A hysterectomy is an operation to remove the uterus and, usually, the cervix. The ovaries and tubes may or may not be removed during this procedure, depending on the reasons for the surgery being performed. If the ovaries are removed, you will commence menopause. A hysterectomy is a major surgical procedure with physical and psychological consequences.

Why is a hysterectomy performed?

Common reasons include painful or heavy periods, pelvic pain, fibroids or as a part of therapy for cancer. You should have a clear understanding of your reason for this surgery.

How is this done?

The procedure is normally performed under a general anesthetic and takes approximately one hour. To commence your anesthetic a drip is inserted into your arm. Once you are asleep, you will have a urinary catheter inserted. The importance of the catheter is to reduce the size of your bladder, keeping it away from the operation site and reducing the risk of complications.

There are three ways to remove the uterus:

Vaginal hysterectomy - The removal of the uterus and the closing of the wound is performed through the vagina. There is no cut in the abdomen. 
Laparoscopic hysterectomy - About four small keyhole cuts are made in the abdomen to divide the attachments of uterus, ovaries, and tubes in the pelvis. The uterus is usually then removed through the vagina.
Abdominal hysterectomy - The uterus is removed through a cut in the lower abdomen. The cut is about 15 20 cm in length and runs across your abdomen, usually below the bikini line. Less commonly, it may be necessary to have a cut that runs from the belly button down to the pubic area.
What are the risks of undergoing this procedure?

Although the risks associated with hysterectomy are low, you should be aware that every surgical procedure has some risk. This may also depend upon the type of surgery you have. 
Severe bleeding from large blood vessels around the uterus or top of the vagina. This is not common. A blood transfusion may be required to replace blood loss. A vaginal pack may also be used to control the bleeding.
Infection in the operation site, pelvis or urinary tract.
Nearby organs such as the ureter (tube leading from kidney to bladder), bladder or bowel may be injured expected to happen to approximately one in every 140 women. Further surgery will be needed to repair the injuries.
The bowel may not work well after the operation; this is usually temporary. Treatment may include a drip to give fluids into the vein and no food or fluids by mouth.
Things to do before you come to the hospital

It is important for you to have all the tests ordered at your outpatient clinic appointment completed prior to coming to the hospital these include blood tests and an ECG and chest X-ray, if you are more than 50 years old

You may be required to have a bowel preparation, which will empty your bowel prior to the surgery.

You should stop eating and drinking at the following times on the day of your surgery unless otherwise notified

At midnight if your procedure is in the morning

At 6 am if your procedure is in the afternoon.

You will need to shower and dress in clean clothes prior to coming into hospital. It is important that you do not shave your operation site as this increases the risk of wound infection.

Please remove all body jewelry.

After your surgery

When you wake from the anesthetic, you will be ready to be transferred, in your bed, for recovery.

Having an anesthetic can make you feel sick and may cause vomiting. You will have a drip in your arm which is necessary to maintain fluid intake and provide pain relief. This will remain in until you can tolerate food and fluids and your pain control is changed to oral medication.

Your nurse will take frequent observations of your vital signs e.g. temperature, pulse, blood pressure.

You may have small amounts of water or ice to suck, then progress from fluids to a normal diet as tolerated.

If you have pain or nausea, please tell your nurse. Effective pain management is important.

You will have a urinary catheter in place. The catheter will normally be removed the day following your surgery.

Recovering at home

What to expect

You may have a blood-stained vaginal discharge which is similar to a light period. This will gradually reduce to nil over 4-6 weeks as your internal wounds heal

You may need to take some simple analgesia for pain/discomfort, especially on waking and settling at night

You may feel fatigued

You may require up to four to six weeks off work. You should have returned to normal activity by two to three months, depending on the type of surgery, although full recovery may take longer

After the operation, you will no longer have a period

For the majority of women, hysterectomy surgery does not have a negative effect on sexual function

What to avoid

For the first two to three weeks lift nothing greater than two kilograms. Increase gently as tolerated over six weeks.

It will take about three weeks before you should drive a car. Only when you know you can act confidently with emergency breaking should you attempt driving the car.

Avoid sexual intercourse for six weeks to allow healing to take place.

Avoid inserting anything into the vagina for six weeks to allow time for healing to take place (e.g. use sanitary pads and not tampons).

It is important to avoid constipation and straining immediately after your surgery as this will assist healing and improve your comfort.

Contact your doctor if you develop any of the following complications:

Your wound becomes red or inflamed, painful.

You have heavy vaginal bleeding heavier than a normal period.

You have offensive vaginal discharge.

You develop a fever i.e. temperature of about 38  C, or you are feeling unwell.

You have pain that is not relieved by simple analgesia.

You are having difficulty passing urine or opening your bowels.

 In case you have a concern or query you can always consult an expert & get answers to your questions!

