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

Uncontrolled alcohol consumption over a prolonged time can severely affect the liver, giving rise to Alcohol-Induced Liver Disease. The liver plays a significant role in digestion as well as filtering the toxins out of the body. Normally, the liver is capable of regenerating its damaged cells and tissues. However, unlimited alcohol consumption interferes with the functioning of the liver. With time, the ability of the liver to regenerate itself also gets affected (reduces) due to excessive drinking resulting in liver problems and disorders.

The stages of alcohol induced liver disease
Alcohol induced liver disease progresses through three stages, alcoholic fatty liver disease, alcoholic hepatitis, and finally cirrhosis.

Alcoholic fatty liver disease: The fatty liver is an early stage of Alcohol induced liver disease, characterized by excess deposition of fats (~ between 5-10% of the total liver weight) in the liver cells and tissues. People with fatty liver should give up drinking for good (or at least till the condition is improved and reversed). Fatty liver seldom exhibits any characteristic symptoms.
Alcoholic hepatitis: Alcoholic hepatitis mostly affects people who are heavily into drinking. More than often, the condition triggers damage and destruction of the liver. Further, there may be swelling and inflammation of the liver. A person with alcoholic hepatitis may experience
Abdominal pain
Fever
Nausea and vomiting
In some patients, the condition may trigger jaundice (excess build up of blood bilirubin resulting for improper functioning of the liver)
In extreme cases, alcoholic hepatitis may result in fatal consequences
Liver cirrhosis: This is the most severe form of alcohol induced liver disease that can give rise to serious and life threatening health complications. Cirrhosis is often an irreversible condition where there is maximum scarring of the liver cells and tissues. In addition to the symptoms associated with alcoholic hepatitis, a person with cirrhosis may also exhibit the following symptoms.
Esophageal varices: It is a condition characterized by bleeding of the esophageal veins
Ascites: In people with cirrhosis, there may be an excessive fluid accumulation in the stomach.
Portal hypertension: It is a condition when the blood pressure in the liver shoots up.
Cirrhosis may also affect the spleen, resulting in its enlargement. There may be mood swings and behavioral problems. A person with cirrhosis should waste no time and immediately consult a specialist to avoid further aggravation.

Factors contributing to alcohol induced liver disease
The following factors in combination with alcohol can wreak havoc, worsening the condition further:

Malnutrition: In some people, excessive drinking can result in malnutrition (alcohol often results in malabsorption of the essential nutrients). Malnutrition, in turn, can adversely affect the liver.
Obesity: Obesity, one of the common consequences of alcohol consumption, can spell doom for the liver and its normal functioning.
Alcohol: It acts as a poison for people suffering from Acute Hepatitis C (viral hepatitis), further damaging the liver. Some research suggests that women who are into heavy drinking are more likely to suffer from liver problems than their male counterparts.
Genetics: It may be responsible for the inability of the body to processes alcohol effectively, resulting in liver problems.

Alcohol Induced Liver Disease - Understanding It In Detail!

If you think fissure and fistula are the same, you are mistaken. While the term fissure refers to the tear of the skin, fistula refers to the abnormal tube-like passages or connections between organs. Fissures get cured with or without treatment in a few days to few weeks, and do not lead to complications. On the contrary, fistulas when left untreated may lead to complications.

So, read on further to know about the distinction, how to recognize the symptoms and avail treatment.

What is anal fissure?
An anal fissure can occur due to various reason, such as prolonged diarrhea, anal sex, vaginal childbirth, rectum cancer, etc. For majority of the cases, it is usually due to constant constipation or strained bowel movements, that tear down the muscles controlling the sphincters to the inner rectum or the anal canal.

What is anal fistula?
Anal fistulas are not tears but abnormal abscesses near the anus, filled with pus. In fistula, a tunnel is formed under the skin which connects these abscesses to the infected glands. Fistulas are usually the results of present or previous abscesses. If ignored or left untreated, one single fistula can lead to the development of a more complex fistula, where the single fistula tract ends up creating multiple openings.

