Crohn's Disease is a medical condition that falls under the category of Inflammatory Bowel Disease. Crohn's disease triggers inflammation of the digestive tract resulting in ulcerations and sores, mostly affecting people between 17-30 years (people of other age groups can also be affected). The inflammatory disease is a chronic illness that gives rise to a host of complications such as frequent and chronic diarrhea, fever, rapid weight loss, abdominal pain, to name a few.
Unfortunately, there is no permanent treatment available for Crohn's Disease. However, effective remedies and treatments are available to reduce and manage the symptoms and complications associated with Crohn's Disease. Many people dealing with Crohn's Disease have benefitted immensely from surgery.

When surgery is recommended for Crohn's Disease?

A surgery becomes essential when the medicines and other nonsurgical treatments fail to control or manage the symptoms and complications triggered by Crohn's Disease, some of which include

Severe intestinal inflammation followed by uncontrolled bleeding
There is a bowel abscess or a perforation
Toxic Megacolon (a fatal condition whereby the large intestine swells up and also becomes dilated due to the inflammation that affects the intestinal walls)
Fistula
An intestinal blockage or narrowing of the intestinal
The surgery for a Crohn's Disease can be of different types depending on the part of the digestive tract affected.

Colectomy: This is mainly carried out in the case of the Crohn's Disease causing such extensive damage to the colon that it needs to be surgically removed. Following the removal of the colon, the small intestine may be connected to the rectum to ensure that the bowel movement is not affected.
Bowel Resection: A bowel resection is usually performed to treat a fistula or to get rid of the diseased and inflamed portion of the intestine to avoid further aggravation.
Proctocolectomy (Ileostomy): This surgery is performed to get rid of both the rectum and the colon affected extensively by Crohn's Disease. Here also, post removal of the organs, the surgeon connects the small intestine (end part or the ileum) to the stroma or a small opening in the abdomen. This rearrangement is done to ensure that the wastes from the small intestine get eliminated.
Stricturoplasty: This surgery goes a long way to open up the areas of the small intestine that have narrowed down due to Crohn's Disease.
Risks associated with the surgery
Every surgery comes with their share of side-effects and risks. In the case of Crohn's Disease, the surgeries can give rise to complications such as

Pain, swelling, bruising is common.
There may be Infection at the site of the incision.
Scarring at the incision site.
There can be a blockage of the bowel (temporary or short-term)
Surgical removal of the diseased part of the small intestine can trigger inadequate absorption of the vital nutrients (Short-Gut Syndrome).

Crohn's Disease - When Should You Go For Surgery?

Anal Fistula is a tunnel like communication structure between anal canal and outer skin. There are certain glands in anus whose secretions keep the anal passage lubricated. If due to any reason infectious agent invades these glands abscess formation occurs which subsequently spreads towards the skin and bursts outside forming an external opening.

So Anal Fistula presents itself as a nodular swelling in area surrounding anal opening. Intermittent pus discharge is seen from this swelling. When pus has accumulated there will be swelling and pain which subsides once the pus has been discharged and this cycle goes on.

Anal Fistula Treatment:

Anal Fistula cannot be treated by oral medicines only - Homeopathic/ Allopathic or Ayurvedic whatever it may be. Continuing oral medicines in hope for fistula treatment only worsens the problem. Different surgical options have been tried to treat Anal Fistula like Fistulectomy/ VAAFT/ Laser/ LIFT etc. but not satisfactory results have been found. A high incidence of recurrence around 20-25 % has been observed with these procedures. 

Besides this other complications like stool incontinence etc. are also seen if there is some damage to sphincter muscles. However Anal Fistula can be completely treated by Graded KsharsutraTM Treatment. Clinical trials conducted by Indian Council of Medical Research (ICMR) at AIIMS new Delhi; PGI Chandigarh and other premier institutes of medical sciences; have proved that Ksharsutra treatment is more convenient and more effective than Surgery in patients suffering from Anal Fistula.

In this treatment; first of all Fistula tract is defined with respect to depth, direction and branching pattern by careful manual probing and MRI Fistulogram. Once the Fistula tract has been defined properly; Graded KsharsutraTM - a specialized medicated thread is placed in Fistula tract. Medicine released from KsharsutraTM debrides the Fistula tract and induces healing. This medicine works for 5-7 days so old Ksharsutra needs to be replaced by a new thread at week or 10 days interval.

No. of Ksharsutra changes required for complete healing of Fistula depends on length of Fistulous tract. It has been observed that a Fistula tract of 3 cm length usually requires 4-5 Graded KsharsutraTM sittings at weekly intervals for complete healing. Thus with this recent concept of Graded Ksharsutra treatment of Anal Fistula has become more easy and more effective.

