A urinary tract infection (UTI) is an infection of the urinary tract, which is the path that urine takes when it leaves the body. The parts of the urinary tract that can be infected include the bladder, urethra, and/or kidneys. The following terms refer to the place that is infected.•      Cystitis (bladder Infection)•      Urethritis (urethra infection)•      Pyelonephritis (kidney infection)It is important to treat UTIs to keep your kidneys healthy. What causes a UTI?UTIs, bladder infections in particular, are usually caused by a type of germ (bacteria) called Escherichia coli (E. coli). These bacteria are usually near the anus (the opening through which the feces leave our body). Some other bacteria, for example sexually transmitted infections like gonorrhea, chlamydia, and vaginal infections, can also cause UTIs affecting the urethra. Who has a higher chance of developing a UTI?Women in general have a higher risk of getting a UTI than men, because the distance between the opening of the urethra and the anus is shorter in women.The chance of getting a UTI is also increased for people who:•       Are sexually active or engage in anal sex•       Use diaphragms or spermicide for birth control•       Are pregnant or menopausal•       Have a history of bladder or kidney infection•       Have conditions that change or block the natural flow of urine, such as kidney stones•       Have diabetes  Do I need to send my urine for culture to identify the bacteria?Based on your symptoms, your doctor will decide if you need a urine culture. Your doctor may request for a urine culture test if the UTI is more than a simple bladder infection or if you are pregnant or have repeat infection.How will my doctor treat my UTI?Your doctor will give you antibiotic pills to eliminate the bacteria. It is important that you complete the course.Depending on your symptoms, your doctor may also give you medicine to reduce discomfort and the urge to urinate.Feel free to talk to your pharmacist about the common side-effects and allergic reactions for the relevant medicines. What can I do at home to feel better?•      Continue to finish all the antibiotic pills, even if you start to feel better•      Drink plenty of water. This helps to flush the bacteria out of the body•      Avoid caffeine and alcohol. They can irritate your bladder•      Apply a warm pad to your abdomen to reduce bladder discomfort How can I prevent getting a UTI again?DOs•      Drink plenty of water•      Practice good perineal hygiene. Always wipe from front to the back•      Wear cotton underwear. Bacteria grows better in moist places. Cotton does not trap moisture•      Drink more fluid and void before and after intercourse DON'Ts•      Avoid holding your urine. Go to the toilet when you need to•      Avoid soaking in bathtubs for long periods of time When should I see my doctor again?Please contact your doctor if you have any of the following:•      Persistent discomfort or a condition which worsens after two days of antibiotic therapy •      Fever. A temperature higher than 38°C•      Chills or night sweats•      Severe flank, back, or abdominal pain•      Severe nausea, vomiting, or diarrhea•      Blood in urine With reference to www.uptodate.com

Sore throats are common. A sore throat is often a throat infection or pharyngitis.Sore throats are usually caused by 2 types of germs—viruses and bacteria. Most sore throats are caused by viruses. Only 10% of sore throats are caused by bacteria. You or your child has seen the doctor and is likely to have a sore throat caused by a virus. Do I need antibiotics?If your sore throat is caused by a virus, you do not need antibiotics. A sore throat caused by viral infection gets better on its own with at-home care, usually within five to ten days. What medicines will my doctor give me? Your doctor will most likely give you medication and lozenges to relieve your throat pain or discomfort. Depending on your symptoms, doctor may also give you medicines to relieve running nose and cough.What about alternative remedies?There are limited evidences on what works and what does not for common alternative remedies. Some of these remedies may not be safe. Check with your doctor before using them. What are the things I can do at home to feel better?DOs•      Get plenty of sleep and avoid talking•      Drink plenty of fluids to keep your throat moist. This helps with swallowing and prevents dehydration•      Drink soothing beverages and eat soft foods•      Gargle with salt water several times a day to help relieve throat pain•      Add moisture to the air in your home. Use a cool-mist humidifier or vaporizer. Be sure to clean it daily DON'Ts•      Avoid spicy foods or acidic foods that irritate your throat•      Avoid smoking or secondhand smoke How much salt should I put in my salt water gargle?About 1/4 to 1/2 a teaspoon (1.5 to 3.0 g) of salt in one cup (250 ml) of warm water. When can I return to work? When can my child return to school?You can resume your usual activities as soon as you feel better. Wear a mask if the air pollution is bad to prevent further throat discomfort. How can I avoid getting a sore throat again?Reduce your chance of having a viral infection by exercising regularly and eating healthily.Also practice good hand washing habits, washing your hands with soap and water to prevent the spread of infection. When