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

6 ways to minimize visible pores on your skin

Pores are openings in the skin through which your body's natural oil, called sebum, is released. They appear larger when they are clogged with dirt or oil, and are home to hair follicles. Dead skin cells and sebum which, put together, form a pimple can stretch out pores. Aging and exposure to the harmful UV rays of the sun also contribute to the appearance of pores on your skin. Pores can be controlled with the right skin care. 

Here's how:
1. Choose your skin care products wisely 
Zinc and magnesium help to maintain your skin's oil balance and clear pores. Products with softening ingredients like rosemary and lavender may soothe your skin and prevent pores from stretching out. You should use products with salicylic acid as an ingredient since it unclogs pores, exfoliating your skin. 

2. Maintain cleanliness
Washing your face temporarily stops your pores from holding extra oil or dirt. Exfoliating two to three times a week can also control the cropping up of pores on your skin. However, these are temporary methods because you will have large pores naturally if your skin is oily.

3. Applying sunscreen
Exposure to the harmful UV rays of the sun for too long can make your pores look bigger. Applying sunscreen on the face and on exposed areas of your skin with SPF 30 can minimize your pores. Also, wear a broad-brimmed hat and withdraw stepping out in the sun between 10 A. M. To 4 P. M.

4. Treating the spot
Oily skin tends to have larger and more noticeable pores. Some areas of your face may be oilier making the pores visible. A clay mask can be used for spot treating if the pores on your nose, cheeks or forehead are large. Apply a thin layer of the mask on your skin and rinse it off with water after a few minutes. The clay extracts the extra oil out of your clogged pores so that the skin looks sleek. Using blotting paper on your oily areas can also be effective. 

5. Maintain a proper diet
Avoid food that is oily and high in fat because unhealthy oil can agitate the skin leading to clogged pores. You should eat low-fat foods like fruits and vegetables instead of munching on chips, cookies and candies. 

6. Remove makeup before going to bed
One of the biggest blunders that you can do is to leave your makeup on and go to bed. Leaving makeup on clogs your pores, stretching them out over time. Even if you forget to wash off your makeup at the sink due to some reasons, make sure that you at least remove it with face wipes. 





6 Ways to Minimize Visible Pores on Your Skin

Colon cancer is a medical condition where malignant cancerous growths mainly originate in the colon or the large intestine. Believed to be the sixth most common type of cancer prevalent in India (As per the Rajiv Gandhi Cancer Institute & Research Centre), the colon cancer can metastasize and affect the other healthy body parts and organs.

The symptoms that may be indicative of colon cancer include:

Irritable Bowel Syndrome.
A person may suffer from anemia (triggered by iron deficiency).
Rapid and unexplained loss of body weight.
There may be rectal bleeding (blood may also appear in the stool). There may also be pain and discomfort during the bowel movement.
A person may experience extreme weakness and fatigue.
Frequent diarrhea or constipation.
A person may complain of abdominal pain and cramps.
There may be a change in the consistency of the stool.
Unfortunately, in most cases, the symptoms associated with colon cancer may not appear in the initial stages, thus complicating the situation.

Prevention and management of Colon Cancer
A little alertness on your part can help to prevent colon cancer.

Regular health checkups and screening: Whether the symptoms appear or not, health check-ups at regular intervals are a must. In addition to preventing colon cancer, regular health check-ups can also help to avert a host of other health complications. The screening tests for colon cancer are necessary for people who have a family history of colon cancer and also those who are above 50 years of age. The various screening tests for colon cancer include:
Colonoscopy (used to examine the inside of the colon for any abnormalities).
Fecal Occult Blood Test (FOBT)/Fecal Immunochemical Test (FIT) (These tests are carried out to detect the presence of blood in the feces).
The screening may also be done using Virtual Colonoscopy or Flexible Sigmoidoscopy.
Forget the unhealthy lifestyle habits: Smoking and drinking (excessive) can be the chief contributors triggering colon cancer. Limiting your alcohol intake and quitting smoking will not only keep you healthy but also keep colon cancer at bay.
Shed the extra pounds: The harmful effects of obesity are known to all. Obesity is considered to be one of the underlying factors that can trigger a colon cancer. A healthy body weight can go a long way in preventing colon cancer and keep you fit and active. Minimum 30 minutes exercise daily is all that you need to stay fit and healthy.
Make healthy changes in the diet: If you want to prevent colon cancer, make your diet as healthy as you can. Enrich it with fruits, vegetables and food items that are rich in fibers, minerals, vitamins, and antioxidants. Dietary fats (red meat or any other processed meats) are a strict no. Choose whole grain products over refined ones.

