Problems of the large intestine are very common and patients should usually consult gastroenterologists for the proper diagnosis and treatment

1. Bleeding per rectum: Bleeding through the anal canal or rectum is usually the most common problem of the patients. It can be due to following reasons: 

A. Piles also known as Hemorrhoids: Hemorrhoids are dilated venous channels of the anal canal. They occur due to long term constipation or chronic cough or due to less fibre intake in the diet. Sigmoidoscopy or proctoscopy is required for diagnosis. Treatment options include medicines and high fibre intake, Injection therapy(Sclerotherapy) for stopping bleeding from piles and Stapler hemorrhoidectomy if the piles are large.

B.  Polyps: Polyps are soft tissue growths seen in the large intestine. They are usually silent but can present with bleeding or anaemia. Polyps usually grow slowly in size and large polyps can turn into cancer of large intestine also known as colorectal carcinoma. Colonoscopy is required for the diagnosis. The gastroenterologists can diagnose the presence of polyps by colonoscopy. Smaller polyps can be removed by polypectomy by gastroenterologists without the need for open surgery. However large polyps or those polyps with suspicion of cancer require surgery.

C. Large intestine Ulcer: They can occur due to early cancer, SRUS, Infections or drugs. They require colonoscopy for the diagnosis. The gastroenterologists usually take Biopsy from the ulcer to know the cause of the ulcer. The mere taking of biopsy does not mean cancer and biopsy samples are seen in the microscope for better diagnosis.

D. Ulcerative Colitis and Crohn s disease: Ulcerative colitis is one form of Inflammatory bowel disease (IBD). The other IBD is known as Crohn s disease. Whereas ulcerative colitis involves only large intestine, Crohn s disease can involve any part of the gastrointestinal tract including small intestine. Ulcerative colitis and Crohn s disease present with Loose stools(diarrhea), bleeding , abdominal pain, weight loss, Anemia and Perianal fissures and  fistula. The diagnosis of IBD is challenging and involves blood tests, CT Scan abdomen, Colonoscopy with biopsy and clinical history. Management includes Medicines which control the inflammation such as Pentasa, Rowasa, Mesacol etc. Severe disease requires additional drugs such as Azathioprine and Anti TNF sich as Infliximab and Adalimumab. Occasional cases require surgery such as those with tight stricture of the intestine, severe dilatation of Large intestine (also known as Toxic megacolon), excessive bleeding, the disease not responding to medical management, or presence of cancer with IBD.

E. Anal fissures: Cut in the anal skin (fissure) causes severe pain in the anal area during passing motions. It is usually due to constipation or straining. It is usually treated by Gastroenterologists initially by medicines and ointments. If the pain continues Surgery is required named as Lateral internal sphincterotomy (LIS).

2. Loose motions or Diarrhea: Excessive passing of liquid motions is known as diarrhea or commonly lose motions. It is usually due to Infections caused by contaminated food and water. It is usually self-limiting. Severe cases with dehydration require admission for IV fluids and antibiotics for the infection. Loose motions for more than 6 to 8 weeks is known as chronic diarrhea. It is evaluated by blood tests and colonoscopy. Usual causes include tuberculosis, celiac disease, ulcerative colitis, microscopic colitis, Malabsorption such as chronic pancreatitis and small bowel bacterial overgrowth.

3. Irritable bowel syndrome (IBS): IBS is very common and at least 20 to 30 percent of Indian patients suffer from it. Symptoms include altered bowel habits such as diarrhoea or constipation, abdominal pain which is usually relieved or increased by defecation. Weight loss or bleeding is not the feature of IBS. Few simple blood tests are required and good medicines are now available for IBS. Few cases may require colonoscopy to rule out alternative causes of the symptoms.

Understanding colonoscopy: Colonoscope is a flexible tube with a camera at its tip to see the inside of the large and small intestine. Bowel preparation is required at least 8 hours before the procedure so that the inside of the large intestine can be seen clearly without the interference of stools.colonoscopy is an OPD based procedure where the patients are discharged the same day. A colonoscopy helps in evaluation symptoms of the large intestine such as loose stools, bleeding and abdominal pain.