should I see my doctor again?Please contact your doctor if your sore throat does not improve within two days or if you have a fever. Also contact your doctor if you have the following symptoms: •      Difficulty swallowing•      Drooling (especially for children)•      Trouble talking or opening your mouth•      Hoarseness lasting more than two weeks•      Body aches, joint pain, or earache•      Skin rash•      Nausea or vomiting•      Constant sleepiness or tiredness•      Increased thirst or dry and sticky mouth with less urine than usual (one wet diaper or void in six hours) or total lack of tears when crying When do I need to go to the hospital or emergency department?Call the ambulance or go to the nearest hospital right away if you have: •      Chest pain•      Difficulty breathing•      Shortness of breathWith reference to www.uptodate.com

When you have surgery, highly skilled professionals will care for you. Beforehand, learn what to expect and how to prepare. This helps you relax, and may speed your recovery. Read this booklet and ask questions to learn more.1. Before SurgeryTalking with your DoctorYour doctor will help you learn about your surgery. Make a list of questions to ask. Your list might include these:•      How do I prepare for surgery?•      What day and time do I arrive?•      Where do I check in?•      Are there any documents or forms that I need to bring along?•      How long will I be in surgery?•      When can I see my family?Your Pre-op ExamYour doctor will ask you about your medical history, do a physical exam, and order some tests. It may include:•      Blood tests, which provide information about your blood and body chemistry•      An ECG (electrocardiogram) records how your heart functions•      A urinalysis (analysis of your urine) gives information about your kidneys and bladder•      A chest X-ray shows an image of your lungs•      Other tests may also be doneIf you have results from those or other tests at home, bring them with you when you check in for surgery. Without them, your surgery may be delayed or cancelled. Preparing for SurgeryFollow your doctor's instructions before surgery. Use the checklists at the end of this booklet. And follow these guidelines:•      Tell your doctor about any medications you take, including aspirin, herbs, or vitamins. Ask if you should continue taking them •      If you smoke, make a plan to quit or cut down•      Ask your doctor if you will need a blood transfusion during surgery and if so, how to prepare for it •      If you are having abdominal surgery, ask what you need to do to clear your bowelThe Night Before Surgery•      If instructed, wash with antibacterial soap where the incision will be made. Hair on this area will be shaved or trimmed at the hospital•      Follow your surgeon's instruction for fasting before surgery•      Don't smoke•      If you've been told to keep taking a medication, take it with small sips of waterArriving for SurgeryBring your insurance documents and any forms you need with you. When you check in, you will get an ID bracelet and be taken to a room to get ready. Your family and friends may be asked to stay in a waiting area.AnesthesiaIf anesthesia is required, the anesthesiologist will talk with you about anesthesia (medicine to block pain and keep you comfortable during surgery) before surgery begins.  2. Going into SurgeryBefore surgery, you may be given medication to relax yourself. You may be taken on a stretcher or in a wheelchair to an operating room. Along the way, you may notice other patients, surgical staff, or equipment.In the Operating RoomThe operating room (OR) is staffed by a team of highly-trained professionals. The OR provides the most sterile and safe surgical setting possible. Your surgical team usually includes the following members：•      A surgeon, responsible for your overall care, will lead your surgical team•      A surgical assistant may help on many major surgeries•      An anesthesiologist provides anesthesia or medication, and monitors vital signs•      A scrub nurse sets up instruments and assists the surgeon•      A circulating nurse prepares the OR, makes sure sterile methods are followed, and helps other team membersThe Equipment•      An IV (intravenous line) will be used to provide fluids to your body, or give you medication or blood. An IV feels like a pinprick when it is inserted•      Monitors show your vital signs (blood pressure, heart rate, heart rhythm, etc.)•      An electrocardiography records your heart functions. It is connected by wires to round sticky patches that are placed on your upper body•      A pulse oximeter is placed on your finger to monitor your blood's oxygen level•      Blood pressure cuff is placed on your arm to monitor your blood pressure•      There will be surgical lights overhead and other equipment around you in the room to help in your operation, and to make sure you are safe and comfortable 3. After SurgeryAfter surgery, you'll be brought to the post anesthesia care unit (PACU, or Recovery Room). You'll receive constant care from a post anesthesia care nurse. When you're coming out of surgery, you doctor may call or visit your family or friends to let them know how you're doing.In the PACUAs the anesthetic wears off, you'll “wake up” in the PACU. Noises may sound louder than normal. You may have blurry vision, a