Dr Ganesh Ramalingam's guide to seeing a general surgeon in Singapore (2022)

Gut feelings. Every individual has their own unique cocktail of bacteria in their gut, and multiple factors, such as diet, lifestyle, and stress, can either turn this cocktail into a 5-star staycation margarita, or a diluted slosh that drastically lowers¹ your quality of life.

And it would seem that not everyone in Singapore has been enjoying great gut health: Research² has shown a sharp rise in irritable bowel syndrome (IBS) cases in Singapore – Singhealth³ concurs, and states that nearly 1 in 10 Singaporeans suffers from the deplorable condition.

Now, we all know the effects of poor gut health aren’t just limited to the body. I know this might be hard to stomach (pun intended!), but gastrointestinal conditions can lead to crippling anxiety, stress, and depression⁴. This is not surprising, as our brain and gut are intricately connected.

Find out if your gut health is the source of your stress.

Good gut health starts with being mindful of your diet and going for regular checkups with a doctor – preferably one who specialises in all things related to digestive disorders.

If you need surgery, you can always come to me; I’m a general surgeon, which means I can treat almost any condition that affects any area of the body.

I have a special interest in gallbladder disorders, hernias, acid reflux, laparoscopic procedures and anything that makes your stomach feel funny.

As such, for the sake of this article, most conditions I mention will be gut-related. Allow me to share more about what I do and why people who see me don’t necessarily need surgery all the time!

What is a general surgeon?

Simply put, a general surgeon is someone who specialises in surgical procedures involving the:

Digestive tract
Head and neck
Abdomen and related contents
Blood vessels and heart
Skin and soft tissue
Surgical treatment of cancer
Emergency procedures like hernia repair and surgery for appendicitis

As general surgeons treat a wide range of people and array of conditions, we are trained to meet several unique needs – including giving dietary advice and helping patients live a better life. I especially enjoy doing bariatric surgery.

Due to my interests, a few words that I use a lot are: Digestive tract, gallbladder, liver, bile ducts, and pancreas.

As a general surgeon, I went through 5 years of specialised training after medical school. My background and experience has given me the power to help people with their stomachs, colons, gallbladders, and more.

I know it doesn’t sound too glamorous, but your gut health is crucial to your overall well being. Countless findings have proven time and time again that your gut can influence your mind endlessly, in the way of neural development, brain chemistry, emotional behaviour, pain perception, and more⁵.

What conditions does a general surgeon treat?

As a general surgeon with a special interest in upper and lower GI disorders, I’ve diagnosed a throng of gut problems. With the help of my experienced staff and ever-growing technology, I’ve helped treat health conditions such as:

Cancerous colon polyps
Hernias
Chronic diarrhoea
Constipation
Gastroesophageal reflux disease (GERD)
Gas and bloating
Gallstones
Heartburn
Inflammatory Bowel Disease (IBD)
Irritable Bowel Syndrome (IBS)
Appendicitis
GI cancers like stomach cancer and colorectal cancer
Anal fistulas

To give you a better picture of what I do daily, some procedures that are commonplace in my clinic are: Colonoscopies, endoscopies, gastroscopies, and blood work.

When and how often do I need to visit a general surgeon?

We all have gastrointestinal issues from time to time, and while most of these hiccups can usually be solved with some of mum’s magical plain porridge or a bottle of Po Chai pills, certain issues certainly need more attention than others. It is also worth noting that certain digestive disorders have become so commonplace that many of us have become negligent when it comes to getting timely medical assistance.

Needless to say, this widespread carelessness can lead to devastating consequences. Therefore, it is of utmost importance that we don’t ignore any unusual symptoms. Remember, early detection is crucial, and helps immensely with uncovering the root causes of disrupted digestive health.

