Ask a Gastroenterologist: Dr Mark Fernandes from Mount Elizabeth Novena Hospital Singapore

Ask a Doctor ForumCategory: Gastroenterology & HepatologyAsk a Gastroenterologist: Dr Mark Fernandes from Mount Elizabeth Novena Hospital Singapore
Dr Mark Fernandes asked 2 years ago
I am Dr Mark Fernandes, Gastroenterologist based in Mount Elizabeth Novena Hospital Singapore, Mount Elizabeth (Orchard) Hospital Singapore, Gleneagles Hospital Singapore, Farrer Park Hospital Singapore, Mount Alvernia Hospital Singapore and Parkway East Hospital Singapore. Ask Me Anything! I am a specialist in Gastroenterology with a clinical interest in Liver Disorders including Hepatitis B, Hepatitis C, Nonalcoholic Fatty Liver Disease, Liver Cancer and in Fibroscan for monitoring the progression of liver disease. I was previously a Consultant and Clinical Tutor at the National University Hospital (NUH), and part of the Liver Transplant Programme team. I graduated from the University of Edinburgh with a B.Sc with First Class Honors in 1997 and subsequently MB ChB with Honors in 2000. After my internship at the Royal Infirmary of Edinburgh, I completed my residency in London and Singapore and obtained my MRCP(UK) in 2003. In 2008, I was accredited as a Specialist in Gastroenterology by the Ministry of Health and admitted as a Fellow of the Academy of Medicine (Singapore). I was awarded the Healthcare Manpower Development Programme (HMDP) scholarship by MOH in 2007 to pursue my Advanced Fellowship in Liver Cancer and Hepatitis B at the Chang Gung Memorial Hospital in Taiwan under Professor Lin Shi Ming and Professor Liaw Yuan Fai. I also furthered my exposure to Liver Transplantation Medicine at the King’s College Hospital, London. Besides active involvement in the liver tumour ablative service and the liver transplantation programme at NUH, I also introduced Fibroscan to enable more accessible monitoring of liver disease progression at NUH. I have been involved in multiple clinical research trials, authored numerous peer-reviewed publications and have been invited to present my research work at international conferences. My research interests and publications include basic science, epidemiology and clinical studies into gastrointestinal cancers, hepatitis B and liver transplant. Learn more about me here: https://patients.smarterhealth.sg/specialist-doctor/mark-fernandes/ I am excited to be here to share/discuss Digestive & Liver Health with everyone. I will be actively answering questions. Whether you've got questions about liver cancer, liver disorders such as Hepatitis B and Hepatitis C, or fatty liver disease, 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.
15 Answers
Maria Ann answered 2 years ago

I am considering going on a high protein diet to lose some weight. However, i’ve noticed from previous experience that whenever i cut out carbs and only eat protein, i tend to get gastric. Is there a linkage between the condition and a high protein diet? What can i do if i want to maintain with the diet and avoid having gastric pain?

Dr Mark Fernandes replied 2 years ago

Thank you for writing to me. The medical term I will use for “gastric” is functional dyspepsia (FD).
An analysis of recent literature showed that the most common foods, recognized by patients to cause dyspepsia appears to be high concentrations of either gluten (grain/wheat products, takeout foods, processed foods) or fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs) (fruit, wheat and grain products, soft drinks, processed foods).
It has been demonstrated that a high fat-meal can also induce greater nausea, pain and fullness both respect to a low-calorie meal and an equi caloric meal, high in carbohydrates for the same volume.
There is much less scientific evidence available to suggest that proteins cause dyspepsia.
Lastly if you are dieting, your symptoms may be a consequence of your body telling you that you are hungry. My suggestion would be to take smaller meals 5 times a day.
Hope this helps

Theresa answered 2 years ago

Hi I had acid reflux a year ago. Since then I had been taking medicine but it does not seems to go away I am concern is there any other treatment ? It causes discomfort in the chest shoulder and neck.

