Everyone can suffer from pain in the stomach, at one time or the other and we usually ignore it. But when the pain is sudden and severe abdominal pain then it is termed as acute pain and this should not be ignored.

Often the following can be expected with acute pain:

Acute abdomen pain is usually synonymous with rapid onset of the symptoms which might indicate life threatening intra-abdominal pathology.
Pain is just a feature and not necessary that it is present at all times. An acute abdomen which is pain free usually occurs in children and women who are in their third trimester of pregnancy.
The differential diagnosis is difficult and wide especially in primary care. This is because the different organs within their peritoneal cavity might have different areas of referred pains.
Abdominal pain usually happens to be in the top three symptoms when patients present their state in the emergency and accident departments. But only few of these have acute abdominal pain.
Management of the abdominal pain should be the primary focus and an assessment should be done to reach the differential diagnosis so that care can be given accordingly.
The clinical evaluation regarding abdomen pain can change quickly. Any diagnosis which had been made can change and both doctor and patient should not be hesitant and seek other treatment.
Conditions which might cause acute abdomen pain are:

Meckel's diverticulitis or Acute appendicitis
Acute cholecystitis
Ectopic pregnancy
Acute pancreatitis.
Peptic ulcer disease
Diverticulitis.
Intestinal obstruction, including paralytic ileus (adynamic obstruction)
Pelvic inflammatory disease.
Gastrointestinal (GI) haemorrhage
Gastroenteritis.
Acute intestinal ischaemia/infarction or vasculitis.
Acute urinary retention
Renal colic or renal tract pain
Testicular torsion
Abdominal aortic aneurysm
Non surgical diseases like pericarditis, sickle cell crisis, acute intermittent porphyria, HIV-associated lymphadenopathy, bowel disease, typhoid, opiate withdrawal, enteritis, pneumonia, myocardial infarction and hepatitis.
Rare causes might include thromboemboli, phytobezoar, and phytobezoar
Diagnosis of abdominal pains:

Patients can be ordered to get their blood tests done. Also if need be then imaging can also be referred to them.
Following tests can be done to rule out the condition causing the abdominal pain:
Blood Tests: these include FBC, LFTs, glucose, amylase, clotting, calcium and arterial blood gas for pancreatitis
Crossmatch or group and save
Pregnancy test in women of childbearing age
Blood cultures
Peritoneal lavage in case of an abdominal trauma
Urine analysis
X ray of the abdomen, ultrasound, CT scan
ECG and cardiac enzymes
Laparoscopy should be a routine procedure

Don't Ignore the Acute Abdominal Pain

Heartburn or acid reflex is a burning sensation that is felt in the throat or chest region after the intake of certain foods. While many of us must have felt heartburn once in our lifetime, too many occurrences such as this could be a fair indication of esophageal cancer.

How an acidburn is related to esophagus?
Esophagus is the tube which carries food from the throat to the stomach. In the case of an acid reflux, the acid from the stomach jumps to the esophagus leading to a condition known as the Barrett s esophagus. This is a condition which replaces the tissue present in the esophagus with a similar kind of tissue found in the lining of the intestine. This being said, Barrett s esophagus doesn t necessarily lead to esophageal cancer.

Key symptoms of Esophageal Cancer
Difficulty swallowing is a key symptom of esophageal cancer. This condition is known as dysphasia. As the tumor grows bigger, it becomes more difficult to swallow food. Esophageal pain is also a common symptom reported by many patients. Loss in appetite and an unexplained weight loss are some of the other symptoms of this type of cancer. Although esophageal cancer does not show any visible signs in the early stage, some of the key indicators are chronic couch, indigestion and hoarseness of voice.

Key risk factors:
Some of the key risk factors for this type of cancer are as follows:

    Men tend to run a higher risk of getting this cancer than women.
    Esophageal cancer are often detected in people above the age of 55 or more
    Chronic tobacco users have higher chances of getting esophageal cancer
    Consumption of alcohol increases the risk of esophageal cancer
    Obesity increases the risk of acid flux thereby, leading to esophageal cancer
    Radiation treatment in the abdomen or chest area might also lead to esophageal cancer

How an esophageal cancer is detected?
Primarily there are 3 ways by which this cancer is detected. The first step for an oncologist to detect this cancer is to perform an endoscopy. If this fails, doctors often try a barium swallow on suspected patients and take an X-ray to understand the esophagus lining. If all this fails, doctors rely on a CT scan to detect this cancer.

How is esophageal cancer treated?
If a patient is lucky and the cancer gets detected in a very early stage, the tumor along with the infected cell can be surgically removed. Apart from surgery, some other alternatives are radiation and chemotherapy. A combination of radiation and chemotherapy or a surgery followed by radiation can also be suggested by the doctor. The treatment plan depends on the stage of detection.

Does Heartburn Lead to Esophageal Cancer?

Causes of bladder control problems in women

Urinary incontinence is the term used to describe bladder control problems that affect several people. Many think it only occurs among older, menopausal women but it actually isn't uncommon amid young and active women.

Inability to control the bladder accompanied by pain can be symptomatic of various disorders ranging from a minor infection to cancer. Fortunately, bladder cancer is rare, and bladder pain is usually not serious.

The varied causes of urinary incontinence in women are as follows:

1) Urinary Tract Infection - This is the most common cause of urinary incontinence and it affects women more than men due to anatomical factors. It can also happen at any age.