Colon Cancer - How To Prevent It?

5 hidden causes of acne, revealed!

Acne is a skin condition that occurs when the openings of oil glands become clogged with oil and dead skin cells. Acne usually appears on the face, neck, chest, back and shoulders. The pimples and bumps heal slowly, and when one begins to disappear, others seem to crop up. Depending on its severity, acne can cause emotional distress and can also scar the skin. But what causes the recurrence of breakouts?

These are attributed to certain hidden causes, which are:

1. Your drug prescriptions

Steroids found in prescription drugs are a key offender, whether taken internally or topically. If taken internally, the offending ingredient will be listed as prednisone, which is the tablet form of steroid. Prednisone is used to treat inflammatory diseases like poison ivy, allergies and arthritis. If medications are taken topically, it could aggravate acne or cause steroid acne. Oral contraceptives are also a common cause of acne.

2. Your beauty routine

Acne caused by topical lotions, creams and makeup are known as acne cosmetica, commonly appearing on face, neck, hairline and scalp. Applying a product regularly to an acne-prone area can do more harm than good. Some people go to bed with ointments or oils in their hair that can get on the pillowcase and then rub on your face. It's best to put a clean towel over your pillowcase every night to prevent buildup.

3. Your cell phone

Cell phones gather all kinds of dirt and bacteria and are a big cause of acne on the chin and around the mouth. Wiping down the screen of your smartphones every day with alcohol or cleaning wipes will keep your phone and your face clean.

4. Using toothpaste to treat a zit

Certain toothpaste can actually cause you to develop acne or an acne-like eruption on the lower parts of your face, including your chin. Fluoride and other whitening and anti-cavity ingredients are quite abrasive and could potentially burn your skin, cause irritation and initiate breakouts.

5. Your workout gear

It's not the act of exercising that is causing breakouts but other issues. If you are using a communal yoga mat, you may be on the side that someone else's feet or perspiration had touched before, with the physical contact causing breakouts. It's best to put a clean towel over it before working out, even if it is your personal mat.

Also, workout gear that constantly rubs in a certain area can cause frictional acne. Constant rubbing ends up making you sweat, causing skin irritation and eventually developing into tiny red bumps. Though it looks like a heat rash, it is actually acne.

If you would like to consult with me privately, please click on 'consult'.
Related Tip: Do You Know that Dandruff Causes ACNE?

5 Hidden Causes of Acne, Revealed!

GERD or acid reflux is caused by the regurgitation of acidic liquid stomach contents back up into the esophagus. It is a long-term condition where stomach contents come back upwards from the gastro-intestinal tract resulting in either symptoms or complications. It is a commonly occurring digestion condition. A burning sensation in the chest is usually caused by acid reflux which radiates up from the stomach to the mid-chest or throat. This condition is also known as the heartburn. A sour taste in the back of the mouth is a common experience amongst the patients. Long term reflux of gastric contents causes the condition to become chronic which can lead to difficulty in swallowing. In some cases the erosion of the tract lining can also cause breathing problems.

Symptoms:

Heartburn is a burning sensation felt in the retrosternal area. Most commonly it occurs post-prandial or nocturnally. Consumption of fatty foods, spicy foods, acidic foods aggravates the condition. Burning sensation is relieved with antacids, water or milk.
Perception of gastric content reflux in the mouth or hypopharynx is termed as acid regurgitation. It is also known as water brash. A bitter or acidic taste is felt in the mouth.
Other symptoms include dysphagia, odynophagia, nausea, chest pain, dyspepsia, epigastric fullness, bloating, frequent belching
Extra-esophageal symptoms like chronic cough, hoarseness, laryngitis, dysfunction of the vocal cords, bronchospasm can also be observed.
Complications:

Peptic stricture
Ulcers of the esophagus
Metaplastic disease (Barrett s esophagus)
Dysplastic disease (Adenocarcinoma)
Laryngitis or bronchitis
Pulmonary disease
Fluid in the sinuses and the middle ear
Diagnosis:
The diagnosis of GERD is made by its most commonly presenting symptom- heartburn. To confirm the diagnosis of GERD, the physicians treat patients with medications for suppression of the production of acid by stomach. If heartburn diminishes to a large extent by the medications, diagnosis of GERD is considered confirmed.

