Dr. Radhakrishna Patta

Anal fissures are the small tears formed in the anal lining. They are also known as anal ulcers. An anal fissure causes a lot of pain and bleeding during your bowel movements. Usually a fissure heals automatically in a few days time. It can be treated with simple home remedies as well.

Causes:

1. You can suffer from an anal fissure if you pass hard and large stools. 
2. Also strained childbirth or suffering from violent spells of diarrhea might get you an anal fissure. 
3. Chronic constipation may also be cause of a fissure. 
4. Other rare causes may be anal cancer, HIV, tuberculosis or herpes. 

Individuals of all age groups can suffer from anal fissures. It is not a very serious problem and heals on its own in a few weeks. Although it can heal itself, there are certain treatments which can help relieve the pain you get from an anal fissure.

Symptoms:
An anal fissure has quite a lot of symptoms for you to understand what you are suffering from:

1. There will be a very visible tear around the anal region. You will be able to spot the tear on the skin very easily.
2. A small lump of skin may form next to the tear.
3. When you will be undergoing your bowel movements, you will feel a very sharp pain in the anal region.
4. You will find spots of blood on the stool passed.
5. You will also feel a burning or an itching sensation in the anal region.

Treatment:
Although most fissures do not require treatment, there are a few remedies that will help cure them faster:

1. Stool softeners: You get certain medicines at the chemist, which are known for their stool softening functions. These stool softeners help to soften the hard stools and initiates smooth bowel movements.
2. Eat fibrous foods: Eat foods rich in fiber like fruits, whole grain cereals, raw vegetables, etc.
3. Take warm baths: Take a bath in warm water as it relaxes your anal muscles, helps to relieve irritation in the region, and increases blood flow in the anorectal region.
4. Use ointment: Apply nitroglycerin ointments and topical pain relievers to promote blood flow to the anal region and to relieve discomfort from the region respectively.

Constipation by itself is not a disease but it a condition in which your bowel movement is infrequent and the stools are hard and difficult to pass.
Constipation happens to most of us at one time or the other and then it goes away naturally. Chronic constipation is constipation which is long-term and it usually signals a deep-rooted medical problem which requires intervention.

Symptom of constipation
While fewer bowel movements is a foremost symptom of constipation, other common symptoms are-

1. Trouble passing stools
2. Pellet-like hard or small stools
3. A sense of being full even after a bowel movement
4. Flatulence, swollen belly
5. Belly pain
6. Throwing up

Causes
Medicines like antacids that contain calcium or aluminium

1. Changes in your lifestyle and usual diet like travelling
2. Having too much of dairy
3. Colon cancer
4. Eating disorders
5. Irritable bowel syndrome or IBS
6. Neurological conditions like Parkinson's disease and multiple sclerosis
7. Inactive lifestyle
8. Less water and fibre in diet
9. Overusing laxatives
10. Pregnancy
11. Problems with the muscles and nerves in the digestive system
12. Drugs like pain medications and narcotics, antidepressants, or iron pills
13. Stress
14. Hypothyroidism

What should you do?
Constipation can be handled by taking simple steps like:

1. Drinking four extra glasses of water a day over your normal intake.
2. Drinking warm water in the morning.
3. Adding more fibre to your diet by eating more fruits and vegetables.
4. Eating more bran cereal and brown rice.
5. You can use a very mild over-the-counter stool softener and laxatives like magnesium hydroxide. But take care to not use them for more than two weeks at a time. If you don’t get any relief, it’s time to call your doctor.

You should not wait to consult a doctor, however, if you have sudden constipation with abdominal pain or extreme cramping and you aren’t able to pass any gas or stool.
Also, call your doctor if:

• Constipation happens out of the blue and is not a new problem for you.
• You see blood in your stool.
• You are losing weight.
• You are experiencing severe pain during bowel movements.
• Your constipation is more than two weeks old.
• You are getting pencil-thin stools.

Diagnosis
The following tests are recommended to unearth the reasons behind chronic constipation:

• Blood tests to check hormone levels
• Barium studies a kind of test which looks for blockages in your colon
• Colonoscopy which again looks for blockages in your colon

A type of constipation which is due to pelvic floor /outlet dysfunction. This may need biofeedback therapy. At times some kind of minor surgery

Prevention
Constipation really is very amenable to diet and lifestyle changes. Eat a well-balanced diet and go for light, regular exercise to prevent chronic constipation. Also, drink two quarts of water every day to keep yourself regular.

There may be times when we get completely drained and fatigued and may feel like our insides could jump out because of the pain that we have in our stomachs. We may dismiss the issue as unimportant or due to a stressful day at work, and may think the stomach pain could be because of the extra spicy food we love to have every once in a while. However, a lot of people may tend to ignore this symptom and that is when stomach ache may turn out to be actually because of a peptic ulcer.

Peptic ulcer or stomach ulcer is a common occurrence and happens to a lot of people; however, it must be understood that not treating the problem in time may be troublesome in the long run and increase the recovery time. In order to be able to identify the peptic ulcers and to take the right treatment measures, it may be important for you to understand the problem and know how it is caused, and how it may be treated.