dry mouth, chills or nausea. A nurse will check your dressing and blood pressure often. You may have an IV, or other tubes used for drainage. If the area operated on hurts or burns, ask your nurse for pain medication if you need it. You may be asked to do deep breathing and coughing to help clear your lungs. Your nurse may ask you to move around in bed, since even these small movements will help you recover faster.After the PACUThe PACU nurse works with the anesthesiologist to decide when you can be moved from the PACU. It's often an hour or more after surgery.If you're an inpatient, you'll be taken to your hospital room, where you'll stay for at least one night. Your family or friends may see you the same day as your surgery.If you're an outpatient, you'll stay in the PACU to recover until discharge. Be sure to have an adult friend or family member drive you home after surgery.4. Your RecoveryYour doctor and nurses will check on you after surgery. Follow your healthcare team's advice about walking, deep breathing, and eating. If you feel pain or nausea, tell them.WalkingWalking helps your blood flow better. It also helps your body functions get back to normal. Be sure to have someone help you the first time you get out of bed, and when you begin walking.EatingFood may be hard to digest after surgery. So, you may have an IV for nutrition when you're in the hospital. When the doctor says you can begin eating, a dietitian or the nurse will help decide what foods are best for you. You'll start with liquids. Later, you'll eat solid foods. At home, follow your doctor's orders about eating and drinking.Breathing and CoughingIn the hospital, you may be asked to use a spirometer for deep breathing exercise. Deep breathing clears the lungs and helps prevent pneumonia. This may be difficult at first. If you have an incision, holding a pillow over it when you cough can help.Coping with PainYou may receive pain medication in the hospital or be sent home with a prescription. Everyone has a different level of pain. So if you have pain or nausea, don't be afraid to ask your doctor or nurse for medication. Also let your doctor or nurse know if you have any side effects from the medication. 5. Going HomeYour doctor will let you know when you can go home. It is natural to wonder how you will care for yourself. Your doctor or nurse will give you guidelines. Be sure to ask them any questions you might have. Having support at home will help, too. Please contact your doctor if you experience any discomfort.Looking AheadYou're likely to spend most of your time recovering from surgery at home. Make sure to plan your home care. Also, you'll need to visit your doctor's clinic sometime after you leave the hospital. Be sure to keep these appointments. Below are some topics to discuss with your doctor or nurse before you go home.•      Pain control•      Medications•      Diet•      Bandages and dressings•      Bathing•      Stitches, staples, and incision care•      Signs of infection•      Home help•      Follow-up visits with doctors•      Driving and other activities•      Returning to workLeaving the HospitalA hospital staff member will take you to your car in a wheelchair. You won't be allowed to drive yourself home, so make sure you have an adult friend or family member available. At home, rely on family or friends. The more they know about your health and surgery, the more help they can provide you. Your nurse can talk to them about their questions and concerns.Appendices:A. Your Pre-Surgery Checklist•      Call your doctor if you have a change in your health. Even a cold or flu can delay your surgery•      If you'll be staying overnight, we will prepare personal toiletries, pajamas, robe, and slippers for you•      Bring a list of your medications (medication name, dosage, and how often you take them)•      Wear comfortable, loose clothing•      Remove dentures and all metallic materials on the body•      Leave valuables (cash, watch, jewelry, etc.) at home•      Remove all nail polish, lipstick, and other makeup before surgery•      Ask an adult friend or family member to drive you home•      Ensure that you have arranged to have people looking after you, providing you with everything you need once you return home B. Checklist for Important Information•      Date and time of surgery•      Hospital•      Address•      Phone number•      Insurance•      Policy number•      Doctor's name•      Doctor's phone number•      Date and times of follow-up appointments

Everyone has blood pressure. Blood pressure is the force of the blood against the walls of your blood vessel walls.  