The liver is the second largest organ in the human body. Everything that is consumed goes through the liver and gets metabolized. Generally the liver consists of fat accumulation, in the range of 2%, but when it reaches close to 10%, the condition is termed as fatty liver. Progression of fatty liver can lead to cirrhosis and eventually liver failure. The liver has an amazing ability to regenerate itself if a part of it is damaged. 

However, if the damage is cumulative, then the repair becomes difficult. Another point to note is that the liver can be resected in parts to ensure that the non-affected liver continues to be available to take care of the metabolism.

Causes: There are two main types of fatty liver:

Alcoholic fatty liver: This is the most common type and is seen in heavy drinkers.
Non-alcoholic steatohepatitis (NASH): The causes for this type are not clear, but obesity, diabetes, and hyperlipidemia are some causes for NASH.
Symptoms: Fatty liver develops over years, and the symptoms are both vague and appear randomly. These can be attributed to any general illness, and so diagnosis is often delayed.

Unexplained weight loss
Jaundice
Loss of appetite
General malaise
Dull pain in the right upper quadrant of the abdomen
Overall physical weakness
Ascites or fluid accumulation in the abdomen
Increased tendency to bleed
Abnormal liver enzyme levels
Diagnosis: If suspected of fatty liver, the following are done to confirm the diagnosis.

Blood tests to check for liver enzyme levels.
Imaging studies including x-ray, CT and/or MRI scan
Biopsy to confirm the diagnosis
Treatment: Fatty liver is a completely reversible condition. If a person with alcoholic fatty liver quits drinking for about 8 to 10 weeks, the damage can be totally reversed.

If there is no history of alcoholism but obesity, then switching to a non-fatty diet with lots of fresh fruits and vegetables, multigrain, dairy products, etc., can help in controlling fat accumulation and use the stored fat. Increasing the levels of physical activity also helps in burning stored fat.

As noted, the liver is capable of self-repair and self-regeneration, so if further triggers are stopped, it can heal itself.

If fatty liver is not controlled, it can develop into cirrhosis and liver failure. If it reaches liver failure, then survival rates and prognosis look very gloomy.

Prevention: Fatty liver disease can be prevented by controlling alcohol intake, adopting a healthy lifestyle, eating non-fatty and non-sugary products, and maintaining an active and healthy lifestyle.

Monitor health periodically to check on liver function, diabetes, and cholesterol levels.

Fatty Liver - All You Need To Know!

Crohn's Disease is a medical condition that falls under the category of Inflammatory Bowel Disease. Crohn's disease triggers inflammation of the digestive tract resulting in ulcerations and sores, mostly affecting people between 17-30 years (people of other age groups can also be affected). The inflammatory disease is a chronic illness that gives rise to a host of complications such as frequent and chronic diarrhea, fever, rapid weight loss, abdominal pain, to name a few.
Unfortunately, there is no permanent treatment available for Crohn's Disease. However, effective remedies and treatments are available to reduce and manage the symptoms and complications associated with Crohn's Disease. Many people dealing with Crohn's Disease have benefitted immensely from surgery.

When surgery is recommended for Crohn's Disease?

A surgery becomes essential when the medicines and other nonsurgical treatments fail to control or manage the symptoms and complications triggered by Crohn's Disease, some of which include

Severe intestinal inflammation followed by uncontrolled bleeding
There is a bowel abscess or a perforation
Toxic Megacolon (a fatal condition whereby the large intestine swells up and also becomes dilated due to the inflammation that affects the intestinal walls)
Fistula
An intestinal blockage or narrowing of the intestinal
The surgery for a Crohn's Disease can be of different types depending on the part of the digestive tract affected.

Colectomy: This is mainly carried out in the case of the Crohn's Disease causing such extensive damage to the colon that it needs to be surgically removed. Following the removal of the colon, the small intestine may be connected to the rectum to ensure that the bowel movement is not affected.
Bowel Resection: A bowel resection is usually performed to treat a fistula or to get rid of the diseased and inflamed portion of the intestine to avoid further aggravation.
Proctocolectomy (Ileostomy): This surgery is performed to get rid of both the rectum and the colon affected extensively by Crohn's Disease. Here also, post removal of the organs, the surgeon connects the small intestine (end part or the ileum) to the stroma or a small opening in the abdomen. This rearrangement is done to ensure that the wastes from the small intestine get eliminated.
Stricturoplasty: This surgery goes a long way to open up the areas of the small intestine that have narrowed down due to Crohn's Disease.
Risks associated with the surgery
Every surgery comes with their share of side-effects and risks. In the case of Crohn's Disease, the surgeries can give rise to complications such as

Pain, swelling, bruising is common.
There may be Infection at the site of the incision.
Scarring at the incision site.
There can be a blockage of the bowel (temporary or short-term)
Surgical removal of the diseased part of the small intestine can trigger inadequate absorption of the vital nutrients (Short-Gut Syndrome).

Crohn's Disease - When Should You Go For Surgery?

An anorectal abscess is a painful swelling near the anus or in the buttock. The swelling contains pus. 60% anorectal abscesses are superficial and resulting from infection in small anal glands present in between internal and external anal sphincters (intersphincteric space). They are known as a perianal abscess. 30% of anorectal abscesses are deep-seated and results in systemic infection. They are call Ischiorectal abscess. Submucous abscess, pelvirectal abscess and pilonidal abscess developed from versatile cause are comparatively less common. Inadequate and improper management of anorectal abscess may potentially cause complication like fistula formation.