Symptoms of anal fissure and anal fistula
Some of the common symptoms of an anal fissure are excruciating pain in the anal area every time the bowel movement occurs, constant itching or burning sensation in and around the anus, bloody stool and visible tears and cracks around the anus.

For anal fistula, some of the very common symptoms are a throbbing pain in the anus, which continues to increase, difficulty in sitting down for longer period, swelling and redness around the anus, accompanied by skin irritation, discharge of blood and pus, and at times fever.

Treatment options
To completely cure anal fissure and fistula, it is the various surgical options that are the most effective ones. However, when diagnosed in its earliest form, medications like antibiotics, analgesics, and antipyretics can often help. It is solely depending on the location, type, and size or severity of the fistula or fissure, the treatments may vary from person to person and so does the recovery time.

Though, these conditions cannot be cured with dietary changes or exercise, following a healthy diet can boost healthy bowel movement, reducing chances of constipation or diarrhea that results in fissures.
Prevention is always better than cure. Therefore, it is essential that you visit the nearest medical facilities once you notice any signs of fissure or fistula , to avail the right treatment and get relief from the symptoms quickly.


Don't Confuse Fissure With Fistula!

Fistula-in-Ano is a type of an abnormal hollow cavity that is lined with granulation tissue. It connects a primary opening inside the anal canal to the second opening in the perianal skin. Ayurveda has perfect surgical techniques which can help you root out this problem without leaving any chances of recurrence.

Kshar Sutra is basically an ayurvedic parasurgical treatment that involves management of Anorectal disorders for treating Fistula-in-Ano. The technique is minimally invasive in nature. Following are some of the tips related to the Ayurvedic Management & Kshar Sutra in Fistula-in-Ano:

Safe and Extremely Cost-Effective: This type of surgery uses a thread, also known as Kshar Sutra, especially prepared by herbal chemical cauterization. Cauterization is the medical practice of getting part of the body burnt, for either removing or closing off a particular part to cure diseases like Fistula-in-Ano. Hence, people can safely go for this treatment procedure because there is absolutely no risk element involved. Moreover, as the use of thread is involved in treating the problem, so basically, the minimum expense is involved. So, patients need not pay much.



Customized Treatment: Usually, three kinds of Kshar Sutra get used, depending upon the number of coatings and the quality of materials implemented. Coatings are created with ayurvedic herbs and treatment for each and every patient takes place in a customized manner depending upon their individual requirements.

Can Get Rid of Other Disorders: While undergoing the Kshar Sutra treatment for Fistula-in-Ano, patients are even routinely investigated with a special type of reference for any other associated disorder like Hypertension, Tuberculosis, Diabetes Mellitus etc.

So, Kshar Sutra not only helps people to get relief from the problem of Fistula-in-Ano but also assists in getting rid of other associated problems.

Maintenance of Diet as Part of Ayurvedic Management: Those patients, who suffer from the painful disease of Fistula-in- Ano, Ayurveda instructs them to maintain a healthy diet in the form of fruits and vegetables. On the contrary, they must avoid the excess amount of spicy foods, along with items that cause constipation and even make sure to not have too much of garlic, chillies and potato.
Keep Yourself Hydrated: Drinking plenty of water is extremely essential as this helps to clear off the channels and also allow people to flush off stools and toxins from the body.

Fistula-In-Ano - Ayurvedic Management & Surgery (Ksharsutra) For It! 

