An anal fistula, is also called as fistula- in -ano, it is a small channel that develops between the end of the large intestine called the anal canal and the skin near the anus. This is a painful condition, especially when the patient is passing stools. It can also cause bleeding and discharge during defecation.

Genesis of fistula-in-ano
Almost all anal fistulae occur due to an anorectal abscess that begins as an infection in one of the anal glands. This infection spreads down to the skin around the anus causing fistula-in -ano. The anorectal abscess usually leads to pain and swelling around the anus, along with fever. Treatment for anorectal abscess involves incising the skin over the abscess to drain the pus. This is done usually under local anesthesia. A fistula-in-ano happens when there is failure of the anorectal abscess wound to heal completely. Almost 50% of patients with an abscess go on to develop a chronic fistula-in-ano.

Symptoms

Pain- Constant pain which gets worse when sitting down
Irritation around the anus, like swelling, redness and tenderness
Discharge of blood or pus
Constipation or pain while evacuation
Fever
Diagnosis
A clinical evaluation, including a digital rectal examination under anesthesia, is carried out to diagnose anal fistula. However, few patients may be advised screening for rectal cancer, sexually transmitted diseases and diverticular disease.

Treatment
The only cure for an anal fistula is surgery. The type of surgery will depend on the position of the anal fistula. Most patients are treated by simply laying open the fistula tract to flush out pus, called Fistulotomy. This type is used in 85-95% of cases and the fistula tract heals after one to two months.

Seton techniques: A seton is a piece of thread (silk, plastic) which is left in the fistula tract to treat anal fissures. This is used if a patient is at high risk of developing incontinence after fistulotomy.
Advancement flap procedures: When the fistula is considered complex, carrying a high risk of incontinence, then this advanced technique is used.
Other techniques like Fibrin glue and Bioprosthetic plug are also used to surgically treat anal fistulas. In the Fibrin glue technique, glue is injected into the fistula to seal the tract, after which the opening is stitch closed. Bioprosthetic plug is a cone shaped plug made from human tissue, which is used to block the internal opening of the fistula. After this stitches are used to keep the plug in place. 

Whatever the surgical technique, one can experience minor changes in continence. Patients usually don t require antibiotics after surgery but have to take pain medication. They may also have to use gauze to soak up drainage from anus. After surgery, patients should seek help if they have increased pain or swelling, heavy bleeding, difficulty in urination, high temperature, nausea or constipation.

Fistula-in-Ano or Anal Fistula - How It Can Be Treated?

Fibromyalgia is a disorder that causes widespread body pain along with sleep deficits, memory loss, mood problems and fatigue. Symptoms may be triggered after a surgery, physical trauma, infection, or stress. Women are much more vulnerable to this disease than men. Many people affected with fibromyalgia may have suffered from headaches, backaches, depression, anxiety, tension, temporomandibular joint 
disorders and irritable bowel syndrome. Most of these patients have undergone multiple consultation with various doctors and undergone many tests, but no diagnosis could be made. These patients are often ignored by doctors and family members as always "complaining of pain".

Symptoms of Fibromyalgia:
1.Extensive Pain- Pain related to fibromyalgia is often depicted as a dull pain that lasts for at least three months. Pain can involve any body part like back,neck, chest, arms, legs. Patients have pain in multiple areas of body and painful areas change over time.

2.Fatigue- Patients afflicted with this disorder feel tired even after sleep. Such people are reported to sleep for longer hours than normal people, but their sleep often gets disrupted due to sleep apnoea and restless leg syndrome.

3.Cognitive Difficulties- These patients find it difficult to concentrate at work and also suffer from memory deficits in daily activities.

4.Other Symptoms: These patients may also have symptoms like burning urination, urgency of urination, numbness,loss of appetite, tingling sensation,diarrhoea, constipation, tinnitus, depression etc

Diagnosis of fibromyalgia:
There are no specific test to diagnose fibromyalgia. Diagnosis is made by a doctor specialised in Pain Medicine using clinical methods based on symptoms and examination. Blood tests like Haemogram, Thyroid function test, RA Factor, ESR are done to rule out other diseases which can cause similar symptoms. 

Treatment of Fibromyalgia
1.First step in treating these patients is to accept their problem and discuss with patient and family members regarding the presence of such disease entity.

2.Lifestyle changes like active involvement in cardiovascular exercises, swimming, yoga, meditation are important to control symptoms.

3.Conventional painkillers do not work in these patients. They requires special medications prescribed by a Pain Specialist for control of symptoms.

4. Counselling of patient is beneficial for associated depression.

Are You Suffering From Body Pains ? It Could Be Fibromyalgia!!