In Detail About Colorectal Disorders!

Renal Tubular Acidosis is a medical condition. When the kidney is unable to acidify urine, it leads to the accumulation of acid in the body. Usually, when blood is filtered by the kidney, it passes through the tubules of the nephrons (the functional unit of the kidney).

Before it flows into the bladder from the kidney, the urine undergoes an exchange of salts, acids and other solutes. Renal tubular acidosis results in the formation of excessive amounts of acid because the kidneys cannot drain them. This may happen because the kidneys cannot reabsorb the alkaline bicarbonate ions from the urine in the early segment of the nephron or because of inadequate production of acidic hydrogen ions in the latter half of the nephron.

Renal Tubular Acidosis is simply associated with abnormal urinary acidification. Other functions of the kidneys remain unimpaired.
There are several different types of renal tubular acidosis-

  Distal Renal Tubular Acidosis (RTA)
This is the most fundamental form of RTA. It is characterized when the hydrogen ions are not secreted into the lumen of the nephron by the alpha-intercalated cells of the medullary collective duct of the distal nephron. When this happens the pH of urine cannot be brought down below 5.3. Renal excretion is inhibited and hydrogen ions are not eliminated which leads to academia. At the same time, Potassium ions cannot be absorbed by the cell which leads to hypokalemia. The end result is protein retention and potassium excretion. Distal RTA can lead to the urinary stone formation, calcium deposits in the kidney, rickets and osteomalacia and Sjogren s syndrome.

  Proximal RTA
When proximal tubular cells reabsorb 85% of filtered bicarbonates and 60% of filtered sodium from the urine, then this again leads to academia. The distal intercalated cells, however, function normally and so the academia is not as severe as in case of Distal RTA. The alpha-intercalated cells can acidify urine to a pH of 5.3 or less because they produce hydrogen ions. Proximal RTA is also associated with Fanconi Syndrome which is characterized by aminoaciduria, uricosuria, glucosuria, and tubular proteinuria.

  Combined distal and proximal RTA
Inherited carbonic anhydrase II deficit leads to combined distal and proximal RTA. This is accompanied by osteopetrosis, cerebral calcification, and renal tubular acidosis. Cases of combined distal and proximal RTA are very rare.

How is RTA understood?
The following steps are applied to analyze Renal Tubular Acidosis-
  Determining the anion gap in acidosis. The normal Anion Gap is 8-12 (4-6 mEq/L)
  Separating the renal from the extrarenal causes of normal anion gap acidosis
  Classifying the types of RTA
  If it is distal RTA, further tests will be necessary to support the diagnosis

How is RTA diagnosed?
Three types of tests can reveal if a person is affected by Renal Tubular Acidosis-
  Urine test
  Acid load test
  Physical examination

Treatment of RTA-
Doctors prescribe either or both of the following two types of therapies-

  Alkali therapy- The pH level of urine is restored and electrolytes are balanced
  Vitamin D supplements- If RTA leads to bone deformities or rickets, your doctor will prescribe vitamin supplements to strengthen your bones.

Timely diagnosis can prevent the effects of Renal tubular Acidosis from becoming compounded. With the right medication, a person can lead a healthy normal life.

What Should You Know About Renal Tubular Acidosis?

The first commandment of healthy living is to eat plenty of fresh fruits. However, did you know that some fruits are healthier than others? Fruits do not have any added sugars but many fruits are rich in natural sugar. However, here are 11 fruits which have lowest sugar content.