Some people have blood pressure that is higher than normal. When that happens, we call the condition high blood pressure or hypertension. When your blood pressure is higher than normal, your heart works harder to pump blood. When your blood pressure remains high for a long period of time, your arteries can get blocked or damaged, and cause the following problems: What do the 2 numbers in my blood pressure reading mean?The top number is the pressure in your arteries when your heart is contracting. The bottom number is the pressure inside your arteries when your heart is relaxed.What is a healthy blood pressure reading?The following is a guide to know your blood pressure condition (adults): Will I know when my blood pressure is high? High blood pressure, unless very high or present for many years, usually has no symptoms. Many people do not know when their blood pressure is high. The best way to find out is to have your blood pressure checked by your doctor or nurse. It is recommended that all individuals 18 years or older be screened for high blood pressure. Measuring blood pressure is a simple and quick procedure that can be done in most clinics.What causes blood pressure to become high?The exact cause of high blood pressure is unknown, however there are several factors that in combination may cause the blood pressure to become high. These factors include smoking, obesity, sedentary lifestyle, and genes.How can I prevent my blood pressure from becoming high?The following can help to control your blood pressure from becoming high:  With reference to www.uptodate.com

Dear Sir/Madam:Greetings.Thank you for choosing Jiahui Medical Endoscopy Center for gastroscopy examination/treatment. We sincerely wish to provide you with the best quality health care patient experience. To fully prepare for your gastroscopy examination/treatment, please pay attention to the following instructions: Before your gastroscopy1. Please stop eating and drinking by 8.00pm in the evening before the examination. Please remember to refrain from taking breakfast and drinking water on the morning of the examination. A few days before the examination, please start having light meals. Avoid eating spicy food and smoking. 2. On the day of examination, please wear comfortable clothing, as you will be requested to change into an examination gown before the examination. You will also be requested to remove and keep your dentures before the examination.3. Prior to the examination, please let your doctor know if you have any of the following medical conditions: high blood pressure, coronary heart disease, arrhythmias, respiratory disease, coagulation disorders or drug allergy.4. If you are having the gastroscopy examination without sedatives, please cooperate by swallowing when your doctor is inserting the endoscope. If there is any nausea or vomiting, your doctor may instruct you to take slow deep breaths. Usually with good preparation and cooperation, the examination can be smooth with less unpleasant effects.5. If needed, your doctor may send some of your gastric tissue or cells for biopsy tests if he or she sees anything suspicious. This procedure is usually harmless.6. Please let your doctor know if you are taking any of the following blood-thinning medications: aspirin, clopidogrel (brand name Plavix, Talcom etc.), warfarin, etc. If necessary, your doctor might request you to stop taking these medications 5 to 7 days before the examination.7. We do not recommend the examination be done if you are pregnant or having your period (menstruation).8. Please tell your doctor or nurse if you have a cold or a blocked nose.9. On the day of examination, please also remember to bring all your medical records and relevant medical tests results and reports. After your gastroscopy1. If you have undergone a gastroscopy without sedatives - After 1 hour, you can resume eating soft and warm food, such as bread, porridge, etc. If you have undergone a gastroscopy with sedatives - After 2 hours, you can resume eating a small amount of soft food for easy digestion such as bread, porridge, etc. If you have undergone a gastroscopy with biopsy done - After 2 hours, please start on cool fluid diet. Later in the day, you can start eating low residue semi-fluid diet. On the next day, you can resume your normal diet.• Low residue diet examples: porridge, bread, noodles, small wonton and steam egg custard, etc.• Fluid diet examples: fruit juice without pulp, lotus root starch paste, clear broth, etc.2. If you have undergone gastroscopy with treatments performed (such as removal of polyp, hemostasis and foreign body extraction):• Please have complete rest in bed on that day after the examination. Avoid any strenuous activity for the next three days• For the first 2 days after the examination, please eat cool low residue fluid diet. Avoid soymilk, milk and carbonated soft drinks. On the third day, you can resume eating soft food. Avoid eating spicy, sour, salty and oily food3. You can resume your usual medications. Your doctor might ask you to discontinue aspirin and blood-thinning medications such as clopidogrel 3 to 5 days if needed.4. You may experience some abdominal bloating that will disappear after a few hours after examination. You may also experience some throat discomfort that will resolve a few days later.5. Please contact your doctor if you have the following symptoms: constant nausea and vomiting, abdominal discomfort, fever and others.If you experience persistent abdominal pain or blood in stool, please contact your doctor and seek help immediately.6. If you have undergone sedative gastroscopy: avoid strenuous activity and sudden position change to prevent vertigo when recovering from anesthesia. Avoid driving or operating heavy machinery on the day of examination. 7. It will be ideal to have someone accompany you home after the examination if you are undergoing a sedative gastroscopy.8. You will be able to get your pathological report 10 working days after the endoscopy procedure. Your doctor may also arrange a follow-up appointment to explain your examination results/report if required.

