Breast examination is a way of detecting early changes that help in detecting lumps or other growth in the breast. This is a manual form of examination that may be carried out by the doctor or even by the patient. This kind of examination helps in detecting the onset of breast cancer and helps in successful treatment of the same. It is an essential screening strategy that all women must go through. Let us cast a glance on the various details regarding this examination, and also how frequently it must be conducted.

Age: Women who have reached the age of 18 are said to have matured physically and sexually. They should perform this examination once they have reached the said age in order to detect any anomalies in the way the physical changes occur in the breast tissue.
Procedure: One should begin by looking at one's reflection in the mirror to find any rashes or dimpling in the breasts. The shape, size and colour of the breasts and nipples must also be studied so as to check for any anomalies. Inverted nipples, redness and soreness must also be reported to the doctor. Once you are done checking the visuals, you can raise your arms and look for any changes. Then, you will need to lie down and feel your breasts by using a circular motion. The finger pads must be used in order to check for any lumps. One must start from the centre and move the breasts sideways. Any wet and slippery feeling must be reported to the doctor immediately.
Pressure: During the breast examination, you must use light pressure for the skin and tissue that lie beneath the breasts, while medium to moderate pressure should be used for the middle portion of the breasts. One must use a firm hand to check the tissue that lies at the back of the breasts, near the rib cage.
Frequency: One must get into the habit of conducting a breast examination at least once a fortnight or once a month, without fail. You can also go to the gynaecologist for an examination in case you are not confident of conducting it on your own with proper movements and accuracy. You may also journalise your breast examination findings.
Menstrual Cycles: When you are going through your menstrual cycle or period, it is important to remember that your breasts can become tender just before or after the start of the cycle. So, do not panic if you think you have found a lump or any other growth at this time. It is best to check again after a week and then visit the doctor about checking the same.

How Frequently Should a Breast Examination Be Done?

Bariatric surgery is unlike other surgeries, the success is defined after 6-18months later. It is not without its complications. But complications managed well by Bariatric surgeons and the introduction of Laproscopy, it gives advantages of reduced post-op pain to less incisional hernias and less post-operative hospital stay. 

Sometime problems may happen like- 

Post-operative bleeding: Managed well by the surgeon. 
Dehydration: Chances of dehydration, therefore, one of the main post-op instructions, would be to increase water intake significantly, after the first week of course, when water is included in the diet. For someone who is not used to drinking lots of water, this can be difficult. 
Indigestion: Difficulty digesting food after the surgery is very common. There could be a burning sensation in the stomach. This is often managed by dietary changes like avoiding fatty foods, eating small frequent meals, avoiding too much sugary food items, etc. Too much fruits and vegetables should not be introduced early on, as fibre can be difficult to digest. Avoid fruits like nuts, seeds, fried foods, processed foods, etc. Gradually moving from water to pureed diet to semi-solids to solids can help in getting the stomach used to it. 
Vitamin and mineral deficiency: With the drastic cut in the amount of food consumption, there could be multiple problems including skin rashes, weak bones, dental issues, hair loss, gallstones, kidney stones, etc. All these are due to deficiency of various essential minerals like calcium, potassium, etc. This can be managed through minor diet modifications to ensure the body gets the required minerals and vitamins, even if they are in the form of supplements. 
Dumping syndrome: With a reduced size of the stomach, the food moves from the stomach into the smaller intestine much faster. Therefore, the sugar levels increase rapidly, producing various symptoms like bloating, diarrhoea, nausea, weakness, and anxiety. This is managed by eating less amount of sugars and fats and spacing out the meals through the day. Five to six small meals are preferred over 2 to 3 large meals. Some people also get relief from lying down after eating. 
Hernias: Less after laproscopic surgery but sometime it may happen. 
Diet changes: Whether it is medications or foods, some substances have to be knocked off your list. A detailed diet plan should be made with the doctor, as some can affect the stomach in an adverse manner. 
Altered bowel habits: Some people may have diarrhoea, others have constipation. Looking into one s diet and making suitable changes will help. Therefore, it is very important that you must keep regular follow-up and consultation with your surgeon, in order to avoid complications.

