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!

Piles or haemorrhoids refer to a condition when the veins of the rectum or the anus get abnormally enlarged and causing significant bleeding and inflammation. Generally, there are two types of piles that are found in the human body. One is internal haemorrhoid which is generally painless and occurs in the inner layer of the anal region. The other is external haemorrhoid which occurs in the external layers of the rectum making it easily visible and extremely painful.

The causes of Haemorrhoids are obesity, a desk-bound lifestyle, untreated chronic gastric conditions like dysentery, diarrhoea, constipation, hereditary factors, pelvic tumours and significant increase in the weight of the uterus at the time of pregnancy.

The symptoms of piles include severe pain in the anal region followed by blood discharge with the faecal materials along with extreme irritability in the particular region and abnormal enlargement around the anal region.
In Ayurvedic treatments, piles are referred to as Arsha Shoola which means extreme painful conditions that resemble needle piercing. However, this intense sensation of pain can be eradicated by Ayurvedic treatments as it concentrates on the elimination of the symptoms. 

Some essential Ayurvedic remedies for piles are as follows:

Haemorrhoid is a medical condition that largely occurs due to a bad digestive system. A prescribed dosage of haritaki and jimikand might help in the overall improvement of your digestive system.
According to the Ayurvedic scriptures, piles can be treated, if you can maintain a healthy dietary regime that should include amalaki, papaya and jamrul, but not excessive starch-containing foods like potato and pumpkin.
A mixture containing radish and milk can be applied in the entrance of the anus twice a day to cure piles.
A juicy extract of mint leaves and ginger along with a pinch of lemon juice and honey can be consumed twice a day to get rid of piles.
If the bleeding is continuous a prescribed dosage of the herb nagakesara might provide adequate relief.

Piles - 5 Ways Ayurveda Can Treat It!

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?

Nuts and dry fruits are probably the oldest and traditional superfoods which our mothers have diligently offered us for our good health. Packed with proteins, iron, magnesium, healthy fats, vitamin B and fiber, these nutritional powerhouses are a must in our diet, but only in a limited quantity. Yes, taking almonds, dates, cashews, pistachios, and walnuts in excess amount can lead to excessive body heat, giving rise to nasty pimples and rashes. Not more than 2 tablespoons of dry fruits are recommended in a day because of their sugar content, they can easily help to put on weight by adding excess calories.

But, how true is the claim or is it a myth? Let's find out.

Here is a brief overview of how overconsumption of dry fruit is detrimental to health:

Weight gain: Studies conducted by researchers over the years has revealed that it takes over 3500 calories to gain 1 pound of weight. However, consuming just 250 calories from dry fruits can result in over 2 pounds of weight in a single month. A sudden increase in weight can bring in other complications such as obesity, menstrual problems in women, high blood pressure, etc. It is therefore imperative to avoid excess intake of dry fruits. To ensure minimum intake of calories, we could focus on dates, apricot, cranberries, blueberries, etc.
Asthma: Sulphur dioxide is often used to process dry fruits. Studies revealed that this foul-smelling gas isn t very harmful when consumed in limited quantities. But, as per food safety experts, the permissible limit of Sulphur dioxide in humans should not be more than 20 mg per day as it can cause asthma, allergic reaction and skin rashes in an individual.
Gastrointestinal problems: Food items with high fiber content help in regular bowel movement and smooth blood flow. However, consuming too much fiber can lead to bloating, diarrhea, flatulence, cramps and constipation. This is exactly the case with dry fruits as well. They contain fiber and have the capacity to wreak havoc in the intestinal lining on overconsumption. Gradual and steady consumption of dry fruits over a period of time can mitigate this risk. 
Tooth decay: Dry fruits that are available in the market come with a thick coat of sugar so that they do not infuse moisture and stick to each other. This sugar significantly contributes to tooth decay. This is the reason why overconsumption of dry foot should be avoided.
Sugar crash: Most dry fruits have a high glycaemic index which can quickly surge blood sugar levels and spike energy levels. Therefore, patients suffering from high pressure should strictly refrain from dry fruits.
While the cons appear frightening, do not cross the nuts off the grocery list completely. Dry fruits when consumed under control, can be really helpful. So remember that moderation is the key. And in case you have a concern or query you can always consult an expert & get answers to all your questions!

