Ulcerative Colitis is one of the severe and chronic forms of Inflammatory Bowel Disease (IBD) that can throw life in a jeopardy. The condition that mainly affects the rectum and the large intestine can cause severe inflammation, ulceration, and abscess formation. The ulceration or the inflammation of the colon and the rectum left unattended for too long can give rise to deleterious consequences including damage and perforation of the colon, osteoporosis. Various studies also suggest that ulcerative colitis can increase the risk of a person suffering colon cancer.

Like most of the IBD, there is no definite cure for ulcerative colitis. The illness is a chronic condition and can flare up or recur at any point in time. Though medications may help to control the damage and the complications triggered by ulcerative colitis, a surgery may be essential in case of

Severe damage to the colon.
The nonsurgical treatments could do little to improve the conditions.
There is an increased risk of colon cancer.
Ulcerative colitis has resulted in Toxic megacolon (a life-threatening condition where the large intestinal muscles have dilated with some swelling).
There are extreme discomfort and bleeding.
Surgeries to deal with Ulcerative Colitis

In the case of Ulcerative Colitis, the nature of the surgery depends on the extent to which the colon or the rectum or both have been affected and damaged.
In the case of extensive damage with a high risk of colon cancer, the surgeon may perform Proctocolectomy or colectomy
Colectomy may involve
Removal of all of the colon- Total Colectomy
Removal of the diseased part of the colon- Partial Colectomy.
Following the excision, the surgeon may carry out necessary rearrangements to reconnect the remaining portion of the colon to the abdomen through an opening known as stroma (the procedure is known as colostomy).
In case of Total Colectomy, the small intestine will be connected to the abdomen by a process known as Ileostomy.
Proctocolectomy involves the removal of both the rectum and colon to avoid further aggravation.
Following the proctocolectomy, the surgeon may carry out Ileoanal Anastomosis (Ileal Pouch-Anal Anastomosis). In this procedure, a pouch is created using a small part of the small intestine. This pouch is then connected to the anus to help in the elimination of the wastes.
General precautionary measures to control Ulcerative Colitis
Making healthy lifestyle and dietary modifications can go a long way to control ulcerative colitis and the associated symptoms.

Spicy foods can worsen the incidence of ulcerative colitis. Enrich your diet with lots of fruits, vegetables (squash, avocados, fish (especially salmon and tuna), meat, dairy products, olive oil, walnuts, flaxseed oil, almonds.
Make sure the diet is a low-fiber diet.
Avoid alcoholic and caffeinated drinks and beverages, foods high in sulfur content, refined sugar.
Research suggests stress and lack of physical activities can aggravate the ulcerative colitis. Mediation and daily exercise can produce fruitful results.
Make sure your sleep is not compromised (6-8 hours daily).

Ulcerative Colitis - How Surgery Can Help Manage It?

It is gastrointestinal bleeding in the upper gastrointestinal tract, commonly defined as bleeding arising from the oesophagus, stomach, or duodenum. Blood is often observed in vomit (hematemesis) or in the stool (melena). Upper gastrointestinal bleeding denotes a medical emergency and typically requires hospital care for primary diagnosis and treatment. The incidence of upper gastrointestinal bleeding is 50-150 individuals per 100,000 annually. Depending on its severity, it carries an estimated mortality risk of 11%.

The causes of upper gastrointestinal bleeding are as follows:

Oesophagal causes (gastrorrhagia):

Oesophagal varices
Esophagitis
Oesophagal cancer
Oesophagal ulcers
Mallory-Weiss tear
Gastric causes: 

Gastric ulcer
Gastric cancer
Gastritis
Gastric varices
Gastric antral vascular ectasia
Dieulafoy's lesions

Duodenal causes
Duodenal ulcer
Vascular malformation, including aorto-enteric fistulae
Hematobilia or bleeding from the biliary tree
Hemosuccus pancreaticus or bleeding from the pancreatic duct
Severe superior mesenteric artery syndrome
The signs and symptoms of upper gastrointestinal bleeding are as follows:

Hematemesis - Vomiting of blood
Melena - Blood in the stool
Hematochezia - Passage of fresh blood through the anus, usually in or with stools
Syncope - Loss of consciousness (fainting)
Presyncope - State of lightheadedness, muscular weakness, blurred vision, and feeling faint
Dyspepsia   IndigestionEpigastric painHeartburnDiffuse abdominal pain
Dysphagia - Difficulty in swallowing. Weight lossJaundice - Yellow discolouration of the skin, mucous membranes, and sclera
The diagnosis of upper gastrointestinal bleeding is made when hematemesis is present. In the absence of hematemesis, an upper source of GI bleeding is likely in the presence of at least two factors among - Black stool, age < 50 years or blood urea nitrogen/creatinine ratio 30 or more

If these findings are absent, consider a nasogastric aspirate to determine the source of bleeding. If the aspirate is positive, an upper GI bleed is greater than 50%, but not high enough to be certain. If the aspirate is negative, the source of a GI bleed is likely lower. The accuracy of the aspirate is improved by using the Gastroccult test. Also, the following diagnostic tests are done:

