Chronic Diarrhoea is a condition that results in watery or loose stools. While most diarrhoea subsides within a few days time, the chronic ones persist up to a couple of weeks. Some common symptoms that can help to identify chronic diarrhoea include bloating, nausea, fever, blood in the stool, abdominal cramps etc. Here is a brief look at the possible causes of chronic diarrhoea:

What are the possible causes of chronic diarrhoea?
Parasites and bacteria: Parasites and bacteria are often transmitted from contaminated food and water. Certain parasites such as the cryptosporidium and Giardia lamblia can lead to chronic diarrhoea. Some common bacteria include Escherichia coli, Campylobacter, Shigella, and Salmonella. In the more developed countries, diarrhoea is often referred to as the traveller s syndrome. Diarrhoea can also result from a course of antibiotics due to an infection from Clostridium difficile.

Viruses: Some of the common viruses that can lead to chronic diarrhoea include viral hepatitis, Norwalk virus, and cytomegalovirus. A certain virus known as the Rotavirus can lead to an acute childhood diarrhoea.
Medication: Certain medication is known to be the culprit when it comes to causing diarrhoea. Antibiotics, for instance, tend to equally destroy both the good and the bad bacteria thereby disturbing the bacterial balance of the intestine leading to chronic diarrhoea. Certain other drugs related to cancer, antacids containing magnesium etc can also lead to chronic diarrhoea.
Artificial Sweeteners: Certain artificial sweeteners are known to be causing chronic diarrhoea. Compounds such as Mannitol, Fructose etc found in certain sugar-free products or chewing gum can lead to chronic diarrhoea in otherwise healthy people. It is, therefore, advised not to consume too many artificial sweeteners in excess at one go.
Intolerance of lactose: Lactose is a type of sugar that is mostly found in dairy products. People who find it difficult digesting this compound often tend to suffer from diarrhoea when they consume dairy products. Our body produces an enzyme to digest lactose. However, this enzyme tends to rapidly feds away from the body with age. Lesser the amount of this enzyme, greater is the chance of lactose intolerance leading to an increased risk of chronic diarrhoea.
Surgery: There are surgeries that can begin the onset of chronic diarrhoea. Certain procedures such as the gallbladder removal surgery and abdominal surgery run a high risk of chronic diarrhoea.
Fructose: For people who find it hard to digest fructose can suffer from chronic diarrhoea. Fructose is a naturally occurring sweetener found in honey, fruits etc and is often added to beverages to enhance the taste.
Certain digestive disorders: Certain other situations such as celiac disease, microscopic colitis, Crohn s disease, ulcerative colitis irritable bowel syndrome etc can lead to chronic diarrhoea. 

Chronic Diarrhoea - What Causes It?

Liver disorders are very common. Gastroenterologists trained in liver diseases are known as Hepatologists.Symptoms of liver disease include jaundice, vomitting of blood(Hemetemesis), bleeding in the motions(also known as Melena or hematochezia),altered sensorium known as Hepatic encephalopathy(HE), Renal failure also known as Hepatorenal syndrome(HRS), Breathlessness (due to Hepatopulmonary syndrome and portopulmonary hypertension).

Let s understand the liver disease point by point: 

1. Hepatitis B: Hepatitis B is a virus which is usually acquired in four ways. Unprotected sexual intercourse with the infected partner, from infected to the child, infected needles, infected blood. It takes many years for the hepatitis B virus to cause liver damage. Once the liver is damaged it is called Cirrhosis or chronic liver disease. When liver is more then 80 percent damage, it causes blood vomiting also known as hematemesis, Ascites(water in the stomach), Jaundice, HE, HRS etc. Treatment depends on virus count which is calculated by HBV DNA PCR and other lab parameters. Once the treatment starts monitoring of viral count is done to document the effectiveness of the treatment. All the family members and sexual partners must get HbsAg screening done to detect early silent infection. All those who test negative, Hepatitis vaccination should be done, by three injections which provide them with 100% protection against the HBV infection.