Surgery For Womb Removal - What You Need To Be Aware Of?

Gastric bypass is a kind of bariatric surgery, which helps in weight loss. This surgery aims to make changes so that your stomach becomes smaller than it used to be. This limits the amount of food you consume and effectively helps you to reduce weight.

Are you fit for the surgery?

Not everybody can go in for this surgery. Your doctor will recommend this surgery after careful evaluation. These are the parameters based on which your doctor will make a decision-

  Your medical history - If you suffer from sleep apnoea, heart ailments, liver diseases, kidney stones or if you have blood clots then you might have to undergo the surgery.

  Your psychological status - Sometimes obesity is the outcome of certain psychological ailments. A doctor will first ensure that these conditions are addressed before you go under the knife.

How is the surgery performed?

Gastric bypass operation is performed under general anaesthesia so you will be asleep for the entire duration of the surgery and it will be pain-free. The surgery is done laparoscopically. Tiny incisions are made through which scope and fine surgical instruments are introduced into the abdominal cavity. The camera guides the surgeon by providing live images from inside the body. Laparoscopic gastric surgery is advantageous because the wound heals faster and does not leave any marks.

Sometimes your surgeon might opt for an open surgery where she/he makes a large incision to reach the stomach.

There are two major steps to the surgery-

  The aim of the surgery is to make the stomach smaller so the surgeon divides it into two portions with staples. The food that you eat will go into the upper part (the pouch) of the stomach. The reduced upper stomach can hold at the most 28 grams of food so you are forced to eat less than usual. This will help you lose weight.

  The other step is the bypass surgery. After the pouch is created, the surgeon links it to the small intestine through the small hole in the pouch. This way, food will pass directly from the pouch to the small intestine. The surgery takes around 3-4 hours. You will be kept under observation for a couple of days and you will be released from the hospital in a week.

Gastric bypass operation is an effective and simple surgery that can help you reach your weight goals when you have a very high BMI and most other dietary restrictions have not been successful.

Gastric Bypass Surgery - Everything You Should Know!

Gastroesophageal reflux disease (GERD) is also called as acid reflux. It is a long-term digestive disorder that affects the lower esophageal sphincter, the ring of muscle between the esophagus and stomach which causes the stomach contents to come back up into the esophagus resulting in either symptoms or complications. Gastroesophageal reflux disease is mild acid reflux that occurs at least twice a week or moderate-to-severe acid reflux which occurs at least once a week.

Epidemiology

In western populations, GERD affects approximately 10% to 20% of the population and 0.4% newly develop the condition. In developed nations, the prevalence rate of GERD is associated with age; with adults aged 60 to 70 being the most commonly affected.

Signs and Symptoms

Esophageal symptoms include:

Heartburn
Regurgitation of food or sour liquid
Dysphagia
Sensation of a lump in the throat
Extraesophageal symptoms include:

Coughing and/or wheezing
Hoarseness, sore throat, or laryngitis
Otitis media
Noncardiac chest pain
Enamel erosion or other dental manifestations
New or worsening asthma
Disrupted sleep
Risk Factors

Obesity
Pregnancy
Hiatus hernia 
Scleroderma and systemic sclerosis
The use of medicines such as prednisolone
Delayed stomach emptying Zollinger-Ellison syndrome which can show an increase in gastric acidity because of gastrin production
A high blood calcium level which can increase gastrin production, leading to increased acidity
Visceroptosis or Gl nard syndrome, in which the stomach has sunk in the abdomen upsetting the motility and acid secretion of the stomach.
Factors that can increase acid reflux involve:

Smoking habit
Eating heavy meals or eating late at night
Eating fatty or fried foods
Drinking certain beverages, such as alcohol or coffee
Medications, such as aspirin
Tight clothes
Increased intra-abdominal pressure
Differential Diagnosis

Heart disease causing chest pain
Laryngopharyngeal reflux OR extraesophageal reflux disease
Infection
Peptic ulcer
Esophageal spasm
Complications

Narrowing of the esophagus (esophageal stricture): Stomach acid causes the formation of a scar tissue which narrows the food pathway.
An open sore in the esophagus (esophageal ulcer): Acid causes an open sore which bleeds, causes pain, and makes swallowing difficult.
Precancerous changes in the esophagus (Barrett's esophagus): Damage from acid can cause changes in the tissue lining the lower esophagus
Anemia
How to arrive at the diagnosis?

Upper gastrointestinal endoscopy/esophagogastroduodenoscopy
Esophageal manometry
Ambulatory 24-hour pH monitoring
Treatment

The goals of treatment are controlling symptoms, healing esophagitis, and prevention of recurrent esophagitis or other complications.