Bariatric Surgery - 8 Complications It Can Cause!

Dysphagia is the difficulty in swallowing food or liquid. Most people suffering from dysphagia are unaware of their medical condition and only realize it in later stages. When not diagnosed and treated in time, it may lead to aspiration pneumonia (lung infection occurring due to food particles or saliva entering the lung), weight loss, dehydration and malnutrition. Some of the symptoms include:

Heartburn
Choking
Drooling
Having the feeling of food getting stuck in the chest or throat.
Food or stomach acid coming back up into the throat
Regurgitation
Hoarseness of the throat
Gagging and coughing while swallowing
Experiencing pain while swallowing
There are two types of dysphagia:

Esophageal Dysphagia:
This is also known as low dysphagia and is the condition in which one can sense food getting stuck in the throat or chest area. The problem lies in the esophagus. Generally, the surgical procedure is required to solve the problem. Some of the causes of low dysphagia include-

Achalasia- lower muscles in the esophagus do not allow food to enter the stomach.
Diffuse spasm- Uncontrolled contractions of the lower esophagus after swallowing food.
Esophageal stricture- Narrowing of the passage of esophagus making it difficult for food to pass. It often leads to GERD (Gastroesophageal Reflux Disease).
Esophageal Ring- A narrowing of the lower portion of the esophagus
Scleroderma- Autoimmune disease where it leads to hardening and stiffening of body tissues.
Oropharyngeal Dysphagia:
This is also known as high dysphagia and is the condition where the throat muscles become weak making it difficult to swallow food. Some of the causes for high dysphagia include- stroke, Parkinson s disease, Zenker s Diverticulum (a condition in which food particles get accumulated inside a small pouch in your throat) and cancer.

Treatments:
Depending on the type of dysphagia, you will be advised any one of the treatment courses available. It can range from swallowing therapy, dietary changes, feeding tubes and medications to even surgery. The treatment is carried out by a multidisciplinary team. A multidisciplinary team includes- a speech-language pathologist, primary physician, gastroenterologist, dietitian, therapist, radiologist and pharmacist. The treatments for dysphagia include:

Swallowing Therapy- If you are suffering from high dysphagia, you will be referred to speech and language therapists. You will be taught a number of exercises to make the process of swallowing easier and simple.
Dietary Changes- In this method, you will be referred to a dietician or nutritionist. You will be advised a well-balanced and healthy diet that may include more liquid and semi-liquid food.
Feeding Tube- When swallowing becomes extremely difficult and the patient is at risk of suffering from malnutrition and dehydration, the patient is usually fed through a nasogastric tube which passes through the nose and into the stomach. PEG (percutaneous endoscopic gastronomy) tube which is directly implanted in your stomach.
Dilation- People suffering from low dysphagia have to undergo surgery. One of the methods is dilation. Through endoscopy, images of inside the throat is taken and a small balloon is inserted.
Botulinum Toxin (Botox) - One of the causes for low dysphagia is achalasia. In such cases, botulinum toxin is used to relax and weaken the stiff and hardened muscles of the esophagus.
These were some of the treatment options for dysphagia that prove it is treatable and can be cured easily. Generally, dysphagia occurs in older people and babies. Whatever may be the cause, the main purpose of the treatment of dysphagia is to make the patient go back to oral feeding.

5 Best Dysphagia ( Swallowing Problems) Treatment Options

Colorectal cancer is otherwise known as cancer of the colon or the rectum. This can affect both men and women with age being a major risk factor. Majority of such cancers are seen to occur after age of 50 years.

Type: colorectal cancers can present as one of the following types: 

Adenocarcinomas are the most common type of colorectal cancers. These cancers begin in the cells making mucous and other fluids. Certain colorectal cancers begin as adenomatous polyps (adenomas) that turn cancerous over a period of time. This is precisely why the adenomas are regarded as pre-cancerous or pre-malignant.

Gastrointestinal (GI) carcinoid tumors, GI stromal tumors, primary colorectal lymphoma, leiomyosarcoma, melanoma & squamous cell carcinoma are certain other colorectal cancers

Carcinoid tumors: start in specialized cells that produce hormones, in the intestine.