2) Medicinal Side Effect: The inability to control one's bladder may be a result of the administration of certain medicinal substances such as alpha-blockers, antidepressants, sleeping pills and various narcotics.

3) Changes in the Reproductive System - Pregnancy and fluctuations in hormone levels can cause bladder irritation, which leads to urinary incontinence.

4) Impacted Stool - When stool gets tightly packed in the lower end of the digestive system and rectum, bladder control is affected. Chronic constipation and constraint strain on the lower intestines leads to the weakening of bladder muscles and hampers the bladder control.

5) Surgical Side Effects - Temporary loss of control of the bladder is often a result of prior surgery and radiation therapy in the pelvic region.

6) Nerve Damage and Neurological Disorders - Strokes and spinal cord injuries have a heavy impact on bladder control and amount to urinary incontinence. Diseases such as Alzheimer's disease, Parkinson's disease and multiple sclerosis also lead to the same.

7) Health Complications - Disorders such as diabetes and obesity directly affect the bladder and the ability to exercise control over it.

8) Disability and Impaired Mobility - For women who are physically impaired and suffer from problems of arthritis, urinary incontinence is a major problem as they are unable to reach the toilet easily.

9) Bladder Cancer - Even though it is extremely rare, bladder cancer affects a number of women every year and is treated through surgery and chemotherapy.



What Causes Bladder Control Problems in Women?

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

AV or arterio-venous fistulas are unusual linkages between arteries and veins. In general, pure blood passes from the arteries to the capillaries to the veins and becomes devoid of nutrients and oxygen (becomes  impure ) by the time it reaches the veins. The capillaries in between absorb the nutrients, to supply them to the tissues and organs lying beneath them. In the case of AV fistulas, the capillaries are bypassed and blood passes directly between the arteries and the veins. Thus, organs are deprived of nutrients.

This can be a severe condition, leading even to heart failure.

AV fistulas and dialysis

Sometimes, AV fistulas have to be deliberately created on the body, to treat for severe kidney ailments requiring dialysis.

What is the surgical procedure for creation of AV fistulas for dialysis?

Following are the steps-

  A vascular specialist checks your arteries and veins to make sure they are sturdy enough to be able to support an AV fistula.
  Then, with the help of wave techniques or an angiogram, the depth of your blood vessels is recorded.
  Anaesthesia is then used on the spot, which is chosen for your AV fistula. Local anaesthesia (anaesthesia of only that spot) is preferred over central anaesthesia (anaesthesia of the whole body).
  With the help of a small cut on the skin surface, the surgeon accesses your blood vessels and makes a connection between arteries and veins.

After this process is completed, dialysis takes usually some weeks to begin.

Why should you go for AV fistula?

Following are the advantages-

  Foreign chemicals or devices, which may cause invasion and damage to vital internal organs, are not introduced in your body.
  As only local anaesthesia is administered, you have to spend significantly less recovery time or  downtime  after surgery.
  There is less chance of the wound becoming infected.
  There is a reduced danger of clotting.

AV fistulas are in essence an unusual connection between your arteries and veins, leading to undernourished organs due to capillaries being bypassed. In some cases like dialysis, AV fistulas need to be created and closely monitored. There are several advantages to this, but you will also need recovery time after the procedure is over.

AV Fistula - Its Surgery & Creation Of AV Fistula For Dialysis!

Life can be tough when living with Crohn s disease as it is a chronic condition. Especially with the disease is marked by phases of relapse and remission, it requires a long-term management to keep the symptoms in check. Though the flare-ups can be typically contained using medications, some of the patients with severe symptoms or complications arising from the illness would require surgery.

Before we proceed with the surgical management of the disease, it is essential to understand what Crohn s disease is in case you are not aware of it. It is a chronic illness in which the intestine or the bowel have become inflamed or marked with ulcers and sores and is a part of disorders collectively known as inflammatory bowel disease(IBD).

When does Crohn s disease require surgery?
Typically, patients who are suffering from complications of Crohn s Disease may require surgery. This may include the formation of a scar that is causing the bowel to narrow down and leading to obstructions, extensive bleeding from the intestine, perforation in the bowel wall or the formation of fistula or abscess. The fistula may be formed in the connecting area between two body parts that do not meet. Also, a condition known as toxic megacolon where the large intestine or the colon becomes severely stretched out causing the toxins to spread all through the blood requires surgical intervention.

What are the different surgical options available for Crohn s disease?

The surgery chosen for Crohn s disease is dependent on various factors such as where the disease has affected, how severe the disease is and most importantly what complication will be treated by the surgery. Here are some of the types of surgeries done for treating Crohn s disease:

Strictureplasty: If the small intestine is affected by the disease, it may show up in the alternating areas of the bowel. Strictureplasty is a surgical way of widening the narrow area of the small intestine into a portion which has been affected by the disease. It doesn t involve removal of the intestine.
Resection: This is yet another surgical process where the affected part of the intestine is removed. It may be required when the stricture has become elongated. The removal of the diseased portion of the intestine may be able to offer some relief from the symptoms.
Colectomy: This surgery refers to the removal of the entire colon, and it is done when the disease is severe and extensive.
Proctocolectomy: When both rectum and colon are affected, both these parts are removed by a process called proctocolectomy. When this process becomes necessary, the waste materials drain into the bag which is emptied every day.
Since, the surgical intervention aims to manage the disease, your doctor would be able to recommend the most suitable option as per your condition.

Crohn's Disease - How Surgical Management Can Help?

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