Hernia are bulges protruding form a weak point on belly (abdomen) through which intestine and abdominal fat comes out to lie just below the skin. It can also be found in groin, upper thigh and chest. There are several types of hernia like inguinal hernia (direct and indirect), femoral hernia, umbilical hernia, umbilical hernia, epigastria hernia and incision hernia.

Who get hernia?

Conditions that lead to increased abdominal pressure are at more risk of developing hernia  

o Persistent cough

o Being overweight or pregnant

o Lifting, carrying or pushing heavy loads

o Straining on the toilet

What are the symptoms of hernia?

o Mostly they are asymptomatic/ no symptoms.

o People just notice a swelling or bulge which gets bigger while standing or straining and disappear while lying down/sleeping.

o Some might feel a dragging/aching sensation.

o The swelling tends to get bigger with time.

o Symptoms develop when there is a complication like strangulation. This happens when the content of abdomen (intestine) come out and can not go back. There will be severe pain in the region and vomiting. Overlying skin will become red. Urgent surgery is needed in this situation otherwise the blood supply to intestine gets cut-off and the intestine in hernia might die (gangrene).

How are hernia treated?

Surgery is the only treatment for hernia. Now a days, most of the hernias are operated laparoscopically (key hole or minimally access technique)

Minimally Invasive Hernia Repair - The surgery is done with a laparoscope which has a small tiny camera, hernia mesh and small tool with it. So the patient can return back to their normal routine earlier as the incision made is smaller.

Advantages of Laparoscopy:

Laparoscopy has clear advantage over open repair in the way of less pain, less complications like wound infection, small and more cosmetic scar, shorter hospital stay, early return to work and daily activities and less chance of recurrence (repeat formation of hernia after surgery).

Before undergoing hernia surgery:

* One week before surgery it is much essential to stop taking drugs that are causing the thinning of the blood. Drugs like Clpodogrel and Acitrome or Warfarin should be stopped with the doctor s advice. 
* Stop herbal supplements and check the fitness of your cardio and diabetes. 
* Gain adequate knowledge about surgery and be prepared for post surgical care.

After hernia surgery:

* Avoid heavy weight lifting, exercises, and physical works with excessive strain a few weeks after surgery 
* Cough or laugh loud only with support to the surgical site until one week after surgery

DO s & DON T s in patients of Hernia:

DO s:

1. Increased intake of fibers in diet. ( Fruits, vegetables and grains)

2. Drink plenty of water and other fluid to prevent constipation.

3. Exercise regularly: sweat and loose excess weight and toxins.

4. Eat small meals more frequently in place of one or two large meals

DON T s:

1. Stop smoking and drinking

2. Don t reduce the amount of food you eat

3. Avoid lying down or bending after meal

4. Avoid wearing tight clothes

5. Avoid food difficult to digest

6. Avoid strenuous activities like heavy weight lifting

Types of Hernias:

Incisional hernia:

This happens at the site of previous surgery. This occurs as a result of poor wound healing at the time of previous surgery or as a result of complications like in infection. It is rare after laparoscopic or key hole surgery.

Umbilical hernia:

This occurs through or around belly button (umbilicus). It can be present at the time of birth and needs no repair as most of them resolve by the end of one year. If it persists or appears after 5 years of age then operation is required.

Inguinal hernia:

These are most common hernias and occur in groin region. They are more common in men.

All You Need To Know About Hernia!

The fact is there are no shortcuts! However, there are some really efficient ways (if followed religiously) that can result in quick riddance from fat and related woes. 
Let's see how to get around obesity in these simple ways:

1. Reduce Salt Intake: More salt in body means more sodium which gives a puffy look to your body. So, it's advised to eat less salt and more potassium as it will reduce the amount of water in the body resulting in reduced weight.
2. Never Skip Exercise: Exercise daily because this is one sure-shot way of reducing weight because it burns direct fat.  Especially cardio exercises can help in reducing weight but you have to be regular in that.
3. Manage Your Diet Well: Diet management is the first and foremost thing that can help you deal with the problem of obesity. It is not easy and everyone's cup of tea to have a control on diet but half the battle is won, if you can deal with this dietary change. Your diet should be low in calories, with less carbohydrates and less fats.
4. Have Mint Leaves: Taking mint leaves in warm water half an hour after taking meals will prove to be beneficial in losing weight as it helps in proper digestion and boosting metabolism.
5. Drink Green Tea: Green tea, an antioxidant by nature can go a long way in helping you reduce weight. So, prefer taking green tea, if not more once or twice a day.
6. Switch To Lukewarm Water: Drinking lukewarm water every time you are thirsty will reduce fat deposits in your body, so you must go for it.
7. Make Homemade Food: Prefer eating homemade food and avoid fatty and fast food.

