Irritable bowel syndrome which is referred to as IBS, in short, is a set of health symptoms that occur at the same time. These symptoms include abdominal pain, changes in bowel movements such as diarrhoea and constipation. You may experience these symptoms in the digestive tract without noticing any visible signs. An irritable bowel syndrome is a disorder that occurs as a result of interactions with the brain and the gut; this is related to functional gastrointestinal disorders. Therefore, irritable bowel syndrome is a type of functional gastrointestinal disorder. The problems can result in the gut-turning extremely sensitive. This alters how the muscles contract in the bowel movements. There are certain home remedies that you can adopt in order to gain some relief from irritable bowel syndrome which is as follows:

A Fiber-Rich Diet: Fiber-rich food items can provide relief from a case of constipation. But at the same time it can cause gas, and in case you are a person already suffering from gas, it will increase it. It can lead to cramping as well. Once you start having fiber-rich food items such as beans, vegetables and fruits, try to gradually increase the amount in your daily diet. If you want to avoid the discomforting feeling of bloating and gas you can take fiber supplements instead. Also, make sure that stay miles away from food items that show even the slightest chance of triggering your symptoms.
Time Matters: Skipping meals is never a good idea when it comes to your health. Also, make sure that you eat your meals at a fixed time every day. This practice will keep your bowel in proper functioning order. For patients suffering from frequent episodes of diarrhoea, eating small portions of food every few hours is a good option and for people suffering from constipation eating bigger portions of high-fiber foods will be extremely beneficial to facilitate smooth movement of the food through the intestines.
Exercise Every Day: Exercising every day is a very healthy practice that ensures a healthy mind and body. Exercising not only stimulates body functions such as contractions of the intestines but also de-stresses you and relieves you from depressive thoughts.
Include Probiotics: According to recent studies, it has been found that Probiotics can aid in providing relief from symptoms of irritable bowel syndrome (IBS). Probiotics are termed as  good bacteria  that normally reside in the intestines and can also be found in yoghurt. There are also dietary supplements available that contain a considerable amount of Probiotics.

Irritable Bowel Syndrome (IBS) - What To Expect

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?

When there is too much accumulation of fat cells in the liver, the healthy tissue gets replaced by the fat cells resulting in fatty liver. The liver colour changes to yellowish greasy one. More than half of liver related diseases are caused due to fatty liver. Some of the common symptoms of fatty liver include excessive sweating, nausea, excess abdominal fat, itchy eyes, gallstones and fatigue. Luckily, though, a fatty liver is a reversible condition. 

Here is a list of 5 effective ways to avoid fatty liver:

Cut down on carbohydrate: Too much consumption of carbohydrate can result in fatty liver. Some of the biggest culprits are white flour and sugar related products. Since, the liver converts excess carbohydrate into fat, over consumption of food items such as pasta, potatoes, rice and breakfast cereals should be checked. A diet consisting of low carbohydrate and low fat should be designed and followed for cutting down fat in the liver.
Cut down on alcohol: Chronic alcoholism is the second biggest reason of a fatty liver. Alcohol results in damage and inflammation of the liver cells, thus infiltrating a lot of fat cells into the liver. Alcohol also restricts the process of healing. Restricting alcohol is an essential towards cutting down fat in the liver. Low-fat alcohol such as red wine and brandy can be consumed twice or thrice in a week. If a person is suffering from a chronic liver condition, a doctor should be consulted before alcohol.
Protein consumption: Breakfast should have an adequate amount of protein. It balances the blood sugar level of body, helps to fight cravings and helps the liver to detoxify foreign objects. Some good sources of protein include eggs, nuts, chicken, seeds and fish. The serving size should not be more than 4-6 ounces per day. Proper intake of protein will slowly reduce fat in the liver.
Fresh fruit and vegetable: Fresh fruits and vegetables are some of the most powerful agents in cleansing liver toxins. They have the capacity to repair liver filters and remove excess fat. Even juice of vegetables fetches excellent results in getting rid of excess fats. Fruits, on the other hand, possesses vital mineral and vitamins that are used by the liver to eradicate fat cells.
Get moving: If the endeavour is to remove fat from the liver, running and daily exercise has a pivotal role in achieving it. If a person has never worked out, a good way to start is to spend half an hour in a day running and doing free hand exercise. One can also get into a gym and try extensive cardio exercises to cut down liver fat. It is not safe to perform any high-intensity training should without an expert supervision.

Fatty Liver - 5 Ways You Can Prevent It!

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

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!

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

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