GI Stromal tumors: start in the interstitial cells of Cajal (ICC), in the wall of the colon.

Lymphomas: start typically in the lymph nodes but they may also start in colon or rectum.

Sarcomas: can start in the muscle and the connective tissue in the walls of the colon and rectum.

Gender: it affects both male and female populace.

Etiology: mostly, the factors that are associated with increased risk of colorectal cancer include the following  

Age exceeding 50 years.

Racial & ethnic background such as African Americans, in the USA, are known to have the highest incidence of colorectal cancer, and mortality rates.

Low fibre and high fat diet. Excessive consumption of red meat (e.g. goat meat, beef, pork, lamb, or liver), processed meats, butter, refined grains, sweets, sugary drinks etc all can increase the risk of colorectal cancer.

Personal history of inflammatory bowel disease (IBD) (e.g. ulcerative colitis), Crohn s disease, adenomatous colorectal polyps, colorectal cancer etc all.

Family history of colorectal cancer or adenomatous polyps etc all.

Inherited syndromes such as familial adenomatous polyposis (FAP) and Lynch syndrome (hereditary non-polyposis colon cancer or HNPCC).

Sedentary lifestyle/ associated Obesity.

Type 2 diabetes.

Tobacco and alcohol abuse.

Features or symptoms can vary from person to person depending on the size and location of the tumour. Following are the signs & symptoms mainly -

Changes in bowel habits, diarrhea or constipation or an alternating diarrhea and constipation.

Occult/ blood in the stool, and 

Problems related to blood loss (e.g. anemia, weakness, fatigue, intolerance to exercise, shortness of breath, increased heart rate, chest pain etc all),

Abdominal discomfort (frequent gas/ flatulence, bloating, fullness, cramps, and pain), vomiting etc.

Unexplained weight loss,

Pain with bowel movement,

Feeling that bowel does not empty completely,

Stools are narrower than usual.

Diagnosis: Following are the diagnostics employed. Abnormal blood test results may be indicative of malignancy, but a follow-up imaging/ biopsy is always the gold standard for accurate diagnosis.
Blood: fecal occult blood test, Carcinoembryonic Antigen (CEA) assay values are raised, Hb/ RBC counts may be low.
Imaging: Colonoscopy, Endorectal Scan/ CT Scan followed by Biopsy clinches the diagnosis and the nature of the disease.
Apart from the above-mentioned barium enema X-Ray, USG, Chest X-ray, PET CT scan etc all help detect metastasis, if any. An increase in level of the serum tumor marker  CEA  is indicative of metastatic spread/ proliferation that can be ascertained through a PET CT scan.
Treatment: Conventional treatment includes surgery, radiation and chemotherapy as contextually appropriate. Simultaneously, an adjunctive/ integrative naturopathic treatment with suitable complementary & alternative medicines (CAM)/ therapies too can help improve clinical outcomes and facilitate recovery as feasible contextually.
Prognosis: preventive measures, earlier diagnosis and right early treatment is key for better prognosis and efficient/ effective therapeutic management. Usually, the chances of cure for an early stage cancer are more. Above-mentioned apart, recovery chances are influenced by the grade, stage of cancer, recurrence and the patient s general health & vitality etc all too.

Prevention: rightly said, prevention is always a better choice. Although genetic risks are difficult to modify, still an adherence to a Mediterranean diet, maintaining an ideal body weight and an active lifestyle with due emphasis on regular exercising (for at least 30 minutes daily), de-stressing and relaxation is highly recommended for prevention or reducing the risks of colorectal cancer. A healthy eating plate comprises essentially a low fat diet, fibre rich foods including whole grain cereals, green leafy vegetables cooked using healthy vegetable oils, fresh fruits of all colours as seasonally available and healthy proteins/ fats including fresh fish, poultry, beans, nuts etc all. It is advisable to limit milk/ dairy, preferably of low fat content, to 1 to 2 servings max daily. Although alcohol is optional and is not for everyone, the consumption of the same, if any, has to be strictly in moderation, and is best avoided. Smoking is to be avoided as well. Again, red meat, butter, refined grains, sweets, sugary drinks including carbonated beverages and other high calorie foods etc all, if any, are to be taken sparingly or are best avoided too. Apart from the generic preventive measures as mentioned above, certain pre-malignant conditions, of which adenomas are the most common, can be successfully treated with complementary and alternative medicines too.