Dear Sir/Madam:Greetings.Thank you for choosing Jiahui Medical Endoscopy Center for colonoscopy examination. We sincerely wish to provide you with the best quality health care patient experience. To fully prepare for your colonoscopy/capsule endoscopy examination, please pay attention to the following instructions:Before Colonoscopy1. Diet recommendations2 days before examination: Low residue diet1 day before examination:     Breakfast - Low residue diet    Lunch - Low residue diet    Dinner - Clear liquid diet1 day before the examination, please avoid the following food:• Grains: glutinous rice, black rice, cereals and others• High fiber vegetables: celery, leeks, bamboo shoots and others • Fruits with seeds: watermelon, kiwi fruit, dragon fruit and others • Dark colored food: tomatoes, animal blood, animal liver, red dates, red hot chili peppers, black fungus, sesame and others• Seaweed: kelp, seaweed and others2. Bowel preparationIf your colonoscopy is in the morning,• Start your bowel preparation on the day before your examination, 2 hours after dinner at 8pm• Dilute 2 packets of prescribed powder in 2 L of warm water and mix well• Finish the above prepared mixture in 2 hours:  ○  In the 1st hour, finish 1 L of prepared mixture  ○  In the 2nd hour, drink 250 mL of prepared mixture every 15 minutesOn the day of your examination:• Start your bowel preparation at 6am• Dilute 1 packet of prescribed powder in 1 L of warm water and 30 mL of Simeticone together, mix them well  ○  Complete the above prepared mixture in one hour durationIf your colonoscopy is in the afternoon,• Start your bowel preparation on the day of your examination 4-6 hours before the procedure without having breakfast• Dilute 2 packets of prescribed powder in 2 L of warm water and 30 mL of Simeticone together, mix them well• Finish the above prepared mixture in 2 hours:  ○  In the 1st hour, finish 1 L of prepared mixture  ○  In the 2nd hour, drink 250 mL of prepared mixture every 15 minutesMinimum to moderate walking exercising required after completing 1st liter of prepared mixture.Please take note: In 1 to 2 hours after consumptions, your bowels will start to clear. You should notice your stools are turning clear in color, after several toilet trips. This means your bowel is well prepared for the examination. If you have constipation issues, please let your doctor know. He or she might add other medications to your bowel preparation.3. Please stop eating and drinking 2-4 hours prior to the examination.4. Please let your doctor know if you are taking any of the following blood-thinning medications: aspirin, clopidogrel (brand name Plavix, Talcom etc.), warfarin, etc. If necessary, your doctor might request you to stop taking these medications 5 to 7 days before the examination.5. We do not recommend the examination be done if you are pregnant or having your period (menstruation).6. Please tell your doctor or nurse if you have a cold or a blocked nose. 7. On the day of examination, please also remember to bring all your medical records and relevant medical tests results and reports. After Colonoscopy1. If you have undergone a colonoscopy with no biopsy done – After 1 hour, you can resume your normal dietIf you have undergone a colonoscopy with biopsy done – After 2 hours, please start on low-residue semi-fluid diet. On the next day, you can resume your normal diet.• Low-residue diet examples: porridge, bread, noodles, small wonton and steam egg custard, etc.• Fluid diet examples: fruit juice without pulp, lotus root starch paste, clear broth, etc.2. If you have undergone colonoscopy with treatments performed (such as removal of polyp and hemostasis): • Please have complete rest in bed on that day after the examination. Avoid any strenuous activity for the next three days• For the first 2 days after the examination, please eat cool low-residue diet. Avoid soybean drinks, milk and carbonated soft drinks. On the third day, you can resume eating soft-textured food. Avoid eating spicy and oily food3. You can resume your usual medications. Your doctor might ask you to discontinue aspirin and blood-thinning medications such as clopidogrel 3 to 5 days if needed.4. After the examination, you may experience some abdominal bloating that will disappear after a few hours upon passing gas. Also, it is normal if you see a small amount of blood in your stools after the examination.5. Please contact your doctor if you have the following symptoms: constant nausea and vomiting, abdominal discomfort, fever and others.If you experience persistent abdominal pain or blood in stool, please contact your doctor and seek help immediately.6. If you have undergone sedative colonoscopy: avoid strenuous activity and sudden position change to prevent vertigo when recovering from anesthesia. Avoid driving or operating heavy machinery on the day of examination. 7. It will be ideal to have someone accompany you home after the examination if you are undergoing a sedative colonoscopy.8. You will be able to get your pathological report 10 working days after the endoscopy procedure. Your doctor may also arrange a follow-up appointment to explain your examination results/report if required. 

