Soreness or swelling that occurs on the inner lining of the stomach is commonly referred to as Gastritis. The main characteristics of this condition include severe stomach pain, constipation, blood in the stool and diarrhoea. The development of gastritis can also cause stomach ulcers. There are many reasons why gastritis or functional abnormality of the stomach is caused, and the main causes include:

Food Poisoning
Consumption of Alcohol, Fried foods and Caffeine
Intake of steroids and Drugs
Allergy to Certain Foods
Physical stress due to flu or some surgery
Unbalanced and Stressful Lifestyle
Symptoms of Gastritis
The main symptoms that occur due to gastritis include discomfort and burning sensation, pain in the stomach, vomiting, poor digestion, dyspepsia, acidity and headache. Some people even experience a feeling of fullness in the upper abdomen after eating food. If any of these conditions last longer than a week, it is advisable to visit a doctor to determine the cause.

Home remedies

It is very necessary to adopt a healthy lifestyle and eating small and frequent meals is always better than eating large three meals in a day.
It is always better to avoid foods that irritate your stomach and hence it is best to avoid fried, acidic and spicy foods.
One of the major reasons behind the occurrence of gastritis is stress. It is necessary that we be trained to cope with this condition and perform relaxing activities that would calm our body and mind like yoga and meditation.
Treatment for Gastritis
It is always better to intake foods like cheese, cereal, baked potatoes, soup and chicken instead of carbonated beverages and painkillers to eliminate this condition. Aloe Vera juice can also be consumed as it is good for treating gastritis problem, and it is very important at first to start with a small amount of the juice.

Use of Special Herbs for Treatment of Gastritis

Asparagus is an excellent herb that is identified to be an antispasmodic, and that reduces the burning sensation in the stomach. The hyperacidity of the digestive system is also reduced by intake of this herb.
Herbs like cardamom provide a soothing effect to the stomach, and are also very beneficial for heartburn.
Many individuals  take fennel seeds after their meal which is very efficient in soothing the stomach and it also facilitate the digestion process. Moreover, it reduces flatulence and even helps in relieving excess acidity.
Ginger, Indian Gooseberry, Licorice, Rhubarb and Bitter Chamomile are other herbs that can be used to treat gastritis effectively.

Gastritis - Easy Home Remedies that Help You Treat it

Any type of surgery is stressful for your body and you will need to take extra care of yourself in order to heal well. Any procedure that is performed on the stomach, liver, gallbladder, intestines, appendix, pancreas or spleen can be categorised as an abdominal surgery. 

Here are ten tips to speed up the healing process after such a surgery.

Be prepared: While preparing yourself for surgery, also prepare your home for your return after surgery. Stock up your fridge with soft foods and keep loose, comfortable clothes easily accessible. Ideally, finish your laundry and house cleaning before the surgery and move away furniture and other things that could trip you.
Understand your medication: After the surgery, you are likely to be prescribed medication to relieve the pain and help with the healing process. Understand the dosage of these medications as well as any possible side effects that you should watch out for.
Get out of bed: The more you move around, the faster your incision will heal. Moving about also aids in the digestive process and helps the bowel work efficiently.
Avoid lifting heavy weights: Do not lift anything heavier than 500 grammes without your doctor s consent. This includes your pets, laundry baskets, grocery bags etc. also, avoid vacuuming for a while.
Get some light exercise: It may be a few months before you can get back to your regular workout routine but ensure that you get a little light exercise every day. Walking is a great way to start.
Keep plenty of pillows at hand: Holding a pillow between your knees or against your stomach can help relieve abdominal pain and discomfort. You may also feel better by propping yourself up on a few pillows when sitting on a chair.
Drink plenty of water: Keeping your body hydrated is crucial to the healing process. Water aids in circulation and ensures that adequate nutrients reach all parts of your body. Ideally, one should drink 8 to 10 glasses of water a day.
Care for your incision: Keep your incision clean and dry by washing it with soap and water daily and thoroughly drying it afterwards. Do not apply any ointment or cream on the area unless advised so by the doctor.
Take a close look at your diet: For the first few days, it is advisable to eat only soft or semi-soft foods that are easy to digest. You may gradually change to normal food as your body s tolerance levels increase.
Get plenty of sunshine: Exposing yourself to a little sunshine on a daily basis can make the recovery process less painful and make you more cheerful.