Colon polyps are growths that are typically found in the large intestine. Although the causes behind the occurrence of colon polyps are not known, this condition is usually seen to affect adults.
These colon polyps might turn into colon cancer over a period of time; the development of cancer can happen over a number of years.
Colon polyps are usually symptomless; hence it becomes difficult to diagnose the condition. They are commonly found as additional results of screening tests for colon cancers. Screening tests are conducted when there is a suspicion of a disease but it displays no significant symptoms. The symptoms can only be visible if the polyps are enlarged. Typical symptoms include:
Rectal bleeding.
Changes in bowel conditions such as diarrhoea and constipation.
Changes in urination patterns.
Change in appearance of stool.
As the presence of most polyps becomes evident only during colon cancer tests, it is recommended that regular tests for colon cancer be conducted for adults over the age of 50. Some of these tests include:
Colonoscopy: This is highly recommended for detecting colon polyps. A small tube used for viewing is inserted into the colon by the doctor.
Flexible Sigmoidoscopy: It is similar to colonoscopy with the only difference being that the tube is smaller.
Computed Tomographic Colonography (CTC): Also known as virtual colonoscopy, various computer systems and X-rays are used to create a detailed picture of the colon so that the doctor can search for polyps.
The size of the colon polyps helps to identify if the polyp is cancerous or not. Chances of the polyp being cancerous are high if the size of the polyp is higher than 1 cm or 0.4 inches. Hyperplastic polyps (smaller polyps) do not become cancerous and hence, do not need to undergo a colonoscopy. Another form of polyp is the sessile polyp which is usually a flat growth without a stalk and grows on the inner wall of the colon. Similar to other polyps, these polyps can be found and removed using a colonoscopy or a sigmoidoscopy.

Causes and Symptoms of Colonic Polyps

It is a slowly and gradually progressing disease in which healthy liver tissue is replaced with scar tissue, hence preventing the liver from proper functioning. The developed scar tissue blocks the flow of blood through the liver and slows the processing of nutrients, hormones, drugs, and naturally produced toxins. It also slows the production of proteins and other substances made by the liver. Cirrhosis is a complication of liver disease which involves loss of liver cells and irreversible scarring of the liver. In other words, Cirrhosis is a condition in which the liver does not function properly due to long-term damage. Typically, the disease comes over months or years.

Although there are many other causes for cirrhosis, the commonest is excessive use of alcohol, viral hepatitis B and C infections and non-alcoholic fatty liver disease. Thus the scarring is most often caused by long-term exposure to toxins such as alcohol or viral infections.

According to the National Institutes of Health, it is the 12th leading cause of death. Men are more prone to develop cirrhosis than women. Globally approximately 57% of cirrhosis is attributable to either hepatitis B (30%) or hepatitis C (27%).Alcohol consumption accounting for about 20% of cirrhosis.

Persons most commonly affected: Adults of both sexes.

Unani approach to Cirrhosis of Liver (Talayyuf-e- Kabid)-

In Unani literature Cirrhosis of the liver is known as  Talayyuf-e- kabid ,  Sighr-al- kabid  or  Jigarki laghari . It is of two types.

1. AcuteType of Cirrhosis of Liver (Talayyuf-e- Kabid Hadd)-

It is rare but very dangerous. It is also called Yarqaan-e- khabees or Huzaal-e- asfar. Mainly occurs due to inflammation in hepatic cells, in which hepatic cells squeeze in few days resulting in improper functioning of liver. It is a disease in which cells throughout the liver are destroyed. Although they are replaced by areas containing normal new cells but also by much scar tissue, which alters the structure of the liver.

Causes and risk factors: Excessive use of alcohol/ chronic alcoholism, poor nutrition, highly toxic condition of the body system, viral infections caused by chronic viral hepatitis (types A, B and C), metabolic diseases such as alpha-1-antitrypsin deficiency, galactosemia and glycogen storage disorders,inherited diseases such as Wilson's disease and hemochromatosis, biliary cirrhosis, toxic hepatitis due to severe reactions to prescription drugs or prolonged exposure to environmental toxins and repeated bouts of heart failure with liver congestion etc.

Signs and Symptoms: The main signs and symptoms of this type are jaundice, pain at the site of liver, vomiting, headache, dizziness, increased body temperature, increased pulse rate, brownish coloured and dry tongue, increased thirst, initially whitish coloured diarrhoea, later on, colour becomes blackish due to contamination of blood, urine passes in less quantity and reddish in colour due to contamination of yellow bile in it,  haemorrhage from nose, stomach, intestine and uterus even abortion in women are seen. The size of the liver feels small on palpation.

2. Chronic type of Cirrhosis of Liver (Talayyuf-e- KabidMuzmin)

This type of the disease occurs due to the improper blood supply to the hepatic cells resulting in the size of liver very small in appearance but liver cells stay normal.

