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: and here: 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.
34 Answers
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.

Sharif answered 2 years ago

I am 23 years old. Since I was 15, I’ve often experienced heartburn whenever I have my meals late. As I grew older, the heartburn has gotten worse. Now, I have heartburn even when I eat on time, with it sometimes happening twice a day. I do not experience vomiting or stomach pain. The heartburn usually goes away after I take medication. I am just worried that I have to rely on medicine for the rest of my life. What should I do?

dr. Lee Keat Hong replied 2 years ago

Dear Sharif, since your symptoms are worsening I will advise that you visit a nearby doctor to have a thorough history and physical examination. Depending on the findings you may also be advised to go for further investigation such as endoscopy. In the meantime, you should also try certain lifestyle changes that may help reduce heartburn symptom such as diet change (acidic food, spicy food etc), head of bed elevation, avoidance of smoking, alcohol etc)

David tey answered 2 years ago
i m 50 years old. 3 months ago my stomach not feeling good, easily to get bloated, burping and farting. now getting better. but recently i have sour taste from my mouth. may i know how to get rid of this sour taste?
dr. Lee Keat Hong replied 2 years ago

Dear David, your symptoms seem to suggest dyspepsia (or ‘indigestion’ to the layperson) with possible underlying acid reflux disease as well. You may adopt some lifestyle changes such as avoiding/cutting down on certain food (spicy, sour, fatty, oily, etc) known to trigger acid reflux issue, sleeping with head propped up (2 pillows), having a smaller amount of meals at regular intervals and many others. Common over-the-counter medication such as antacid may help also. If your symptoms fail to improve, you should consider consulting a doctor for further evaluation.

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