What causes peptic ulcers?
A peptic ulcer is diagnosed as inflammatory sores on the lining of the stomach or the food pipe, which transfers food to the stomach or even in the intestine. There are a number of factors that can cause inflammatory sores in the stomach region. The factors are as follows:

1. The use of medicines that are meant to be painkillers or anti-inflammatory drugs. The acid levels of the stomach and the food pipe may get disturbed because of these medicines and may give rise to ulcers.
2. In a lot of cases, the ulcers may also take place because of the presence of a tumour or a gastrinoma in the stomach that imbalance the levels of acid in the stomach.
3. High alcohol consumption may also lead to the formation of sores on the stomach lining.
4. Using tobacco or smoking are some other factors that contribute to the acid imbalance in the stomach.
5. In the case of some serious illnesses, a lot of people may fall prey to peptic ulcers.
6. Those who may have undergone radiation treatment around the stomach may also experience ulcers.

Though it may be known that excessive pain in the abdominal region may be due to stomach ulcers, it is important to understand that it happens due to bacterial infections, and when there is a bacterial infection in the body, you may have to undergo proper treatment. The treatment for this problem includes the use of medications as suggested by a qualified doctor, surgery in some severe cases, and most importantly lifestyle changes. In case you have a concern or query you can always consult an expert & get answers to your questions!

Irritable bowel syndrome is a disorder of the large intestine. It may cause abdominal pain, bloating, diarrhea and constipation. The condition is not life threatening in nature and does not make you susceptible to colon disorders such as Crohn's disease, ulcerative colitis and colon cancer, however, symptoms of IBS may act as deterrents in leading a normal life.

Symptoms:
The symptoms of irritable bowel syndrome are: 

1. You may experience symptoms of constipation
2. Frequent episodes of diarrhea
3. Abdominal cramps especially on the lower part of the abdomen
4. Constant bloating
5. Abnormal stool structure 
6. You belly might stick out 

In some cases, you may experience sexual problems and urinary problems. In addition, if you also suffer from stress related disorders then it might aggravate the symptoms.

Causes:
The primary cause is that the colon becomes very sensitive such that small stimulation may cause it to react. When the food passes through the colon, it tends contract strongly and leads to complications, such as bloating and constipation. It may also lead to weak contractions of the colon which leads to hardened stool.
There are certain things which may symptoms of IBS, they are: 

1. Stress: Any type of stress tends to aggravate symptoms of irritable bowel syndrome.
2. Foods: Certain foods such as chocolate, spices, cabbage, milk and carbonated beverages may trigger symptoms of IBS.
3. Hormones: Hormonal changes such as the ones during menstrual cycles may aggravate symptoms of IBS. 
4. Illnesses: Various illnesses such as diarrhea or conditions such as overproduction of bacteria in the intestines may lead to symptoms of irritable bowel syndrome.

Women are more likely to be affected by symptoms of IBS as are people who are below 45 years of age. If someone in your family has irritable bowel syndrome, then you are also likely to develop this disorder. It may also aggravate symptoms of hemorrhoids, along with aggravating symptoms of stress.

Gastroesophageal Reflux Disease (GERD) is a form of digestive disorder, which affects the lower oesophageal sphincters or the muscle ring present between the stomach and the food pipe. GERD incorporates the return of the contents of the stomach back to the oesophagus or food pipe. The functioning of the lower oesophageal sphincter is disrupted.

Causes:  Hiatal hernia is a common cause of GERD. An unhealthy lifestyle and diet may also lead to GERD. Intake of an excess amount of chocolates, fried food, coffee or alcohol triggers the chance of a reflux. GERD also occurs in obese people and pregnant women.

Symptoms: Heartburn, also known as acid indigestion, is the primary symptom of GERD. The affected person may feel a burning chest pain which starts from behind the breastbone and reaches up to the throat. The feeling can be defined as food coming back to the throat with a bitter, acidic taste. The burning sensation may last as long as two hours.

Other symptoms include:

1. Excess saliva secretion
2. Chronic conditions of sore throat
3. Laryngitis
4. Gum inflammation
5. Tooth cavities
6. Unpleasant breath

In order to diagnose GERD, several tests may be conducted . They are:

1. An X-Ray of the upper part of the digestive system.
2. Endoscopy to examine the inner part of the oesophagus.
3. Ambulatory acid test for monitoring the amount of acid within the oesophagus.
4. An oesophageal impedance test to measure substance movement inside the oesophagus.

Treatment

1. A person must make several changes to his daily lifestyle and diet plan for treatment of GERD.
2. Food and beverages like chocolates, fatty food, coffee, alcohol and peppermint should be avoided in order to reduce the weakening of the lower oesophageal sphincter. Several food items irritate the damaged oesophageal lining and should also be avoided. They include citrus fruits, tomato and pepper.
3. Smoking cigarettes results in weakening of the lower oesophageal sphincter and should be stopped to reduce GERD.
4. One should elevate the head of the bed on which he or she sleeps on blocks measuring 6 inches. This reduces the heartburn as gravity minimizes stomach reflux to return to the oesophagus.
5. Over the counter medicines can be used to cure GERD. Antacids are a good example and neutralize the acid in the oesophagus and stomach, reducing heartburn. Combining antacids with foaming agents is also effective. A foam barrier is formed over the stomach, preventing the occurrence of acid reflux.
6. Medicines for reducing acid in the stomach are prescribed in cases of chronic GERD, which include H2 blockers by the likes of cimetidine, famotidine or nizatidine.

GERD is a digestive disorder, which causes disruption in digestion, as reflux from the stomach is returned to the oesophagus. Proper treatment measures should be taken. In case you have a concern or query you can always consult an expert & get answers to your questions!