2. Hepatitis C: Hepatitis C is a virus which is acquired by injection drug abuse and infected needles and blood. Transmission by unprotected sexual intercourse is possible but chances are very low. Hepatitis C virus damages the liver slowly and takes years before clinical symptoms of liver failure appear. Once the liver is damaged it is called Cirrhosis or chronic liver disease. When the liver is more than 80 percent damage, it causes blood vomiting also known as hematemesis, Ascites(water in the stomach), Jaundice, HE, HRS etc. All hepatitis C virus infected patients must be treated irrespective of virus count. Baseline virus count by HCV RNA  is done to measure the effectiveness of the treatment. HCV Genotype is done for patients with cirrhosis. Vaccination is not available for hepatitis C but newer medicines(Direct acting antivirals DAA) for Hepatitis C can cure it with more than 95% certainty.

3. Acute viral Hepatitis: Sudden infection in the liver can be due to multiple causes but commonly is due to Hepatitis A and Hepatitis E, which are caused due to eating or drinking contaminated food and water. Rarely Hepatitis B and Hepatitis C can cause Acute hepatitis including Acute liver failure. Acute hepatitis presents with Jaundice, loss of appetite, generalised fatigue, vomiting and abdominal pain.  Patients are usually treated on an outpatient basis but if they have severe vomiting, abdominal pain or altered sensorium, they are admitted for inpatient care and monitoring. Drugs or complementary and alternative medicines (CAM) such as herbal or bodybuilding protein supplements which contain steroids and heavy metals can cause acute hepatitis.

4. Liver transplant: Removing the damaged liver and to put a new liver in the patients is called Liver transplant. Liver transplant is major surgery and costs around 20 to 30 Lacs. Indications of liver transplant are an acute liver failure due to hepatitis viruses such as hepatitis A, Hepatitis B, Hepatitis C and Hepatitis E, decompensated cirrhosis due to any cause including chronic hepatitis B and C, Drug-induced liver failure such antitubercular drugs(ATT). The donor for liver transplant is either a close relative (Living donor liver transplant LDLT) or a brain dead donor (deceased donor liver transplant DDLT).

5. Chronic liver disease or Cirrhosis: It is the end result of slow damage to the liver, where many liver cells are damaged and replaced by fibrosis. Apart from viruses such as Hepatitis B and Hepatitis C, Alcohol is one of the most common causes of cirrhosis.

Drinking alcohol for years together causes irreversible liver damage causing cirrhosis. Alcohol can cause acute severe hepatitis, acute liver failure and chronic liver disease.  Patients with suspected heavy alcohol drink must-visit Hepatologist (Liver doctor ) for proper diagnosis of stage of liver damage and deaddiction programme. USG Abdomen, blood tests, endoscopy and Fibroscan is usually done to know the liver health.

Fatty liver is also known as non-alcohol fatty liver disease(NAFLD) is a lifestyle disorder due to lack of exercise, high fat diet, obesity and due to drugs. Fatty liver causes silent liver damage and if not recognised in time can cause irreversible liver damage and cirrhosis. The evaluation includes Liver function tests, Ultrasound abdomen, Fibroscan. Treatment includes daily moderate-intensity aerobic exercise, drinking coffee and a low-fat diet. Few medicines are available which help in the reversal of fatty liver.

What Should You Know About Liver Disorders?

The area in and around anal region is some time affected with pain swelling and pus or watery discharges. This abnormal presentation may be due to anal fistula. It is characterized by a nodular swelling in or around anal region with occasional pain and watery or blood mixed pus discharge. The symptoms might be mild but as the time passes the fistulous tract may become deep and develop multiple branches with multiple openings. This makes the treatment more difficult. Therefore it is always advisable as soon as this condition is diagnosed it should be treated promptly to avoid further complications. 