Fast facts on Anorectal abscess-

* Anorectal abscess should be drained at the earliest.
* Conservative medical management almost invariably invites complication like fistula formation.
* Surgical drainage of pus reduces the chance of fistula formation by 50%.


What causes Anorectal abscess?

* Blocked and infected anal glands (cryptoglandular infection).
* Untreated anal fissure that becomes infected.
* Sexually transmitted infections.
* Penetrating injury of the perianal or buttock region.
* Crohn s disease.
* Colon cancer.
* Tuberculosis.



What are the symptoms of Anorectal abscess?

Superficial abscess-

* Constant and throbbing pain that worsens on sitting down.
* Swelling, redness and tenderness of the skin around the anus.
* Discharge of pus.
* Pain is often associated with bowel movement.

Deep abscess-

* All or some of the symptoms of a superficial abscess.
* Fever with chill and rigor.
* General weakness.
* Sometimes fever is the only symptom of the deep abscess.

The anorectal abscess should preferably be explored under general or spinal anesthesia. Medical management often fails and subsequently fistula is formed.

Anorectal Abscess - Know In Detail About It!

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

Gallstones are small stones that form in the gallbladder as a result of the deposits caused by the bile, a type of digestive fluid. Actually, the gallbladder stores bile and releases it into the duodenum (part of the small intestine) for the digestion of fats. However, when the gallbladder is unable to release the bile properly, the bile deposits start building up and manifest in the form of stones. These stones vary in size, ranging from tiny sand-like grains to big golf ball-like stones.

Symptoms of gallstones: Many times, individuals have stones in their gallbladder and yet they do not experience any discomfort. These stones are very small in size and therefore, do not cause trouble. This is why they are called silent stones and for such individuals, treatment is not needed. But if an individual experiences discomfort, it is a signal for treatment. The signals come in the form of specific symptoms such as pain in the upper right side of the abdomen, pain between the shoulder blades, nausea, vomiting, fever, and even jaundice.

Causes of gallstones: Gallstones may result due to common. Excess bilirubin produced by the liver causes hard, dark brown stones called pigment gallstones. Even when the gallbladder cannot empty the bile, stones are formed due to the concentration of bile.

Treatment: Once gallstones are detected through a CT scan or ultrasound, the doctor begins the course of treatment. Gallstones can be removed only through surgery. In surgery, the gallbladder is removed to help the bile flow directly into the duodenum from the liver. This surgery is called cholecystectomy and it is a safe procedure. The removal of gallbladder does not affect the digestive system in any way. 

Prevention: Gallstones can form in any individual s gallbladder but some people are more susceptible to the condition. Such individuals include women over 40, those who lead a sedentary lifestyle, obese/overweight individuals, and those with a family history of gallstones. Therefore, such people should be aware of the risk they face. If such individuals report any symptoms related to gallbladder stones, they should get it diagnosed immediately. Apart from this, one should also keep a check on the diet. A high-fat or high-cholesterol diet should be replaced with a high-fiber diet and one should also take meals on time. Not eating anything for long hours and fasting increases the risk of gallstones. Regular exercise also helps in this matter. Last but not the least, one should drink plenty of water as it regulates the functioning of the liver and prevents the formation of stones. Gallstones are a common disorder but they cause difficulties for the patient and hence, one should get it treated on time. If surgery is recommended, one should not delay it and get it done as soon as possible. Delay only aggravates the problem.

Gallstones - What All Should You Know About It?

There is hardly any individual across the world, who has not experienced abdominal pain. In most instances, these aches are not very serious and can be diagnosed and treated by addressing the underlying condition. It is very crucial to recognize the symptoms which are severe and know when an individual should seek medical assistance. 

Most common causes of abdominal pain: 

Some of the most common causes of abdominal pain include Indigestion, infection, menstrual cramps. It may also be due to food poisoning and allergies, irritable bowel syndrome, gas formation and bloating, lactose intolerance, pelvic inflammatory disease or ulcers and hernia, gallstones and kidney stones, urinary tract infection, Crohn s Disease or gastroesophageal reflux disease. 

Some patients have abdominal pain but the source of pain lies in the spine. These patients are often seen by multiple doctors and have undergone many tests but their diagnosis is never established. These patients should visit a pain specialist to reach a diagnosis and treatment plan. They have conditions like neuropathies or facet joint arthritis which cause abdominal pain due to a condition known as referred pain. 

Symptoms of abdominal pain that are cause for concern: 

Abdominal pain along with any sign of dehydration or fever or is unable to pass stools.
Abdominal pain associated with tenderness in the abdomen, painful and frequent urinations or persistent loose motions or bloody/ tarry stools. 
Severe or recurrent abdominal pain. 
Determining the cause of abdominal pain and treating it.

Detailed medical history and thorough physical examination would be performed. Further tests like USG, Endoscopy etc may be needed to reach a diagnosis. 
The treatment of abdominal pain is entirely dependent on the cause of the pain.

Abdominal Pain - Know the Causes Behind It!

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