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!

Gastric acids are chemicals provided by your stomach to aid digestion. But the corrosive effects they induce are counteracted by the secretion of other chemicals. It is when the secretion of these chemicals is impaired that it leads to damaged stomach lining, causing acidity, also known as acid reflux.

Ayurveda promises some easy home treatments for acidity which are quite efficient in ensuring fast recovery for you. You can use any of these listed Ayurvedic treatments if you suffer from acidity.

1. Amla powder (Indian Gooseberry) and honey
 
Soak one teaspoonful of amla powder in half a cup of water. Add honey and stir and drink empty stomach in the morning. Repeat similarly for the evening.
 
2. Cumin seeds

You can reduce cumin seeds to their powder form, then you have to add half a spoon of it to water; presumably, one liter. Then, keep the solution boiling then filter it. You will have to make sure that you drink this solution instead of normal water. Take this water based solution everyday till recovery. This is quite an effective remedy for acidity.
 
3. Mulethi (liquorice) and honey
 
You can reduce liquorice root to powder, then to half a spoon of this powder add little honey to form paste. Lick to consume this paste twice daily after meals. Liquorice neutralizes the acids quickly to give relief.

4. White pumpkin juice
 
Take white pumpkin peel and slice it and make a pulpy juice out of it. Half a cup twice daily gives fast recovery from gastritis and acidity. Alternatively you may eat sweet made of pumpkin (peetha ki methai) after meals.
 
5. Buttermilk

You can take half a glass of buttermilk and add a pinch of each asafetida and turmeric to it. With it, also take care to add a tiny amount of fenugreek and drink it at night, to make the most of its benefits.

6. Jaggery

You can try taking boiled ash gourd with jaggery. This relieves the burning sensation in the stomach to a considerable extent.

6 Ayurvedic Home Treatments For Acidity

Diarrhea is a disorder that affects people of all age groups. Medically speaking, Diarrhea is a mechanism that the body uses to eliminate germs from the body. Usually this disorder lasts for a few days to a week. It is usually accompanied by nausea, fever and dehydration.

Children can be affected by diarrhea in a number of ways, some of them are:
1. Infections: Various infections, such as the ones caused by rotavirus and salmonella bacteria can lead to diarrhea. Usually diarrhea in children is caused by viruses; if it is viral in nature, then it can also cause stomach cramps, headache and vomiting. It also leads to loss of fluid from the body. Hence, the child's fluid intake should be compensated accordingly. Usually oral rehydration solution that contains nutrient such as potassium and sodium are preferred.

2. Medications: Intake of certain medications, such as antibiotics and laxatives can cause diarrhea in children. If the cause is due to antibiotic intake, then you should consult a doctor. The doctor may alter the dosage or ask to increase the child's water intake. Yoghurt may also help ease the symptoms of diarrhea if it is caused by antibiotics.

3. Food poisoning: Diarrhea may also result from food poisoning; symptoms of this type usually disappear quickly. Along with loose and watery stools, the child may vomit frequently.
The major complication that results from diarrhea is dehydration. Severe dehydration may lead to severe brain damage and seizures. It may also cause symptoms of dry mouth, fatigue, dizziness and dark yellow urine.

Certain preventive measures are:
1. Use your good judgment while eating outside. Do not consume food from places which use unhygienic modes of preparation.

2. Make sure your child does not drink contaminated water and there is access to clean and filtered water all the time.

3. Your child should be eating a balanced diet that primarily consists of vegetable and fruits. They also help in adding fiber to the diet that keeps your bowels healthy.

All About Diarrhea in Children

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!

Are you experiencing a sudden pain in the right upper part and at the center of your abdomen? This might be an indication of the presence of gallbladder stones. These stones are deposits of digestive fluid which may form in your gallbladder.

