Colorectal surgery: How to be sure you need it?

Colorectal surgery is performed to repair damages that occur in the organs of the anus, rectum, and colon. The damage that takes place in these organs can be the result of problems with lower GI like diverticulitis (a condition wherein pouches known as diverticula in the colon wall become inflamed), cancer and inflammatory bowel disease (a group of intestinal disorders that bring about inflammation of the GI).

Who needs this surgery?

In general, colorectal surgery is an essential treatment option for ulcerative colitis, colorectal cancer, Crohn's disease (an inflammatory bowel disease that gives rise to inflammation of the gastrointestinal tract) as well as certain diverticulitis cases. In such cases, the intestinal tract undergoes major reconstruction.

There are also other bowel problems that may require surgery but not of a serious nature and these are anal fissures, hemorrhoids, bowel incontinence and rectal prolapse. Most of the surgical procedures will aid in repairing tears, get rid of blockages, or make tighter sphincter muscles (muscles that surround openings in the body).

Colorectal surgery is also performed in cases of pelvic floor disorders like rectocele (a condition in which the rectum bulges towards the vagina) and perineal hernia (a hernia that involves the pelvic floor).

At the same time, injury, ischemia or compromised blood supply and obstruction may require the performance of bowel surgery as well. Scar tissue and masses can form within the rectum, clogging the organ and preventing the normal discharge of feces from the body.

Problems like ulcerative colitis (an inflammatory bowel disease that leads to the development of ulcers in the colon as well as inflammation of the area) and diverticulitis can give rise to perforations in the rectum. Surgery is suggested in instances when drugs fail to treat the problem of ulcerative colitis.

Likewise, in the case of recurrent instances of perforations or complications in diverticulitis, surgery may be required to remove the portion of the colon affected.



Colorectal Surgery: How To Be Sure You Really Need it

The mere thought of biting into a chilled watermelon or sipping chilled watermelon juice during summer is a refreshing thought. What many do not readily realise is that not just they are not just a refresher, but they are also loaded with multiple health benefits. Another surprising fact is that they have been in use since 5000 years ago and are referred to in ancient literature. There are about 300 varieties and are easily available during summer.

Many may think that watermelon is loaded with water. However, there are also multiple compounds including vitamins and minerals; vitamins C, A, B1, B5, and B6; minerals like potassium and magnesium, and compounds like carotenoids and lycopene. These have multiple benefits on the health and so watermelon can be consumed without any second thought in abundance.

Read on to know some of the wonders of this melon.

Hydration: One of the best remedies to avoid the ill effects of summer is to improve hydration levels, and there could be no better way to do this than with watermelon (eat it or drink it!) It is 92% water, and therefore leaves you refreshed and rejuvenated.
Heart health: Lycopene helps reduce cholesterol, reduce thickening of artery walls, and reduces oxidative stress. The various minerals and vitamins also add to the heart health qualities of watermelon. The citrulline in it also increases nitric oxide level in the body, which expands or dilates blood vessels and improves blood pressure.
Anti-inflammatory benefits: The lycopene and vitamin C reduce the levels of C-reactive protein which are responsible for inflammation. The antioxidant levels also lower inflammation, thereby reducing the onset of degenerative diseases like Alzheimer s.
Eye health: Watermelons, through their anti-inflammatory effects, reduce the onset of age-related macular degeneration. Those who already have it can also see the delayed progression of the condition, thereby prolonging vision loss.
Muscle soreness: Those who have muscle soreness should reach out for a slice of watermelon to get instant relief from this soreness. Watermelon also improves exercise endurance and performance, and the added benefit on the heart also improves exercise tolerance.
Skin and hair benefits: These benefits come from multiple sources in the melon. The vitamin A helps improve skin regeneration, vitamin C helps collagen formation and improved skin tone. Lycopene and beta-carotene help control the damage caused by sun exposure and pigmentation.
Digestive benefits: The very nature of watermelon almost completely water and high fibre directly benefits the stomach. It cleanses the stomach and promotes bowel movement. Not just the red portion, even the rind and seeds are beneficial as there is a lot of citrulline and chlorophyll which are also healthy.

Watermelon - One Fruit, Many Benefits!

Problems of the large intestine are very common and patients should usually consult gastroenterologists for the proper diagnosis and treatment

1. Bleeding per rectum: Bleeding through the anal canal or rectum is usually the most common problem of the patients. It can be due to following reasons: 

A. Piles also known as Hemorrhoids: Hemorrhoids are dilated venous channels of the anal canal. They occur due to long term constipation or chronic cough or due to less fibre intake in the diet. Sigmoidoscopy or proctoscopy is required for diagnosis. Treatment options include medicines and high fibre intake, Injection therapy(Sclerotherapy) for stopping bleeding from piles and Stapler hemorrhoidectomy if the piles are large.