What is an MRI scan?Magnetic resonance imaging (MRI) uses powerful magnet and radio waves together with computer technology to provide very detailed and clear pictures of the body organs and structures. MRI, unlike X-ray and Computed Tomography (CT) scans, does not use ionizing radiation. The images created by MRI have higher resolution and greater details than X-ray imaging and CT scan. What is an MRI scan used for? The MRI is capable of creating images that show the differences between healthy and unhealthy body organs and structures. MRI of different body parts help to diagnose diseases and medical conditions. The following are some purposes of MRI for different body parts and structures:•      MRI of the head – Detects cancer tumors, stroke, dementia, diseases involving the protective covering surrounding the nerve fibers in the brain and spine (demyelinating disease), and epilepsy•      MRI of the spine – Detects torn ligaments around joints and spine problems, especially related to the spinal discs, bone and soft tissue tumors, and joint diseases•      MRI of the abdomen and pelvis – Detects and analyze tumors from spleen, kidney, colon, prostate, bladder, and other organs•      Magnetic resonance cholangiopancreatography (MRCP) – Creates images of the liver, gallbladder, bile duct, pancreas, and pancreatic duct. Detect tumors, infection, and inflammation •      Magnetic resonance angiography (MRA) – Creates images of the arteries. Detect abnormal narrowing or abnormal vessel wall dilation that could cause repture What preparation do I need to do before an MRI scan?Usually, there is little preparation involved. You need to remove metal objects from your body such as dentures, jewelry, hairclips, because an MRI scan works through strong magnet fields. Please let your doctor or radiologist know if you have any surgical implants, such as screws that fix fractures, surgical clips that repair blood vessels, or a pacemaker. You may also be asked to not eat or drink for a few hours before your scan.What will happen during an MRI scan?In some cases, an injection of a special dye may be given into the bloodstream via a vein on the arm. This dye is relatively harmless, and helps to see things in the body more clearly.You will be asked to lie on a movable bed that will pass through an enclosed tunnel. Stay very still during the scanning, so that images remain sharp and clear. If you have a fear of confined spaces (claustrophobia), you should discuss this with your doctor before going for the scan. You will be given ear plugs or ear phones to protect your ears as the scanning can be quite noisy. Our MRI technicians will watch you through the glass window in the room next to you. We will be able to hear you at all times and also speak to you over the speakers. The whole procedure takes about 20 to 60 minutes.What are the risks of doing an MRI scan?Unlike X-rays and CT scans, MRI does not have any ionizing radiation, thus MRI is a safe and painless medical imaging examination that carries little risks with it.Although MRI scans are thought to be safe, the long-term effects of strong magnetic fields on a developing baby are not yet known. For this reason, pregnant women are advised to only have an MRI scan if it is urgent and absolutely necessary.On rare occasions, the special dye used can cause an allergic reaction. The chances of this dye causing damage to the kidneys are much less than the special dye used in CT scans. Therefore, MRI is sometimes helpful in patients with kidney problems.Do follow the instructions from your doctor, nurse, and radiologist closely to prepare and care for yourself after the procedure. Ask them questions if you have any concerns.

What is a gastrointestinal endoscopic examination?Gastrointestinal endoscopic examination is the most common and direct method used to look at your digestive tract. During the procedure, a flexible tube with a camera attached is passed through your digestive tract to capture pictures on a color TV monitor.Endoscopic examination has been around for a long time and is a relatively fast and safe procedure. It is mainly used to detect inflammatory changes of the layers of the digestive tract, ulcers, cancer, and other diseases.Gastrointestinal endoscopic examination is superior to ultrasound and computed tomography (CT) examination because besides being the most direct way to look at lesions and abnormal changes in the digestive tract, some tissue can be removed (biopsy) at the same time to confirm the nature of disease – whether it is inflammatory, benign growth, or malignant cancer. In addition, treatments can also be carried out using endoscopy. What are the different types of gastrointestinal endoscopic examination?Gastrointestinal endoscopic examination can be broadly divided into 3 types:Other types of gastrointestinal endoscopic examination include endoscopic ultrasound, capsule endoscopy and enteroscopy (small intestines). What are the treatments that can be done under gastrointestinal endoscopic examination?The treatments that can be done include but are not limited to the following:•   Removal of polyps from the stomach and intestines•   Digestive tract bleeding control and treatment•   Treatment for early cancer in gastrointestinal tract•   Intestine dilation and placement of stents•   Pancreas and bile duct treatment – removal or stones, cysts drainage, and placement of stents Why do I need a gastrointestinal endoscopic examination?　Digestive tract problems are very common and occur frequently among people nowadays because of work stress, unhealthy eating habits, and sedentary lifestyle. These cause undesirable effects such as stomach discomfort, stomach pain, acid reflux, gas, stomach distension, heartburn, diarrhea, constipation, and at times blood in the stools.These symptoms may be caused by any of the following digestive tract problems: •   Chronic gastritis•   Esophageal reflux•   Gastrointestinal functional disorders•   Ulcers in the stomach or intestines•   Polyps in the stomach or intestines•   Inflammatory bowel disease•   Cancers of the digestive tractEndoscopic examination provides the most accurate visual inspection of the digestive tract. It can detect cancer at an early stage, especially colon cancer and gastric cancer which are ranked 2nd and 3rd as the most common cancers respectively.Early detection, early diagnosis, and early treatment can greatly improve your chances of recovering from cancer of the digestive tract. Thus, it is generally recommended that for people aged 40 years and above to have regular gastroscopy screening and those over the age of 50 to have regular colonoscopy screening. If you have digestive tract symptoms or a family history of digestive tract cancer, screening should be started at an earlier age. Is gastrointestinal endoscopic examination painful？