A fistula is an abnormal, tube-like connection, a passage or hole that forms between two organs or an organ in your body and your skin. There are various types of fistulas that can develop in different parts of your body but the most common types are-

1. Obstetric Fistulas: This is the name given to a hole between the vagina and rectum or bladder. A vaginal fistula that opens into the urinary tract is called a vesicovaginal fistula and one that opens into the rectum is called a rectovaginal fistula. 

A woman with obstructed labour or labour that is not attended by a doctor or a midwife, can suffer labour pain for up to six or seven days. And as the labour produces contractions that push the baby s head against the mother s pelvic, the soft tissues between the baby s head and the pelvic bone are compressed and do not receive adequate blood flow between the mother s bladder and vagina and/or between the rectum and vagina.
This means that a hole forms on the vaginal wall between the urinary tract and her rectum. The urine and faeces thus start to leak from the vaginal opening causing soiling and foul smell.

Apart from labour, hysterectomies that damage the vaginal wall can also cause such types of fistulas.

Enterovaginal   A woman may have gas and foul smelling fluids leaking out of her vagina due to an enterovaginal fistula which is a hole between the vagina and the digestive tract. It s usually caused due to inflammatory bowel disease or IBD and ulcerative colitis.

2. Anal fistula

These are fistulas that form between the end of the bowel and skin near the anus.

An anal fistula usually develops due to a previous or current anal abscess. An anal abscess is an infected cavity filled with pus found near the anus due to an acute infection in the internal glands of the anus.

Common symptoms are:

Pain in the anorectal area
Swelling
Redness
Fever
Rectal bleeding
Urinary symptoms, such as trouble initiating urination or painful urination
Causes:

Inflammatory bowel disease   a chronic condition of the GI track which causes inflammation
Diverticulitis   An infection in the large intestine
Tuberculosis, HIV
Surgery near the anus
Anal abscess and likewise anal fistula are treated by surgical drainage in which an incision is made in the skin near the anus to drain the infection causing an anal abscess. Hospitalization may be required for patients who have impaired immunity like diabetics.

Anal fistula though has no medical treatment and surgery is almost always necessary to cure it.

If the fistula is straightforward which means one that involves minimal sphincter muscle, a fistulotomy may be performed. This involves cutting open the whole length of the fistula so it heals.
Seton is another procedure in which a surgical thread called a seton is placed in the fistula and left there to help it heal.

Different Types of Fistula and Treatments!

Hyper acidity (Amlapitta) is also called Acid Dyspepsia, which is one of the most common problem. Hyperacidity is a condition in which stomach secretes excess amount of acid.

Hyperacidity is very closely associated to Amlapitta in Ayurveda which is caused by the imbalance of agni or the digestive fire leading to the vitiation of pitta dosha.

Causes of Hyperacidity:

Hurry ,  Worry , and  Curry  are the three main reasons for the disease.

Diet (Ahara)

Spicy fried junk food

Carbonated drinks

Excessive use of chilly, mustard, garam masala powder (spice mixture), garlic etc. in diet

Salty and sour foods like chips

Eating of stale, fermented foods (dosa, uttappa, idli, dhokla etc. bakery food items).

Excessive intake of fast food

Excessive intake of Oily foods, pickles

Excessive intake of tea/coffee.

Lesser intake of water

Irregular meal times

Skipping meals

Repeated food intake (before the digestion of the previously taken food)

Incompatible food like taking non-veg with milk, sour fruits with milk, pizza followed by milkshake

Eating too late at night

Regimens (Vihara)

Lack of rest

Fast moving lifestyle.

Insufficient sleep at night.

Sleeping immediately after meals.

Sleeping in daytime

Mental factors

Stressful lifestyle
Excessive anxiety

Anger

Other causes of acidity include:

Medications: Some anti-inflammatory drugs, when taken for a long period of time can develop chances of hyperacidity.

Drinking alcohol

Smoking

Pregnancy

Obesity

Fasting

All the above factors result in an excessive increase of  Pitta dosha  in the body and exhibits symptoms of amlapitta.

The condition of Amlapitta is explained with a simile just as milk is poured into curd pot immediately attains sourness and gets into an inspissated form. In the same way, repeatedly eaten food gets improperly burnt and causes acidity.

