Colorectal surgery deals with the disorders of the rectum, anus and colon. Another name of colon is  large intestine . These three body parts form the last stages of the digestive process. When the human waste passes through the colon, its salt and water are extracted before it exits the body as human excreta.

Colorectal disorders

Swelling and inflammation of the veins in the anus (also called as Haemorrhoids)
Anal fissures- unnatural cracks and fissures in the anal area
Fistulas or the unnatural connections between the anus and other anorectal areas
Conditions of constipation
Incontinence in passing of faeces
When the walls of the rectum protrude through the anus- also called as Rectal prolapse
Birth defects such as imperforate anus
Anal cancer- this condition is rare
Colorectal cancer- cancer of colon and rectum
Any injuries to the anus
Removal of any objects inserted into the anus
Bowel habits after colorectal surgery
Many patients report cases of diarrhoea, leakage of stool or gas, urgency to use the toilet and a feeling of insufficient evacuation of faeces. Relax; these conditions are not going to last forever. Your rectum and anus are adjusting to new conditions after this surgery. These organs may take six to twelve months to adjust to new bowel habits.

Is there a need to take a laxative or stool softener?
There is no need to take laxatives after a colorectal surgery. Drink lots of water to make your stool softer and easy to pass. If there is a water deficiency in your body, then it may lead to your faeces becoming hard. In that case, take milk of magnesium, colace etc.

Activities post surgery
You can continue with your normal schedule after this surgical procedure. Carry on running, jogging, exercising, climbing up the stairs etc. even after your surgery. Gastroenterologists recommend that patients should desist from lifting loads weighing more than 10 pounds so that there are no post surgery complications.

Diet after colorectal surgery
Avoid spicy and heavy to digest meals after your surgery. Once the intestines begin working normally, you can continue having your spicy food. Chew your food well to aid its digestion.

Returning to work after colorectal surgery
Most people are back to their work after taking a break of 2-5 days. If the surgery is pretty detailed, you may have to take a break of up to a month. Patients undergoing laparoscopic surgery may have to take a rest of 2- 4 weeks before they report back to work. Take it easy before slipping into your regular schedule. If working hurts after your surgery, don t do it.

Colorectal Surgery - Disorders It Can Treat!

Bariatric surgery is unlike other surgeries, as its effects are not instant but gradual and are seen over the months. Like any other surgery, it is not without complication. But again unlike all other surgeries, the complication rate can be negligible if a strict protocol is followed. Moreover, the factors like technology advancements, development in the field of advanced laparoscopy, enhanced skillset of the bariatric surgeon, dedicated management of bariatric and metabolic surgeries by bariatric surgeons, play a vital role in the reduction of complication rate which eventually results in safe surgery.

As the procedure is done laparoscopically, the pain is just for a day and is minimally managed by analgesics.

The fear of increasing incidence of incisional hernias while operating an obese patient is so negligible or nil, as the procedure is performed through tiny key holes and all precautions are taken to suture the sheath through which the ports are put to perform the surgery.

Reduced hospital stay and early resuming to work is one of the biggest benefits of this laparoscopic bariatric procedure.

Sometimes, problems that may be faced are:- 

Post-operative bleeding: Normally, this a nearly bloodless surgery involving 5 to 10ml loss of blood. However bleeding from the staple edges is known, but this can be managed well by the surgeon, by choosing the right size of the cartridge as well the right technique of application of the cartridge.

Dehydration: We are normally accustomed to drinking water at long intervals (a few hours) as we can consume nearly 200 to 400ml at one go. Following bariatric surgery, gulping or drinking water in one go is not possible in the first 2 to 4 weeks, due to reduced capacity of the gastric pouch. Hence, care needs to be taken to drink small quantities of water at frequent intervals to avoid dehydration. This is possible only if the patient is counselled about this prior to surgery and is fully aware of this. Also, the patient needs to be given good and clear post operative instructions regarding the quantity and frequency of liquid consumption, not forgetting the type of liquids. Coffee taken frequently could be another cause for dehydration. Family members and colleagues and friends at work play a major role in reminding tthe patient about consuming water frequently. Special care needs to be taken in people who are not accustomed to consuming adequate quantities of water prior to surgery as a general habit.

Vomiting/Fullness/ Discomfort/Indigestion: Following bariatric surgery, soft food is introduced in the diet in the third week, after the first 2 weeks of taking liquids. Due to the reduced capacity of the gastric pouch, the morsel size is significantly reduced and one has to chew the morsel well and eat slowly, giving a gap of 40 to 50 seconds between the morsels. This prevents distension or overdistension of the gastric pouch and thus avoids vomiting. This again requires good counselling prior to the surgery and on the follow up visit too before stating soft food. There is a subjective difference when we say small morsels and we cannot reach a standardization as the morsels size of each individual varies prior to the surgery itself. The best way to avoid this confusion is to make the person have the first soft food meal before you where in you can physically show the way food is expected to be eaten. However, by mistake, there is a chance that one can have a regular sized morsel as over years one is used to eating in that manner. If this happens, the person will vomit , and this will be a reminder to gauge the morsel size the next time the person eats. Following the vomiting, there could be a burning sensation in the stomach which will subside afer taking an antacid. If one follows the instructions of small morsel size, chewing properly and eating slowly, there is no chance that there will be vomiting. Another reason for vomiting could be keeping the stomach empty for a longer duration or having sicy food on an empty stomach. Avoid nuts, seeds, fried foods and processed foods. Very rarely vomiting could be due to reduced size of the joint between the gastric pouch and the small intestine. This could require an Endoscopy and necessary treatment.

