In recent years there has been a rise in gastrointestinal disease due to lifestyle changes. Conditions like irritable bowel syndrome, gastroesophageal reflux disease, nonalcoholic fatty liver, cancer of colon, liver and pancreas have been affecting the young and the elderly equally.

The advancement of medical science has given rise to a series of laparoscopic surgeries relating to gastrointestinal diseases. These surgeries are minimally invasive compared to open surgeries. Let s have a look at the various forms of gastrointestinal surgeries.

Conditions Cured through Gastrointestinal Surgeries:

Gastrointestinal surgery can be used to prevent and treat the following health disorders.

  Peptic ulcer disease
  Barrett s Esophagus
  Hiatal hernia
  Radiation bowel injury
  Gastrointestinal tumours
  Inflammatory bowel disease
  GERD
  Achalasia
  Malignant disease of the pancreas
  Malignant disease of the biliary tract
  Infectious disease of the colon and rectum

Types of Gastrointestinal Surgeries:

Some examples of gastrointestinal surgeries include  

  Colon Cancer Surgery   It may involve local excision which is done in the early stage of colon cancer. Here the doctor inserts a cutting tool into the colon to remove the cancerous growth. Colectomy is the next stage that is performed only when the cancer has spread to the nearby tissues.

  Oesophagal Cancer Surgery   It includes esophagectomy or removing the oesophagus partially leaving the patient with the ability to swallow.

  Gall Bladder Cancer Surgery - It involves four stages of treatment namely Cholecystectomy, Surgical Biliary Bypass, Endoscopic Stent Placement and Percutaneous Transhepatic Biliary Drainage. Each procedure is performed at different stages depending on the severity of the condition.

  Liver Disease Surgery   Liver disease surgery involves Partial Hepatectomy, Liver Transplant and Ablation used at different stages of cancer.

  Pancreatic Cancer Surgery   The four stages of pancreatic cancer surgery includes Whipple procedure, Total Pancreatectomy, Distal Pancreatectomy and Gastric Bypass.

Apart from these open surgeries, the laparoscopic procedures include  

  Laparoscopic Adrenalectomy
  Laparoscopic Appendectomy
  Laparoscopic Nephrectomy
  Laparoscopic Splenectomy

Benefits of a Gastrointestinal Surgery:

  Minimally invasive due to which scarring is less
  Shorter recovery period
  Reduced chances of infection
  Reduced chances of reoccurrence of the disease

Most of these benefits apply specifically to the gastrointestinal surgeries performed using the laparoscopic technique.

With the rampant increase in gastrointestinal diseases among the masses the wide ranges of gastrointestinal surgeries have made treatment and prevention easier and more accessible.

Gastrointestinal Surgery - Everything About It!

Excessive gas can be defined as bloating, belching, flatulence and burping. It does not matter what you call it, but what matters is how you treat it and get relieved from the embarrassing symptoms. 

Here are some ways in which you can avoid gastric problems:

*Avoid eating foods that can cause gas or acidity. Vegetables which are known to cause acidity are Brussels, Onions, Garlic and Broccoli; dairy products like cheese, milk, ice cream and whole grains can cause acidity. The reason is that these products have fiber, starch and sugar which cannot be digested easily, thus causing pain in the intestines. Fruits which contain sorbitol and aerated drinks should also be avoided. Eat everything but in moderation.

*Avoid drinking before meals as the stomach acids are lost and the food cannot be digested well. Water and liquids should be taken half an hour after a meal for a better digestion.

* Food should be eaten slowly. Eating and drinking quickly, allows a lot of air to go into the stomach with the food. This in turn can cause a stomach pain.

* Over the counter drugs can be taken for immediate help in digestion. These medicines contain enzymes which aid in digestion. The enzyme works to dissolve the sugar that is found in many fruit and vegetables.

* Some habits like chewing gum, drinking from a straw and smoking, etc. causes air to fill in the stomach, thereby, leading to gas.

* Artificial sweeteners such as sorbitol should be avoided as these are difficult to digest and can easily lead to a feeling of bloating. 