B.  Polyps: Polyps are soft tissue growths seen in the large intestine. They are usually silent but can present with bleeding or anaemia. Polyps usually grow slowly in size and large polyps can turn into cancer of large intestine also known as colorectal carcinoma. Colonoscopy is required for the diagnosis. The gastroenterologists can diagnose the presence of polyps by colonoscopy. Smaller polyps can be removed by polypectomy by gastroenterologists without the need for open surgery. However large polyps or those polyps with suspicion of cancer require surgery.

C. Large intestine Ulcer: They can occur due to early cancer, SRUS, Infections or drugs. They require colonoscopy for the diagnosis. The gastroenterologists usually take Biopsy from the ulcer to know the cause of the ulcer. The mere taking of biopsy does not mean cancer and biopsy samples are seen in the microscope for better diagnosis.

D. Ulcerative Colitis and Crohn s disease: Ulcerative colitis is one form of Inflammatory bowel disease (IBD). The other IBD is known as Crohn s disease. Whereas ulcerative colitis involves only large intestine, Crohn s disease can involve any part of the gastrointestinal tract including small intestine. Ulcerative colitis and Crohn s disease present with Loose stools(diarrhea), bleeding , abdominal pain, weight loss, Anemia and Perianal fissures and  fistula. The diagnosis of IBD is challenging and involves blood tests, CT Scan abdomen, Colonoscopy with biopsy and clinical history. Management includes Medicines which control the inflammation such as Pentasa, Rowasa, Mesacol etc. Severe disease requires additional drugs such as Azathioprine and Anti TNF sich as Infliximab and Adalimumab. Occasional cases require surgery such as those with tight stricture of the intestine, severe dilatation of Large intestine (also known as Toxic megacolon), excessive bleeding, the disease not responding to medical management, or presence of cancer with IBD.

E. Anal fissures: Cut in the anal skin (fissure) causes severe pain in the anal area during passing motions. It is usually due to constipation or straining. It is usually treated by Gastroenterologists initially by medicines and ointments. If the pain continues Surgery is required named as Lateral internal sphincterotomy (LIS).

2. Loose motions or Diarrhea: Excessive passing of liquid motions is known as diarrhea or commonly lose motions. It is usually due to Infections caused by contaminated food and water. It is usually self-limiting. Severe cases with dehydration require admission for IV fluids and antibiotics for the infection. Loose motions for more than 6 to 8 weeks is known as chronic diarrhea. It is evaluated by blood tests and colonoscopy. Usual causes include tuberculosis, celiac disease, ulcerative colitis, microscopic colitis, Malabsorption such as chronic pancreatitis and small bowel bacterial overgrowth.

3. Irritable bowel syndrome (IBS): IBS is very common and at least 20 to 30 percent of Indian patients suffer from it. Symptoms include altered bowel habits such as diarrhoea or constipation, abdominal pain which is usually relieved or increased by defecation. Weight loss or bleeding is not the feature of IBS. Few simple blood tests are required and good medicines are now available for IBS. Few cases may require colonoscopy to rule out alternative causes of the symptoms.

Understanding colonoscopy: Colonoscope is a flexible tube with a camera at its tip to see the inside of the large and small intestine. Bowel preparation is required at least 8 hours before the procedure so that the inside of the large intestine can be seen clearly without the interference of stools.colonoscopy is an OPD based procedure where the patients are discharged the same day. A colonoscopy helps in evaluation symptoms of the large intestine such as loose stools, bleeding and abdominal pain.

In Detail About Colorectal Disorders!

There are many food items which would become stale after a few hours, but there are certain foods which may last forever without the need to can them or freeze or dehydrate. If an individual is new to the field of food storage, these staples can be an excellent way to begin.

White rice: There are numerous researchers who have found that polished or white rice keeps up their nutrient content and flavour for almost 30 years if it can be stored in oxygen-free containers in temperatures that range below 40 degrees Fahrenheit. Brown rice, on the other hand, doesn t last more than six months owing to the availability of natural oils in the bran layer.
Honey: Honey is preferably the only food that would last forever due to the perfect chemistry and the handiwork of the bees. The nectar extracted from the flower gets mixed with the enzymes present in the bees  bodies which alter the composition of the nectar. The nectar is further broken down into simple sugars and is accumulated in the honeycombs. The processing, as well as sealing of the honey, is primarily responsible for the incredible shelf life.
Salt: Since sodium chloride is a mineral which is taken from the natural components of the earth, its shelf-life should come as a natural consequence. It is used for centuries as a means of preserving other food products as it can extract out all the moisture. But this doesn t indicate that the table salt would last forever. Experts say that the addition of the iodine to the table salt reduces the shelf life of the salt which means that if the label says that it is an iodized salt, it will not last over five years.
Soy sauce: When left unopened, a container filled with soya sauce would last for a significantly long period. But it is also dependent on the type of soy sauce and the additives used. Even if the soy sauce has been opened, this salty condiment will last for many years if stored in the refrigerator.
Sugar: Quite similar to many items, the storage process of the sugar determines whether the sugar is going to last for long or not. Granulated and powdered sugar must be kept under an airtight condition to steer clear of moisture. Although retailers are needed to provide the manufacturing dates of the sugar, manufacturers say that the sugar remains edible even if it has hardened and become brown.
Pure maple syrup: Pure maple syrup, as well as commercial sugars such as granular sugars and honey, has an irresistible life owing to its shield against any kinds of microbial growth. Unopened maple syrup shall last forever, and in case there is the formation of mould, boiling it to a certain degree and skimming the surface and ultimately pouring it to a clean and air-tight container would eliminate all the problems.
Clarified butter: This kind of butter is boiled unless the total moisture is extracted which is the reason that it doesn t go bad. As long as the clarified butter or ghee is stored in sealed container under cool temperature, it would last for about 100 years.