Vitamin and mineral deficiency: It is seen that many of the obese patients are seen to have vitamin B12, vitamin D, iron and protein deficiencies in their blood tests that are done prior to surgery. With the significant reduction in the amount of food consumed after bariatric surgery, the existing deficiencies are bound to increase. Hence, it is necessary to do these tests, before surgery and rectify the deficit prior to the surgery.  

Gall bladder stones: Significant weight loss which is consistant over a short duration could lead to the formation of gall bladder stones, be it with or with out surgery in a small percentage of patients. To avoid this there are two schools of thought, one is have a prophylactic removal of the gall bladder along with the bariatric surgery and another is to put the patient on ursodeoxycholic acid (a tablet) for the first few months after surgery during which there is significant weight loss.

Skin sagging: In the morbidly obese, when the skin is overstretched beyond a certain point, it tends to sag once significant weight is lost. This sagging is influenced by a number of factors like age of the patient, the BMI, pre existing sagging, pre-existing muscle tone and protein supplements taken during weight loss and exercises done during the weight loss period. Skin sagging is less if the age is less than 45, BMI less than 45, good protein intake during weight loss and good toning exercises done during the weight loss period.

Hairfall: Significant weight loss either by diet and exercise, aerobics, bariatric surgery, will entail hair loss. But this can be minimised to a greater extent by ensuring good protein intake during the weight loss period and adequate supplements in terms of vitamins and minerals.

Dumping syndrome: With a reduced size of the stomach, the food moves from the stomach into the smaller intestine much faster. This causes the pancreas to release excessive amount of insulin, leading to very low blood sugar levels , producing various symptoms like abdominal cramps, bloating, diarrhoea, sweating, dizziness, nausea, weakness, and anxiety. This is managed by eating less amount of sugars and fats and spacing out the meals through the day, having four to five small meals compared to  2 to 3 large meals. Having a high protein diet and avoiding liquids during meals is also an option.

Bariatric Surgery - Know Problems Of It!

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

What is DVT?

Deep vein thrombosis is a kind of vascular disorder. It happens when a thrombus (blood clot) forms in the deep vein anywhere in the body. It especially develops in the legs. This is a grave ailment and can actually be fatal for you unless you seek treatment right away.

What are the symptoms of DVT?

A worrying feature of deep vein thrombosis is that in most cases it shows no symptoms in the earlier phases. Moreover, what makes diagnosis hard is that even when symptoms manifest, they are very similar to those of other disorders like tissue or muscle inflammation or arthritis.

Here are some typical deep vein thrombosis symptoms:

  One or both of your legs become swollen
  Your legs feel tender and hurt a lot in all postures
  The skin of your legs always feel hot to the touch
  Your skin looks blotchy or discoloured
  You bleed when you cough
  Wheezing and breathing problems
  Dizziness
  Frequent and sharp chest pain

Who is susceptible to DVT?

Deep vein thrombosis usually happens when you sit or lie in one position for long stretches of time especially when you are recuperating after an illness or surgery. It can also happen to you for other reasons-

  Injury: An injury to your legs can narrow the blood vessels and that reduces the blood flow through the veins. That is why blood clots can develop there.
  Pregnancy: The additional weight that woman has to carry in the course of her pregnancy exerts extra pressure on the veins of the legs and pelvis and thus clots may form in the veins.
  Contraceptive pills: Birth control pills raise the chances of a woman getting deep vein thrombosis by four times.
  Obesity: Obesity means forcing extra pressure onto your veins.
  Smoking: Smoking interferes with the flow of blood through your veins and raises the possibility of getting blood clots.
  The family history of deep vein thrombosis: if anyone in your family has deep vein thrombosis, you might contract it too because it is hereditary.

Complications:

DVT becomes lethal if the blood clot becomes dislodged and travels from the legs to the lungs, it can cause a pulmonary embolism. This can lead to blockage of the artery of the lung and in that case, a person may die.

Treatment for deep vein thrombosis:

Treatment for DVT includes both invasive and non-invasive vascular techniques.

  Blood-thinning medicines: They prevent blood platelets from clumping together and reduce the size of the existing clots.
  Thrombolytic drugs: If medicines are not effective, work, these drugs will be injected into your veins. They travel down the veins to where the blockage is and disintegrate the clots so that blood can once again flow through the vein uninterrupted.
  Compression stockings: They exert pressure on the vein containing the clot, prevent it from moving, and do not allow new clots to develop. You have to wear them throughout the day.
  Surgery: In very rare cases, when non-invasive methods have no effect, you may have to undergo a kind of vascular surgery called venous thrombectomy. The surgeon will make a minute incision in the vein where the clot is lodged, siphon it out and then repair the damaged vein.

