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Treatment of Abdominal Pain
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Following are the most common foot conditions which require surgery:
- Plantar fasciitis: It is one of the most common causes of heel pain which is aggravated in the morning with initial few steps. Too much pressure on feet can damage or tear the ligaments because of which the plantar fascia becomes inflamed, and the inflammation causes heel pain and stiffness.
- Rheumatoid arthritis: It is an autoimmune condition that affects the joints and causes swelling of the joint lining (synovium). It commonly affects the small joints of the hands and feet. Surgery is required when the condition leads to deformity or cartilage loss.
- Sesamoiditis: It is a condition where there is a pain on the bottom of the foot at the base of the great toe. Excision of the chronically inflamed sesamoid is required.Ankle arthritis: It is usually caused by osteoarthritis where the cartilage covering the ends of bones gradually roughens and becomes thin and the bone underneath thickens. This leads to pain, swelling, and occasional deformity of the joint.
- Fracture: Healing fractures require immobilizing the foot with a boot and sometimes even surgery.
- Bone spurs: An excessive growth of bone is causing pain or limitation of movement. These spurs develop at the edge of the joint causing pain, tenderness, and difficulty in walking. Surgery is required to remove these excessive growths.
- Gangrene: It is one of the most common conditions requiring amputation where the death of the tissue occurs.
- Clubfoot/Talipes Equinovarus: It is a foot deformity in newborns where the foot is rotated inwards (varus) and downwards (equinus).
- Claw Toes/Hammer Toes: It is a condition affecting the toes in people as they age causing difficulty and pain while walking. The affected joints require replacement with artificial joint or fusion (surgical stiffening).
- Morton's Neuroma: The patient presents with pain in the forefoot, in the “ball” of the foot causing irritation of one or more of the small nerves, just before they travel into the toes.
- Hallux Valgus/Bunion: It is one of the most common conditions, especially seen among women, where bony lumps develop on the side of the foot and at the base of the big toe causing malpositioning of the foot. For some people, it is only a cosmetic problem. Bunionectomy is a surgery performed to remove the bony prominence.
- Hallux Limitus/Rigidus: It is an arthritic condition of the big toe joint leading to pain and loss of motion.
- Diabetes mellitus: It affects circulation and blood supply causing delayed healing. Ulcerations, infections, and sometimes severe infections require amputations.
- Cysts and ganglions: These are painful lumps that cause pressure and rub on the shoe while walking. If a change in the footwear doesn’t solve the problem, surgical removal of the cyst or ganglion is done.
What do we mean by a hiatal hernia?
The hiatus is an opening in the diaphragm (the muscular wall) which separates the chest cavity from the abdomen. Normally, the esophagus (food pipe) goes through the hiatus and attaches to the stomach. In a hiatal hernia, the stomach bulges up into the chest through that opening.
What does statistical data say about a hiatal hernia?
Statistically, approximately 60% of individuals who are above age 50 or older have a hiatal hernia.
In which age group is hiatal hernia very common?
The incidence of hiatal hernias increases with age. It is commonly seen in the older age people specifically in people who are above 50.
What are the causes of hiatal hernia?
The most common risk factors are as follows:
- Obesity Congenital deformities, such as scoliosis
- Certain types of surgery
- Major trauma
- Conditions which causes an increase in abdominal pressure within the abdomen, such as heavy lifting, or bending over, frequent or violent coughing, violent sneezing, violent vomiting, and straining during bowel movements
What are the types of a hiatal hernia?
There are four types of a hiatal hernia and they are as follows:
- Sliding hiatal hernia: This is the most common variant of a hiatal hernia. It occurs when your stomach and esophagus slide into and out of your chest through the hiatus. It is usually asymptomatic.
- Fixed hiatal hernia: It is also known as a paraesophageal hernia. In a fixed hernia, part of the stomach pushes through diaphragm and stays there.
- Type III hiatal hernia: In this type, as a hernia goes on increasing, the phrenoesophageal ligament stretches and displaces the gastroesophageal junction above the diaphragm
- Type IV hiatal hernia: Type IV hiatal hernia includes a large defect in the phrenoesophageal ligament causing other organs, such as colon, spleen, pancreas and small intestine to enter the hernia sac.