Dry Fruits - 5 Reasons Why You Must Not Eat Too Many!

Hemorrhoids are masses, clumps, cushions of tissue in the anal canal - they are full of blood vessels, support tissue, muscle and elastic fibers.

Although hemorrhoids are thought of as unpleasant inflammations, we all have them.1 It is when the hemorrhoidal cushions become too big (inflamed) that problems occur - when this happens they are called piles or pathological hemorrhoids.

"Piles" are the swollen ones that are painful and cause problems, hemorrhoids can refer to the swollen ones (pathological hemorrhoids) or simply the normal structure. 

Piles can be of various sizes and may be internal (inside the anus) or external ones (outside the anus). Typically, internal piles occur from 2 to 4cm above the opening of the anus. External piles (perianal hematoma) occur on the outside edge of the anus. The internal ones are much more common.

Internal hemorrhoids -

They are classified into four grades:

Grade 1 - there are small inflammations, usually inside the lining of the anus. They are not visible.
Grade 2 - larger than Grade 1 hemorrhoids, and also inside the anus. When passing a stool they may get pushed out, but soon return.
Grade 3 - often called 'prolapsed hemorrhoids'; these appear outside the anus. The patient may feel them hanging out. They can be pushed back in if the patient presses with his/her finger.
Grade 4 - these cannot be pushed back in and need to be treated by a doctor. They are large and stay outside the anus all the time.
External hemorrhoids -

called perianal hematoma. These are small lumps that are located on the outside edge of the anus. They are extremely itchy and can be painful if a blood clot forms inside (thrombosed external hemorrhoid). Thrombosed external hemorrhoid requires medical treatment straight away.

What are the signs and symptoms of piles?

A symptom is something the patient feels and describes, such as a pain, while a sign is something everybody can see, such as a rash.

A hard lump may be felt around the anus. It consists of coagulated blood, called a thrombosed external hemorrhoid. This can be extremely painful.
After going to the toilet, a feeling that the bowels are still full.
Bright red blood after a bowel movement.
Itchiness in the anus area.
Mucus discharge when emptying the bowels.
Pain while defecating.
The anus area may be red and sore.
When passing a stool the person may strain excessively.
Why do piles occur?

The blood vessels around the anus and in the rectum will stretch under pressure and may swell or bulge. Inflamed veins (hemorrhoids) can develop when pressure increases in the lower rectum. This may be due to:

Chronic constipation
Chronic diarrhoea
Lifting heavy weights.11
Pregnancy.12
Straining when passing a stool.13
The tendency to develop hemorrhoids may also be inherited. The risk of developing piles grows with age

What are the treatment options for piles?

In the majority of cases, piles resolve on their own without the need for any treatment. Treatments can help significantly reduce the discomfort and itching that many patients experience.

A good doctor will initially recommend some lifestyle changes.

Diet - piles can be caused by too much straining when doing bowel movements, which is the result of constipation. A change in diet can help keep the stools regular and soft. This involves eating more fiber, such as fruit and vegetables, or even switching your cereal breakfast to bran.16

Water is the best drink, and the patient may be advised to increase his/her water consumption. Some experts say too much caffeine is not good.

Body weight - if the patient is obese, losing weight may help reduce the incidence and severity of hemorrhoids.

Simple things you can do yourself to help prevent piles:

Try not to strain when you go to the toilet.
Avoid laxatives.
Exercise.
HOMEOPATHY TREATMENT FOR PILES

it is treated  in homeopathy by constitutional medications which relives ressure and which initiates free stools. Thus, constitutional homeopathic medications restore your body s normal functions.

Hemorrhoids - Everything You Should Know About It!

Piles can be really painful and embarrassing but fairly common at the same time. it should not be taken as a social stigma as with awareness and proper treatment, the condition can be managed and treated well. If overlooked then it may lead to many complications which are difficult to manage.

