Is there a relation between weight loss surgery and type 2 diabetes? Yes, there is and a very promising one. Many diabetics may not know this but a key hole procedure called metabolic/ bariatric surgery can help resolve type 2 diabetes.

It s scientifically proven that these surgeries can normalize blood sugar levels and control diabetes in most patients. This means that you may not need any medicines post such a surgery. One long-term study which tracked 400 people with type 2 diabetes showed that six years after bariatric surgery, 62% diabetics showed normal blood sugar levels. Apart from this, they also showed better blood pressure, cholesterol and blood triglyceride levels that can cause heart disease.

Should you get a metabolic/bariatric surgery done? You are a fit candidate for bariatric surgery if your:

BMI is 27.5 or higher
And if are finding it difficult to maintain blood sugar with medicines & lifestyle changes.
Your doctor will give you a physical exam to check whether you are fit for a major surgery and if you are emotionally ready to commit to necessary lifestyle changes like eating healthy and exercising regularly.

Types of weight loss/diabetes surgery:

The most popular type of weight loss surgery is one in which the size of your stomach is reduced so that you feel full even after small meals. Other types of bariatric surgeries change the way your body absorbs calories and nutrients and vitamins. A few other types of bariatric surgeries do both.

Gastric Bypass: In this surgery, your surgeon makes a small stomach pouch by dividing the top of the stomach from the rest. This small pouch is connected to intestine so other part of stomach is bypassed. So, when you eat, food goes into this small pouch, which makes you feel full faster and also makes it possible for your body to absorb fewer calories. This is a very promising type of bariatric surgery for diabetics as up to 80% of people have normal blood sugar after it. And they also lose 60% to 80% of their extra weight on an average.
Gastric Sleeve: In this surgery, your surgeon will remove a major part of your stomach. When your stomach is small, you will feel full faster. It also reduces hunger pangs. This type of surgery is also very effective in reducing diabetes and losing weight.
Adjustable Gastric Band: In this surgery, your surgeon puts an inflatable band around the top of your stomach. This forms a small pouch which makes you feel full faster. The good point is that your stomach is not cut and your intestines are not shifted. There are thus lesser complications. It also helps in controlling diabetes. The con is that you lose less weight in this type of surgery.
Biliopancreatic Diversion: This is an uncommon surgery but most effective for diabetics. In this the doctor removes a large part of your stomach and also changes the way the food goes to your intestines. This helps in losing weight but also affects digestion long term.
As with any major operation, all bariatric surgeries come with potential risks of bleeding, infection, and leaks in the digestive system. It is necessary to change lifestyle to avoid weight regain.

Is There A Relation Between Weight Loss Surgery & Type 2 Diabetes?

What is Laparoscopic Gallbladder Removal Surgery (Laparoscopic Cholecystectomy)?

Gallbladder removal is one of the most commonly performed surgical procedures. Gallbladder removal surgery is usually performed with minimally invasive techniques and the medical name for this procedure is Laparoscopic Cholecystectomy or Laparoscopic Gallbladder Removal.

The gallbladder is a pear-shaped organ that rests beneath the right side of the liver. Its main purpose is to collect and concentrate a digestive liquid (bile) produced by the liver. Bile is released from the gallbladder after eating, aiding digestion. Bile travels through narrow tubular channels (bile ducts) into the small intestine. Removal of the gallbladder is not associated with any impairment of digestion in most people.

What Causes Gallbladder Problems?

Gallbladder problems are usually caused by the presence of gallstones which are usually small and hard, consisting primarily of cholesterol and bile salts that form in the gallbladder or in the bile duct.

It is uncertain why some people form gallstones but risk factors include being female, prior pregnancy, age over 40 years and being overweight. Gallstones are also more common as you get older and some people may have a family history of gallstones. There is no known means to prevent gallstones.

These stones may block the flow of bile out of the gallbladder, causing it to swell and resulting in sharp abdominal pain, vomiting, indigestion and, occasionally, fever. If the gallstone blocks the common bile duct, jaundice (a yellowing of the skin) can occur.

Diagnosing 

Ultrasound is most commonly used to find gallstones.
In a few more complex cases, other X-ray test such as a CT scan or a gallbladder nuclear medicine scan may be used to evaluate gallbladder disease.
Gallstones do not go away on their own. Some can be temporarily managed by making dietary adjustments, such as reducing fat intake. This treatment has a low, short-term success rate. Symptoms will eventually continue unless the gallbladder is removed. Treatments to break up or dissolve gallstones are largely unsuccessful.

Surgical removal of the gallbladder is the time-honored and safest treatment of gallbladder disease.

What are the Advantages of Performing Laparoscopic Gallbladder Removal?

Rather than a five to seven inch incision, the operation requires only four small openings in the abdomen.
Patients usually have minimal post-operative pain.
Patients usually experience faster recovery than open gallbladder surgery patients.
Most patients go home the same day of the surgery and enjoy a quicker return to normal activities.
Are you a Candidate?