Signs and symptoms

Vomiting

Loss of proper taste of food

Loss of interest of food

Headache

Heart &chest burn (retrosternal burning)

Sour or bitter test in mouth and belching.

Nausea

Throat burn

Regurgitation of food or sour substance

Gaseous distention/ bloating of abdomen

Pain in abdomen

Chest pain

Foul smelling loose motions.

Burning sensation over feet, hands

Mouth ulcers

Fatigue (especially in legs)

Tiredness

Fainting

Ayurveda has explained 2 main types of amlapitta:

Urdhvag Amlapitta: Mainly characterized by vomiting due to upward movement of pitta 

Adhoga Amlapitta: Mainly characterized by loose motions due to downward movement of pitta.

Investigations

If there is chronic hyperacidity, following investigations are useful:

Gastroscopy (Upper Gastrointestinal Endoscopy)

Barium Meal x-ray

Gastrin levels in blood

Serology + histology for H. Pylori

Stool routine examination

Complications 

If not treated at the proper time or if faulty diet, regimen and habits continued, it can complicate as

Gastric Ulcer
Chronic Gastritis
Duodenitis
Prevention

 Prevention is better than cure  it is better to avoid all the causative factors of acid-peptic disorders (amlapitta).

Avoid excessive salty, oily, sour and spicy foods

Avoid heavy and untimely food

Avoid smoking and alcohol intake

Avoid overcooked, stale and contaminated food

Avoid fried and junk food items

Do not skip meals

Avoid fast

Do not overeat

Avoid untimely and irregular food habit

Avoid foods containing excess amount of garlic, salt, oil, chilies etc. very often.

Avoid toor dal, horse gram, fenugreek

Avoid lying down immediately after food

Avoid, smoking, alcohol, tea, coffee and aspirin type drugs

Follow the meal times

Take Light food, Coconut water, articles having cooling properties

Take vegetables like white pumpkin, cucumber, leafy vegetables except Methi

Take Wheat, old rice, green gram

Fruits like gooseberry, dry grapes (black resins), black grapes, pomegranate, fig, dry fig, custard apple.

Take adequate amount of fluids like pomegranate juice, amla juice, kokam syrup.

Medicated water with ushir (wala) or coriander-cumin seeds or tulsi seeds (sabja) or laja (puffed rice). 

Take Warm water.

Take Moravla (jam made from amla), gulkand (jam made from rose petals) 

Take One teaspoonful of ghee with warm milk

Take adequate sleep

Exercise regularly

Avoid stress

Follow mental relaxation techniques like meditation, Yoga and Pranayama

Medical management

As the disease is of Pitta origin, all measures are undertaken to pacify pitta.

Some important drugs useful in Amlapitta

Shatavari, Yashtimadhu, Amalaki, Sunthi, Guduchi, Ushir, chandan shankhabhasma, suvarnamakshik bhasma, pravalpishti, sariva, bhunimb etc

Some important Ayurvedic Medicinal Preparations are helpful when taken under proper guidance

Kamdudha Rasa 

Sutashekhar Rasa 

Prawal Panchamrit 

Shankh vati

Bhoonimbadi kwath

Avipattikar Churna

Shatavarighrit etc

'Panchakarma procedures' like Vamana (induced vomiting) or Virechana (induced loose motions) whichever is needed as per the symptoms should be administered. In chronic cases, Asthapana basti (medicated enema) is indicated.

Hyperacidity And Ayurveda!

Peptic ulcers are wounds that develop in the stomach lining, less esophagus or small intestine. They are usually due to inflammation caused by bacterial H. pylori, in addition to corrosions from stomach acids. An ulcer is generally rooted in the stomach or inner layer of the small intestine. A stomach ulcer is the most visible sign of peptic an ulcer disease.

People with an ulcer may have a really hard time dealing with it. It is an open wound on the outer or internal surface of the body, which causes excessive pain. It is due to a breakdown in the mucous membrane or skin which fails to recover.

