Any kind of injury on the surface of the skin is immediately noticed by us, but when something happens to one of our internal organs, it can take a little longer to get to your notice for example, an obstruction in the bile duct. The bile duct is a tubular structure responsible for carrying bile from the liver and gall bladder through the pancreas to the small intestine. This bile helps the digestion process and the absorption of fat.

An obstruction in the bile duct can be triggered by a number of factors. Some of these are:

    Gallstones
    Inflammation of the bile ducts
    Cysts
    Traumatic accidents
    Bile duct or pancreatic tumors
    Hepatitis infections
    Cirrhosis or severe liver damage
    Abnormal narrowing of the bile duct

This can affect anyone, but the people who have a history of gall stones or tumors in the abdomen are at a higher risk of suffering from bile duct obstruction. Chronic pancreatitis, sudden weight loss or obesity can also increase this risk. The symptoms of biliary obstruction include light coloured stool, dark urine, pain in the upper right abdomen, nausea, vomiting and fever. Your doctor will also probably need an X-ray of the bile ducts, blood tests, a hepatobiliary iminodiacetic acid scan and ultrasonograph to confirm a diagnosis before they can start treating you for the same.

If not treated in time, bile duct blockages can lead to a dangerous buildup of bilirubin in the body and trigger a number of life threatening diseases. Treatment for biliary obstruction can be through medication or surgery with surgery being the more preferred mode of treatment. It is aimed at resolving the underlying cause of the obstruction and alleviating the blockage. Treatment for biliary obstruction can be two common forms of treatment include a cholecystectomy and ERCP. The former involves the removal of the gall bladder and is suited to obstructions caused by gallstones. The latter is a procedure to remove small stones from the bile duct or place a stent inside the duct.

There are many ways bile duct obstruction can be prevented which first and foremost includes following a healthy lifestyle. If you are overweight, exercise for at least half an hour a day to regulate your weight and reach a healthy BMI. Decrease your intake of sugar and saturated fats as both these can cause gall stones. Also, increase the amount of fibre in your diet. All the above mentioned tips will certainly help you in preventing bile duct obstruction.

Bile Duct Blockage -  8 Factors Behind it!

Following are some common Gall Bladder and Biliary Disorders. Read on to know in brief about them. 

1. Gall stones: Gall stones also known as cholelitiasis is a condition in which gall bladder contains stones or calculi. Usually, these stones are asymptomatic and do not cause any trouble to the patients. Few patients experience recurrent right upper abdominal pain. This condition is known as biliary colic and if it persists, the patiet is adviced gall bladder removal surgery. Sometimes the patient presents with severe right upper abdominal pain with fever and deranged Liver function tests. This condition is known as acute cholecystitis. The surgery is minimally invasive and is called Laproscopic cholecystectomy. If there are dense adhesions, the surgeon may plan to convert the surgery to open cholecystectomy. The patient is usually discharged by day 3 of surgery.

2. Common bile duct stone or choledocholithiasis: Occasionally stone from the gall bladder slips into the common bile duct (CBD stone).This causes obstruction of the bile duct causing Fever, abdominal pain and Jaundice. This is called Cholangitis and is a medical emergency. The patient requires urgent hospitalisation and decompression of the bile duct by inserting a plastic stent in the CBD with the help of ERCP. Severe untreated cholangitis can be life threatenig.CBD Stones which are detected because of dull aching abdominal pain, deranged liver function tests or by ultrasonography also need removal. The CBD stone is removed by an endoscopic modality called ERCP, which is minimally invasive and needs no surgery.

3. Bile duct cancer or cholangiocarcinoma: Cancer of bile duct usually occurs in the elderly patients who present with gradually progressive jaundice. Because of the obstruction to the flow of bile, produced in the liver, the patient develops jaundice. Gastroenterologists examine the patient and CT scan abdomen with MRCP is required to fully evaluate the stage and extent of the tumour. The treatment is multimodality and requires the expertise of Radiologists, Surgeons, Oncologists and gastroenterologists. The Gastroenterologists can help in decreasing Jaundice by inserting plastic or a metal stent (SEMS self-expanding metal stent ) in the common bile duct. These are very aggressive tumours and very few patients are fit for surgery. Survival is very low for these tumours.