Deep vein thrombosis is easily curable with treatment. Do not delay it, as DVT has the potential to kill you.

Deep Vein Thrombosis (DVT) - All You Should Know About It!

Cover small intestine is very significant in maintaining proper digestive health by jogging nutrients are fluids that be eat or drink. Yourself in delivering the waste products in the large intestine. This surgery which is the small bowel resection is done to remove part or the entire small bowel. This is basically done when part of our small bowel as blockage or when the diseased.

Importance of intestinal surgery or small bowel resection
There are several conditions which may affect our small bowel. Generally your doctor might advise you to remove a portion of your small bowel but in some cases a portion of your small Bible might have to be removed to confirm that a disease have been ruled out if tissue diagnosis might be required. Some situations where you may require surgery involves:

Severe ulcers that develops in the small bowel leads to bleeding and in some cases infection also
A situation where there is either a congenital blockage in the intestine or maybe from a scar tissue
Cancer is an obvious option
Some injuries to the small bowel is an obvious situation
In some cases there may be a pocket of intestines present there since birth
Several diseases which cause inflammation in the small bowel
Risks Involving Small Bowel Resection
It is very obvious that any kind of surgery has some potential risks so does the small Bowel resection, which includes which includes:

There maybe some difficulty in breathing
Infections are very common
There might be some damage in the structures surrounding it
There maybe case a of heart attack
Abnormal bleeding
Bleeding resulting in blood clots
Pneumonia
Bleeding in the stomach area
The abdomen might start collecting pass which is known as intra abdominal abscess
If the intestinal blockage is formed by a scar tissue then it requires more surgery
They might be problems while absorbing the vitamins and nutrients which is commonly known as short bowel syndrome
Due to some infections diarrhoea is always a frequent risk.
A Long-term Outlook after small bowel resection A majority of people have recovered well from the surgery. You can definitely resume your normal day to day activities even if you had ileostomy and you are required to carry a drainage bag. Diarrhoea might still be a concern for you if you had a big section of your bowel removed and you still might have problem in digesting foods. Inflammatory diseases might still require for the medication.

Intestinal Surgery - Know The Risks Involved!

Rectal problems in women are quite common. It is experienced by many women in some form or the other such as rectal itching, pain or bleeding. Rectal problems are more common in women than in men. These conditions need to be attended to immediately as severe rectal problems may cause several health problems. There are many ways to deal with rectal problems in women.

Treating rectal itching: Rectal itching is a common rectal problem. These can be treated by

    Improve hygiene: You should clean the rectum area gently using cotton balls moistened with water. You should apply mild ointments to prevent irritation and soothe the skin.
    Unscented toilet paper or unscented lotions and creams: You should use white toilet paper that does not have any scent. Scented soaps, creams or lotions should be avoided as it may cause further irritation. You can also apply ointments containing 1% hydrocortisone.
    Control excessive sweating: Rectal problems may occur due to excess sweating. You should avoid sweating too much by wearing light clothes and using talcum powder for the absorption of moisture.

In case of excessive itching, you should follow the following tips:

    Do not scratch the area as scratching may lead to further itching. You can take an oral antihistamine during the night to get better sleep.
    You can take a warm sitz bath after every bowel movement, for at least three days, every day. The anus should be dried properly after the bath.
    Abstain from foods that stimulate rectal itching like tea, coffee, aerated drinks, alcohol, chocolate, spicy food, tomatoes and excess vitamin C, for a period of two weeks.
    You must maintain short fingernails to avoid injuries during scratching. To prevent unconscious scratching during sleep, wear cotton gloves.
    Stress should be managed as increased stress may lead to enhanced rectal itching. When you are anxious, do not scratch the rectal area.

Treating rectal bleeding: Rectal bleeding is another problem, which may be accompanied by other rectal problems. In case of rectal bleeding, avoid taking aspirin or any other non-steroidal, anti-inflammatory drug. These drugs may cause bleeding in the digestive tract. This will increase the blood amount in your stool. Bleeding hemorrhoids can worsen by the intake of these medicines. For soothing pain, opt for an acetaminophen. Constipation and diarrhoea may also lead to rectal bleeding. However, it is advised to consult a doctor before consuming any medicine.

Prevention
For prevention of rectal problems, you must have a good sense of hygiene. Keep the rectum region clean and avoid sitting in the toilet for a long time. You should have a fiber-rich diet including fresh fruits and vegetables. Avoid food items, which may cause rectal problems. General rectal problems are not very serious and can be treated using simple measures. Maintaining proper rectal hygiene is very important to avoid rectal problems. It is highly recommended to visit a doctor if the problem persists.

Rectal Problems in Women - Doctor Recommended Tips

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