Dr Mark Fernandes replied 2 years ago

Many patients think that only certain people have acid reflux. This isn’t true. Practically everyone suffers from acid reflux when the lower esophageal sphincter (LES) opens and closes each time during a 24hr period. This usually happens at least 50x/day ina normal individual. In patients who are symptomatic, the LES may be opening and closing more often in a day or may be remaining open for longer periods of time. Some patients may also have esophageal hypersensitivity to even small amount of acid in the lower oesophagus. The mainstay of treatment remains proton-pump inhibitors which reduced gastric pH. However bare in mind that these medications do no prevent or reduce the reflux episodes themselves. Lifestyle changes such as sleeping at an incline and reducing foods which may increase LES relaxation such as alcohol, coffee, and large meals may help.

William answered 2 years ago

Doctor, my right lower abdomen is often bloated and the pain from it spreads to my stomach and then my lower back. I also get nausea. That said, I don’t feel a burning sensation in my throat or chest. Can I assume this is not GERD? What examination should I do to check on my condition?

Dr Mark Fernandes replied 2 years ago

It is possible from your history that you may have two conditions. The first- the abdominal bloating radiating to the back may be due to irritable bowel syndrome especially if the symptoms of bloating are releveived by passing motion.

The second set of symptoms you have sound more like gastro-oesophageal reflux disease.

If your symptoms persist, please see your doctor and consider gastroscopy and colonoscopy. Also consider hydrogen and methane breath testing for lactose and fructose intolerance and small intestinal bacterial overgrowth.

Lily answered 2 years ago

I have my stomach ulcers treated with PPI. But taking it leaves a sour taste in my mouth, and if I don’t take it the pain gets severe. Should I consider surgery for this condition?

Dr Mark Fernandes replied 2 years ago

I think it is important to understand and find out what the cause of your stomach ulcers are. If it is due to helicobacter pylori, this needs to be treated. Taking PPIs is the treatment for both ‘gastric pain’ and reflux symptoms. I do not think surgery is necessary.

Rhona Wong answered 2 years ago

I feel bloated and have stomach aches after my meals. I have to drink hot tea to relieve it. Sometimes the pain is so bad I have to take painkillers. I am also starting to have constipation. What can I do to treat my condition?

Dr Mark Fernandes replied 2 years ago

I think it would be important to get further evaluation with a gastroscopy and colonoscopy. It would be important to exclude a stomach ulcer and to rule out causes for constipation. There are excellent treatments available for both ‘gastric pain’ and constipation

Cally answered 2 years ago

I have been diagnosed with severe gastritis. I vomit a lot. My condition seems to have gotten worse and now I sometimes vomit blood. While it is not frequent, when I do, i also get a terrible stomach pain. Is there any surgery or treatment I can consider to permanently cure my condition?

Dr Mark Fernandes replied 2 years ago

I think it would be important to understand what the basis for diagnosis of severe gastritis was, Did you have a gastroscopy? If not you need to have one. Usually treatment with proton-pump inhibitors(PPIs) is very effective. If your symptoms do not respond to PPIs then you need to be reassessed for the cause of your symptoms.

Shawn answered 2 years ago

My brother is under treatment for his stomach ulcer. Since taking medication, his vomit is greenish in colour. Is this normal or is his condition getting worse?

Dr Mark Fernandes replied 2 years ago

It is possible that your brother may have developed some side effects to the medication. Best to see your doctor to clarify.

Clara answered 2 years ago

Doctor, my mother has been treating her reflux with PPI but it only seems to make her feel like vomiting even more. Is there any other treatment she should try?

Dr Mark Fernandes replied 2 years ago

Thank you for your question. If your mother has not been evaluated with a gastroscopy or further investigations, this should be considered.

Karen answered 2 years ago

Hi doctor, is it true that eating preserved foods in high quantities like kimchi etc will cause us to have a higher risk of stomach cancer?

Dr Mark Fernandes replied 2 years ago

The strongest risk factor for stomach cancer is the presence of helicobacter pylori infection. However dietary factors are thought to play a part as well. The World Cancer Research Fund found that there is probable evidence that both salt and salt-preserved foods are associated with an increased risk of stomach cancer. Kimchi has a high sodium content and has been linked to gastric cancer. Ingestion of salt directly damages the stomach lining, enhancing the carcinogenic effects of gastric carcinogens, increasing nitroso compound formation, and facilitating H. pylori infection.

Shela answered 2 years ago

Can a gluten-free diet really help with one’s gut health?

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