10 Quick Tips To Help You Recover Post Abdominal Surgery!

One of the more severe illnesses included in the larger group of diseases known as inflammatory bowel disease (IBD), Crohn's disease is typically a long-lasting, chronic condition. The intestine or bowel, most commonly the colon and the lower part of the small intestine, are either marked by sores or get inflamed and ulcerated. It is a common occurrence in adolescents and in young adults.

Crohn's disease is subdivided into five types, each having its own set of symptoms:
1. Ileocolitis: The most common type, it affects the colon and the ileum and results in considerable weight loss as well as diarrhea and cramps.
2. Gastroduodenal Crohn's disease: People who suffer from this type of disease have their stomach and duodenum affected and many experience symptoms like nausea, loss of appetite and weight loss.
3. Crohn's colitis: This involves only the stomach, and can cause joint pains, rectal bleeding, skin lesions and diarrheas,
4. Ileitis: This type affects the ileum and the symptoms are identical to those of ileocolitis.
5. Jejunoileitis: In this type, the jejunum gets affected and general symptoms include the formation of fistulas, diarrhea, intensive back pain as well as areas of inflammation.

Causes
Despite the uncertainty as to the nature of the specific causes of Crohn's disease, there have been a few possible causes which have been identified. These include:
1. Immune system problems
2. Genetic disorders
3. Environmental factors
a) Certain edibles
b) Viruses or harmful bacteria
c) Smoke

Symptoms
The primary symptoms of Crohn's disease include the following:
1. Diarrhea: This can occur for about 10 to 20 times a day in more severe cases.
2. In rare cases, there may be blood in your stool.
3. In more intense cases, you may even develop a fever.
4. Cramping and intermittent belly pain.
5. Anemia, due to a reduction in iron levels caused by bloody stools.
6. Weight loss.
7. Erratic appearance of small tears in the anus, called anal fissures.

Causes, Types and Symptoms of Crohn's disease

The liver is the engine of the human body. It is basically composed of 2 types of cells (a cell is the basic building block of the human body)   hepatocytes (liver cells) and cholangiocytes (bile duct cells). It also has other supporting tissue and their respective cells. The hepatocytes are by far the most numerous cell type, not surprisingly tumours (otherwise called mass or lump.  Tumor  means lump in Latin), of this cell form the majority of abnormal growths in the liver. Abnormal growths can be benign (that is, they do not grow rapidly, spread to other parts of the organ or to other parts of the body) or malignant (grow rapidly, spread to other parts of the organ and to other parts of the body, i.e. cancer). These abnormal growths from liver cells are Focal nodular hyperplasia (FNH), Adenomas (the benign variety) and hepatocellular cancer (otherwise called Hepatoma/HCC, the cancerous type). What we need to recognize is that certain adenomas can turn into HCC, over a period of time. The other type of growths in the liver are those that have originated elsewhere in the body and spread to the liver, for example a growth of the breast spreading to the liver. These are in fact the commonest tumours of the liver. I will discuss these at a later date.

Benign growths of the liver

Common benign growths are Haemangiomas, FNH and Adenoma. Most of these are identified when a scan is performed as investigation for some other problem. Accurate diagnosis of the nature of these lumps is important to determine the type of treatment needed. This can be ascertained by a carefully selected scan like an Ultrasound, CT scan or an MRI. The technology of these scans is continuing to evolve and get better year on year. There are different types of Ultrasound, CT and MRI scans with different applications, based on whether contrast is used or not, the different phases of scanning, the type of MRI scanning sequence etc. Therefore, these scans although commonly available and used very frequently, need to be performed under the supervision of a team involving Liver doctors and radiologist who is well versed in the diagnosis of liver lumps, for accurate diagnosis without the need for unnecessary tests (Box 1).

Haemangiomas are by far the commonest. It is estimated that 5% of the adult population harbor this lump in their livers! They occur in both sexes and at all ages but are commonest between 30 to 50 years in women. Most of them are small, less than 4-5 cms in diameter and are are identified on Ultrasound. MRI and its various applications is the scan of choice for accurate diagnosis. This is crucial as most of them do not need treatment.

Focal Nodular Hyperplasia (FNH) are the second most common liver lumps. They are usually single and small (less than 4 cms) and occur in women between 35   50 years of age. About 2.5-3% of population harbor this lump in their livers. Special MRI techniques using special contrast agents is diagnostic and the findings are quite distinct from haemangiomas. Again treatment is not recommended apart from selected circumstances. Assessment in a dedicated Liver team is recommended for accurate diagnosis and a proper management plan to be formulated.