Anal Fistula - How Non Surgical Treatment Is Better Than VAAFT/Surgery?

A stressful event like speaking in public, going to a job interview can give you butterflies in your stomach that may literally make you want to run to the bathroom. Stress affects every aspect of our lives including digestion. This includes indigestion, heartburn and irritable bowel syndrome. When put in a stressful situation, the body releases hormones known as corticotropin-releasing hormone or CRH. This, in turn, signals the adrenal gland to pump out adrenaline and steroids that help with the body's flight or fight response. Here are a few ways stress affects the gastrointestinal system.Here are a few ways stress affects the gastrointestinal system.

Stress kills appetite: Stress eating is a real problem that results from the contradictory reactions of hormones. The hormones released by stress kill a person's appetite, but at the same time, the steroids released by these hormones make the person crave unhealthy foods like ice-cream, chocolate or potato chips. These foods aren't easy to digest and can cause indigestion, gas buildup and heart burn.
Stress leads to ulcers: Ulcers are caused by bacteria, but stress strengthens the infection and disturbs the balance of hydrochloric acid and protective secretions in the stomach. This increases the risk of ulcer formation in the stomach. Once the ulcers are present in the stomach, stress can worsen the symptoms.
Stress alters the gastrointestinal pathophysiology: Stress can cause changes in gastrointestinal secretions and reduce the amount of oxygen available to the digestive system. It also impairs gastroduodenal motility and amount of enzymes being secreted by the pancreas. Additionally, it interferes with the passage of food through the intestinal tract and alters colonic motility. Stress also affects the absorption of nutrients from the stomach and increases the blood flow to the digestive system by four times the normal amount thus decreasing metabolism rates.
Stress affects irritable bowel syndrome: Stress in itself does not cause irritable bowel syndrome but can worsen the situation. This is because stress can make the colon contract and cause abdominal pain. These contractions are usually uncoordinated and can lead to constipation. It also makes the body more sensitive to pain thus increasing discomfort.
Stress lowers immunity: A large part of the immune system is housed in the gut. Stress reduces the secretion of enzymes in the gut and leaves the digestive system vulnerable to bacterial infections. By weakening the immune system in the gut, stress also increases the risk of suffering from infections in other parts of the body.

Stress & Its Effects on Gastroenterology

An anorectal condition can be difficult to live with and often remains undiagnosed, due to it being perceived as an embarrassing ailment. Fistulas are conditions where two body parts, that are not meant to be connected, become linked as part of the disorder. Rectal fistulas can be painful and standard treatments are available, which can cure the condition. However, these treatments come with serious side effects.

Most people prefer Ayurvedic fistula treatments over the conventional medications for the lack of side effects as such. Ksar sutra is one such branch of treatment in Ayurveda, which has shown tremendous results against fistulas. Here is a look at all that you need to know about Kshar Sutra.

What does Kshar Sutra mean?
Kshar Sutra is a form of treatment, which uses threads laced with the juices of medicinal herbs to treat rectal fistulas.  Kshar  refers to the herbs and  Sutra  stands for the thread used for the treatment. It is a minimally invasive surgical procedure with almost no side effect or danger. The Kshar Sutra form of treatment was first discovered by Sushruta, Vagbhata and Charak. In recent times, BHU s Shalya Tantra Department has once again proved its efficacy in case of rectal disorders.

How is the treatment done?
Once the thread has been coated with the medicinal herbs, the same thread needs to be inserted into the fistula in ano. The patient is anaesthetized and the thread is inserted into the fistula using a probe. The thread is then taken out from the other side and the two ends of the thread are tied together. This thread is changed after every 7 days. This thread insertion effectively cuts the tract and unhealthy tissue is removed from the region.

Why is Kshar Sutra beneficial?
Benefits for this form of treatment include-

Lower risk of anal incontinence, which may occur in case of conventional medicine and surgery.
Lower risk of the anal canal getting narrower after the treatment is completed.
Minimally invasive treatment, which is why patients can resume normal life after just 3-4 days of recovery.
Apart from the treatment, patients should also follow a diet rich in fibre, fruits and vegetables. Drinking large quantities of water will also result in a better prognosis. Lastly, engaging in daily walks will also help you deal with the condition. 

Ksharsutra in the Treatment of Fistula in Ano, Anorectal Disorders!

The abdomen houses multiple organs and pain in the abdomen could indicate a problem with any of these organs. From a medical point of view, the abdomen and associated pain can be divided into nine areas or quadrants the right, middle and left sideways and the upper, middle, and lower quadrants from top to bottom. The doctor would usually ask the patient to point to the area of the problem for instance, right lower quadrant or upper left quadrant.