Colorectal Cancer - In a Nutshell!

Oily skin and summers: what is the ideal way to handle it?

Oily skin is a condition that can be characterized by shine on the skin and a large number of pores. The oil in question is a result of overactive sebaceous glands that produce excessive sebum. This can result in acne and blackheads. Summer is a time of the year where skin problems due to oily skin are worsened by factors such as sweat and dust. So proper skin care is necessary in order to negate the effects of oily skin.

There are multiple ways to handle this condition in summers:

1. Using cleansers - Proper cleaning of skin is a very important step in lessening the effects of oily skin. Harsh cleansers have an opposing effect as they facilitate secretion of oil, so a mild cleanser is usually the best option. Some cleansers may contain ingredients that irritate the skin, so care is advised in selecting a proper one.

2. Hydration and food - Keeping the body well hydrated in summers combined with a diet free of greasy, oily food and less fats can help in reducing the effects of oily skin.

3. Using masks to clear the face - Masks such as clay masks, yogurt, and baking soda can help in cleansing the skin by clearing the oil. It should be noted that these treatments should not be overdone as they can cause the skin to dry up too much and over secrete oil.

4. Skin moisturizers - People often have this notion that oily skin does not require moisturizer application. Selecting a moisturizer that is fit for oily skin and using it will help moisturize the skin and keep it healthy.

5. Sunscreen - Sunscreen is a necessity during summers, and the sunscreen you choose should be specifically for oily skin in order for it to work effectively. Application of sunscreen can help prevent the UV rays of the sun from penetrating the skin and cause complications.

6. Dermatological treatment - In case of severe oiliness, treatments such as chemical peels and creams laced with tretinoin can help.



Oily skin and summers: what is the ideal way to handle it?

Achalasia is a serious disorder of the esophagus in which your nerves and muscles fail to work properly. This disorder causes problems in your body such as chest pain, difficulty to swallow food and excessive coughing. 

You will also face problems in breathing in case the food enters in to the lungs. There is a valve in your lower esophageal splinter, which closes the esophagus from your stomach. If you have problems like achalasia then perhaps your lower esophageal splinter fails to open while swallowing food it can lead to accumulation of food in esophagus. In this condition the nerves in your body gets damaged and hence cause health complications.

You are at risk of achalasia when you are middle aged, but it can also occur during childhood. Auto immune disorder often places you at risk for achalasia.

Symptoms of achalasia:
The major symptom of achalasia is dysphagia in which you face problems while swallowing food. You may feel that the food is struck in your esophagus which causes choking and problems when you breathe. There may be other symptoms of achalasia which includes:
1. Loss of weight
2. Heart burn
3. Discomfort or pain while you eat food
4. Chest pain
5. Risk of esophagus cancer

Treatment for achalasia:
Esophageal manometry is a technique your doctor may use, if he suspects achalasia when the symptoms include difficulty while you eat and swallow foods. A tube measures the muscular activity in your stomach and reports about the functioning of your esophagus. Another way to diagnose is through X- ray of the esophagus or endoscopy.

The treatment for achalasia generally starts with oral medications. Sphincter nitrates and calcium blockers often help to relax the muscles. Botox can also help to relax your sphincter and help you swallow food.
Esophagomyotomy also helps to treat achalasia in which your doctor can use an incision to access the sphincter and also alter it to enable better flow into the stomach. It s a generally successful procedure, but sometimes can cause gastro esophageal reflux disease (GERD) which causes heart burn and would require intensive care. Sometimes surgery can also help to give relief but it can also cause acid reflux, respiratory problems, tearing of esophagus along with other serious complications.

Laparoscopic surgery is a simple and effective way of treating this problem .The tight lower esophageal sphincter is released to make way for easy passage of food.The patient recovers in one day and is discharged home following this operation.

Achalasia - Symptoms + Treatment

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