However, all the pains might not be due to gas and could be a sign of something serious. These could be:

* Lactose intolerance: This is the inability to digest milk and milk products. The sugar in the milk is known as lactose and cannot be digested easily. 

* Irritable bowel syndrome: People who suffer with pain in the lower abdomen constantly might be suffering from IBS.

* Colon cancer: If the pain lasts too long then getting a screening done is a good idea to rule out if one is suffering from colon cancer or not.

* Upper gastrointestinal disorders: If one gets belching occasionally, then it is alright, but a constant belching might be a sign of gastrointestinal disorder in the upper tract. These could be gastroesophageal reflux disease (GERD), gastroparesis, or peptic ulcers.

Gastric Problems - Effective Ways To Manage It!

A fairly common disorder, which affects the intestines, irritable bowel syndrome affects many adults across the world. If you are suffering from this disorder then you would have problems with bowel movements, mostly the irregularity of it. Sometimes you may suffer from constipation, other times you may suffer from diarrhea and the type of stool will also vary often between thin and hard or soft and liquid.

Common symptoms of irritable bowel syndrome
Some of the common symptoms of irritable bowel syndrome or ibs are as follows:

Constipation or diarrhea, the latter of which can become quite severe during certain episodes
Gas or bloating which can make you uncomfortable
Cramping around the stomach area especially the lower belly which tends to become worse after having food and better after bowel movements
Quality of stools may vary quite a lot from time to time such as very hard to lose
Stomach may start sticking out and become misshapen
May also come with sexual as well as urinary problems
Causes of irritable bowel syndrome
The causes for irritable bowel syndrome vary from person to person. This disorder usually has triggers and yours may be different from someone else suffering from the same problems. However some general triggers and causes could be:

Hormonal problems: this is especially the case with women who tends to suffer from ibs more than men. Hormonal changes in the body such as before and after pregnancy and menopause or periods are known to be common.
Dietary causes: this is one of the major external triggers that have been reported by people. A variety of foods are known to have triggered or cause ibs. Some of the foods that have been implicated are beans, chocolate, cauliflower, cabbage or milk among many others.
Underlying illnesses: sometimes ibs itself may be a symptom of a larger underlying problem such as gastrointestinal disorders, such as bacterial overgrowth and gastroenteritis.
Mental health and stress issues: people going through psychological stress such as before exams or reviews have known to have ibs as stress becomes a trigger in their case. If you have mental health issues in the long run, these are also known to trigger or cause ibs.
Treatment options
Some of the treatment options for ibs are:

Antibiotics
Mental health counseling
Antidepressants
Medications for bowel spasms
Medications for diarrhea or constipation
Specialized medications for ibs for other underlying conditions.

Symptoms, Causes and Treatments for Irritable Bowel Syndrome

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

Curd is a staple in every household in India; whether it is served with piping hot parathas or by itself after a meal. The simple food item is packed with a number of nutrients and helps in increasing the health benefits in your body.

Here are a few reasons why you should be eating curd, almost every day:

Probiotics help in digestion: Curd, being rich in probiotics (good bacteria), improves digestion as it kills all the harmful bacteria in the digestive tract and aids the proliferation of good bacteria. Probiotics also help in the prevention of various digestive issues such as cramps, bloating and abdominal pain caused due to Irritable Bowel Syndrome.
Promotes weight loss around the belly: A hormone called cortisol, also called the  stress hormone  persuades the fat cells to produce more fat around your belly area. Consuming a cup of curd daily increases the amount of calcium in your body which limits the release of cortisol, thus, helping you lose weight. Curd also retains one-third of lean muscle mass which helps you maintain your physique post those dropped kilos for a longer time.
Curd strengthens your immunity system: A cup of curd is loaded with good bacteria which is essential for fighting off germs, thereby making your immune system stronger and more persistent. Making curd a part of your daily diet is a great idea as it is effective in preventing yeast infections around the vaginal area.
Toughens up your skeletal system: Like all dairy products, curd is rich in calcium which is necessary for strong bones and teeth. Apart from calcium, curd is rich in phosphorous and together, they quicken the bone growth process and helps in preventing arthritis and osteoporosis.
Helps in improving cardiovascular health: Eating curd helps in improving cardiovascular health as it discourages the spread of cholesterol around the arterial area, thus, reducing the risks of a coronary disease. Curd reduces hypertension which is a pre-cursor to most heart ailments.