Conditions like an ulcer caused by bacterial infection, mimic the symptoms of GERD. To get a clearer diagnosis, an endoscopy is then performed. The common diagnostic modality for GERD is Upper intestinal gastro-endoscopy. A tube containing an optical system for visualization is swallowed, the tube progresses down the gastrointestinal tract, and then the lining of the esophagus, stomach, and duodenum can be examined. A normal esophagus is observed in most patients with symptoms of reflux. 

However, sometimes the lining of the esophagus appears inflamed. If erosions (superficial breaks in the esophageal lining) or ulcers (deeper breaks in the lining) are seen, a diagnosis of GERD can be made definitely. Other complications of GERD like ulcers, strictures, and Barrett's esophagus are also identified. Biopsies also may be obtained. Other common problems that may be causing GERD like symptoms can be diagnosed (for example ulcers, inflammation, or cancers of the stomach or duodenum) with EGD. Previously, barium meal x-ray was undertaken to diagnose GERD. It is now discontinued.

Other tests that are carried out are esophageal acid testing, esophageal motility testing, gastric emptying studies and acid perfusion test.

Treatment:

Lifestyle modifications   Avoiding acidic foods, quitting smoking, weight loss, abstaining from alcohol consumption improves symptoms in people with GERD.
Medications   Proton pump inhibitors (Pantoprazole, Omeprazole, Rabeprazole), H2 receptor blockers (Ranitidine, Cimetidine) and antacids.
Surgery   In cases where the proton pump inhibitors are unsuccessful in relieving symptoms of GERD, a surgical procedure called Nissen fundo-plication is done.

GERD - Complications Associated With It!

If you have taken the big decision to go ahead with bariatric surgery, one thing you need to prepare for well in advance is the additional effort that is required after the surgery to ensure it is a success. The results will be evident only after a few months post the surgery. This period requires your constant attention. 

Listed below are some after-care measures that are essential for the success of a bariatric surgery.

Hospital stay: Most patients are advised hospital stay for four days, during which the hospital staff will ensure the sleeve is working fine. No food is allowed for 48 hours. Diet is gradually advanced from water to clear liquids, about 50 ml to 100 ml and then to 150 ml.
Wound care: Depending on whether a laparoscopic or open surgery was done, the number and location of incisions will vary. However, the wound should be maintained clean and it should be ensured that there is no infection of the site. Wound care should be done by the nursing staff if required. Suture removal, if required, should be done as per doctor s advice.
Pain management: Finish the course of antibiotics and pain killers to ensure infection is completely gone. Pain would continue, if the infection is not completely controlled.
Diet: The first two weeks would be a completely liquid diet. The next two weeks will consist of a pureed diet. After these four weeks, solid foods will be introduced.
Foods to avoid after a bariatric surgery include anything with a higher protein content and anything that has too much oil as the stomach s ability to digest these is reduced. Refrain from:

Carbonated beverages
Hard meat
Nuts and seeds
Fried foods
Food items to include post bariatric surgery include those which are easy on the stomach, including:

Liquids such as soups, broth, juice, and milk
Pureed cooked vegetables and eggs
Soft mashed food including meat and vegetables
Adherence to this will reduce complications. While eating, the patient should also remember to chew nicely, eat and drink slowly, increase water intake throughout the day, and avoid fats and sugar. It is advisable to eat three proper meals a day and avoid snacking during the day.

Remember that the need for bariatric surgery arose in the first place due to uncontrolled eating of oily food. After undergoing a bariatric surgery, diet pattern is definitely going to move to a healthier side with reduced fat and sugars. It is not an easy shift, but definitely required, if the surgery is to be a success. Imagine the new you and you will be able to do it!

Bariatric Surgery - Aftercare Tips You Must Follow!

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