Although there are many advantages to laparoscopic gallbladder removal (cholecystectomy), the procedure may not be appropriate for some patients who have severe complicated gallbladder disease or previous upper abdominal surgery. A thorough medical evaluation by your personal physician, in consultation with a surgeon trained in laparoscopy, can determine if laparoscopic gallbladder removal (cholecystectomy) is an appropriate procedure for you.


Laparoscopic Cholecystectomy - Laparoscopic Gallbladder Removal Surgery!

The bladder is a hollow storage organ that collects urine from the kidneys and stores it until it can be passed out of the body through the urethra during the process of micturition or urination. It has a thin inner lining of cells called urothelial cells and a thick muscular wall, which exerts pressure to push the urine out of the body.

Causes of Bladder Tumors

In most cases, the bladder tumor develops on the inner layer due to a combination of some of the following factors.

1. Hereditary: A strong family history of cancer predisposes a person to cancer.
2. Gender: Men are 3 times more prone for bladder cancer than women.
3. Ethnicity: White people are more prone for bladder cancer black people.
4. Smoking: Smokers develop bladder cancer 2-6 times more frequently than non-smokers. cigarettes contain toxic, carcinogenic substances which reach the kidney and are stored in the bladder, leading to their damage.
5. Occupational hazards: Some workplaces have a higher likelihood of causing bladder cancers, especially dye and rubber industries. The effects can be damaging, and the person may develop cancers years after the exposure has happened.
6. Recurrent bladder infections: In some people, this can also lead to bladder cancer in the long run.

Types of Bladder Tumor

Depending on the extent of the cancerous spread, it can be of two types:

1. Non-muscle-invasive bladder tumors: The tumor spread is limited to the inner part of the bladder (urothelial cells)
2. Muscle-invasive bladder tumor: The tumor has spread to the thick muscular outer layer. This is more advanced and prognosis is poor compared to the noninvasive type.

The most common and diagnostic symptom of bladder cancer is the presence of blood in the urine, known as hematuria. This will be intermittent and happens whenever the tumor bleeding happens. Other symptoms include pain in the lower abdomen and frequent urination.

Diagnosis

From the most noninvasive to the most invasive diagnostic test, these include:

1. Urine microscopy to detect cancer cells in the urine
2. Cystoscopy A tube inserted into the urethra to look into the inner wall of the bladder is highly diagnostic
3. Ultrasound, CT Scan, and biopsy can also be further used to identify severity of the tumor.

Treatment

Once the tumor is diagnosed, treatment would depend on the severity of the tumor. For both invasive and noninvasive tumors, definitive therapy is surgery, known as transurethral resection of the bladder tumor (TURBT). The cancerous bladder tissue is removed through a cystoscope as done for diagnosis. The bladder is then flushed with chemotherapy agent to kill any residual cancer cells in the bladder. This is then followed by BCG vaccine, which is again done 1 to 4 weeks for several months to avoid recurrence. In some cases, radiotherapy may also be included.

Bladder Tumor and Its Common Causes

In recent years, there has been the emerging trend of resorting to customized treatment for different types of cancer. These treatments vary from individual to individual, depending on the severity of their condition. PSMA PET scan and DOTA scan are two such procedures used in the treatment of prostate cancer.

Before identifying the benefits of these scans, let us have a look at the risks of prostate cancer.

Prostate Cancer- What is it?

Prostate cancer shows up in the prostate gland of men, which produces the fluid that transfers and nourishes the sperm. It is a very commonly occurring condition in men and early treatment can cure it completely.

Symptoms of Prostate Cancer:

Prostate cancer starts showing its symptoms from the middle stages. One should seek medical help if he observes the following warning signs-

  Pain while urinating
  Bone pain
  Reduction in force of urine
  Erectile Dysfunction
  Presence of blood in semen

With increasing age and obesity, there remains a high chance of developing prostate cancer.

What is PSMA PET scan?

It is an effective and reliable mode of diagnosis to identify the extent of prostate cancer. It is also known as Prostascint scan. This scan is recommended for patients in the early stage of cancer and to determine whether the disease has spread to the pelvic lymph nodes.

In this process, the patient is injected with an antibody and a radioactive material that can be detected by cameras. The doctor then sees a three-dimensional picture of the affected area on the monitor. The complete process takes three days to finish.

Benefits of PSMA PET scan:

  Helps to determine the position and range of a tumour
  Helps the doctor to plan effective methods of treatment to eradicate a tumour completely
  Helps to predict the result of treatment up to a certain extent, unlike other imaging tests

What is DOTA scan?

It is a highly advanced scan used to detect the spread and sensitivity of tumours concerning prostate cancer. The molecules injected during the scan attaches itself to the neuroendocrine tumours known as carcinoids.