5 Reasons You Should be Eating Curd Daily 

Gastric (stomach) cancer occurs when malignant cells form in the lining of the stomach. By far, it is known to be the second most common cause of cancer-related deaths not only in Asia but also worldwide. Though it can affect both male and female populace, it is seen more commonly in men and in people aged 50 years or older.

Type: Gastric cancers can present as one of the following types - 

Adenocarcinoma: Begins in the glandular cells lining the inside of the stomach. This forms a majority of the stomach cancers.
Lymphoma: Begins in immune system cells present in the walls of the stomach. Occurrence of lymphoma, in the stomach, is rare.
Carcinoid Tumor: Begins in hormone producing cells of the stomach.  Occurrence of carcinoid cancer, in the stomach, is rare.
Gastrointestinal Stromal Tumor (GIST): begins in nervous system cells of the stomach. Occurrence of GIST, in the stomach, is rare.
Gender: It affects both male and female populace.

Etiology: The factors that are associated with increased risk of gastric cancer include the following mostly  

 Helicobacter Pylori  bacterial infection in the stomach is a common cause of gastric cancer of both the intestinal (expanding) & diffuse (infiltrative) type. Furthermore, studies indicate that high salt intake is synergistic with H. Pylori infection in the manner that it is likely to increase the risk of gastric cancer that is induced by H. Pylori bacteria.
Smoking, consuming alcohol, red meat, salty/ smoked/ processed foods, low intake of fruits and vegetables, diets rich in nitroso compounds, eating foods contaminated with aflatoxin fungus etc all.
Atrophic gastritis characterized by chronic stomach inflammation is known to increase the risk multi-fold. Chronic gastric inflammation can lead to atrophy of the gastric mucosa, metaplasia, dysplasia and finally carcinoma.
History of pernicious anaemia, gastric ulcers, adenomatous gastric polyp etc all.
Family history of gastric cancer. Several familial syndromes that have been associated with a pre-disposition to gastric cancer include familial adenomatous polyposis, Lynch syndrome, Peutz-Jeghers syndrome and e-cadherin mutation (diffuse type)
Blood group A, Obesity etc all are known to be associated with diffuse or cardia gastric cancer.
Low socioeconomic status - persistent lifestyle issues/ irregularities including high stress coupled with an improper diet/ dietary pattern.
Epidemiological evidence is indicative of a risk or pre-disposition to gastric/ stomach cancer for people suffering from diabetes mellitus (DM).
Very high dose ionizing radiation exposure is an uncommon risk for gastric cancer.
Features: There are often no early stage symptoms. Early stage symptoms, if any, are non-specific and are likely to be ignored, thus delaying the diagnosis most often. Hence, gastric/ stomach cancer is often detected at an advanced stage where the disease is either locally advanced or metastatic. The various presentations (of signs & symptoms), by stage (early or advanced), of gastric cancer are as enumerated below:

Early Stage   can present with one or more of the following non-specific symptoms/ signs -

Dyspepsia (Indigestion),
Stomach/ Epigastric discomfort,
Bloated feeling after eating,
Mild Nausea/ Vomiting,
Blood in Vomit (Haematemesis),
Heartburn,
Weight loss (Cachexia)
Anaemia,
Occult blood in stool/ Melaena,
Advanced Stage   presents with one or more of the following symptoms/ signs -
GI Bleeding with black tarry stools (Melaena),
Persistent Nausea/ Vomiting,
Blood in Vomit (Haematemesis),
Early Satiety,
Anaemia,
Loss of Appetite (Anorexia),
Weight loss (Cachexia),
Persistent pain in the abdomen,
Fluid build-up in the peritoneal cavity (Ascites),
Edema of the lower extremities,
Liver Enlargement (Hepatomegaly)/ Jaundice,
Difficulty swallowing food (Dysphagia)
Screening: Is generally recommended for asymptomatic populations in high incidence areas or as surveillance for high risk individuals. The goal of screening, as usual, is to be able to detect & diagnose gastric cancer at an early stage which is potentially curable. It is mostly endoscopic/ radiologic.
Diagnosis: Following are the diagnostics employed in gastic cancer - 

