A MORE accurate method for checking the small intestine for cancerous growths, ulcers and bleeding has been introduced at Singapore General Hospital (SGH).
It is the first hospital in the region to offer double balloon endoscopy as a routine service.
Developed in Japan, the method has been used on more than a dozen patients here so far and has successfully located tumours in a number of them.
With several thousand people a year here seeking treatment for small intestine problems, and with other hospitals already testing it, the service is likely to become more widespread - although it isn't suitable for everyone.
Double balloon endoscopy overcomes a problem doctors have long encountered in trying to examine the inside of the 6m-long small intestine.
The traditional method, the barium X-ray, can only produce blurred images. A more recent method, introduced in 2003, requires a patient to swallow a camera capsule which takes 50,000 pictures over eight hours as it passes through the intestines.
But again, the results can be erratic, as the camera cannot be controlled.
'Sometimes it's looking up, sometimes backwards. We don't see everything - even with 50,000 images,' said Dr Ooi Choon Jin, a gastroenterologist at SGH.
There is also a small risk of the camera becoming stuck. Occasionally, surgery is needed to remove it.
The new endoscope not only gives doctors a close-up look at the small intestine, but it also enables them to carry out minor procedures, such as snipping off small polyps, applying medication, or taking a sample for biopsy.
If a biopsy shows the growth is cancerous, the film from the endoscope gives surgeons an accurate picture of where the tumour is.
SGH is charging private patients $1,156 for an endoscope examination and subsidised patients $282. This is cheaper than the camera capsule, which costs $2,070 for private patients and $867 for subsidised patients.
Dr Ooi said that out of the several thousand people who may have problems with their small intestines, only 600 to 800 will need to have it checked with either a camera capsule or the new endoscope.
But the endoscope does have its drawbacks. It is not recommended for patients who have had multiple operations, for example, because it heightens the danger of the intestine being torn during examination. There is also a small risk of perforation.