Benefits of DOTA scan:

  Helps to detect the exact location of a tumour
  Helps the doctor to plan for effective radioactive therapies
  Helps to identify the exact stage of a cancerous tumour

Both PSMA and DOTA scans are the fruits of modern scientific research and go a long way in eradicating cancerous cells from the body. Early detection of the disease with these scans increases the chance of being cured of the disease.

Prostate Cancer - Knowing The Importance Of PSMA PET Scan & Dota Scan!

Losing weight is a daunting task. This becomes all the more difficult for obese people. In many cases, the patient may be advised to undergo bariatric surgery. There are many types of bariatric surgery. Some surgeries address both the stomach and the small intestines while others address only the stomach. A gastric band surgery is one such procedure.

For this procedure, an adjustable band is placed around the upper half of the stomach. This creates a small pouch that can hold a limited amount of food. The band is connected through a plastic tube to a small device placed under the abdominal skin. Sterile fluid may be injected or removed from the band through this device. By injecting saline, the band is made tighter and by removing the liquid the band is loosened. This allows the band to be customized to improve weight loss.

The result of a gastric band surgery may vary from person to person. Band adjustment starts after the third week of surgery. Because the size of the stomach is reduced, the person will feel full faster and hence eat less. In most cases, a person can expect to lose 60 to 75 % of their excess body weight. This should not be confused with a person s total weight. The procedure can be reversed at a later date if need be.



Some people may develop side effects like nausea and vomiting after the procedure. But why this procedure has not gained acceptance compared to other bariatric procedures like gastric bypass and sleeve gastrectomy is because, the compliance with the band is not very good and complications like band erosion, band slippage, band migration are very high. Another dreaded complication following the band surgery in non-compliant patients who eat large quantities and overstretch the small gastric pouch above the band is severe GERD.

In severe cases, rarely, grains of undigested food is seen in the mouth on waking up in the morning. This could be life-threatening. Vitamin deficiencies are rare provided supplements are taken regularly during the weight loss period.  

Gradual band adjustment is required and regular follow up with the bariatric surgeon will yield good results. Over adjustment is not good at all and could lead to higher chances of complications like band erosion. However, proper dietary compliance can make the results of a band better. Ideally, a patient should get follow up checks every month after such a surgery.

All said and done, the percentage of excess weight loss in the gastric bypass and sleeve gastrectomy are far superior to the adjustable gastric banding. Even the compliance, and maintenance of weight loss over years is better in the other bariatric procedures compared to the band.

Gastric Band Surgery - Know How Competent Is It?

Cancer is the most dangerous disease noticeable throughout the world. The most common type of cancer that affects men is prostate cancer. Prostate is a small exocrine gland situated directly below the bladder and in front of the rectum. This is gland is approximately in size of a walnut and plays an important role in production of a milky fluid during orgasm of sex in which the semen travels. During the climax stage of the prostate gland is forced to push the fluid and remove the semen out of the reproductive structures.

Prostate gland is a slow progressive disease which makes many males left unidentified even the presence of prostate cancer even until they die. 6 out of 100 male over the age of 60 are getting prostate cancer. Though prostate cancer can be cured at a better rate when compared to other type of cancer it is always best to stay protected. Prevention is always better than cure. Here are few tips to keep your prostate healthy.

Signs and symptoms of prostate cancer-

During the early stages of prostate cancer there are usually no symptoms. Most men at this stage find out they have prostate cancer after a routine check up or blood test. When symptoms do exist, they are usually one or more of the following:

The patient urinates more often

The patient gets up at night more often to urinate

He may find it hard to start urinating

He may find it hard to keep urinating once he has started

There may be blood in the urine

Urination might be painful

Ejaculation may be painful (less common)

Achieving or maintaining an erection may be difficult (less common).

If the prostate cancer is advanced the following symptoms are also possible:

Bone pain, often in the spine (vertebrae), pelvis, or ribs

The proximal part of the femur can be painful

Leg weakness

Urinary incontinence

Fecal incontinence

Ways to have a healthy prostate  

Diet and weight   the most important factor is the diet to maintain a healthy weight. Avoid fatty food items and take fats from vegetables than from animals. Avoid dairy products and increase the intake of fresh fruits and vegetables.

Exercise   have a regular practise of doing exercise at least for 30mins a day. This really helps you to keep your body fit.

Be precautious   if you have a family history of prostate cancer or if you feel you are at high risk of getting prostate cancer talk with your doctor about it and take preventive drugs as per the doctor s advice.

Red foods   research shows that men who consume red foods like watermelon, tomato and other red fruits are at lower risk of getting prostate cancer as they contain a powerful antioxidant called lycopene

Caffeine   three to four cups of coffee per day reduces your risk of getting prostate cancer.

Stop smoking   if you are at high risk of getting prostate cancer it is best advised to quit smoking and alcohol.

Prostate Cancer - What To Expect

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