Ask a Gastroenterologist: Dr Tan Poh Seng from Mount Elizabeth (Orchard) Hospital Singapore

Ask a Doctor ForumCategory: Gastroenterology & HepatologyAsk a Gastroenterologist: Dr Tan Poh Seng from Mount Elizabeth (Orchard) Hospital Singapore
dr. Tan Poh Seng asked 3 years ago
I am Dr Tan Poh Seng, Senior Consultant Gastroenterologist at PS Tan Digestive & Liver Centre based in Mount Elizabeth (Orchard) Hospital. Ask Me Anything! I specialise in digestive diseases, endoscopic procedures (gastroscopy, sigmoidoscopy, colonoscopy, polypectomy, endoscopic variceal ligation and capsule endoscopy), liver diseases, viral hepatitis, fatty liver, liver cirrhosis, liver cancer and liver transplantation. Prior to entering private practice, I was: - Director of Clinical Services, Senior Consultant, Division of Gastroenterology & Hepatology, National University Hospital (NUH) - Senior Consultant of the Liver Transplant Programme at the National University Centre for Organ Transplantation - Clinical Lead for the Hepatobiliary Tumor Group at the National University Cancer Institute - Assistant Professor at the Yong Loo Lin School of Medicine, National University of Singapore - Core Faculty Member for the Gastroenterology & Hepatology Senior Residency programme at NUH I completed my specialist training in Singapore and obtained membership of the Royal College of Physicians (UK), as well as attained my Master of Medicine from the National University of Singapore. I received further advanced specialist training in Gastroenterology & Hepatology and undertook my fellowship and research training in advanced hepatology and transplant hepatology at the Recanati/Miller Transplantation Institute and the Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai (New York, USA). The prestigious Fellowship of the Royal College of Physicians (Edinburgh) was conferred to me in 2018. Learn more about me here: I am excited to be here to share/discuss Digestive and Liver Health with everyone. I will be actively answering questions. 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.
30 Answers
Jauhari Malik answered 3 years ago
Doctor, my father is 50 years old and diagnosed with liver cirrhosis. He has been hospitalised several times but did not get better. Around two weeks ago when he was at home, his stomach was swollen, he looked very weak, and was unable to get up from his bed. He also vomited blood. What should I do? Is his disease threatening his life?
dr. Tan Poh Seng replied 3 years ago

Thank you for your question. What you described is very serious! Your father needs to see a gastroenterologist immediately for urgent endoscopy to stop the internal bleeding that is causing him to vomit blood. It is a serious complication of liver cirrhosis.

After that he will need meticulous care to treat his cirrhosis which is causing him to feel weak and swollen.

imanuel answered 3 years ago
Doctor, I am 38 years old. Yesterday, the color of my feces was white and pale. I am worried. I know I eat normally and have enough rest. Is this dangerous?
dr. Tan Poh Seng replied 3 years ago

Thank you for your question. Your stool color suggests that you might have obstructive jaundice, which means blockage in your biliary system in or around your liver. Patients with this condition often have dark coloured urine and yellow eyes and skin colour.

I would recommend that you do these tests: liver panel (including bilirubin, alkaline phosphate, SGPT and SGOT), INR and CT scan of your hepatobiliary system.

juwarno answered 3 years ago

Doctor, I am 58 years old. Almost a year ago, I had abdominal pain on the lower right side of my waist. During that time I was treated by a doctor and my diagnosis was gastroesophageal reflux disease (GERD). During treatment, an ultrasound was done, as well as a laboratory blood test. I also took medication. However, until now, there is no change and I still experience the pain. What should I do? Thank you.

dr. Tan Poh Seng replied 3 years ago

Thank you for your query. Apart from gastroesophageal reflux disease (GERD), other organs such as the kidney, pancreas or large intestine may also cause pain in that area.

Ultrasound (USG) does not see these organs well. You should consider having a check such as a CT or MRI scan and colonoscopy to make sure these organs are not the reason for your pain.

ihsan answered 3 years ago
Doctor, my mother is 58 years old. These two months, she has been complaining about the pain in her upper stomach. She often vomits, her stomach is a bit swollen and her skin is yellowish. The doctor said there is a stone in her pancreas and that it should be removed immediately. Is there any solution beside surgery? Does herbal medicine help?
dr. Tan Poh Seng replied 3 years ago

Thank you for the question. From what you have described, your mother could have one of these few possible conditions:

1) a gallstone causing blockage in the liver/pancreas/biliary system which can lead to infection and inflammation of these organs. For this condition the stone usually has to be removed or the blockage bypass by endoscopic retrograde cholangiopancreatography (ERCP). Surgery at a later date may be necessary depending on the exact diagnosis and timing;
2) advanced liver disease. For this condition the treatment is targeted at the liver depending what is the cause and severity;
3) other problems affecting the liver/pancreas/biliary system.