Risk Factors Associated With Gall Stones:

Family history of gallstones

Women are twice as likely as men to develop gallstones

Overweight

High cholesterol

High-fat diet

Rapid weight loss

Over age 60

In the case of gallbladder stones, you need to dissolve and remove them. Among the different modes of treatment of gallbladder stones, homeopathy is considered to be an ideal method.

Homeopathy successfully dissolves small and medium-sized gallstones and help you avoid the gallbladder removal. Homeopathy also provides fast pain relief in gallbladder attacks and can be used for prevention and treatment of biliary colic. The medicines are natural, effective and have no side effects. In patients with gallbladder removal homeopathy can alleviate the digestive disorders after surgery. Here is a list of the top homeopathic medicines, which help in dissolving and removing gallbladder stones:

Chelidonium: This is an effective homeopathic medicine used in the treatment of gallbladder stones. It treats the pain caused because of the stones and jaundice when the bile ducts are obstructed. The medicine is used when the skin turns yellowish, stool turns clay colored and the urine becomes dark. The patient may have an urge for having hot drinks. This medicine is also ideal for gall bladder problems in women during pregnancy.

Lycopodium: This medicine is the best natural cure for gall bladder stones when accompanied by gastric symptoms such as acidity, a bloated abdomen, or gas in the abdomen. Distension in the abdomen may occur even after taking a small meal. Gas rolls in the abdomen and it is difficult for it to pass out. Acidity is likely, which worsens after taking flatulent food containing starch. The patient s appetite may decrease and the craving for sweet and hot drinks increases.

Calcerea Carb: This is another effective homeopathic medicine for gallbladder stones. It is mostly used in case of obese patients who have a flabby and fatty constitution. The abdomen is full of excess fat with hardness and distension. Profuse sweating on the head and an increased sensitivity to cold air are other symptoms. The patient might crave for boiled eggs or unusual things such as lime, chalk and pencils. He may avoid hot food and crave for sweet drinks. The medicine is also used in relieving sour belching and sour vomiting.

Carduus Marianus: This is a very effective medicine in case of an inflamed gallbladder. Pain is experienced in the right upper abdomen and it is also accompanied by nausea and vomiting of burning fluid. It treats jaundice in gall stones as well.

Phosphorus: This homeopathic medicine is used in case of gall bladder stone patients who experience sour belching and vomiting after any meal. The patient will love cold drinks, chicken, ice cream and fish in his diet.

Homeopathic medicines treat gallbladder stones effectively without any side effects. In case you notice the symptoms of gallbladder stones, you should consult a homeopathic practitioner.

Can Homeopathy Help In Dissolving And Removing Gallbladder Stones?

While the very mention of the word  Farting  makes some of you cringe and cover your nose, you can t ignore the sheer obviousness of the whole process. It is as natural as eating, drinking, sleeping & other daily habits you associate yourself with. Farting occurs mainly when the air is trapped within your body. Air might be swallowed during eating or from intestinal gas and chemical reactions in the stomach. In hindsight, farting can be a good thing. Don t think so?

Here are 6 reasons for you to believe that farting is actually wonderful and not as gross as you think it might be:

The hydrogen sulphide present in the fart is poisonous and smelly, but if used in small amount, is known to be beneficial in the prevention of heart disorders and strokes.
The smelling farts containing hydrogen sulphide, which is known to be useful for slowing down the ageing process
Farting, openly and without inhibition, while being in a relationship can actually be considered as taking a step forward in terms of honesty and comfort in the relationship. If you can share the process with your other half without hesitation and can accept the pungency that comes with it, then the relationship is definitely working well.
Farting can work as a self-defensive mechanism, as proved by recent researchers.
Holding your fart for a long time might cause uncomfortable conditions, such as bloated bowel movements and haemorrhoids. No matter how much you hold them, the farts will release themselves once you re relaxed, especially when you re sleeping.
Bottom-line: Just let it go. If you wish to discuss any specific problem, you can consult a doctor.

5 Reasons Why Farting is a Wonderful Thing

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