4. Gall bladder cancer: Gall bladder cancers are very aggressive and lethal cancers. The patients present with obstructive Jaundice and Itching all over the body. Definitive treatment is surgery but very patients present in the early stage. Advanced stage cancers are treated with palliative intent by metal stenting (SEMS for cancer of gall bladder) to reduce jaundice.

Learn More About Gall Bladder And Biliary Disorders!

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!

Ovaries are a part of a woman s reproductive system. The primary function of ovaries include producing  ova  or eggs and secreting hormones such as progesterone and estrogen. Cysts are fluid filled sacs that form the ovaries; they usually do not cause any symptom and are not painful.

There are primarily two types of ovarian cysts:

1. Follicle cysts: During a woman s menstrual cycle, the egg develops in a sac known as the follicle. Under normal circumstances, the sac breaks open and releases the egg. When this doesn t happen, fluids start accumulating in the follicle to form a cyst.

2. Corpus luteum cysts: Follicle sacs dissolve after releasing the egg, but in some cases, these sacs remain and the opening of the sacs gets sealed. It again results in fluid accumulation, leading to the formation of corpus luteum cysts.

Symptoms

Usually, cysts do not cause any symptom. If the size of the cysts increases, they may cause symptoms such as stomach pain, pain during bowel movements and sex as well as pelvic floor pain. The breasts may become tender and one may experience rapid breathing. Other symptoms of ovarian cysts are fever, nausea and dizziness. Usually, rupturing of a cyst leads to these symptoms surfacing; hence you would know when exactly to call the doctor.

Treatment

The treatment options for ovarian cysts are:

Laparoscopy: Laparoscopy is carried out if the cysts are small in size. An incision is made close to the navel, through which an instrument is inserted to get rid of the cyst.
Birth control pills: For chronic ovarian cysts, oral contraceptives are prescribed to stop the ovulation process in order to arrest the formation of cysts.
Laparotomy: In case of large cysts, this procedure is recommended. A relatively bigger incision is made in the abdomen, through which the cyst is removed.
Ovarian cysts, if left untreated, can certainly cause infertility. Pre-menopausal women and who suffer from frequent hormonal imbalances in the body are the most vulnerable to this condition.

Ovarian Cysts - 3 Ways it Can Treated

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?

Heartburn or acid reflex is a burning sensation that is felt in the throat or chest region after the intake of certain foods. While many of us must have felt heartburn once in our lifetime, too many occurrences such as this could be a fair indication of esophageal cancer.

How an acidburn is related to esophagus?
Esophagus is the tube which carries food from the throat to the stomach. In the case of an acid reflux, the acid from the stomach jumps to the esophagus leading to a condition known as the Barrett s esophagus. This is a condition which replaces the tissue present in the esophagus with a similar kind of tissue found in the lining of the intestine. This being said, Barrett s esophagus doesn t necessarily lead to esophageal cancer.

Key symptoms of Esophageal Cancer
Difficulty swallowing is a key symptom of esophageal cancer. This condition is known as dysphasia. As the tumor grows bigger, it becomes more difficult to swallow food. Esophageal pain is also a common symptom reported by many patients. Loss in appetite and an unexplained weight loss are some of the other symptoms of this type of cancer. Although esophageal cancer does not show any visible signs in the early stage, some of the key indicators are chronic couch, indigestion and hoarseness of voice.

Key risk factors:
Some of the key risk factors for this type of cancer are as follows:

    Men tend to run a higher risk of getting this cancer than women.
    Esophageal cancer are often detected in people above the age of 55 or more
    Chronic tobacco users have higher chances of getting esophageal cancer
    Consumption of alcohol increases the risk of esophageal cancer
    Obesity increases the risk of acid flux thereby, leading to esophageal cancer
    Radiation treatment in the abdomen or chest area might also lead to esophageal cancer

How an esophageal cancer is detected?
Primarily there are 3 ways by which this cancer is detected. The first step for an oncologist to detect this cancer is to perform an endoscopy. If this fails, doctors often try a barium swallow on suspected patients and take an X-ray to understand the esophagus lining. If all this fails, doctors rely on a CT scan to detect this cancer.

How is esophageal cancer treated?
If a patient is lucky and the cancer gets detected in a very early stage, the tumor along with the infected cell can be surgically removed. Apart from surgery, some other alternatives are radiation and chemotherapy. A combination of radiation and chemotherapy or a surgery followed by radiation can also be suggested by the doctor. The treatment plan depends on the stage of detection.

Does Heartburn Lead to Esophageal Cancer?

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