Abdominal pain can be triggered by a number of factors. Sometimes, it's mild enough to be overlooked while at others, the pain can be debilitating. Most abdominal problems start with the same symptoms and hence the cause of this pain can be a little difficult to pin point. In many cases, the location of the pain can help understand the factors that are triggering it.

Generalized pain can be simply be triggered by indigestion. On the other hand, it could also be a symptom of a number of illnesses like irritable bowel syndrome, appendicitis, viral gastroenteritis and intestinal obstructions etc. However, the former are more common. This type of pain resolves itself without medical intervention.

In other cases, abdominal pain can be localized to the upper or lower abdomen on the right or left side or in the centre of the abdomen. This sort of pain is usually sporadic and comes and goes with great intensity. In most cases, this sort of pain is a symptom of a serious problem and should not be ignored. One of the most common examples of localized abdominal pain is the pain caused by appendicitis in its later stages. Severe pain that is located just above the centre of the belly button could be a sign of pancreatitis. A burning sensation and severe cramps in the center of the stomach could point towards stomach ulcers that could cause perforations if left untreated. Other causes for this type of pain include endometriosis, ovarian cysts, angina, kidney infections and a spleen infection.

Mild stomach pain whether localized or general can be relieved using home remedies and does not often require medication. However, if the pain is severe or if it comes on suddenly, you must immediately consult a doctor. Another reason to consult a doctor is if the pain persists for more than 24 hours. If the pain is accompanied by black or bloody stools or vomiting and nausea, do not ignore it. Black stools are often an indicator of the presence of blood in the digestive tract. Abdominal pain that worsens with movement or is tender to touch is also something that should be shown to a doctor. Other reasons to consult a doctor are abdominal pain with persistent vomiting following meals and unexplained weight loss and a loss of appetite.

The bottom line is, that when it comes to abdominal pain, it's better to consult a doctor and be told that there's nothing to worry about rather than self medicate and wait for it to worsen.

Abdominal Pain & When To Consult A Doctor

Ulcerative colitis is a chronic inflammatory condition whereby, tiny abscesses and ulcers are formed on the inner lining of the large intestine, or on the colon or rectum. These ulcers may burst frequently resulting in diarrhea and bloody stools. This disease may also be responsible for causing anemia as well as harsh abdominal pain.

Ulcerative colitis normally alternate periodically from flaring up to receding quickly. These periods of remission can either last for weeks or maybe, even for years at a stretch. They are, however, not permanent and although the disease may seem to have disappeared completely, it can soon show up again in no time. Usually beginning in the rectum, it can, by and by, spread rapidly to other parts of the colon. If it is, however, limited only to the rectum, then it is more commonly referred to as ulcerative proctitis.

Surgery is generally obligatory and mandatory when it comes to treating ulcerative colitis. If surgery is not performed, you may suffer from long-lasting side effects, including cancer and colon rupture. Here are the different types of surgery that you may undergo:

1. Colectomy: This is done when the entire colon needs to be removed and is usually performed to eliminate the perils of acquiring colon cancer.

2. Proctocolectomy: This concerns the total removal of both colon and rectum and is usually the standard procedure when dealing with ulcerative colitis.

3. Ileal Pouch Anal Anastomosis: If the treatment does not require a permanent stoma, and if you can still manage to let out stool from your anus, then this surgery, also called restorative proctocolectomy would be most appropriate.

Here, both colon and rectum are removed, but at the same time, the small intestine is utilized to form an internal reservoir, called a J-pouch, which is linked to the anus and can hereafter serve as your new rectum.

Types Of Ulcerative Colitis Surgery

The uneasy feeling in our abdomen, feeling inflated or growing in size is a common problem faced by people anywhere in the world. Medical professionals refer to this as  bloating,' i.e., a feeling of a full, tight, abdomen. The abdominal system includes organs such as the stomach, liver, pancreas, gallbladder, intestines, etc. It is when the gastrointestinal tract is filled with gas, pain due to bloating arises. Such bloating brings pain in different parts of the body (which would be continuously shifting) along with a feeling of a swollen tummy (though not physically swollen actually). 

This article shares the common causes of bloating and tries to help its readers find a solution.