With a mental mapping of the organ in each of these quadrants, the diagnosis is arrived at, with confirmation by imaging if required. Some of the most common causes for lower abdominal pain are listed below, and the kidneys are important organs in this area.

Lower left abdominal pain is caused because of the problems in the large intestine, small intestine, spleen, left kidney, ureter, ovaries, fallopian tube, urinary bladder and their associated structures.
Some of the common issues in this area could be menstrual cramps, urinary tract infections (UTIs), left kidney stones, uterine disorders, intestinal obstruction, ectopic pregnancy, constipation, colon cancers, pelvic inflammatory disorder, Crohn s disease, inguinal hernia, and a ruptured spleen.
Lower right abdominal pain can be due to appendicitis, right inguinal hernia, UTI, right kidney stones, colon cancer, menstrual cramps, uterine disorders, intestinal obstruction, ectopic pregnancy, pelvic inflammatory disorders, diverticulitis, Crohn s disease, endometriosis, and lymph node inflammation.
As is evident from this list, many of these are related to the urinary tract and kidneys. Whether it is the kidneys per se, the urinary bladder, the ureters, or the associated nerves and blood vessels, UTIs are very common. And if one of these organs is affected, then the chance of the infection spreading to the surrounding organs is very high. There is a constant flow of urine through these structures, and so the infection can pass through easily.
A person who has had kidney problems would have very characteristic symptoms. The pain would be in the lower back, on either side of the spine, depending on which side is affected. While the pain experienced due to kidney stones is acute and can be stabbing in nature, the UTI would appear in bouts. The associated symptoms should always be kept in mind when identifying and treating kidney problems.
There could be nausea, diarrhoea, blood in the urine, fever, profuse sweating and severe fever, which could help in discovering the problem.
These should not be ignored and diagnosis should be confirmed with blood tests and imaging including X-rays and CT scans. The treatment would depend on the condition, and early identification of the problem leads to better prognosis and a simpler treatment.

Lower Abdomen Pain - Can It Be A Sign Of Kidney Problem?

Cirrhosis is a severe problem of the liver, wherein the liver stops functioning properly due to long-term damage caused by its exposure to toxic substances like alcohol or viral infections. Every time the liver gets affected, it tries to repair itself through the body s natural healing process. Now, due to this continuous healing process, scar tissue gets formed. With the progress of cirrhosis, resulting in the formation of more and more scar tissue, the liver becomes unable to function properly. 

What are the symptoms of Cirrhosis?
Usually, cirrhosis doesn t have signs or symptoms till the time when extensive liver damage has occurred. In those cases, the signs and symptoms which occur include:

One could sense discolouration in the eyes and skin, giving a clear indication of jaundice.
Excess fluid might get accumulated in your abdomen, resulting in utter discomfort.
One may not feel like having any food due to loss of appetite.
You might have uneasiness and discomfort in your upper stomach, provoking you to vomit.
There can be noticeable swelling in your legs, which make it difficult for you to walk properly.
Drowsiness and slurred speech could also be associated as symptoms of cirrhosis.
There might be redness in the palms of one s hands.
So we see that there are numerous signs and symptoms which you could come across, giving a clear indication of the problem of cirrhosis.

Causes which lead to cirrhosis
There are various kinds of diseases and conditions, which can damage the liver and lead to cirrhosis. Some of the most common causes are:

Chronic alcohol abuse over a long period of time can cause severe damage to the liver, hence resulting in cirrhosis.
The virus out of chronic hepatitis B and C attacks the liver and gradually lead to the formation of scar tissue, thereby resulting in Cirrhosis.
Accumulated fat in the liver due to the intake of an unhealthy diet.
Other possible causes can include:

The genetic digestive disorder is another serious cause behind the occurrence of cirrhosis.
Autoimmune hepatitis, where liver disease is caused by one s body s immune system.
Iron is an important part of haemoglobin as it carries oxygen from our lungs to other parts of our body. The problem arises when too much iron gets accumulated in the system, which can poison organs like liver, heart and pancreas. Presence of too much iron in the liver cause cirrhosis.
Poor formation of bile ducts.
Treatment
Treatment mainly depends on the underlying cause and extent of your liver damage. Some of the treatment options which doctors would adopt are:

People should stop drinking immediately if the cirrhosis has been caused due to alcohol consumption.
As one of the reasons for cirrhosis in non-alcoholic persons is obesity, so making a conscious attempt to lose weight is must if they want to get rid of this problem. Loss of weight and keeping blood sugar under check would gradually make the liver healthy.
Damage to liver cells caused by hepatitis B or C can be healed through the specific treatment of these viruses.

Liver Cirrhosis - Possible Factors That Can Lead To It!

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