Causes and risk factors: The main causes of this type are the application of permanent pressure at the site of the liver such as ascites, alcohol abuse, hepatitis C virus infection, cardiomegaly, poor nutrition, highly toxic condition of the body system, peritoneal inflammation, improper diet in old age and starvation etc. Other causes which develop this disease are, obstruction of the external bile duct by stone, scar, inborn defect or tumour, use of certain medications, syphilis and passive liver congestion. Obesity has recently been recognized as a risk factor in non-alcoholic hepatitis and cirrhosis.

Signs and Symptoms: It is a slowly progressing disease. In early-stage symptoms, of indigestion like flatulence, constipation and diarrhoea may be present. General weakness, the feeling of being unwell, loss of appetite, loss of weight, and a loss of interest in sex may also be there. There may be a dull abdominal ache, nausea and vomiting. Eventually, the patient dies due to anaemia or ascites. The feeling of dullness is the peculiar sign of the disease. Other symptoms and signs include low-grade fever, bad breath, jaundiced skin and bloated and swollen abdomen.

Complications and Risks associated with Cirrhosis of Liver (Talayyuf-e-Kabid)-

Ascites (retention of fluid in the abdominal cavity) is the most common complication of cirrhosis and is associated with a poor quality of life, increased risk of infection and a poor long-term outcome. Other potentially life-threatening complications are hepatic encephalopathy (confusion and coma) and bleeding from oesophageal varices. Cirrhosis is generally irreversible, and treatment usually focuses on preventing progression and complications. In advanced stages of cirrhosis, the only option is a liver transplant.

Preventive measures for cirrhotic patients (Talayyuf-e- Kabid ke Mareezon ke liye Ehtiyaati Tadaabir):

Cirrhotic patients must completely avoid alcohol. Alcohol accelerates liver failure and hastens death in cirrhotic patients.
Avoid liver toxins. Acetaminophen (Tylenol), should be avoided because they can be toxic in cirrhotic patients.
Juice therapy helps the liver to detoxify toxins from the body. Cirrhotic patients should mix one part of pure juice with one part of water before drinking.
Cirrhotic patients are strongly advised to eat smaller meals. To avoid overworking the liver, five or six smaller, lighter meals per day are recommended.
Avoid fatty foods and processed foods, especially foods prepared with animal fats or hydrogenated oils. These types of foods put additional load on the liver.
Cirrhotic patients are also advised to eat only lean proteins (containing no fats) and in limited amounts.
Vegetable proteins are very beneficial in Cirrhotic patients. High protein intake causes increases of ammonia levels in the blood, possibly resulting in mental confusion, and in severe cases, coma. However, do not severely limit protein intake, as this may cause protein deficiency and impair the healing process.
Routinely increase consumption of fruits and steamed vegetables as fruits and vegetables are easy to digest, thus less work for the liver. In addition, they are good sources of vitamins, minerals, and antioxidants that help the liver detoxify and heal.
Cirrhotic patients are advised to practice intermittent fasting.
They are also advised to protect against hepatitis B, C and E.
Fundamentals of Management in Unani Medicine-

Identify the cause of the disease and treat it accordingly
Correct the digestive processes
Use hot dresses
Use mild and early digestible diet
In case of ascites treat it
Management/ Treatment-

In Unani medicine, very effective treatment is available for the Cirrhosis of Liver by strengthening the Liver cells and restoring normal size and functions of the Liver. In Unani medicine, there is a number of hepatoprotective drugs that protect the Liver either acute or chronic type.

SootshekharRas Swarna yukta 125 Mg twice a day
PittariAvleh 10 gm twice a Day
Duration of the treatment: 3 to 6 months or it depends upon the condition of the patients. If the patients with cirrhosis have diabetes, then the treatment may take long time for curing the disease. Diet plays a key role along with Unani Medicines. Hence, it is strictly advised to follow a proper diet plan.

Talayyuf - E - Kabid Or Cirrhosis Of The Liver - Know More About It!

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