Gastrointestinal endoscopic examination generally does not cause great discomfort. However, some may feel nauseous during a routine gastroscopy examination. Others may feel stomach distension or discomfort during routine colonoscopy. If you wish to avoid these unpleasant side effects, you can choose a sedative endoscopic examination.Sedative endoscopic examination uses a combination of sedatives (medicines that help you to sleep or reduce your anxiety) and anesthesia drugs (medicines that prevent pain during procedure or surgery) on top of the routine gastroscopy or colonoscopy to achieve a state of light quiet sleep. The whole procedure takes about 30 to 60 minutes. It effectively reduces nausea, vomiting, pain, and other unpleasant side effects.Reducing your anxiety and discomfort will help you to tolerate the examination and have a more satisfactory experience. After the procedure, your doctor and nurses will observe you closely till you are fully awake and well before discharging you.Am I suitable for sedative endoscopy?If you have any of the following conditions, please discuss with your doctor to determine whether you are a suitable candidate for sedative endoscopy:•   Serious heart or lung diseases •   Sleep apnea or snoring •   Bleeding in the digestive tract•   Declined liver function or severe anemia•   Severe neurological disease (such as stroke, convulsions, frequent epilepsy relapse)•   History of drug abuse or history of allergies to sedative drugs What are the risks of doing sedative endoscopy?The sedative medication that is used to help you to sleep during the procedure is called Propofol. This medication helps you to fall asleep quickly before the procedure and wake up quickly after the procedure. It acts fast and clears the body fast, thus it has relatively few side effects. A small number of patients may experience a short period of drowsiness, giddiness, nausea, vomiting or other unpleasant effects which the anesthesiologist can help you to manage.Endoscopic examination, with or without sedation, is an invasive procedure and there are risks of injury, bleeding, and infection. However, the chances of these happening are rare. There is also a small possibility of it affecting the heart and lungs or drug allergies occurring, depending on the patient’s current health condition. Some complications caused by endoscopic examination such as bleeding, perforation, etc. are usually managed during the procedure itself. Talk with your doctor about your current health condition and obtain a good risk profile before your procedure.Endoscopic examination generally does not produce unpleasant side effects, however a small number of patients may experience the following for a short period of time: •   Hoarseness or throat discomfort•   Small amount of bleeding (due to biopsy or severe nausea and vomiting)•   Stomach bloating or distensionOver time the above symptoms or discomfort will resolve by themselves. Avoid food and drinks that may irritate your gut. Drinking salt water or sucking lozenges can help to reduce throat discomfort. On the day after the procedure, consume cool and easily digestible food and avoid strenuous activity to reduce the chances of any gastrointestinal tract bleeding.

What is a Computed Tomography (CT) scan used for?A CT scan can take images of body parts from many angles and combine them together to show clear-cut sections of your body. These images show much more than a typical X-ray image.The following are common uses of CT scans of different parts of the body:•  Head CT scan - detects stroke, tumors, bleeding, and fractures. Also used to assist stereotactic surgery and radio surgery for treatment of brain tumors•  Lung CT scan - detects acute and chronic changes to lung structures and lung cancer screening•  CT pulmonary angiogram (CTPA) - for diagnosis of pulmonary embolism•  CT cardiac angiography - looks at the blood vessels that supply the heart•  Abdomen and pelvic CT scans - diagnosis of abdominal and pelvic diseases. Also used to diagnosis and staging of abdominal cancers•  CT colonography (also known as virtual colonoscopy or VC) - detects tumors in the lower gastrointestinal tract•  Extremities - assesses complex fractures, especially those around the joints, before surgeryBesides the above, CT scans can also be used to guide biopsies and determine location for radiotherapy, etc. What preparation do I need to do before a CT scan?Usually, there is little preparation involved. You may need to remove metal objects from your body such as jewelry, hair clips, etc. It is best not to wear clothes with metal zips, studs, etc. You may also be asked to not eat or drink for a few hours before your scan. What will happen during a CT scan?You may be given a special iodine-based dye as a drink or injected through your veins. This dye is relatively harmless and helps to see things in the body more clearly. This special dye, also known as an oral contrast agent, may give you a warm, flushed feeling, and an odd taste in your mouth which will soon disappear. For some people, this dye may cause nausea, vomiting, or itchy rashes that can be relieved with medications.  You will be asked to lie on a movable bed that will pass through a ring-shaped scanner. Stay very still during scanning so that images remain sharp and clear. It is also normal to hear some buzzing, clicking, or humming noises during the scan. Our CT technicians will see you through the glass window in the room next to you. We will be able to hear you at all times and also speak to you over the speakers. The whole procedure takes about 30 minutes. What are the risks of doing a CT scan?A CT scan uses a low dose of radiation and is thus a relatively safe test. However, we recommend that pregnant women avoid having a CT scan if possible, as there is still a small risk of the unborn child developing abnormally.On rare occasions, the special dye used can cause an allergic reaction or kidney failure. Let your doctor or radiologist know if you have any of the following:•  Kidney disease or poor kidney function•  Diabetes or taking a medication called metformin Your doctor and radiologist may request you to do a blood test to determine if you should continue the scan with a contrast agent. Your doctor, radiologist, or nurse will advise you on how to take medications, when to contact us if you feel unwell, and how much fluid to drink to flush the dye out of your body. Do follow these instructions carefully, and ask them questions if you have any concerns.