What are the sign and symptoms of hiatal hernia?
Common symptoms include:
- Chest pain or epigastric pain, coughing
- Difficulty in swallowing
- Belching, eructation, and hiccups
How to diagnose the condition?
To diagnose this condition following tests or procedures are included:
- X-ray of the chest and abdomen Barium follow-through examination of gastrointestinal tract (GI) to visualize GI tract.
- Upper endoscopy for examining the esophagus and stomach from inside Esophageal manometry for measuring the rhythmic muscular contractions of esophagus while swallowing, and also, measuring the force exerted by the muscles of esophagus.
What is the treatment available for it?
It includes medications and surgery which are as follows:
- Antacids to neutralize stomach acid and to reduce acid production
- Medications that heal the esophagus
- Surgery of opening of diaphragm to make it smaller and for reconstruction of an esophageal sphincter
What are the causes of lump in the breast?
Infections, injuries, benign growth (noncancerous growths), and cancer are the commonest cause of breast pain and lumps. Pain may also be caused by various medications, such as digitalis preparations, methyldopa, spironolactone, aldactone, diuretics, anadrol, and chlorpromazine. The other common cause is hormonal change during puberty, before and during menstruation, around menopause, during pregnancy (especially) in the first trimester, and during breastfeeding.
How to treat the pain associated with it?
The treatment includes medical treatment, auxiliary mode of treatment, and surgical treatment. Medical treatment includes the following medication:
- Hormonal preparations, such as oral contraceptives and progesterone supplements, or hormone replacement therapy have been extensively used for the medical treatment of breast pain and lumps.
- Some powerful drugs are available, but they may have severe adverse effects, such as weight gain, heavy periods, muscle cramps, deepening of the voice, increased body hair, acne, bleeding between periods, changes in voice, lowering of libido, reduced breast size, fatigue, depression, and headaches.
- Drugs which can be used include Danazol (a modified testosterone) and bromocriptine (a dopamine agonist).
- Antibiotics are used along with nonsteroidal anti-inflammatory drugs to relieve the pain associated with the infection.
- Local application of painkillers in the form of lotions and gels can be used to relieve the pain, but it is contraindicated in pregnant or breastfeeding women. Supplements that may help include vitamin E, soy supplements, and chaste berry. Vitamin E affects hormones that govern breast growth, such as estrogen, which triggers the proliferation of cells that make up breast glandular tissue.
Surgical treatment includes following things:
- Surgery is not done to treat breast pain unless it is associated with a breast lump.
- Surgical removal of the lump in cancerous and benign conditions is the most widely used method of treatment.
- In cases of pain associated with breast cancer, surgical removal of lump and breast tissues (total mammectomy) is always indicated.
- An abscess of the breast often needs to be drained by a doctor because antibiotics alone cannot adequately treat an abscess.
Auxiliary treatment includes:
- Use of a well-fitting supportive bra will help reduce movement and pain associated with it.
- Applying heating pads or ice packs can minimize the pain associated with inflammation.
- A warm bath may also help reduce pain.
- Breast massage with oil or diluted essential oils, such as fish oil and flaxseed oil, helps dissolve fibroadenomas.
- Dietary changes and supplement use may also help reduce the pain. It includes reduction of caffeine, salt intake, a low-fat diet, and reducing excessive dairy products as they promote the production of estrogen, which is associated with breast tenderness.
In case you have a concern or query you can always consult an expert & get answers to your questions!
Following are the ways to prevent the unpleasant and often painful side effects of constipation after back surgery:
- Resume activity as early as possible after surgery to help body functions return to normal. Walking is one of the ways in which constipation can be prevented as it helps in the movement of bowels.
- Minimize the use of narcotic medications which are used to control pain as narcotics slow down the bowel motility thereby leading to constipation. If possible, try to take a non-narcotic painkiller.
- Drink plenty of water and increase fluid intake at least more than 2 liters/day to prevent hard stools and constipation.