In Ayurveda, a complete cure to haemorrhoids is possible, so seeking medical attention can be of great help to relieve you from this condition. Piles, also known as Haemorrhoids is a condition in which veins at the lower end of rectum get inflamed and enlarged. When pressure on the rectum and anus increases, it causes added pressure to these veins, resulting in formation of haemorrhoids. They may burst and cause rectal bleeding. Haemorrhoids are most commonly found in middle-aged and old people while also in people who suffer from regular constipation. 

Types of Piles -

Haemorrhoids are of two kinds, internal and external based on their location. Internal haemorrhoids are located in the inner lining of the anal tract. These veins within the rectum are concealed and cannot be felt so they are painless but when ruptured can lead to bleeding. External haemorrhoids are located on the outer surface of the rectum and can be seen, felt and when inflamed become painful. These are the more troubling type of piles. 

Causes and Symptoms of Piles 

Piles are caused mostly by constipation, but other causes may include untreated gastric conditions such as dysentery, sedentary lifestyle, obesity, genetic constitution and weight of increasing uterus during pregnancy. 
If you are experiencing bleeding in anal region during defecation without any pain; you are suffering from 1st stage of Piles. If problem is not treated at this stage; Pile masses start progressing. 
In starting, Pile mass come out during passing stool and go inside by itself (2nd stage). Later on these pile masses need to be reduced manually. If still Piles is not treated; Pile mass comes out again even after manual reduction while coughing, sneezing etc. (3rd stage). While piles may be an embarrassing issue to talk about, it should not be ignored either. It can be easily dealt with simple ways, and in most cases, all it takes is some lifestyle changes to get rid of the problem. 
However, if left untreated, there could lead to severe complications. Some of them have been listed below. 

Bleeding: In patients who have chronic bleeding, it could lead to chronic blood loss. Patient can develop anaemia because of this regular bleeding. 
Mass protruding out from anal opening: If Piles are not treated at 1st stage; it can lead to development of pile mass which protrudes out from anal opening while passing stool and go inside. In later stages; this pile mass come out even on sneezing and coughing. At this stage they are prone to get infected as most of the time Piles are outside the anal opening. 
Hygiene issues: The itching and discharges can lead to the patient having poor hygiene around the anal area. This further can lead to complications like infections. The area around the anus also becomes difficult to clean if the masses are more in number and size. 
Surgical correction may be attempted in severe cases, but this also can lead complications in some people. These include: 
Excessive bleeding which does not stop after the surgery. 
Postsurgical infection 
Anal fistula, which is a connection between the area of piles and the anal canal. 
Damage to sphincter muscles leads to faecal incontinence, which is a loss of control over passing stool.
Ayurveda Treatment of Piles 
Ayurveda has various approaches to the treatment of piles. Piles can be treated by diet, lifestyle, herbal supplements, Ayurvedic medication, and exercise. Ensuring good digestive health helps with piles if constipation is the cause of it. 

Vegetables such as onion, bitter gourd, radish, and turnip are high on roughage and are a must to add to your diet as well. 
Other than the diet you need to introduce specific lifestyle changes such as a colon cleanse every once in a while, and regular exercise. 
Increase water intake, up to 8 glasses per day. 
Keep away from processed foods 
Increase consumption of fruits and vegetables 
Do not sit for more than an hour in one position 
Stick to stool timings and develop good stool habits 
Do not suppress the urge to pass stools for too long and for too often 
So, follow the instructions of your Ayurveda doctor to embark on the road to cure. If these measurements are not successful; kshar karma or Ksharsutra ligation of Pile mass is necessary. In the ligation procedure; Ksharsutra   medicated thread is legated at the root of Pile mass. 

Medicine released from Ksharsutra blocks the blood supply to pile mass and Pile mass sheds off in 7   10 days. Ksharsutra ligation is a para surgical procedure done under local anaesthesia. No hospitalization or bed rest is necessary in Ksharsutra Treatment for Piles. Daily routine activities along with office work can be done during Ksharsutra Treatment. So Piles can be treated completely in all its stages with Ayurvedic treatment. However, this procedure is to be performed only by a surgical specialist of Ayurveda..

Painful Piles - Why You Should Not Ignore Hemorrhoids

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