Hepatic adenomas (Hepatocellular adenoma, HCA) are rare lumps and occur in 0.2 to 0.3% of the population, again occurring mostly in young women during their reproductive period. They are again solitary and most usually 3-4 ms in diameter.

There are a couple characteristics which make this lump different from the previous 2, there is a strong relation between hormones the development of HCA and some of these HCA can turn into the malignant Hepatocellular carcinoma (HCC). Therefore, accurate characterization and diagnosis of these HCA is essential. Sometimes biopsy of the lump, molecular and genetic tests maybe necessary to determine if the HCA has a high chance of progressing to HCC. Imaging tests are generally adequate, contrast MRI Liver and its different techniques is accurate in diagnosing HCA and sub-typing it, however CT and contrast-enhanced Ultrasound is sometimes necessary along with MRI.

Generally, a HCA in a male is recommended for surgical resection. While in women, discontinuation of the OCP pill/ any other such hormone is recommended for a period of 6 months, if the HCA does not have any worrying features and size is less than 5 cms. IF HCA is larger than 5 cms and has features suggestive of a high risk for change to HCC, surgery is advised. Again these decisions have to be made as a part of a Multi-disciplinary team (Box 1)

Malignant growths beginning within the Liver

As mentioned earlier, usually malignant growths which are seen in the liver spread to it from elsewhere in the body. Hepatocellular cancer/Hepatoma (HCC) is the commonest malignant tumour beginning within the liver, as apposed to those that spread to the liver from elsewhere. It occurs between 40-70 years of age and occurs commonly in men. It is estimated that 17000 new patients develop this tumour every year in India. The vast majority (> 80%) of these develop in patients who have chronic liver disease (cirrhosis). Importantly the number of HCC cases is increasing year on year as cirrhosis due to fatty liver disease, Hepatitis B (3% of Indian population carry this virus, ie nearly 40 million individuals) and alcohol are continuing to increase in India. Nearly overall it is the 4th or 5th most common cause of cancer and the second most common cause of cancer-related death. This is continuing to increase too. We do not have a national policy in India to screen and diagnose these lumps in the liver at an early stage. Most patients present at a late stage when effective treatment is not possible.

Hepatitis B is a vaccine-preventable disease, there are good drugs to treat it and decrease the risk of cirrhosis and HCC in HBV patients, therefore it is important to test for this virus infection. The fatty liver disease can cause chronic liver damage and HCC, regular exercise and consuming a balanced diet can reduce the risk of fatty liver disease.

The usual mode of detection of these growths is when a scan is done for some other reason. Occasionally patients can develop pain in the abdomen or jaundice which leads to an investigation. The treatment of HCC depends on the extent of tumour, the extent of the chronic liver disease (the stage of cirrhosis) and the overall condition of the patient. These patients are best seen, assessed and treated in a team (Box 1) which specializes in the treatment of Liver disease.

The best treatment for HCC is surgery. However, this is suitable only for certain carefully selected patients. This can take the form of liver resection (where a portion of the liver with tumour is removed) or liver transplantation (where the whole liver is removed and a donated liver (full or partial) is replaced into the patient. Indeed surgical has excellent survival rates; more than 75% of patients survive for more than 5 years after resection or transplantation making treatment for these cancers one of the most satisfactory.

Other treatments which can be combined with surgery in selected patients or can be combined with patients not suitable for surgery are different types of Interventional radiological therapy   chemotherapy or radiotherapy delivered through fine catheters introduced into the blood vessels of the liver (TACE: Transarterial chemotherapy, TARE: Transarterial radiotherapy) and or heat energy delivered to the tumour area by means of carefully placed needles/probes (RFA: radiofrequency ablation, MWA: microwave ablation).

HCC is unique cancer as its treatment should be tailored to the patient, the treatments are varied and range from catheter-based non-invasive treatment to major surgery and transplantation. This necessitates that HCC patients are best managed in a multidisciplinary team which is highly skilled in and specializes in the management of liver diseases.

Box 1: A liver tumour multidisciplinary team   Integrated Liver Care team

The team should be one with expertise in the management of benign liver lesions and should include a Hepatologist, a Hepatobiliary & Transplant surgeon, Diagnostic and Interventional radiologists, Medical oncologist and a Pathologist.

Each member of the team must hold specific and relevant training, expertise and experience relevant to the management of benign liver lesions.