Orthostatic blood pressure
Complete blood count with differential counts
Hemoglobin level
Type and crossmatch blood
Basic metabolic profile, BUN,
Coagulation profile
Serum calcium
Serum gastrin
Endoscopy
Chest radiography
Nasogastric lavageAngiography (if bleeding persists and endoscopy fails to identify a bleeding site)
Upper gastrointestinal bleeding can be managed in the following ways:

Airway management and fluid resuscitation using either intravenous fluids and or blood
Medications to stop the bleeding (Proton-pump inhibitors are often given in the emergency)
Surgical intervention
Treating the consequences (like anaemia) that the bleeding may have caused
Precautions are taken to prevent re-bleeding

What Are The Reasons Behind Ulcer?

Cyclic vomiting syndrome (cvs) is characterized by periodic bouts of nausea and vomiting that happens at cyclical intervals. It affects all ages, but is more common in children. The condition is quite stereotypical in that there are paroxysms or bouts of vomiting that is recurrent and follows days of normal health.

Causes: there is no definite reason identified, but it is said to have a strong hereditary correlation. Studies have shown mitochondrial heteroplasmic (abnormal growth of mitochondria, which is a cellular component) to be one of the factors that can lead to cvs. The genetic correlation, however, is very difficult to establish, specifically because vomiting and nausea are common symptoms that occur with most conditions in children. And cvs is most commonly noted with conditions like infections and emotional excitement. Infection could be either tooth decay or sinusitis or anything else. Lack of sleep, anxiety, holidays, allergies, overeating, certain foods, menstruation - a host of factors have been shown to induce cvs. There is also a strong association with migraine and conditions that lead to excessive production of stress hormones.

Symptoms: the syndrome (a group of symptoms) usually has 4 phases:

1. Symptom-free interval phase: the child is completely normal in this phase, which happens in between bouts.

2. Prodromal phase: prodrome is an indication that a disease or a condition is about to happen. In cvs, this is usually nausea and abdominal pain that can last from a few minutes to a few hours. Treatment in this phase can curb the disease. However, there could be some children in whom this may not manifest and the child may directly start with vomiting.

3. Vomiting phase: repeated bouts of paroxysmal vomiting happen associated with nausea, exertion, fatigue, and drowsiness.

4. Recovery phase: as the nausea and vomiting begin to subside, which may take a couple of days, the child returns back to normal slowly. However, the lethargy and energy levels will take a couple of days to return to normal.

Treatment: treatment again depends on the severity and the phase at which it is being recognized. If a child has repetitive bouts, then the parent and the doctor would have identified a pattern to it.

1. If the causative agent has been identified, for instance, infection or migraine, then managing that takes care of the cvs also.

2. If identified during the prodromal phase, again it can be managed with suitable anti-emetic medications.

3. If identified after full onset, rest and sleep and medications to control nausea and vomiting are required. Adequate hydration with electrolyte replenishment and sedatives can provide additional support.
However, in most cases of childhood csv, the pattern will be identified and that helps in better management, both the child/parent and the podiatrist.

Cyclic Vomiting Syndrome in Children - Causes, Symptoms, Treatment

Lower abdomen pain can originate from a range of medical issues. In some cases, the pain disappears just like the way it came, in some cases, it takes longer medical treatment to cure the pain. Once the origin and the root cause of the pain are diagnosed, there are plenty of medical options to cure the pain. In this piece, we will briefly touch upon the causes of lower abdomen pain:

Appendicitis: This is one of the most common causes of lower abdomen pain. It typically originates from the right side of the stomach and soon diverges into the other side as well. The pain can become unbearable in a matter of hours.
Pelvic inflammatory disease: This is an infection that is caused in the reproductive system of a woman. This is often characterized by vaginal discharge, fever, weakness, intercourse related pain and pain in the lower abdomen.
Miscarriage: In case there is a loss of fetus on or before the twentieth week, the mishap is termed as miscarriage. It results in acute pain in the lower abdomen pain, vaginal bleeding, back pain, fluid expulsion from the vagina etc.
Fibroids: This is a growth in the uterus that is often non-cancerous and is commonly characterized by symptoms such as heavy periods, constipation, pain in the legs and back area, pain in the lower abdomen area, frequent urination etc.
Cancer: A cancerous growth in the lower abdomen area can lead to very sharp pain in the back and surrounding area. The pain is dull in nature and slowly spreads to other areas in a short interval of time.
Cholecystitis: This is a disorder that results in swelling of the gallbladder area. It results in a sharp pain in the lower abdomen area. A doctor needs to be immediately consulted if a person is suffering from this disease.
Intestinal obstruction: When the lower bowl gets blocked due to the contents of the lower intestine, a person can feel a sharp pain in the lower abdomen area.
Salpingitis: When a woman faces stiff pain in the lower abdomen area due to an inflammation of the fallopian tube, Salpingitis is the culprit behind it. This is a sexual disease and needs a doctor s consultation to get rid of it.
PMS: A woman can face throbbing pain in the lower abdomen area during her monthly periods. Other symptoms include cramps, weakness, fatigue etc.
Endometriosis: When there is an extension of the uterus tissue just outside the wall of the uterus, it leads to symptoms such as lower abdomen pain, cramps etc.
Polycystic ovarian syndrome: This is a disorder of the hormone and can lead to symptoms such as heavy periods, a growth of facial hair accompanied with sharp pain the lower abdomen area.