Shortcuts to Undo Obesity. Check For a Surprise!

Vaginal discharge or odor is one of the most common conditions in women, yet the least talked about or taken help for. It is of vital importance that more and more women become aware of the condition and stop neglecting it. It is this neglect towards the condition that leads to some ancillary side effects and the increase in the complexity of the situation. Before things take a turn for the bad, it is imperative that you take help from concerned medical specialists and fight the condition during its initial days itself.

Why consult a specialist?
Treating the condition as soon as you notice it leads you to stem other diseases and infections that may be caused as a side effect. Also, vaginal discharge and foul odor can become not only the cause of discomfort for your day to day life, but also a great hindrance in your private life. Don t let a curable condition hamper your personal life and most importantly your conjugal life. Visiting a doctor will help you get rid of both the excessive discharge and foul order. All you have to do is shred that mental neglect and confining attitude, step out of the home and make way to the doctor s clinic.

What causes vaginal discharge?
Some of the most common causes of vaginal discharge include-

Yeast Infection: Vaginal yeast infection is by far the most common cause of vaginal discharge. This relatively common condition is caused by fungus. This factor is characterised by itchiness, irritation and swelling.
Urethritis: Another cause influencing excessing vaginal discharge includes Urethritis. This condition is influenced by the inflammation and irritation in the tube carrying urine, also referred to as the urethra.
Gonorrhea: Gonorrhea is an alarming cause of vaginal discharge. This disease is sexually transmitted and affects warm and wet areas of the body.
Other causes of vaginal discharge include pregnancy, anxiety, cervix inflammation, cervical cancer or history of the same.
Causes of vaginal foul odor:
Some of the most common causes of vaginal odor are-

Infection: Fungal infection is a major cause of vaginal odor.
Sweat: Accumulation of sweat in wet and humid areas of the body leads to a certain amount of odor. The same goes for the vagina.
Hormonal change: Change in hormone and discharges also lead to a foul-smelling vagina.
Overused tampon: Using a tampon for a longer period than prescribed can also lead to accumulation of periodical blood and bacteria, leading to foul smell from the vagina.
Treating vaginal discharge and foul odor:
In case that vaginal discharge and a foul odor is becoming a major concern in your life and making things uncomfortable for you, it is the time that you make your way to a medical specialist. Other preventive practices often suggested by doctors include- wearing loose clothes, not wearing a tampon for a long time, losing weight, consulting a doctor before starting a specific treatment or medication, etc.

Vaginal Discharge and Foul Odour - Know the Reason Why?

An estimated of 10 percent or more children snore for more than 1 night. Snoring results from the obstruction of breath when the air makes its way through the mouth. The air passage of the throat through which the air goes in and out causes the tissue to vibrate causing snore. The sound of the snore totally depends on the amount of air passing through the mouth and the frequency at which the throat is vibrating. Children above the age of three years tend to snore when they are deep in sleep.

Primary and secondary snoring:
Children who are otherwise healthy should not have a snoring problem unless there is some health disorder. However, if loud snoring is observed in otherwise a perfectly healthy kid, seeking medical help is a wise thing to do. In general, primary snoring is defined as a condition which is not associated with other sleep-related disorders such as lung disorder, OASS, inability to sleep for a longer duration etc.

Other possibilities:
It is estimated that close to three percent of the children suffers from breathing problem while sleeping. OSAS is a condition which is characterised by pauses in breathing and gasps along with loud snores. There could be instances where a kids  muscle relaxes way too much obstructing the air to pass through. The body and the brain are both alerted at this stage. As soon as the brain sends a signal, the body wakes up. Thus, most kids suffering from this disorder are not able to sleep well and tend to feel tired throughout the day.

Common causes of sleep apnea:
Sleep apena is a major cause of snoring. It can be caused because of allergies, obesity, GERD etc. In children sleep, apnea can also be caused by tonsil. Since the tonsil size of children less than 7 years of age tends to be bigger than adult individuals, it causes snoring related problem. Swollen tonsils not only obstruct air but creates other health related problems as well.

Symptoms of sleep apnea during the day and night:

Loud snore
Snorts, gasps, pauses during sleep
Heavy sweat during sleep
Social and behavioural problems
Failure to get up in the morning
A nasal voice
Easily irritated, cranky and aggressive
Relief measure:
The first thing a that a doctor does is a physical exam followed by observing the symptoms of a kid. Primary snorting can be addressed by physical exercise, counselling and breathing exercise. Problems related to apnea are addressed through medicine, counselling, and exercise. Certain dietary restrictions also needed to be followed during this time. However, apena is completely treatable within a certain time frame.

Mouth Breathing - What Can Cause It?

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