Causes: The causes of anal fistula are many. The major reason is the formation of pus. Incompletely cured abscess, microbial infection, ulcers, inflammation of anus and the region around it, and complications that arise out of a surgery can cause the anal fistula. The individuals suffering with diabetes, ulcerative colitis, malignancies and also individuals undergoing chemo or radiotherapy or having some other immune compromised conditions are prone to develop anal fistula. 

Treatment: Practically it has been noticed that any amount of oral medications either from allopathy/ homeopathy or Ayurveda is not of much help. In allopathy the surgeons usually advice Fistulectomy i.e. complete excision of fistulous tract or VAAFT   Video Assisted Anal Fistula Treatment. However in both these case a fairly high incidence of recurrence has been noticed. In Ayurvedic surgery; Fistula has been categorized among eight diseases which are difficult to cure. A highly specific Ksharsutra procedure has been advised in Ayurvedic surgery to treat this problem. Subsequently, efficacy of this Ksharsutra therapy was compared with surgery in 1991. This clinical trial was conducted by Indian Council of Medical research at AIIMS New Delhi and PGI Chandigarh. They have clearly reported that Ksharsutra treatment is more convenient and more effective as compared to surgery in the patients of Anal fistula. The recent concept of Graded Ksharsutra has further improved the efficacy of this therapy. Facility of Graded KsharsutraTM is available only at Sushruta Ano rectal Institute Rohini; New Delhi. 

Ksharsutra Therapy: It is a highly specific and most effective amongst all available treatments for the patients of Anal Fistula. In this treatment; the first step consists of proper identification of fistulous tract with respect to depth, direction and branching pattern. This is usually achieved by careful probing or taking the help of MRI Fistulogram, Ultrasound etc. One the tract has been defined Ksharsutra is placed in the tract with the help of malleable probes under local anesthesia. Since there is no injury to the soft tissue hence no pain or bleeding is expected after this treatment. Patient can continue his routine activities as usual from the very first day. The Ksharsutra   medicated thread is changed at weekly interval. Usually the Fistula heals @ 0.5 to 1 cm per sitting. Therefore the anal fistula which is 4-6 cm long they usually heal in 8-10 sittings. After Ksharsutra Treatment the sphincter control remains normal and the fistula heals completely.

Anal Fistula - How Can It Be Treated Using Ayurveda? 

Fatty liver or fatty liver disease refers to the accumulation of fat cells in the liver. The liver typically contains some amount of fat. The liver tends to convert usual food into protein, fats and sugar. Some fat in your liver is normal. However, in case that it makes up more than five to ten percent of the organ's weight, you may have a fatty liver.

The basic fatty liver is otherwise called steatosis. Over the top fat in the liver can cause the liver to get swollen and lead to liver damage. Fatty liver aggravation can be brought on by excessive alcohol abuse in which case the condition is known as alcoholic steatohepatitis. However, it can also be brought about by obesity and is then known as nonalcoholic steatohepatitis or NASH. As the ailment advances, liver irritation can prompt cirrhosis and liver failure.

Ayurveda is an old Indian medical system that makes use of herbs existing in nature to create homegrown cures using the intrinsic power present as a part of these herbs. Ayurveda uses the intrinsic power of normal herbs to bring results when it comes to curing various ailments. The herbs are natural and are hundred percent safe. They enhance the body s digestive system and help recover from various diseases and

disorders. The herbs enhance the immune system and strengthen the body in a healthy way.

Here are a few methods to treat fatty liver with Ayurveda:

Terminalia (Arjuna): The herbs of Arjuna have been used since ancient times for its radiant properties. It has unique healing effects on the heart as it tones the cardiovascular muscle and in this way protects it as well. It does so by reinforcing the cardiovascular muscles.

Boerhavia Diffusa (Punarnava): Punarnava is a brilliant Ayurvedic herb with diuretic properties and builds the renal blood stream. It has astringent, sharp, mitigating and calming properties.