Lifestyle modifications include the following:

Losing weight (if overweight)
Eating small and frequent meals instead of large meals
Waiting 3 hours after a meal to lie down
Elevating the head end of the bed by 8 inches
Avoiding bending or stooping positions
Medications

H2 receptor antagonists (ranitidine, cimetidine)
Proton pump inhibitors (omeprazole, pantoprazole)
Prokinetic agents (aluminum hydroxide)
Antacids (magnesium hydroxide)
Surgery

Transthoracic and transabdominal fundoplication
Placement of a device to augment the lower esophageal sphincter

Gastroesophageal Reflux Disease - What Should You Know

Even though Prostate cancer is one of the most common types of cancer among men and a lot of research has been conducted towards its understanding, it still remains one of the least talked about forms of cancer. This can lead to a lot of confusion and misinformation that gives rise to a number of myths associated with the disease. Some of the most common myths about prostate cancer are:

1. It occurs only in old men

Although the risk of developing prostate cancer does increase with age, especially after 60-65 years of age, it can develop at any age in a man s life. Ageing cells are more susceptible to mutations and hence more susceptible to cancer but other factors such as genetics, geographic location, overall health, lifestyle, etc. can play a major role in whether someone stands a chance to get prostate cancer.

2. It is a slow-growing cancer

Research has discovered 29 different types of prostate cancers, each of which behaves a little differently from others   some are very fast growing and aggressive while others are slower in developing. Prostate cancer also tends to be more aggressive in younger men than older men; aggressive cancers metastasize faster, i.e. spread to other parts of the body quicker and progress rapidly. Therefore, it is important not to ignore any initial symptoms and consult a doctor as quickly as possible to have the best shot at successful treatment.

3. You can t get prostate cancer if no one in your family had it

While having a family history of prostate cancer does significantly increase the risk of a man developing prostate cancer himself, it can also be diagnosed in men who have no genetic history or predisposition. It depends not only on genetics but also on a number of other factors which can contribute to prostate cancer.

4. If you don t have any symptoms, you don t have cancer

Prostate cancer is known to be one of the most asymptomatic forms of cancer and even when symptoms are present, they are very often misinterpreted as something else. The most common symptoms are: needing to urinate frequently, difficulty in urinating, blood in urine or semen, erectile dysfunction and pain in the pelvic area. Although all of these symptoms don t always mean cancer, it is best to go to the doctor in case you experience these symptoms.

5. Prostate cancer is inevitable   you can t prevent it

It is true that genetics, ethnicity and age do increase the risk of prostate cancer in men. However, research has shown that lifestyle changes such as avoiding red meat in your diet, regular exercise and preventing stress, do have an effect on the genes that regulate growth of tumours.

Hence, you should stop believing everything you hear or read on the internet, they may not always be true. Any symptoms out of the ordinary should be immediately checked out by your doctor. Do not ignore unusual symptoms   they might prove to be very costly later in life.

Prostate Cancer - 5 Most Prevalent Myths About 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!

Dysentery is the inflammation of the intestine that causes appearance of blood and mucous in stool. It is caused by bacteria or parasites. In this condition, the patient passes semi liquid stool many times in a day. It is a contagious disease and is transmitted via the faecal oral route. Thus, a group of people like a family living together or students in a hostel are more prone to picking up the infection. This infection is also transmitted via anal sex. 

Ayurveda is a herbal medicinal treatment, originated in India. It is known to have cure for various health problems. Usually Diarrhoea cures itself through diet change, but in case of dysentery, medication is required to combat bacteria and parasites. Some ways to treat Dysentery with Ayurvedic remedies are as follows:

Isabbael for Chronic Amoebiasis: Isabbael is a formulation that treats dysentery caused due to Amoebiasis. When the stool contains mucus and the infected patient feels a cramp before passing stool, it is considered an Amoebiasis infection. Isabbael is very good for bacillary dysentery as well. It is advised to consume 1 teaspoonful twice daily with water for 5 to 7 days for best results. 
Ambimap for dysentery: Ambimap herbal formulation possesses a multi-purpose approach to control and cure dysentery (Pravahika). It is known to treat and cure all types of parasitic infection and provides immediate relief. For best results, 1 or 2 tablets should be taken 2 to 3 times a day with water.
Churna for dysentery: Churna is a polyherbal Ayurvedic medicine in powdered form and is high beneficial in treating dysentery.
You can also opt for Ayurvedic remedies that can be formulated at home. They are as follows:

Combine powdered dry ginger root, amla powder, long and black pepper in equal proportions. It is advisable to store this dry mixture in a glass container. For best results, consume one teaspoon of this mixture with lukewarm water two times a day. 
Another great way to combat dysentery is to drink buttermilk. Just add a bit of rock salt as well as powdered roasted cumin seeds. Drink this mixture two times a day preferably with breakfast and at lunchtime. 

Dysentery - 3 Ayurvedic Home Remedies to Help Treat it 

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