Causes of peptic ulcer:
Several reasons can cause stomach, esophagus, and small intestine to break. Contains:

Helicobacter pylori (H. pylori), a type of bacteria that can cause stomach infections and swelling
Continuous use of Aspirin (Bayer), Ibuprofen (Advil), and other anti-inflammatory drugs (the risks linked with this behavior among women and people over 60 years of age)
Smoking
Alcohol drinking
radiation therapy
stomach cancer
Symptoms of peptic ulcer:
The most common symptom of peptic ulcer is burning abdominal pain, which spread from navel to chest, which can range from light to severe. In few circumstances, the pain can get you up at night. Small peptic ulcers cannot develop any symptoms in initial stages.

A burning, grinding pain in the upper middle part of the stomach and is comforted just by eating or taking antacids.
Change in taste
Sickness
Bloody or dark stool
Ambiguous weight loss
Indigestion
Vomit
Pain in chest
Below are the ways to you from Peptic ulcers?
Stomach ulcer pain is not a joke: it can leave you weak. Fortunately, following these steps are ways to reduce your risk of getting ulcer.

Avoid some foods such as spicy, lemon, fatty, etc., because they can be burdens your stomach. Specifically, if you have seen that particular types of food disturb your stomach, keep away from it.
Improve the quality of your life by including exercise, stress-free activities, yoga etc. in your daily routine.
The heavy consumption of alcohol can cause ulcers. They have been contributing to the development of ulcers, so it is good to reduce the consumption of alcohol.
Taking no steroid anti-inflammatory medicines can reduce the risk of disturbing your stomach lining and thus avoiding the growth of ulcers.
Management of anxiety level avoids the expansion of ulcers. Do yoga and other comforting arts that help prevent the ulcer.
Some lifestyle choices and habits can reduce your risk of developing the peptic ulcer. 

5 Things You Can Do To Protect Yourself From Peptic Ulcer!

It is important for you to know about inflammatory bowel disease or IBD, it is a group of intestinal disorders, which leads to prolonged inflammation of your digestive tract. The digestive tract is made of the mouth, stomach, oesophagus, small intestine and large intestine. It performs the task of breaking down food, removing unusable materials and waste products, and for breaking down nutrients from food. Inflammation along with the digestive tract causes disruption in this process. IBD is a fatal condition which can be life threatening in some cases.

Major types of inflammatory bowel disease
The term inflammatory bowel disease is an umbrella term under which many diseases are included. The two major and most common diseases under IBD are ulcerative colitis and Crohn s disease. Crohn s disease (a chronic inflammatory disease of the intestines, especially the colon and ileum, associated with ulcers and fistulae) can lead to inflammation in any part of your digestive tract. It commonly affects the small intestine s tail end. In case of ulcerative colitis, inflammation takes place in the large intestine.

Causes of IBD
Although the exact cause of IBD is not known, several factors may lead to this condition. They are as follows:

Genetics: You are more likely to develop IBD if someone in your family has the disease. This is because of the genetic component of IBD.
The immune system: The body s immune system plays a role in IBD. Usually, your immune system defends your body from pathogens. A bacterial or viral infection in the digestive tract may lead to an immune response. The digestive tract becomes inflamed as the body fights against the bacteria or viruses. The inflammation goes away when the infection is gone.
However, in the case of IBD, the digestive tract inflammation may occur without any infection. Your immune system attacks your body s cells. This is called an autoimmune response. IBD can also occur when the infection is cured, but the inflammation remains.

Symptoms
The various symptoms of IBD depend on the severity and location of the inflammation. They are as follows:

Diarrhoea which occurs when the bowel cannot reabsorb water.
Bleeding ulcers which cause blood to show up in your stool.
Stomach pain, bloating and cramping because of bowel obstruction.
Weight loss and anaemia, which leads to delayed development and growth in children.
In patients with Crohn s disease, canker sores may develop in the mouth.
Ulcers and fissures may appear on the anus or genital area.
IBD may also be associated with problems such as eye inflammation, arthritis and skin disorders.
The major complications which may arise from IBD include colon cancer, malnutrition with weight loss, fistulas, intestinal rapture and bowel obstruction. It is important for you to consult a doctor on noticing any of the IBD symptoms.

Inflammatory Bowel Disease - Know the Types!