Phyllanthus Niruri (Bhumi Amla): It is an exceptionally effective herb appropriate for the management of Hepatitis B and different types of Hepatitis. It has been utilised as a soothing agent for the kidney and liver damage. It is fit for taking out poisons and toxins from the body.

Andrographis (Echinacea): Andrographis is well known for its superb effects on the immune system. It boosts the immunity of the body. It has incredible control over the inflammatory responses in the body. Echinacea is found to have antimicrobial properties that function admirably in infective conditions. It gets rid of distinctive types of diseases and infections.

Cinnamomum Zeylanica(Dalchini): It is a typical Indian herb utilised mostly in each Indian kitchen. Its regular use reduces breathlessness and reinforces the heart muscles, vascular framework and acts as an antioxidant. Cinnamon  is also known to control nausea, sickness and diarrhoea.\

Fatty Liver - Effective Ayurvedic Ways to Treat it

Common Signs of Diarrhea

Diarrhea is a very common condition, which is associated with the passage of the ingested fluids and foods through your colon more frequently than usual or in huge amounts. This condition is mostly caused by the action of viruses, parasites, bacteria, medications like antibiotics, certain digestive disorders, abdominal surgery, lactose intolerance, and consumption of an excessive amount of alcohol etc. Here are some of the common symptoms, which indicate that you are suffering from diarrhea:

Passing watery and loose stools
Frequent bowel movements
Pain or cramps in the abdomen
Feeling of nausea
Vomiting
Bloating in the stomach

If you are suffering from a more serious form of diarrhea, you might also experience symptoms like:

Presence of mucus, blood and traces of undigested food in your stool
Fever

Diarrhea mostly gets cured even without consuming any medicines within a couple of days. However, you need to consult a doctor and get proper treatment for diarrhea in the following cases:

If you are continuously experiencing the condition for more than two days
Your stools contain blood or are black
Severe pain in the rectum or abdomen is bothering you
You experience signs of dehydration like excessive thirst, weakness, dizziness, dry mouth, urine of dark color or reduced frequency and amount of urination
Your body temperature exceeds 102 F (39 C)



Common Signs of Diarrhea

Infants often suffer from certain diseases which need proper care and timely treatment for quick recovery. At times, it can be difficult to communicate with an infant and understand his/her needs and problems but with a close observation you will surely be able to detect any alteration in the baby's behavior and sense it when he/she is ill. Here are some of the most common diseases infants are susceptible to and what you can do about them.

1. Abdominal distension
It is normal for a baby's belly to stick out after he/she has been fed, but if between feedings there is swelling in the abdomen or it feels hard, it can be an indication of a problem. If this symptom is accompanied by vomiting and absence of bowel movements for more than two days, your baby may be suffering from abdominal distention. This condition may have been caused by swallowing of extra air by the baby while crying or feeding. In such a situation, a pediatrician should be consulted for proper diagnosis and treatment.

2. Jaundice
It is common among newborns to develop mild forms of jaundice as the undeveloped liver is often not able to eliminate the chemical bilirubin from the blood. Mostly, this situation proves to be harmless till the level of bilirubin reaches a certain limit. After that, the disease must be properly treated to avoid damage to the baby's brain or nervous system.

3. Rsv infection
Rsv or respiratory syncytial virus is responsible for causing respiratory problems among infants. Rsv infection usually affects the bronchial passage and shows symptoms like cough, runny nose and mild fever which may even lead to bronchitis. Moreover, this infection may also develop into viral pneumonia, which makes it more important to consult a pediatrician if your baby shows any of the above symptoms.

4. Diarrhea
Infants are susceptible to watery bowel movements due to the action of virus, allergens, specific medications or bacteria. If you observe that your baby is passing stools more often than usual and it is watery, then it may be a case of diarrhea. Sometimes, these symptoms are accompanied by high fever, abdominal pain, lethargy, vomiting, dry eyes and mouth etc. In this situation you should consult your pediatrician and focus on replacing the fluids your baby has lost, to prevent dehydration.

4 Common Diseases that Babies are Susceptible To

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