- Eat food which has high fiber content, such as whole grains, legumes, oatmeal, brown rice, beans, fruits, and vegetables, to provide roughage which will help to stimulate the intestines.
- Avoid eating food items, such as cheese, meat, white rice, processed food, and milk, which aid in constipation.
- Use a fiber laxative to reduce the risk of constipation. Try and use natural laxatives, such as prune juice or apple cider. Use bulk fiber laxative which adds bulk to the stool and helps keep water in the colon.
- Drink natural laxative, such as tea which will help you get the urge for passing stools.
- Stool softener/emollient laxatives help fluid to mix with a stool to soften it making it easy to pass through the intestines and colon.
- Stimulant laxatives, such as Dulcolax and milk of magnesia, are commonly used to prevent constipation by stimulating bowel contractions.
- Eat small quantity of food at short intervals rather than eating in large quantities at a time to aid digestion and prevent constipation.In cases of very bad constipation suppositories, such as Dulcolax are inserted into the rectum. This process helps by causing a contraction of the rectum and pushing the stool out. The action of the suppository is very quick.
- An enema is also used commonly to relieve constipation. It is usually water or saline which is injected into the rectum up to the colon thereby stimulating the colon to contract.
- Lubricants are similar to stool softeners which are used to relieve constipation (For example, oil-based products, such as mineral or cod oil).
- Do not delay to go to the washroom when you get the urge to pass stools.
- Use home remedies such as honey, lemon juice, coffee, castor oil, or raisins to prevent constipation.
- Herbal laxatives also help the intestinal muscles to push stools through the colon as well as soften stools.
Thus, by using the above methods, constipation post a back surgery can be resolved. In case you have a concern or query you can always consult an expert & get answers to your questions!
There are many questions which patients, as well as their relatives, have regarding the surgery to be performed or regarding the disease condition. Every patient has a right to have complete information about the surgery. The patient also has a right to have a second or third opinion from another surgeon if he is not sure whether his ailment requires surgical intervention. Some of the prominent questions which every patient should ask prior to his/her surgery are as follows:
- Is there a need for the operation?
- Alternatively, can it get better with medications itself?
- Why is there a need for surgery?
- Are there any other options or alternatives instead of going through surgery?
- What are the chances of the operation being successful?
- What can be done if the surgery fails?
- What are the risks and complications of the operation?
- Can you assure that I will not face the same complaint/ problem again after surgery?
- Will the surgery benefit me?
- Under what type of anesthesia will the surgery be performed?
- Can the operation get delayed?
- What are the blood tests and investigations I need to do before an operation?
- How many hours before surgery do I require to stop eating and drinking?
- How much will the operation cost me?
- What type of insurance do you take?
- How many hours will the surgery take?
- What are the chances of surgery being successful?
- What is the guarantee that I do not face the same complaint again?
- Could you tell me about your experience regarding this type of surgery?
- Should I take a second opinion?
- Where will the surgery be performed?
- Will I require blood during operation?
- How long after surgery I need to be in the hospital?
- What will happen if I do not undergo surgery?
- What will the procedure do?
- How long will the surgery take?
- Will the operation ever need to be redone?
- Some of the questions which present post-surgery can be as follows:
- When will I get discharged?
- What type of care do I need to take?
- How long will it take for complete recovery to take place?
- What are the things I need to avoid?
- What are the dietary changes which need to be taken care?
- How long do I need to continue with the medications after surgery?
- When can I resume back to work?
- When and how frequently do I need to come for follow-up?
- What are the signs of infection?
- What activities am I allowed to do?
- Can I have a sexual relationship and when?
- What shall I do about constipation?
- When will the sutures be removed?
- What extra care do I need to take for early and quick recovery?
In case you have a concern or query you can always consult an expert & get answers to your questions!
Body weight control management to stay fit, healthy and desired shape. Body weight management 90% from diet, exercise. Few obese people requires assist through drugs like orlistat, less than 1% requires non operative endoscopic gastric balloon placement for four to six months for effective weight control. Few extreme obese people require surgeries like sleeve gastrectomy, and metabolic surgery.