Yap Chin Kong Gastroenterology & Liver Clinic

12/03/2026

A 50 year old male on a weekly weight loss injection, tirzepatide lost 20kg over 18 months. These medicines are effective and target the appetite center in the brain to reduce eating. One of the side effects is gastric (stomach) paralysis. On ultrasound scan in the clinic we can see food residue, despite a 16 hour fast. Usually the stomach is empty after a 6 hour fast. This can pose a risk to the patient during sedation for procedures such as gastroscopy, colonoscopy or other procedures because stomach contents are still present.

We like the stomach to be empty, to prevent aspiration of stomach contents into the lungs during moderate/deep sedation.

The ultrasound picture shows the stomach with internal solid contents (white echoes, right panel).

27/08/2024

Food may contain toxins generated by bacteria. Some toxins are not destroyed by cooking.

https://www.cfs.gov.hk/english/multimedia/multimedia_pub/multimedia_pub_fsf_213_01.html

Bongkrekic acid is a rare toxin produced by the bacterium Burkholderia gladioli parthovar cocovenans (B. cocovenenans). While it may be a food safety hazard, there are steps consumers can take to minimise our exposure and risk.

23/08/2024

Healthy lifestyle choices. Avoid or minimise processed foods and chose fresh food, vegetables and fruit.

https://www.cam.ac.uk/research/news/red-and-processed-meat-consumption-associated-with-higher-type-2-diabetes-risk?fbclid=IwY2xjawE0zXdleHRuA2FlbQIxMQABHaVCsb4xgBzvSUTjk6qkIIcerBfYmHzJXcgvJQcN4NXjcfBOmt52-CT_cA_aem_Emymi5EvKF2KHnf4ra7zig #

Meat consumption, particularly consumption of processed meat and unprocessed red meat, is associated with a higher type 2 diabetes risk, an analysis of data

07/03/2024

Our environment plays an important role in cancer. It has been estimated up to 70% of some cancers can be attributed to the environment and 30% to bad genes we inherit from parents. Some well known environmental factors are hepatitis B & C viruses, human papilloma virus, Helicobacter pylori, radiation and chemicals like asbestos and petro-chemicals.

For many years petro-chemical by products have been implicated as environmental carcinogen and this latest news serve as yet another reminder. If you look at the list of ingredients in cosmetics and soap you may find some with petro-chemical by products.

Sadly, with time, people will forget. Again

A tiny amount of petrochemical product used daily in cosmetics and soap, diluted many many times seems in significant to lay people.

However if applied and absorbed through the skin over many decades, the cumulative effects maybe significant. That may explain why cancer occurs more commonly as we get older because it takes many years for the carcinogens to do their damage.

How should humans look after "beauty" without resorting to these products? Is it the fault and power of commercial advertisements that created man-made "standards of beauty" that is now nearly impossible to change? When it comes to "beauty" many will take health risks. That's human weakness/nature. The cosmetic giants understand human nature very well.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10048826/

High levels of the chemical benzene, which has been linked to cancer, were detected in numerous consumer acne products, including from major brands such as Proactiv, Clinique, and more.

07/02/2024

A concerning statistic if young people have 25% mental health issues.

https://www.channelnewsasia.com/singapore/poor-mental-health-young-adults-seek-help-moh-survey-3802531?fbclid=IwAR2y-pI9EU9FTFYKBDYv6xPfICKcs1nFmlZ1lDZtkA9oR2oMKzm4qZypJxI

More Singapore residents are, however, willing to seek help, particularly from informal support networks, according to a survey by MOH.

28/09/2023

Eat more bland foods. Eat out less. Cook more at home to control better the ingredients that go into food.

https://www.straitstimes.com/singapore/s-poreans-eating-too-much-salt-more-than-one-in-three-now-has-high-blood-pressure?fbclid=IwAR1csTYeBVoXS5NNSWDapf6U8wvuxGlaNOHoYVAR76Pa6xbDXp2PCO8zeuQ

MOH is considering regulations to reduce sodium content in food, including labelling similar to that for sugar. Read more at straitstimes.com.

15/09/2023

The new variant of COVID-19, Omicron XBB.1.5 sublineage which also includes EG.5 or Eris and BA.2.86, maybe more contagious.

Be vigilant, mask up and avoid in-door gatherings, crowds as much as you can.

Do our part as a responsible person.

https://www.channelnewsasia.com/singapore/updated-covid-19-vaccine-pfizer-comirnaty-omicron-xbb15-eris-ba286-3773301?cid=internal_sharetool_androidphone_15092023_cna

https://www.reuters.com/world/middle-east/israels-health-ministry-recommends-some-wear-masks-indoors-amid-rise-covid-cases-2023-09-12/?fbclid=IwAR3qOagE1HnhAm6LyTpGaJ-MqgrPWu6Oc9-_Pau2-s9PTaroSiYmKDCaOdg

Israel's health ministry on Tuesday advised people with compromised immune systems to wear masks in crowded indoor spaces as it marks an increase in COVID-19 hospitalisations ahead of the Jewish holidays.

20/07/2023

https://www.bbc.com/news/health-66221116

The antibody treatment donanemab slows clinical decline by around a third, a large trial confirms.

16/07/2023

New obesity medicine. Tirzepatide.

In Singapore:
30% are overweight
10% are obese
12% are diabetics, and rising.

Potentially useful for fatty liver associated with obesity.

We need to do better to win the war against diabetes/obesity. It's about changing life styles and diets.

https://www.healthhub.sg/live-healthy/764/its-not-a-small-world-after-all
https://www.diabetesatlas.org/data/en/country/179/sg.html

Original Article from The New England Journal of Medicine — Tirzepatide Once Weekly for the Treatment of Obesity

16/07/2023

https://annals.edu.sg/an-unusual-case-of-ear-pain-in-a-child/?fbclid=IwAR2pRClkRKDjFr5sfOxHfWe85xKRM0ssLUNalRd-ReHV2CxVumj6sLw-EJc #

A previously healthy 4-year-old French boy presented to the children’s emergency department complaining of left otalgia for 3 days. He had initially experienced left ear itch, which progressed to increasing sharp pain. There was no associated otorrhoea, blood-stained ear discharge or hearing loss....