Limes and lemons: Limes and lemons are known as sour fruits. While they are rich in vitamin C, they do not contain a lot of sugar. Freshly squeezed lime juice and hot water is the perfect drink to curb your appetite and raise metabolism.
Raspberries: Raspberries are rich in fiber but have only a little more than a teaspoon of sugar per cup. This makes them the perfect fruit to start the day with.
Strawberries: Strawberries may taste sweet but a cup of fresh strawberries has only about 7 grams of sugar. However, a cup of strawberries has enough vitamin C to take care of your daily requirements.
Blackberries: A cup of these berries also has minimal sugar. Along with fiber, these fruits are also rich in antioxidants. These berries also help lower the risk of type 2 diabetes, cardiovascular diseases, and other such conditions.
Kiwi: Did you know that kiwis are technically berries? Each kiwi has less than 6 grams of sugar but is very rich in vitamin C.
Grapefruit: A grapefruit is a perfect breakfast. These citrus fruits are rich in fiber and low in sugar. Half a grapefruit contains only 52 calories and minimal sugar. They are also rich in vitamin A, vitamin C, and potassium.
Avocado: Avocados are naturally low in their sugar content. One raw avocado has less than a gram of sugar. However, they are full of vitamin C, vitamin K, folate, and potassium.
Watermelon: Summer would be incomplete without watermelons. Though they taste sweet, watermelons are very low in sugar. A cup of watermelon has less than 10 grams of sugar.
Cantaloupe: Cantaloupes are rich in vitamin A but a cup of this fruit has only about 14 grams of sugar. They are also rich in vitamin B, magnesium and fiber.
Oranges: Eating an orange is the best way to boost our vitamin C levels and keep infections away. One orange typically contains less than 70 calories and 12 grams of sugar.
Peaches: A medium sized peach has less than 13 grams of sugar. This is an example of how taste can be deceptive when it comes to calories.
Given the sugar content in these fruits, it would be a great idea for the diabetics and weight watchers to include them in their diet and have a healthy and hearty meal. If you wish to discuss about any specific problem, you can consult a General Physician.

11 Best Fruits That Are Low In Sugar Content!

Cumin, also known as 'jeera' in the Indian subcontinent, is an ancient seed that has been prized for more than 3000 years. Ayurveda holds this spice in high regards and uses it for treating a host of health disorders including burning of excess fat.

Why are cumin seeds considered to aid in weight loss?

An effective detoxifier: Ayurveda considers the accumulation of toxins to cause weight gain and other medical conditions. While certain toxins are easily removed with water, fatty toxins stick to cells and disrupt cell metabolism resulting in weight gain. To detox such hard-to-remove toxins, cumin seeds are predominantly used in Ayurveda. The seeds remove excess kapha from the intestines and detox liver effectively.
Lowers cholesterol that aids in burning fat effectively: Black cumin is rich in phytosterols which are plant fats resembling cholesterol present in animal fats. When consumed, they limit the amount of cholesterol absorbed by the body. Taking a tablespoon of cumin seeds every day has been medically proven to lower the amount of cholesterol up to 10 percent and bad cholesterol up to 14 percent. This reduction in addition to the cholesterol-lowering measures that you may have adopted would be helpful in burning fat much faster. Taking about 2 grams of cumin seeds combined with light freehand or aerobic exercises can lead to subsequent weight loss in people who lead a sedentary lifestyle.
Lowers blood sugar levels and regulates metabolism: Any person with high blood sugar levels is aware that low insulin levels tend to create a craving for sweets and carbs while high insulin levels can cause extreme thirst and fatigue. Cumin seeds have been proven to lower the blood sugar levels. It lowers blood sugar levels by increasing insulin and glucose sensitivity. In this way, black cumin seeds can aid you to shed off extra pounds by improving the blood glucose levels as well as glucose absorption. In addition to all these benefits, black cumin seeds contain high amounts of oleic acid which is a fatty acid causing acceleration in the way in which the body burns fat.
Other benefits from cumin seeds: Constipation and indigestion are other common reasons for weight gain. An excellent source of fiber, antioxidants, and that has anti-flatulent properties, the cumin seeds can cure constipation, bloating and heaviness, thus, aiding in weight loss. Lack of sleep may also be causing weight gain. Cumin seeds can cure you of insomnia, thus. regulating your sleep pattern and metabolism.
Hence, cumin seeds are a simple and effective ayurvedic remedy for weight loss. Cumin seeds are more potent, and you can take a spoon of roasted or plain cumin seeds every day. Obese or normal, irrespective of your weight, taking cumin seeds regularly have quite a few benefits.

1 Tablespoon Of Cumin - Know How It Can Work Wonders!

Water effectively constitutes 70-75% of human bodies and keeps us protected from many harmful things. But many people have a frequent question: is it alright to drink water before you brush your teeth? Will it harm your body? Let us discuss the same in this article.