If you’ve experienced or are currently experiencing any of the following, consider visiting a trusted professional as soon as possible:

GI tract issue	Symptoms(s)
Abnormal bowel movements	Whether it’s constipation, faecal incontinence, or diarrhoea, these symptoms can be signs of a range of underlying health problems that include: – Neurological issues – Hormonal malfunctions – Lactose intolerance – Irritable bowel syndrome (IBS) – Crohn’s disease, and more
Jaundice	Jaundice is an indication that your liver is not working properly. It could be due to multiple factors, such as: Hepatitis B or C, Alcoholic hepatitis, and CBD stones. Many hepatitis patients could also develop liver cirrhosis, which is a deceptively asymptomatic process.
Blood in vomitus or stool	Blood in your stool or vomit is a very serious condition. The latter could be due to varices, ulcers, or even a tear in the oesophagus.
Rectal bleeding	Seeing red whilst you’re sitting on the toilet can be alarming. If you experience any rectal bleeding, see an expert without any delay. While the most common cause of rectal bleeding is haemorrhoids, please do not take any chances with your health.
Abdominal pain and bloating	If you are suffering from severe abdominal pain (with or without nausea), or mild abdominal pain accompanied by bloating after meals, it’s time to visit your gastroenterologist.
Constant heartburn	Heartburn presents as pain, or a burning sensation in the heart or chest. While heartburn is a common problem that is easily abated with medicines, consistent heartburn that lasts for more than a week definitely calls for a visit to your gastroenterologist. Heartburn might be an initial sign of GERD, which develops when stomach acid disturbs the oesophagus lining. In severe cases, surgery might be imperative.
Gallstones	If you experience sudden stomach pain in your right side, it might signify gallstones. Gallstones come in many sizes: They can be as tiny as a grain of sand, or as large as a golf ball. As we age, the chances of developing gallstones increase. Individuals who are obese or pregnant are also at higher risk of developing gallstones.
Dysphagia (difficulty swallowing)	If you have difficulty swallowing, or cough and/or choke whilst eating or drinking, it is time to consult a gastroenterologist, especially if your condition isn’t getting any better. Early diagnosis can prevent your condition from worsening exponentially: Some dysphagia sufferers totally lose the ability to swallow.
Stomach ulcers	If you experience unexplainable weight loss, discomfort when eating, a burning sensation, or pain in your stomach, consult your gastroenterologist before your ulcers deteriorate your digestive health even further.

Note: This is not an exhaustive list.

Even if you do not have any alarming symptoms, you should still get screened every 10 years, especially if you’re above the age of 50. Depending on your family history and other risk factors, you might require more regular checkups.

I’d like to stress that while the above symptoms could simply be signs of a minor health concern, you don’t want to guess wrongly and potentially neglect a serious condition. A quick visit could protect not just your life, but the peace and happiness of your loved ones.

What to look out for when choosing a general surgeon

We all know that along with medicine, who your doctor is matters too. A good doctor will offer a reliable diagnosis, and a reliable diagnosis means getting highly effective treatment. I hope that you remember that gastrointestinal diseases are life-threatening when ignored or mishandled.

On that note, how do you pick the right doctor? Here are a few qualities I believe a medical professional should possess:

The ability to make sound decisions under pressure.
Social skills to help calm their patients in stressful cases.
Good communication skills, so their patients can understand their conditions.
Counselling skills. A patient should be able to share sensitive problems with their doctor without feeling nervous or overwhelmed.
A holistic approach. For example, IBD can lead to many challenges for patients, which is why treatment plans must consider not only physical, but also emotional and mental health.
Teamwork. Regardless of the field of practice, doctors often need to work together – With each other, and their patients.

Questions to ask during your visit

If you’re intending to make an appointment, being preparedis one of the best ways to make the most of your upcoming session. Here are some great questions to ask:

Will I need a colonoscopy, endoscopy, or any other tests?
What are some common treatments for my condition?
What do I do if I have alarming symptoms or a flare-up?
Are there any medicines that could worsen my condition?
What are some serious signs or symptoms I need to watch out for?
Are there ways I need to change my diet/lifestyle?

I make it a point to examine your body during your session together. Following your initial consult, you might be sent for X-rays, scans, stool tests, motility tests, and blood tests. Thereafter, you’ll be suggested procedures that will help your condition.

I hope this article gives you a better understanding of what I do, and that you don’t necessarily need to be suffering from something when you see me. As I always preach – prevention is key, so get screened and tested whenever you can!