Overeating: Many of us can recall exactly how many times we have ignored the level of consumption in a particular meal and then felt an irritable stomach pain. Overeating refers to the consumption of food more than the amount of energy an organism can produce in one process. Along with weight gain and obesity, bloating might also result from overeating. The fact is, overeating is completely voluntary, and hence, a person can choose to avoid over-consumption of food and thereby, the pain from bloating.
Lactose intolerance: The terminology might not be familiar, yet over 65% of the global population is lactose intolerant. It varies with age and gender, and anyone has either of the four different types of lactose intolerance   primary, secondary, developmental, and congenital. Though lactose intolerance does not cause damage to the gastrointestinal system, inability to digest thesugar in milk (lactose) can cause abdominal pain, bloating, diarrhea, etc.
Irritable bowel syndrome: People with irritable bowel syndrome (IBS) are yet to know what caused it in the first place. Though the exact causes of IBS are yet to be known, many doctors blame the miscommunication between the brain and the intestinal tract of a person which causes abnormal expansion and contraction of the intestinal walls. This results in irritable pain and abnormal bowel movement. 
Two cases might arise due to IBS

The abnormal movement of the intestinal walls might speed up the excretion process and hence, the passage of stool   diarrhea.
The spasms might slow down the excretion process resulting in constipation.
Irritable bowel syndrome (IBS) can occur over the years, and the absolute cure is yet to be found. Additional symptoms of IBS are   bloating and excess gas, pain in the lower belly, mucus in stools, etc.

Solutions to bloating
Bloating can be easily taken care of if the person is ready to implement certain dietary changes. For example, avoiding gassy foods such as cabbage, broccoli, lettuce, reduces the formation of gas in the stomach. Limiting the amount of fatty foods and foods with high fiber content, quitting milk products (if lactose intolerant), can help a lot. A diet plan, getting active and regularly exercising can help to eliminate the problem of gas and bloating.

Conclusion
Even though bloating can be uncomfortable and painful at times, it is not a cause for concern. Bloating can be remedied quite easily with a proper diet chart and routine exercise.

Bloating - Why It Happens?

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?

An anorectal abscess is a painful swelling near the anus or in the buttock. The swelling contains pus. 60% anorectal abscesses are superficial and resulting from infection in small anal glands present in between internal and external anal sphincters (intersphincteric space). They are known as a perianal abscess. 30% of anorectal abscesses are deep-seated and results in systemic infection. They are call Ischiorectal abscess. Submucous abscess, pelvirectal abscess and pilonidal abscess developed from versatile cause are comparatively less common. Inadequate and improper management of anorectal abscess may potentially cause complication like fistula formation.


Fast facts on Anorectal abscess-

* Anorectal abscess should be drained at the earliest.
* Conservative medical management almost invariably invites complication like fistula formation.
* Surgical drainage of pus reduces the chance of fistula formation by 50%.


What causes Anorectal abscess?

* Blocked and infected anal glands (cryptoglandular infection).
* Untreated anal fissure that becomes infected.
* Sexually transmitted infections.
* Penetrating injury of the perianal or buttock region.
* Crohn s disease.
* Colon cancer.
* Tuberculosis.



What are the symptoms of Anorectal abscess?

Superficial abscess-

* Constant and throbbing pain that worsens on sitting down.
* Swelling, redness and tenderness of the skin around the anus.
* Discharge of pus.
* Pain is often associated with bowel movement.

Deep abscess-

* All or some of the symptoms of a superficial abscess.
* Fever with chill and rigor.
* General weakness.
* Sometimes fever is the only symptom of the deep abscess.

The anorectal abscess should preferably be explored under general or spinal anesthesia. Medical management often fails and subsequently fistula is formed.

Anorectal Abscess - Know In Detail About It!

Types of abdominal and pelvic surgical incision

At the time of a surgical procedure, while making an incision a doctor has to take care of a number of factors before making an incision. Considering a number of factors, different types of incisions have come into fore, such as 

Midline Incision: It s the commonest incision and is done along the linea alba (fibrous structure running through the mid of the abdomen). These are preferred, especially in diagnostic laparotomy as it permits a wide access to the abdomen.
Pfannenstiel Incision: It is transverse in nature, extending from the umbilicus to the pubic-symphysis. It is generally employed for abdominal hysterectomy of benign nature and caesarean section.
Chevron Incision: It is an incision under the rib-cage and is done on the abdomen. It starts from beneath the ribs on the right abdomen and extends till the other mid axillary line. Thus, the entire abdominal width is incised for proper reach into the liver. The incision can be up to 2 feet.
Kustner Incision: It is transverse in nature and extends from the symphysis pubis till the iliac spine (anterior). This type of incision takes time to perform. A Pfannenstiel incision offers more exposure than a Kustner incision.
Lanz Incision: It is a variation of the more common mcburney-incision (also known as Gridiron s incision). It is generally used for open appendectomies. There are quite a few variations for this type of an incision.
Gridiron s incision: It is done for appendectomies. It is an oblique short incision which is done in the lower right quadrant in the abdomen.
Kocher s Incision: It is oblique in nature, extending from the abdominal upper right quadrant and is generally used for performing an open cholecystectomy. Gallbladder, biliary tract and certain liver operations can be suited for a Kocher s incision. This however is different from the same named incision used for the thyroid gland surgery.
Cherney Incision: It is transverse in nature. It allows a great range of exposure for the pelvic sidewall. It is less painful than a midline incision. It allows for the greatest pelvic exposure and hence is a widely preferred and practiced incision.

8 Types Abdominal and Pelvic Surgical Incisions

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