doc? Now my bowel movement is hard. Would straining be dangerous for my condition? Can you give any advice for me? Thank you

Fitri Purnamasari answered 2 years ago

Doc, my husband at 42 years old has recurring hemorrhoids. He has undergone surgery but it still recurs. What should he do?

Cinta Reziana answered 2 years ago

Doc, I have been having mucus in my stools, like pus, for these 2 days. What disease is this, Doc? How to treat it?

Efan Andriansyah Dasopang answered 2 years ago

Doc, I want to ask. My mother is 51 years old. She complains about pain in her stomach, constipation, and blood in her stools (fresh blood), losing weight due to loss of appetite. We consulted a doctor and she was advised to undergo colonoscopy. After colonoscopy, it turned out my mother has ulcerative colitis. Now she is under treatment. But, she doesn’t get better although she takes medications. What should she do, Doc? And what is actually the cause of ulcerative colitis? What kind of lifestyle should she have? Thank you, Doc

Raesa answered 2 years ago

How much is the treatment cost for hemorrhoids, Doc?

Rezky answered 2 years ago

Doc, I have been having diarrhea for a week. My anus feels hot after defecation. I have stopped eating spicy food and fries but to no improvement. Please give me your advice, Doc

Mario answered 2 years ago

My elder sister, 51 years old, has had mucus and blood in her stool since 2 days ago, Doc. It started with 3 days of constipation, but when she can move her bowel again, she has this condition. What should we do, Doc?

Fatwa answered 2 years ago

There is something like a boil in my anus. When I strain while having bowel movement, it hurts. How to differentiate the dangerous anus boil (tumor) from the benign one?

Ratna Dewi Wulandari answered 2 years ago

Doc, 9 months ago I had surgery for anal fistula. But one week after surgery, there is pus leaking through the stitch and it stinks. Now the stitch is dry, but the fistula recurs. Can the Mount Elizabeth Hospital Singapore handle an anal fistula with a guarantee of recovery? It has been hurting me a lot. If so, how much is the estimated cost for the surgery? Thank you

Gunar answered 2 years ago

Doc, I had abscess surgery last week and now my anus is red and itchy. Does it mean the disease is still there?

Mona answered 2 years ago

Lately I have been feeling pain in my lower left abdomen. When it hurts, I can not stand up. My stomach aches like I need to defecate but I can not. Please give me advice and solution, Doc

Agustan answered 2 years ago

Good afternoon, Doc. I am currently on treatment for intestinal inflammation. I have been on treatment for around 3 weeks. While I am on treatment, I have bleeding stools in the morning. Is this a side effect of the treatment?

Safitri Pertiwi answered 2 years ago

I have undergone surgery for gallstones but the pain recurs. What is the cause of it, Doc?

Husna answered 2 years ago

These 3 months, I have been having constipation and taking soft laxatives. But these two days, I have been having stomach ache but the stools won’t come out. Is this a laxative effect? How do I treat my constipation?

Putra answered 2 years ago

What should I do to stop my piles from collapsing?

Siti Nurmalasari answered 2 years ago

Doc, can a hernia mesh be broken? Because my husband who had hernia surgery last month is now having his lower abdomen swollen and painful again

diah pasyah answered 2 years ago

Hello, Doc, if we have piles, should we treat it with surgery or traditional medicines? If it is traditional medicine, what should we take?

Siti agus koniah answered 2 years ago

Good afternoon, Doc. I am a 26 years old female. I had surgery for anal fissure last month. If today I don’t defecate, I will see fresh blood in my stool the next day. And sometimes it still hurts after defecation. I still feel a mucus in my anus. When would my condition get back to normal, Doc? And is this fresh blood after surgery a danger sign?

Maesyaroh answered 2 years ago

Doc, I have thick red blood in my stools. What disease is this?

Candra answered 2 years ago

Doctor, is surgery necessary for 0.5 cm gallstones?

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