If you are finding certain symptoms like stomach pain, cramping, frequent diarrhoea, weight loss of your child or fever, then there are chances that he is suffering from crohn's disease. Crohn's disease is a bowel disease that causes swelling and inflammation along the digestive tract of your child. Mostly, it affects the end of the small intestine, but it can occur anywhere from the mouth to the anus.

Causes behind the disease
It is not common in children, but if your child is showing symptoms, then one of the following may be the reason:
1. Immunity system of the child,
2. Genetics, and
3. Environment.
The main cause behind such a disease can be any of the above. However, it has been found that if you have someone suffering from this disease in the family, then your child has more chances of getting affected by it.

Diagnosing crohn's disease
If you find the above-mentioned symptoms in your child, then it is better to take him or her to a doctor. Mostly, this disease is chronic in nature, meaning that it will continue even if it is treated. However, with proper treatment the symptoms can be reduced.
For diagnosing this disease the following tests may be done
1. Different lab tests that include a blood test for blood count and white blood cell count, and stool test to look for the bacteria that cause the inflammation and urine.
2. X-ray for detecting whether your child is suffering from crohn's disease and what is the exact position of it in the digestive tract.
3. If further required, they may do an endoscopy to find out the exact location and get more details.

Complications arising out of crohn's disease
If your child is suffering from this disease and is left without treatment for long, he or she may suffer from the following complications.
1. When the disease thickens, it may obstruct the intestinal walls by swelling of the intestine. Thus, the space from where the digestive matter passes becomes less and may lead to bowel obstruction.
2. Fissures may develop at the mucus membrane of the anus.
3. Fistulas or ulcers can occur as they tunnel through the affected area to the nearby tissues. All these are painful for your child to bear.
4. Your child cannot absorb the nutrients of the food like any other child and hence there are chances that they suffer from nutritional deficiencies.

With such problems that may not seem very huge in the beginning, your child may lose his appetite and forget about normal living. Thus, the moment you find any such symptoms, discuss them with your doctor.

What You Must Know About It if Your Child Suffers From Crohn's Disease

Irritable bowel syndrome is a disorder, which generally affects the colon (large intestine). It usually show symptoms like abdominal pain, cramping, bloating, diarrhea, gas and constipation. IBS is a long term condition. It can result in sudden mood swings, depression and thus, holds you back from living your life to the fullest. IBS can be controlled by managing lifestyle, stress and managing your diet. Medication and counseling could also be required to manage IBS.

Symptoms of IBS:
1. Immense cramping and pain.
2. A feeling that your belly is bloated all the time
3. Severe gas
4. Alternating and sudden bouts of constipation and diarrhea.
5. Presence of mucus in the feces.

Whenever you experience such kind of symptoms, it is always advisable that you must consult a doctor, so that it doesn't lead to a serious condition.

When should you consult a doctor for IBS?
IBS is not a chronic disorder and can be controlled by home remedies. It may also require medical treatment if the symptoms become acute and persist for too long. If you experience certain symptoms like rectal bleeding, weight loss and heavy abdominal pain that might increase at night, you may be at a risk for colon cancer. If such symptoms persist, you should visit a doctor as soon as possible.

Causes of IBS:

Foods: Most people are susceptible to IBS if they consume foods like spices, fats, fruits, cabbage, beans, broccoli, cauliflower, carbonated beverage, milk or alcohol. These foods irritate the lining of the stomach and trigger IBS. However, the trigger may vary from person to person.
Stress: Signs and symptoms of IBS can also increase if you are very stressed out. Stress makes your muscles too worked up and this may result in IBS. However, you should know that stress aggravates or triggers the symptoms but doesn't cause IBS.
Hormones: Women are more likely to develop IBS. Fluctuations in the hormonal cycle can trigger IBS. This usually occurs around or during menstruation.
Other illnesses - Sometimes illness such as gastroenteritis (infectious diarrhea) or bacterial overgrowth in the intestines can trigger symptoms of IBS.
Age: You will be more likely to develop IBS if you are 45 years of age or above.
Hereditary: People having a family history of IBS are more susceptible to develop IBS.
Mental problems: Depression, personality disorder, anxiety and a history of sexual abuse can also trigger symptoms of IBS.

Irritable Bowel Syndrome - Can Severe Gas be a Sign of it

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