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

Ask a Doctor Forum › Category: General Surgery › Ask a Colorectal Surgeon: Dr Teoh Tiong Ann from Mount Elizabeth (Orchard) Hospital Singapore

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dr. Teoh Tiong Ann asked 3 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.sg/hospital/mount-elizabeth-hospital-singapore/ Learn more about me here: https://patients.smarterhealth.sg/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.

69 Answers

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Achmad Sunarto Sabdo answered 3 years ago

Is it true that piles are incurable?

dr. Teoh Tiong Ann replied 3 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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* Keen to tele-consult with Dr Teoh Tiong Ann? Leave your details at https://patients.smarterhealth.sg/specialist-doctor/teoh-tiong-ann/ and we’ll help arrange an appointment.

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Aditya Utomo answered 3 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 3 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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* Keen to tele-consult with Dr Teoh Tiong Ann? Leave your details at https://patients.smarterhealth.sg/specialist-doctor/teoh-tiong-ann/ and we’ll help arrange an appointment.

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Sunarti answered 3 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 3 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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* Keen to tele-consult with Dr Teoh Tiong Ann? Leave your details at https://patients.smarterhealth.sg/specialist-doctor/teoh-tiong-ann/ and we’ll help arrange an appointment.

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rayhan answered 3 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 3 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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* Keen to tele-consult with Dr Teoh Tiong Ann? Leave your details at https://patients.smarterhealth.sg/specialist-doctor/teoh-tiong-ann/ and we’ll help arrange an appointment.

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Ajeng Karina answered 3 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 3 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 3 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 3 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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* Keen to tele-consult with Dr Teoh Tiong Ann? Leave your details at https://patients.smarterhealth.sg/specialist-doctor/teoh-tiong-ann/ and we’ll help arrange an appointment.

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Maryati answered 3 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 3 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 3 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 3 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 3 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 3 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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* Keen to tele-consult with Dr Teoh Tiong Ann? Leave your details at https://patients.smarterhealth.sg/specialist-doctor/teoh-tiong-ann/ and we’ll help arrange an appointment.

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panji answered 3 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 3 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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* Keen to tele-consult with Dr Teoh Tiong Ann? Leave your details at https://patients.smarterhealth.sg/specialist-doctor/teoh-tiong-ann/ and we’ll help arrange an appointment.

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