Pain In Lower Abdomen - What Could Be The Causes?

Coughing during the night can really wreak havoc for your sleep and cause inexplicable discomfort in the throat and chest region. Thankfully, you can manage it by soothing your tickling throat as well as sensitive airways before you go to bed at night. 

Drink herbal tea: A mugful of non-caffeinated tea mixed with a teaspoon of honey before going to bed can help you to a considerable extent. This is because any warm liquid has the power to break down the formation of mucus in the throat region and with a bit of honey, the herbal tea becomes even more powerful.
Try to sleep in an inclining position: Gravity is your greatest enemy while combating night-time cough. When you lie down flat on your back at night, all the mucus and dust particles, which you have swallowed all through the day, would accumulate in the throat area and aggravate it making more cough. But you can easily defy gravitational force by piling up some pillows and prop yourself on them while sleeping. You may also keep a wooden block of 4 inches height under your head, which would keep the acids in the stomach so that they don t come up to irritate your throat.
Make sure you use the steam cautiously: When your airways are dry, it can make you cough harder. Therefore, you may find relief if you take a warm shower or a bath before going to bed. But you have to be sure that you don t have asthma as steam can prove harmful for you.
Check the level of humidity: Humidifiers are known to soothe the problem of persistent coughing when the surrounding air is dry. But too much of moisture during the night can also make you cough. This is because dust mites, mold and other allergens thrive well in the damp air and they could conspire to make your cough even worse. So, pick up a cheap hygrometer from a hardware store and see that the humidity level stays within 40 to 50 percent.
Equip yourself at night: Keep all the things from drops to water to cough syrup or anything that soothes coughing at your bedside so that you can help yourself in case you wake up in the middle of the night and start coughing.
By following these few tips every day, you can manage the night time cough and have a good night s sleep without any interruptions.

Night Time Cough - 5 Tips to Manage it

A cough is not necessarily to be worried about always. It is the natural response of our body to throw out harmful particles which somehow managed to enter our respiratory tract. There is sticky mucus situated in the pathway to lungs which plays a major role in trapping harmful particles. Coughing once or twice is generally a natural phenomenon but if it s persistent it is called the chronic cough, and there is a reason to worry.

Is your cough chronic?
An acute cough aggravates within a very short span of time, maybe 2-3 days. There are situations when coughing doesn t hinder your day to day activities and are easily neglected. Sometimes these infrequent bouts of a cough can persist for long and continue for more than 2 months, which has been characterized as a chronic cough.

A chronic cough is sometimes found associated with blocked or running nose. Persons suffering from a chronic cough feel very exhaustive and suffer from a headache, dizziness along with excessive sweating. Under such situations, you must consult a pulmonologist.

Know the causes of a chronic cough
There are several causes for persistent coughing, and the following are the common causes of a chronic cough and medication is taken in consultation with a trained medical practitioner only.

Infections: Bacterial or viral infection in lungs can be one of the causes of a chronic cough. Tuberculosis is one of them which initiates as a chronic cough and is later characterized by emitting blood after cough bouts.
Drug Interactions: Antihypertensive drugs have been found to be responsible for a chronic cough in some people. Hypersensitivity to the prescribed drugs is found to responsible for the cough bouts, and change in medication takes care of the issue.
Asthma: It s a situation characterized by blockages in the bronchi which disallows the normal air flow during inhalation and exhalation. Due to inadequate oxygen, brain assumes that there is a blockage which needs to be expelled and coughing pattern starts. However, asthma has to be treated, and the bronchi have to be brought back to normal with the help of medication by an expert medical practitioner.
COPD: The most common cause of a chronic cough nowadays is COPD, better known as Chronic Obstructive Pulmonary Disease. This is one of the progressive diseases which means it deteriorates with time. Active smokers are the biggest victims of it. Persons exposed to high degree of pollution or similar occupational hazards are also at high risk. Exposure to these pollutants causes inflammatory responses in lungs resulting in the tapering of the airways and destruction of lung tissues. These can be measured by lung function tests. In asthma, the narrow airways can be broadened by external medication, but in case of COPD, it s not possible.
To conclude, chronic cough is a preventable disease by reducing the exposure to risk factors as mentioned above. Quitting smoking, improving the indoor air quality with the use of solar cooking and moving on battery run vehicles can prevent COPD from further worsening. You can also undergo pulmonary rehabilitation program which is being counseled and coordinated by many physicians to benefit the individual suffering from the issue.

Chronic Cough - Why It Happens?

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