Roughly 1 in 4 Chinese adults are now overweight or obese. Being overweight or obese may have negative effects on your health and increase the risk of getting obesity-related disease such as high cholesterol, diabetes, heart disease, sleep apnea and some types of cancer. Why do you need to lose weight?DiabetesLosing 5% of your total body weight can improve blood sugar control. If you lose 10-20% weight, your blood sugar level may be restored to normal range.Cardiovascular DiseasesObesity can increase your risk of cardiovascular diseases. Every kilogram of weight loss can reduce blood cholesterol levels by 1% and blood pressure by 2 mmHg.Joint PainLosing weight is also good for your joint health. If weight loss is successful, arthritis and joint pain can be significantly alleviated.Sleep ApneaObese people are more likely to suffer from sleep apnea. Just 10% of weight loss is good enough to reduce snoring and improve your sleep quality. So start your weight control journey today!Knowing your health risk Body mass index (BMI) is a ratio of your weight to height, and it is commonly used as an indicator of body fat.Waist circumferenceMeasuring waist circumference helps screen for possible health risks that come with overweight and obesity. If most of your fat is around your waist rather than at your hips, you're at a higher risk for heart disease and type 2 diabetes.High risk Waist Circumference•    Male ≥ 90cm•    Female ≥ 80cmThe Law of Energy BalanceHealth experts agree that the best and safest way to lose weight and promote health is to reduce calorie intake, eat a balanced diet and be more activeWhat is energy balance?Food provides us calories (energy) for daily activities. The calories we consume should be balanced with the calories we burn through physical activity. When it is imbalance between the two, it can lead to weight gain or loss. Excessive calorie intake together with low physical activity level can lead to weight gain.A Healthier Way to Lose WeightIn order to let you better understand what is a healthier, more sustainable way to lose weight, our dietitian made a healthy plate for you. Excessive calorie intake can increase your risk of getting obesity-related diseases, such as cardiovascular disease, high cholesterol, diabetes and some cancers. Limiting fat intake is one of the key ways to lose weight, and also can improve your own health. For the same amount of carbohydrates and proteins, fats contain more than twice as many calories. This means that adding fat can easily increase the calorie content of foods, even in small amount can lead to excessive calorie intake. Eating healthier foods in moderation will provide less calories and fat. Reading food labels can help you better understand the nutrient facts of food products. In addition, you also need to consider about the portion you consume. A healthier food can also provide excessive calories if consumed in excess. Tips on eating habits•    Be aware of all the food and beverages you consume daily is the first step. Recording your food and beverage intake in the food diary can help you know your eating habits better•    Don't skip meals. If you do so, you may become so hungry that eat much more at the next meal or snack before the next meal•    Please eat slowly and chew well at your mealtime•    Sit down to eat instead of eating on the run•    Eat more fruits, vegetables and wholegrain products as they contain more fiber, which makes you feel fuller and longerKnowing potential sources of extra calories•    Extra calories can easily be ingested through•    Extra portion•    Large portion•    Sugary drinks, desserts, high fat food•    Overeating occasions, such as buffet, social gatherings, etc.•    Alcoholic drinks•    Eating for other reasons other than hunger, such as emotional eatingAt the other end of the calorie balance, lack of physical activity may also contribute to weight gain.Here are some tips to help you become more physically active.•    Walking instead of driving or taking public transport•    Climbing stairs instead of using elevators•    Take a walk during your lunch breakWeight loss journey could be challenging and frustrating. Our experienced dietitians will tailor your weight loss plan based on your medical history, lifestyle and food preferences to help and support you throughout the journey. If you need help and support for your diet, Please contact 400-868-3000 for an appointment with our dietitians.