The team should be one with the skills required not only to appropriately manage these patients but also to manage the rare but known complications of diagnostic or therapeutic interventions.

The Increasing Problem Of Liver Tumours In India!

Anal Fissure is a small tear in the anal area. This can happen due to injury while passing hard formed stool or even by repeated bowel motion. It may be very painful especially at the time of passing hard stool. 

Symptoms

Most commonly sought symptoms in Anal Fissure are as given below: 

  A noticeable tear in the skin close to the anus. 

  Cutting or burning pain in anal passage while passing stool which may persist for a considerable time

  Sometimes pain is so severe that patient stops eating in an attempt to avoid defecation to avoid pain

  Blood stains on stools may also be there

  If not treated in time; skin starts growing from the lower end of fissure to form a tag known as sentinel tag/sentinel piles.

  At times; sentinel tag may get inflamed.

Causes

  Passage of hard stool through anus. 

  Chronic Diarrhoea

  Trauma to the anus and anal canal like during childbirth

  Inflammation in anus because of crohn's disease or some other inflammatory disease 

Anal Fissure treatment: Diet: High fiber diet like green leafy vegetables, salads, fruits like papaya, chikku are advised. Resins with milk can also be taken in night. Adequate quantity of liquids especially butter milk is advised. Banana, apple etc. should be avoided. 

Graded Kshar Karma & Ksharsutra: Anal Fissure can be completely treated by Graded Kshar Karma and Ksharsutra treatment. In acute anal fissure; stool softener along with Graded Kshar Karma is advised. In this treatment; Graded Kshar - a specialized Ayurvedic medicine is applied in fissure region. This medicine debrides the fissure and induces healing. Usually pain subsides in a week or 10 days time period when fissure is still in healing phase.

Considering pain has subsided; some patients discontinue the treatment to further aggravate and complicate the problem. For complete healing of anal fissure usually 3-5 Graded Kshar Karma sittings are required at a weekly interval. In between these weekly sittings patients are advised to apply certain medicines in anal passage by themselves. If anal fissure has progressed to development of sentinel tag then Graded Ksharsutra TM treatment is the treatment of choice. 

In this treatment Graded Ksharsutra TM is ligated at the root of sentinel tag. Medicine released from Ksharsutra blocks the blood supply of sentinel tag and it sheds off in a week or 10 days time period. No hospitalization or bed rest is required in this treatment. Patient can continue his normal routine activities as usual during his treatment. So, you can say no to surgery in Anal fissure.

Anal Fissure - Say No To Surgery!

An Anal fistula (also known as fistula-in-ano) is a small tunnel that can develop between anal canal and the skin near the anus often resulting from an untreated or inadequately treated perianal abscess. No medicinal treatment shows complete cure of anal fistula except few conditions like tubercular fistula. Early surgery, short & straight fistula tract and anal fistula treatment with ksharasutra give promising results with high rate of success.

Fast facts on Anal fistula:

Essentially surgical intervention required.
Recurrence is common.
Should be planned for surgery as early as possible, late cases are mostly complicated.
Anal fistula treatment with ksharasutra shows high rate of success.
What Causes Anal fistula?

Abscess in buttock and/or around the anus.
Long standing anal fissure.
Traumatic injury to the perianal region.
Tuberculosis.
Crohn s disease.
AIDS.
Not maintaining local hygiene.
What are the symptoms of Anal fistula?

Discharging wound at perianal region or buttock which is repeatedly swelling, discharging some amount of pus and/or blood and resolving. The swelling is often associated with pain and fever.
There may be single or multiple wounds.
Passing of flatus through the tunnel like wound.
Anal fistula is notoriously famous for its recurrence even after repeated surgery. An anal sphincter sparing or minimal invasive surgery should always be the choice of patient as well as surgeon. Two stage seton fistulotomy and multistage anal fistula treatment with ksharasutra have shown promising result with lowest rate of reported recurrence and complications like incontinence of stool.

Benefits of treatment with ksharasutra:

Very less incidence of recurrence.
Least chance of post operative stool incontinence.
Minimal invasive procedure.
Minimal blood lost.
Cutting of tract and its healing goes on simultaneously.
Can be performed in elderly patients.
Can be performed in diabetic patients.
Less hospital stay
Patient can continue normal life after a sitting of ksharasutra replacement.

Anal Fistula - Know The Symptoms & Ayurvedic Treatments For It!

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