From a western medicine perspective, herbal medicine generally would not solve these conditions and I would not recommend herbal treatment.

danti answered 3 years ago
Doctor, I am 28 years old and have had gastric pains since 5 years ago. I reduce the symptoms by carefully choosing what I eat and drink. But, lately I am feeling stressed in the office, so I get frequent stomach aches and I sometimes even black out. What should I do? Is the fainting due to my gastric getting severe or is it another disease? Thank you :)
dr. Tan Poh Seng replied 3 years ago

Thank you for the question. There are a few possibilities for your symptoms:

1) H.pylori infection in your stomach
2) Stomach ulcer
3) Acid reflux
4) Sensitive stomach due to food or stress
You should consider getting your stomach checked for the above conditions especially if it is so painful that you black out.

Farrell answered 3 years ago
Doctor, my father is 47 years old. In 2015, he had surgery to remove his gallbladder, and last October he had his appendix removed, but till today he still has gastric reflux problems. He has always maintained healthy eating habits. The medical check up results (USG, CT scan, endoscopy)  in October last year showed negative gastritis helicobacter, 3-12 mm liver cysts, and the rest of the results are good. Why does he still have gastric reflux problems? What is the solution, Doc? Thank you.    
dr. Tan Poh Seng replied 3 years ago

Thank you for your question. Gastric reflux is not related to the gallbladder or appendix so removing these two organs will not make gastric reflux go away. Gastric reflux is generally due to the inlet of stomach becoming “loose” or if we overeat so the food content or stomach acid goes back up into our food pipe. So in order to reduce gastric reflux, he can try to avoid overeating, avoid lying down within 3-4 hours after food, avoid gassy drinks and avoid tight clothing.

Your dad might find sleeping with his head and upper body in higher position does help to reduce gastric reflux at night. If he still has gastric reflux, then he might need regular anti-reflux medication to control the reflux.

Ros Tah answered 3 years ago
I have been feeling pain in my left stomach for years. Sometimes the pain spreads out all the way to my back. What is the solution, Doctor?
dr. Tan Poh Seng replied 3 years ago

Thank you for the question. This type of pain could be due to pancreas or stomach issues. Please go for a check if you have not had a check on these two organs. Treatment depends on what is the condition discovered.

citra answered 3 years ago
Doctor, is it true that consuming alcohol can lead to liver cancer? My dad is diagnosed with liver cirrhosis - is it due to alcohol consumption?
dr. Tan Poh Seng replied 3 years ago

Thank you for the question. Liver cirrhosis can be caused by excessive alcohol intake over a long time. There are also other causes such as hepatitis B, hepatitis C, fatty liver and other liver diseases. Liver cirrhosis can result in liver cancer. There are treatment for liver cirrhosis and liver cancer.

We often use a combination of medications, endoscopy and radiology procedures to manage cirrhosis and liver cancer. For some cases, liver transplant is necessary to cure the cirrhosis and liver cancer.

Vera answered 3 years ago
Hello Doctor. I am a 42 year old female. Since I was a child my weight has always been below average. My  current weight is 36 kg and my height is 158 cm. I cannot eat a lot, because it makes me nauseous. I had dengue fever and hepatitis when I was 7 years old. What might be the cause of my condition, Doc? What treatment should I undergo?
dr. Tan Poh Seng replied 3 years ago

Thank you for the question. Your weight is below the normal range for your height and so you should do a check up to make sure there is no disease/condition resulting in your low weight.

I would recommend that you do some blood tests checking your blood count, liver panel, kidney panel, thyroid panel, glucose and CRP as a start. Urine and stool test may be necessary as well. F

or your poor digestion, you should check for H.pylori infection in your stomach and also get a scope done. You should visit a dietician to optimise your nutrition intake as well.

Nur Hayati answered 3 years ago
Doctor, what is the medicine for treating a bloated stomach?
dr. Tan Poh Seng replied 3 years ago

Thank you for the question. The medication for bloating depends on the reason or diagnosis for the bloating. Sometimes I use medicine to speed up the digestive tract movement, or medicine to cleanse the large intestine. If the bloating is just due to gas and the organs are normal, then avoiding certain food that cause bloating might help.

Food that commonly cause bloating include onion, garlic, cabbage, beans, milk, cheese, etc. Some bloating might be due to water retention in the belly which will require more investigations and different treatment approaches.

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