Ask a Gastroenterologist: Dr Lee Keat Hong from Mount Elizabeth Novena Hospital Singapore

Ask a Doctor ForumCategory: Gastroenterology & HepatologyAsk a Gastroenterologist: Dr Lee Keat Hong from Mount Elizabeth Novena Hospital Singapore
dr. Lee Keat Hong asked 2 years ago
I am Dr Lee Keat Hong, Gastroenterologist and Hepatologist practicing at Mount Elizabeth Novena Hospital Singapore and Mount Alvernia Hospital Singapore. Prior to entering private practice, I was Consultant at the Division of Gastroenterology and Hepatology, National University Hospital (NUH), Singapore as well as Asst Professor at Yong Loo Lin School of Medicine, National University of Singapore. I have been invited to speak at prominent global and national medical conferences such as the Asian-Pacific Digestive Week (APDW), Asian-Pacific Association for the Study of Liver (APASL) and Asian EUS meetings. Notably, my accomplishments in clinical research work in viral Hepatitis B has been published in reputable medical journals such as Hepatology International and Antiviral Therapy. I treat all general gastroenterology and hepatology conditions. My sub-specialty interest is in advanced diagnostic and therapeutic endoscopic ultrasound (EUS). I remain a visiting consultant at NUH and continue to contribute to the training of future doctors and gastroenterologists. Learn more about my specialty and services here: https://aliveomedical.com/ and here: https://patients.smarterhealth.my/specialist-doctor/lee-keat-hong/ I am excited to be here to share/discuss Digestive and Liver Health issues with everyone. Whether you've got questions about digestive or liver conditions, 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.
18 Answers
Vania answered 2 years ago
Doctor, these three days I found my stools becoming too watery. What problem is that? I don’t have any stomachache though. This condition makes me weak.
dr. Lee Keat Hong replied 2 years ago

The most common medical cause for sudden loose stools is acute gastroenteritis, usually as a result of exposure to gastrointestinal pathogens such as viruses and bacteria. Sometimes this may be accompanied by fever, vomiting, abdominal cramp and loss of appetite. These symptoms usually will resolve with adequate rest and hydration (drinking enough fluids).

In your case, I will recommend at least a GP consult as you are complaining of fatigue (feeling weak). It could be a sign of inadequate hydration or even loss of body electrolyte (due to loose stools) for which more targeted treatment is indicated.

Surjani answered 2 years ago
I have had gastric pain for a long time. Now sometimes in the morning I feel cold and weak. The back of my neck aches and the pain radiates to my left shoulder. I am a 70 year old female whose weight is 35kg and blood pressure is 137/70. Is my problem related to my gastric pain?
dr. Lee Keat Hong replied 2 years ago

Your symptoms (cold and weak, neck ache) are non specific and may occur in many other medical situations (such as spine issue, muscle strain etc). In any case I recommend that you see a doctor to get a complete history and physical evaluation then decide what investigations or treatment is required further. As for your gastric pain, have you seen a doctor before? Since it has been there for a long time you should also consider visiting a doctor if you have not seen one.

Normalina Tarigan answered 2 years ago
Doctor, what is the medicine for gastric problems?
dr. Lee Keat Hong replied 2 years ago

There are many digestive conditions that can give rise to gastro problems. For example, gastro-esophageal reflux disease (GERD) results in symptoms such as abdominal pain, bloating and burning sensation and is usually treated with antacid and acid suppressants (H2RA or PPI medications). Therefore it is recommended that patients with digestive issue / gastric problems to be assessed and diagnosed correctly before being prescribed 'medicine for gastric problems'.

Semiati sarlotha answered 2 years ago
Doctor, I have a history of gastric acid. The last time I checked, I was diagnosed with gallstones. Now it feels like the gallstones recurred because my upper right stomach, near the ribs, radiates with pain through my back. I feel my gastric acid acting up again as well and my body is cold. What medicine should I take? The doctor usually gives me a vitamin for the liver, gastric medicine and painkillers.
dr. Lee Keat Hong replied 2 years ago

Gallstones and 'gastric acid' conditions may co-exist, i.e both may be present in the same patient. Gastro-esophageal reflux disease (GERD), or sometimes known as 'gastric acid' to a layperson, typically presents as a burning sensation at the stomach, heartburn and acid brash. Pain from gallstones commonly starts at the upper right part of the abdomen radiating to the back and often described as being sharp and 'colicky'.

Diagnosis of gallstone disease can be achieved by ultrasound imaging of the gallbladder. It is advisable to have gallbladder surgery if the pain is recurrent (rather than taking painkillers only) as it may progress to complications such as gallbladder infection and jaundice.

MARSELLINA answered 2 years ago
 I am 49 years old. I am always burping and have had gastric acid for a long time now. What medicine works for this?
dr. Lee Keat Hong replied 2 years ago

Burping and 'gastric acid' symptoms are most commonly related to a medical condition called dyspepsia and gastro-esophageal reflux disease (GERD). Patients are usually advised to have a combination of lifestyle changes and medical therapy to help with the symptoms. Examples of lifestyle changes include dietary (less spicy, less heavy meal, reduced caffeine), avoidance of smoking, alcohol and keeping ideal body weight. If life-style changes doesn't help much, medications such as antacids, H2RA (e.g. ranitidine) or PPI (e.g. omeprazole) is a reasonable 'add-on' to help achieve symptom control.