7 Foods That Never Expire!

Screening for cancer of the colon or large intestine and rectum is a proven way of saving a person from the impacts of colorectal diseases. This is partly because colon cancer is something that can be prevented if detected at an early stage and the polyps which may advance to cancer are removed properly. Thus if you are turning 50 soon, be prepared to present yourself for a screening colonoscopy that will help you ensure good health and well-being. It may sound uncanny, but do you know that 50,000 people across the world die from colorectal cancer every year, and it is ranked second in terms of cancer-centric deaths.

Understanding the importance of having colonoscopy
You may wonder how a painful, invasive, embarrassing, uncomfortable and time-consuming health test may be called a present. There are reasons enough. A screening colonoscopy is able to expose a cancerous tumour that's presently under way and cast light on the chances and risk factors that may precede it. When you choose to intervene early, you have the power to nip those risks at their budding stage, much before those malicious cells become malignant.

Spreading of the colorectal cancer
Your large intestine is really a big and last organ of the gastrointestinal system where the small intestine discontinues. Its primary function is to remove the water out of the leftover solids of digestion and get rid of them in the form of stool. Cancer may start to develop anywhere within the tube that expands 5 feet long and squares the vacant area of the abdomen. The large intestine expands up towards the right side, i.e. the ascending colon and then turns left through the liver, i.e., the transverse colon, bending down right at the spleen on its left, i.e. descending colon and loops to the middle, i.e., the sigmoid colon before it runs across the rectum and ends at the anus.

People who need a colonoscopy
To simplify matters, it can be said that all adults are at a potential risk of the colorectal cancer, including those people who lead a healthy life. But some people are at a higher risk. Those individuals have a specific gene mutation that predisposes them to develop into numerous polyps. The risk is also high with people who are first-degree relatives of a person diagnosed with cancer before the age of 50. People with Ulcerative colitis, various types of inflammatory bowel diseases and Crohn's disease are also at a higher risk.

Colorectal cancer is a serious ailment and screening colonoscopy is a feasible means of detecting any polyps that may be cancerous in the future. Speak with a reputed gastroenterologist today to stay ahead of the disease.

When Should You Start Having Colonoscopies?

A Gastroenterologist is a physician with dedicated training and unique experience in the management of diseases of the gastrointestinal tract and liver. If you are planning to visit one, you most likely have a problem in one or many organs like esophagus, stomach, small intestine, colon and rectum, pancreas, gallbladder, bile ducts and liver. 

Visit your doctor to understand the severity of your condition and the course of treatment, as it is obvious that during this time you must be suffering from anxiety and you may not ask the questions arising in your mind. That is why you need to prepare in advance for your first visit with a gastroenterologist. Being an active partner in the doctor patient relationship is bound to have its benefits. Here are some handy tips:

1. Come mentally prepared: Don't let the anxiety get to you. If you need some extra help calming down, try yoga or meditation. You can simply go out on a walk alone to help you focus your thoughts. This is just like any other doctor visit. The good part is that you are taking the first step in easing your discomfort and starting treatment, so go with a positive mind.

2. Maintain a diary of symptoms: It is likely that you are experiencing discomfort from past few days or weeks before you finally realize the need to seek out a specialist. Try to remember as much as possible about the symptoms you experienced in a chronological order. Write down any over the counter medicines you've tried or anything unusual that you may have consumed in the past week. 

3. Take stock of your medical history: It is likely that your doctor may want to know about any historic conditions you've suffered that may or may not relate to your present condition. Many ask you to fill out forms during your first time patient registration which includes many minor details about your medical past. List down any allergies, especially food allergies you have. 

4. Take stock of your recent medical tests: Bring your latest blood tests and imaging tests (X-rays, ultrasounds, MRIs, and CT scans) with you for the doctor's visit. If you have a pre-existing condition like diabetes, thyroid or you suffer from other chronic conditions like increased uric acid, carry your most recent medical reports with you. 

5. Make a list of questions for the doctor: In most cases, the first visit is a crucial factor in determining whether you want to continue the course of treatment with a particular doctor. This comes out of your ability to trust the doctor, his knowledge and diagnosis and an overall comfort level that comes with how well he handles your questions. Start by making a list of questions you want to ask about your specific condition and course of treatment and see if you get satisfactory answers. 

6. Brace yourself: If you want to suggest a treatment option, make sure you read up all about it before you tell the doctor.

6 Tips For Your First Visit With A Gastroenterologist

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