Physical Examination: May be remarkable for palpable abdominal mass, weight loss (cachexia), abdominal distension, ascites, hepatomegaly, lower extremities edema and lymphadenopathy for gastric cancers in the advanced stage. For early gastric cancers, however, physical examination is largely uninformative.
Blood: Hb- may be low, ESR   raised, tumor markers CEA & CA-19-9 could be raised sometimes in adenocarcinoma but are not frequently elevated. Abnormal blood test results may be indicative of malignancy, but a follow-up gastroscopy/ biopsy is always the gold standard for accurate diagnosis.
Stool: Occult blood may be +ve
Barium Meal X-Ray: Could show a filling defect at the site of the carcinoma/ cancer growth.
Gastroscopy/ Biopsy: Clinches the diagnosis.
Endoscopic Ultrasound: Maximizes tumor staging as it helps determine the depth of invasion of the tumor.
CT Scan: Of chest, abdomen & pelvis helps detect metastatic disease, if any, and also helps stage the disease (TNM) appropriately.
Bone Scan: Helps detect osseous metastasis (bone mets), if any.
Treatment: Conventional treatment includes surgery, chemotherapy and radiotherapy as contextually appropriate. Surgery (i.e. gastrectomy either sub-total or total), with an adjuvant chemotherapy and/ or radiotherapy as contextually relevant, is the only treatment that is known to cure the disease in light of the prognostic indicators as briefly enumerated in the section below. Chemptherapy and/ or radiation alone cannot be curative. Mostly, it can improve symptoms, and may prolong survival. Simultaneously, an adjunctive or integrative naturopathic treatment with suitable complementary & alternative medicines (CAM) too can help improve clinical outcomes and facilitate recovery as feasible contextually.
Prognosis: For gastric cancer is variable. Preventive measures, earlier diagnosis and right early treatment is key for an effective therapeutic management & better prognosis. Like most other cancers, the chances of cure for an early stage gastric cancer are more. The cure/ recovery chances are influenced by the grade, stage of cancer, recurrence and the patient s general health & vitality etc all. Distal tumors are known to be cured more often than the proximal ones. Again, intestinal-type gastric cancers are known to have a better treatment outlook in comparison to the diffuse-type gastric cancers.

Prevention: Rightly said, prevention is always a better choice. Although genetic risks are difficult to modify, still an adherence to a relative Mediterranean diet, maintaining an ideal body weight and an active lifestyle with due emphasis on regular exercising, de-stressing and relaxation is highly recommended for reducing the risks of many cancers including gastric cancer. A healthy eating plate comprises essentially a low fat diet, fibre rich foods including whole grain cereals, green leafy vegetables cooked using healthy vegetable oils, fresh fruits of all colours as seasonally available and healthy proteins/ fats including fresh fish, poultry, beans, nuts etc all. The consumption of alcohol, if any, has to be strictly in moderation, and is best avoided in a high risk scenario. Smoking is to be avoided too. Again, red meat, butter, refined grains, sweets, sugary drinks including carbonated beverages and other high calorie foods etc all, if any, are to be taken sparingly. Not only it is important to eat healthy, but also it is equally important to eat properly. Insufficient chewing, eating until full, eating meals within a short time etc all are best avoided so as to ease off digestive burden on the stomach/ other organs in the GI tract. Last but not the least, consumption of clean and filtered water, natural probiotics like freshly prepared yogurt/ butter milk, maintenance of cleanliness & hygiene including oral hygiene etc. all can help guard against H. Pylori infections. Breastfeeding is known to be protective against H. Pylori infections too.

Gastric Cancer - In a Nutshell!

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