Gastroenterology in Singapore

Gastroscopy (Upper Endoscopy): A gastroscopy examines the oesophagus, stomach, and upper part of the small intestine using a thin, flexible camera. It is used to investigate symptoms such as persistent acid reflux, upper abdominal pain, difficulty swallowing, unexplained weight loss, or to assess abnormalities identified on imaging. It is also used for the investigation of suspected stomach cancer and Barrett's oesophagus.

Colonoscopy: A colonoscopy examines the full length of the large intestine and is both a diagnostic and preventive tool. It is the gold standard investigation for colorectal cancer screening, the assessment of rectal bleeding, changes in bowel habit, inflammatory bowel disease, and polyp detection and removal. In Singapore, colonoscopy is performed to a high technical standard by experienced endoscopists, with short waiting times and next-day results available in most cases.

Capsule endoscopy: Capsule endoscopy is a procedure using a vitamin-sized capsule containing a tiny wireless camera, which the patient swallows. It travels through the digestive tract, taking thousands of pictures, transmitted to a small recorder worn around the waist. Unlike standard endoscopy, it reaches the small intestine, an area a traditional camera tube cannot access.
It helps to:

• Investigate unexplained bleeding in the small intestine, the most common reason for the procedure.
• Diagnose inflammatory bowel disease, including Crohn's disease and ulcerative colitis.
• Detect tumours in the small intestine or elsewhere in the digestive tract.
• Diagnose or monitor coeliac disease, an immune reaction to gluten.
• Examine the oesophagus checking for enlarged veins (varices).
• Screen for polyps, particularly in patients with hereditary conditions affecting the digestive tract.
• Clarify inconclusive imaging results from prior X-rays or scans.

Med Alliance coordinates:

• specialist selection
• pre-procedure preparation advice
• scheduling
• post-procedure follow-up
• result communication

Ultrasound, CT, MRI, MRI enterography, MRCP & CT colonography.

Non-invasive imaging of the abdominal organs, including the liver, gallbladder, pancreas, intestines, and bile ducts. Used to detect, stage, and monitor a wide range of conditions from gallstones and liver disease to inflammatory bowel disease and GI cancers.

• Abdominal ultrasound — first-line investigation for gallbladder, liver, and kidney conditions
• CT scan — detailed cross-sectional imaging for diagnosis, surgical planning, and cancer staging
• MRI — high-resolution soft tissue imaging, particularly for liver, pancreas, and pelvic structures
• MRI enterography — dedicated MRI of the small intestine; preferred for monitoring Crohn's disease
• MRCP (MR cholangiopancreatography) — non-invasive imaging of the bile ducts and pancreatic duct; used when gallstones, strictures, or pancreatic conditions are suspected
• CT colonography — virtual colonoscopy using CT imaging; an alternative to standard colonoscopy for colorectal screening in selected patients

For patients who fall into higher-risk categories for gastric cancer, including those with a family history, from regions with higher incidence (parts of East Asia, Eastern Europe, and Central Asia), or with known H. pylori infection - proactive screening using gastroscopy can detect early changes before they become cancer.

Singapore's endoscopists use high-definition imaging and, where appropriate, narrow-band imaging (NBI) and chromoendoscopy to improve detection of early mucosal changes.

Med Alliance can coordinate appropriate screening for patients who may not know where to start.

Reflux & GERD (Gastro-Oesophageal Reflux Disease): Chronic acid reflux is one of the most common conditions seen by GI specialists in Singapore. For patients who have not responded to medication, or where reflux has caused structural changes to the oesophagus such as Barrett's oesophagus, surgical intervention including laparoscopic fundoplication can offer a long-term solution. Our specialists assess each patient carefully before recommending any surgical approach, and conservative management is always explored first.

Gallbladder Disease (Cholecystitis & Gallstones) Gallbladder removal (laparoscopic cholecystectomy) is one of the most commonly performed and well-established procedures in Singapore, typically done as a day procedure with rapid recovery. For patients with symptomatic gallstones, recurrent cholecystitis, or gallbladder polyps, our specialists provide a precise assessment before recommending the appropriate timing and approach for surgery.

Med Alliance coordinates:

• specialist assessment
• pre-operative planning
• surgical scheduling
• post-operative follow-up
• recovery support

This is one of the most critical areas of gastroenterology. Our specialists combine surgical precision with a nuanced understanding of each cancer type and, when needed, work closely with oncologists to develop a coordinated, multidisciplinary treatment plan.

Stomach Cancer (Gastric Cancer): Singapore has experienced gastric cancer surgeons who offer both open and minimally invasive surgical approaches, including robotic-assisted gastrectomy. Early-stage gastric cancer, when identified through screening or a surveillance gastroscopy, has significantly better outcomes - one of the reasons we encourage appropriate screening, particularly for patients from regions where gastric cancer incidence is higher.

Oesophageal Cancer: Oesophageal cancer requires highly specialised surgical expertise. Treatment typically involves a combination of chemotherapy, radiotherapy, and surgery (oesophagectomy), and the coordination between disciplines is as important as any single intervention. Our specialists have substantial experience in complex oesophageal cases, including minimally invasive and robotic-assisted oesophagectomy.

Pancreatic Cancer: Pancreatic cancer is one of the most technically demanding conditions in GI oncology, both diagnostically and surgically. Singapore's leading pancreatic surgeons are experienced in the Whipple procedure (pancreaticoduodenectomy) and other complex resections, with access to multidisciplinary tumour boards and advanced imaging. Early, accurate diagnosis and access to the right expertise are critical; this is where Med Alliance's role is most meaningful.

Cancer Surgery (General GI): For cancers of the colon, rectum, liver, and biliary system, our network includes surgeons with specialist training in minimally invasive and robotic oncological surgery, offering patients both precision and shorter recovery times.

Med Alliance coordinates:

• medical records review and specialist selection
• multidisciplinary team input where needed
• pre-surgical preparation
• translation and interpretation
• post-operative recovery and follow-up
• communication with your home oncology team if you are an international patient

Minimally invasive surgery has significantly changed recovery times and outcomes for many gastrointestinal conditions. Singapore's top GI surgeons are experienced in both advanced laparoscopic and robotic-assisted platforms, which offer greater precision in confined anatomical spaces and are particularly valuable in complex oncological and revisional surgery.

Rather than recommending a surgical approach in advance, our specialists assess whether laparoscopic or robotic surgery is genuinely appropriate for each patient's anatomy and diagnosis, not simply what is available or promoted.

For patients with obesity and related metabolic conditions, including type 2 diabetes, hypertension, and fatty liver disease, where lifestyle and medical management have been insufficient, bariatric surgery can offer a meaningful and lasting improvement in health.

Singapore's bariatric surgeons have extensive experience in sleeve gastrectomy, Roux-en-Y gastric bypass, and other metabolic procedures. All patients are assessed through a structured pre-operative programme including metabolic, nutritional, and psychological evaluation before any surgical recommendation is made.

Med Alliance coordinates:

• pre-operative multidisciplinary assessment
• surgical scheduling
• post-operative nutritional and follow-up support
• long-term outcome monitoring support

Hernias (including inguinal, umbilical, incisional, and complex abdominal wall defects) are a common reason for GI surgery referral in Singapore. Our specialists are experienced in both laparoscopic and open repair, including complex abdominal wall reconstruction for recurrent or large hernias. The approach is always chosen based on the patient's specific anatomy and hernia type.