In your case, especially with your age (49 years old), I will recommend a full medical evaluation and endoscopy if it hasn't been done before.

Geri nas answered 2 years ago
Doctor, I had a test and the result shows my SGPT score was high at 98. Does high SGPT indicate a problem in the liver? How do I decrease it?
dr. Lee Keat Hong replied 2 years ago

SGPT is an enzyme that is found in many organs (such as liver, heart and muscle), hence a raised ALT on blood test may not necessarily mean it is a liver problem. The next step for you would be to obtain a medical consult and determine the cause of the high ALT, only then can a doctor advise on the next management step.

Pak Dhe Concom answered 2 years ago
Doctor, I feel dizzy everyday and my body feels weak as if I will faint. I also feel nauseous, and sometimes my stomach hurts and feels full. My hands and feet are weak. My sight is dim and my breath is short, Doctor. Please give me your advice.
dr. Lee Keat Hong replied 2 years ago

The few symptoms that you have been experiencing are non specific in nature and do not all point to one particular medical diagnosis. For example, shortness of breath may be related to a lung (asthma) or heart (heart failure) condition. Similarly, dizziness may be related to ENT (vestibular condition), neurological (stroke) etc.

Have you seen a doctor already? I recommend a complete history and physical examination by a qualified doctor as your symptoms may not be properly assessed through an online forum alone. Frequently your doctor may also order investigations such as blood tests to further arrive at a diagnosis.

Merliana answered 2 years ago
Doctor, I am a 64 year old female who had a stroke 6 months ago. Now I can walk. I saw a neurologist and was prescribed hypertension medicines - himfastatin, amilodipin, clopidogrel. But I feel my gut is burning and it is hard for me to breathe. I grew thinner (my weight before the stroke was 46kg and I am now 36.5kg). I also have gastric acid reflux. Please give me the solution, Doc. Thank you.
dr. Lee Keat Hong replied 2 years ago

Clopidogrel sometimes may cause stomach discomfort and worsening of existing gastric reflux condition. In this case, gastric medication may be prescribed to help ease the symptom. However, you do experience quite a significant weight loss – in this intentional (from eating less, exercises)? If the weight loss is non intentional, I will recommend a full body check-up to make sure that you do not have a medical cause for the sudden weight loss (such as thyroid problem, stomach problem etc).

Igorwisnuwardana answered 2 years ago
Doctor, my USG showed that my liver fat is within the normal limit. Sgot and sgpt are normal too. What medicine should I take? I have also been doing regular exercises everyday when I consulted an internist.
dr. Lee Keat Hong replied 2 years ago

Since your USG showed normal liver fat, you do not need to take any medication. In addition to regular exercises, I will recommend a healthy diet as well (more fruits and vegetables, less oily / fatty food).

Pajamin Pa Min answered 2 years ago
Doctor, what is the medicine for gastric acid reflux?
dr. Lee Keat Hong replied 2 years ago

Common medications for gastric acid reflux include antacid, histamine receptor blocker (such as Ranitidine) and proton pump inhibitor (such as Omeprazole).

Apit Cahyo answered 2 years ago
My wife used to complain about having gastric pain. That was till one day when her stomach hurt so much, we sent her to the hospital. There, we found out that she had a gastric ulcer. She was hospitalized for a few days and given some medications. When she was out of the hospital, she got better. But these days, she complains of stomach ache if she eats foods where the flavors are a bit strong. Does it mean her problem is not totally cured, Doctor? Or should people with gastric ulcers not consume strong-flavored foods, such as spicy food, forever? 
dr. Lee Keat Hong replied 2 years ago

Spicy food is not known to be a cause of stomach ulcer. There are various reasons for getting stomach ulcers, common ones being infection with a bacteria (Helicobacter Pylori) and medications (painkillers such as NSAIDs). More importantly though, what was the cause of her stomach ulcer previously (what did the doctor tell her)? Was it caused by bacteria, and has it been treated? If she has been treated, is there a repeat endoscopy (Gastroscopy) to be sure that the gastric ulcer has healed?

Hudayati answered 2 years ago
Dr. Lee, what is the cause of pain above the belly button? That part feels hard and makes me lose my appetite. I am always full although I've consumed only a small portion of food. If I force myself to eat, I will vomit. 
dr. Lee Keat Hong replied 2 years ago

Pain above the belly button (upper part of the abdomen) may be caused by problems with the stomach, small intestine or even pancreas. When you mentioned that it is 'hard', do you mean that you can feel a mass above your belly button? I suggest you visit a doctor to have yourself checked, most likely your doctor will offer some investigations such as blood tests and scans since you are losing your appetite also.