Many people believe that they should not drink water before brushing their teeth because of the bacterias present in saliva after you wake up. But this is a myth and it does not have any scientific logic. When you drink water after waking up before brushing, your saliva goes with the water down into the stomach which results in the killing of the bacteria due to the high acid content inside it. Therefore there is absolutely no harm if you drink water before brushing teeth.

If you are familiar with Japanese culture then you must know that the Japanese drink two glasses of water every morning immediately after they wake up. Drinking water immediately after you wake up without brushing your teeth does not harm you in any way. Doctors always recommend drinking two full glass or at least one, on an empty stomach. There are several benefits your body receives when you consume water every morning after you wake up.

Drinking water every morning has its own long list of benefits. Let us have a look at them-

Boosts your immunity- Drinking water every morning strengthens your immunity system. Helps you to fight diseases and germs much better.
Clears the bowels- After your drink water in the morning, you will get an urge of flushing out your bowels. This way the bowels remain clear and you do not face any constipation issues.
Speeds up metabolism- Your metabolism gets boosted when you drink water resulting in faster digestion and metabolic rate. It also keeps you hydrated through the day.
Prevents headaches and migraines effectively and it also helps in preventing colon infection because your bowels get cleared easily.
Helps in weight loss- Drinking water every morning helps you to lose weight by a significant margin due to the fact it occupies the stomach killing the desire to eat much in the morning.
Beneficial for skin- Increase in the freshness of your skin complexion which water delivers if you drink it every day in the morning. It flushes out the toxins and dead cells which helps in increase of new and fresh body cells.
Thus as you can see the long list of benefits you will receive if you drink water every day after you wake up.

Is It Alright To Drink Water Without Brushing Your Teeth?

The human body is an intricate mechanism that functions amazingly. And when there is any trouble it does not fail to show signs of trouble, and all we need to do is, to notice it and solve our problems. This is applicable to all types of health issues, including a perianal abscess.

What is Perianal abscess?
Perianal abscess is an extremely painful condition of anal abscess that occurs when one cavity in the anus starts getting filled up with pus. Very often it appears as a painful swelling similar to boil just near the anus. Usually, it appears red in color as well as slightly warm to touch. If the location of the anal abscesses is in the deeper tissue, then it might be less visible and it occurs in people suffering from inflammatory bowel disease.

The worst part is that in certain cases, anal abscesses might lead to more painful anal fistulas. Generally, fistulas occur only if the abscesses fail to heal and break open on the skin s surface. Therefore, it is important that the abscess heals properly or else it may lead to intolerable pain and may even require surgery.

Symptoms of Perianal Abscess
The immediately noticeable and probably the most common anal abscess symptom is constant and throbbing pain around the anal area. Swelling accompanies the pain and its rate increases during bowel movements.

Various common signs of Perianal abscess are:

bleeding or rectal discharge
constipation 
fatigue
Swelling or tenderness,
Skin irritation all around the anus.
Patients with deeper abscess might also show symptoms such as chills, fever, malaise, etc. Various reports state that certain people also feel a lump or nodule at their anus s rim. Facing difficulty while urinating might also be experienced by some people affected by perianal abscess.

HOW TO DIAGNOSE PERIANAL ABSCESS?
One must immediately seek medical if they experience any of the above-mentioned signs or symptoms. Clinical evaluation along with digital rectal exam is sufficient for the proper diagnosis. But, in some cases, patients might need other tests to screen for rectal cancer, diverticular disease, inflammatory bowel disease and sexually transmitted infections. Your physician might also suggest a CT scan, an MRI, or an ultrasound.

HOW DO YOU TREAT PERIANAL ABSCESS?
Just after the diagnosis, prompt surgical drainage would be carried out by the doctor before the abscess erupts. A deeper or larger abscess might require hospitalization as well as an anesthesiologist s assistance. In most cases, patients are prescribed certain medications for pain relief just after the procedure. Antibiotics are mainly given to those people who have comparatively weaker immunity or suffer from diabetes.

Know More About Perianal Abscess!

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