Courtesy of THIS Quarterly magazine  
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Maintaining Good Colorectal Health

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  Maintaining Good Colorectal Health  

THERE ARE THREE MAIN REASONS TO maintain good colorectal health. Regular bowel movement frees one from the distressing symptoms of constipation, diarrhoea, flatulence and bloatedness. Like the heart, the colon contracts rhythmically with propulsive movements which are stimulated when we eat. For optimal function, the colon needs to be filled with adequate soft bulk, ideally by consuming 35 grams of dietary fibre a day with adequate hydration. An average Singaporean consumes only 13.5 grams of fibre a day, which explains why constipation is so common locally.

The colon contains an amazing pool of micro organisms (100 trillions made up of thousands of different species) referred to as “microbiota” whose importance to health we are just beginning to realise. They breakdown vegetable cells in the colon to produce nutrients for the colon, liver and muscles; they produce vitamins
B and K; they develop and modulate the body’s immune system and they “detox” some toxins and carcinogens. While it is true that microbiota contains some harmful bacteria, they are often kept in check by the overwhelming number of good bacteria.

This balance is a delicate one that can be destabilised by many factors. Consuming an excess of fibre, for instance, can cause too much gas production which results in wind and bloatedness, while indiscriminate use of antibiotics may lead to the overgrowth of harmful organisms within the gut, causing diarrhoea and thrush. Chronic imbalances often leads to hypersensitivity of the gut, causing irritable bowel syndrome and other inflammatory bowel diseases.


A recent genetic study shows that the microbiota of colorectal cancer patients is less diverse than healthy individuals and there is significant loss of bacteria which ferment dietary fibre to produce useful fuel for colonic cells. To maintain a healthy microbiota, have a balanced diet and regular bowel habit. Supplements with pre- or probiotics are unnecessary unless an imbalance has been specifically diagnosed.

Much has been written about colorectal cancer, and it has created fear and distress in some people. It should not be so as most colorectal cancers are curable and preventable. Five years ago, the incidence of colorectal cancer in Singapore has stopped increasing and, as it has been in America, is likely to start decreasing. The risk of colorectal cancer can be reduced by adopting a healthy lifestyle to maintain good colonic health: adequate fibre, fruits and vegetables; less red and processed meat (less than 0.5kg per week), less carbohydrates and fats to avoid obesity and type II diabetes, regular exercise, avoid smoking and drinking too much alcohol (not more than two drinks per day) and avoid unnecessary irradiation eg. indiscriminate use of abdominal and pelvic CT scans, 1% of all colorectal cancer in Great Britain and USA is due to irradiation.

It is unnecessary and unhealthy to have regular colonics, colonic cleansing or coffeeenemas because colonic content or microbiota is benefical instead of being harmful. People forget that it provides essential nutrients to the cells lining the colon which are shed and renewed every six days.

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DR GOH HAK SU | Colorectal Surgeon



Goh Hak-Su Colon & Rectal Centre

6 Napier Road #04-08
Gleneagles Medical Centre
Tel : (65) 6473 0408
Website :
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