Vera answered 2 years ago
My mother was diagnosed with liver cirrhosis last February. The cause is still unknown because the laboratory results showed negative hepatitis B & C, negative autoimmune. My mother doesn’t drink alcohol and doesn’t have a history of hepatitis. Her blood test, abdomen usg, and fibroscan/elastography shows she has liver cirrhosis. There has never been any symptoms or complaints by her regarding this condition before. This was known when we found a high sgot sgpt score in her blood test. These 6 months, she has been prescribed Hepamax and AHFC biolife. Are those medicines enough? Or are there any other medicines or vitamins she should consume? Is there any test she should undergo? Thank you
dr. Lee Keat Hong replied 2 years ago

Medications for liver cirrhosis are targeted at the actual cause of the liver cirrhosis itself (e.g. if the cirrhosis is related to Hepatitis B then antiviral treatment is needed) and complications related to liver cirrhosis (e.g if patient has ascites there is medication to reduce water retention in the body). I am not familiar with both Hepamax and AHFC biolife. Looking at the product information (from the Internet), both of these are liver supplements though evidence on its actual benefit in liver cirrhosis is lacking.

Since your mother has liver cirrhosis, she should also undergo screening for varices if it has not been done. Equally important, she will need to be followed up regularly by a doctor trained in managing liver cirrhosis (Gastroenterologist) as she is at higher risk of developing liver cancer and decompensation.

Nony answered 2 years ago
Doctor, I did a USG, CT scan, stomach endoscopy recently due to my gastric acid reflux causing some pain. I don’t have a gall anymore, and I also had surgery to remove my appendix. Is it still possible to cure gastric acid reflux if I don’t have a gall anymore? Currently I am taking prosogan 30mg, vometa 10mg,dogmatil 50 mg. But the effect is temporary and the discomfort will be back after a while. Are there any other recommended medicines, Doc? I keep my diet healthy though.
dr. Lee Keat Hong replied 2 years ago

How long have you been taking your medications? Medications such as Prosogan (Lansoprazole) may take up to 2 months sometimes for symptoms to completely subside. I generally do not prescribe Vometa and Dogmatil for long term use due to potential medical side effects. If your reflux symptoms persist, what I recommend is for you to consider getting a pH study done (e.g. 24-H pH impedance study) to look for the degree of 'acidity' and response to treatment.

Friscila Boky Ohman answered 2 years ago
Doctor, I have been experiencing gastric acid reflux for the past 3 months. I have taken a lot of medicines, from antacid (Carsida Sanmaag Polysilane), Inpepsia to even PPI medications (Omeprazole, Lapraz, Nexium) and the one I am currently taking is Pantozol. But the problem keeps recurring. I did a stomach USG and the result is normal. I was advised to have an endoscopy/UBT to see if there is bacteria, but I am afraid to head to the hospital in this pandemic. I keep my diet healthy, but the problem keep recurring. Does it mean I have to keep taking these medications, Doc?
dr. Lee Keat Hong replied 2 years ago

I recommend endoscopy in your case as you have been taking your medications for 3 months already. Usually I would expect at least some response to treatment especially after 3 months of taking PPI medications.

Saniah Saniah answered 2 years ago
Doctor, I have been feeling pain in my epigastrium. My stomach is uncomfortable. Why is this so, Doc?
dr. Lee Keat Hong replied 2 years ago

Pain in the epigastric region can be due to stomach, pancreas, gallbladder and even intestinal problems. Sometimes, it may also relate to underlying heart disease. I recommend that you get a full medical evaluation (history, examination) to understand more about your problem before getting proper medication.

Keisha Alfaridzi answered 2 years ago
Doctor, I feel pain in the lower left part of my stomach. It has been hurting for a long time. If I press on it, I can hear the sound of water and air bubbles. I had a stomach USG. Everything is normal beside my intestines and gut that have not been examined. My bowel movement is normal too. What problem is this, Doc? Thank you
dr. Lee Keat Hong replied 2 years ago

Pain at the lower left abdominal region may originate from the intestines, kidney / ureters and even female reproductive organ. Is there any mention in your USG about the kidney stones which may be the cause of the pain? You should also consider getting a colonoscopy to exclude intestinal condition.

Luhut Sihombing answered 2 years ago
I am 54 years old. For the past 3 months I have been regularly taking vitamin C at a dose of 500 mg. Two days ago, my hands and feet felt cold and I had trouble sleeping. My stomach also feels nauseous in the morning and after eating. Does this have to do with the vitamin C I am taking? What could be the possible causes and what is your recommended treatment? Thank you
dr. Lee Keat Hong replied 2 years ago

The recommended daily vitamin C dose is around 65 mg to 90 mg a day, and the upper limit is around 2000 mg. Your current dose of 500 mg daily is still within this range so I do not think that it is the cause of your symptoms.

The symptoms you described seem to indicate neurological (cold hands and feet, trouble sleeping) and digestive (nausea) issues. Before taking any new medication, I recommend seeing a doctor to get a proper physical examination (neurological, abdominal) to get a diagnosis and subsequently getting treatment.

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