Gallstones are solid deposits/stones of digestive fluids that form in the gall bladder. The size of these stones varies from person to person. While some people may develop only one stone in the bladder, others may develop multiple gallstones simultaneously.

Signs you must watch out for-

Abdominal pain
Pain in the back or between the shoulder blades
Vomiting and nausea
Heartburn
Bloating and indigestion
Change in bowel movement
Dark urine
Fever and chills
Rapid heartbeat
Yellowish skin and pale eyes (Jaundice)
These are the most common symptoms that a person with gallstones encounters. One should consult the doctor right away upon experiencing these symptoms. If ignored for long, these signs can aggravate and lead to further complications.

Complications that may arise from gallstones-
There are quite a few complications of gallstones, including the following-

Cholecystitis- when gallstones become stuck at the neck of the gallbladder, it causes inflammation.
Obstruction in the pancreatic duct- a gallstone blocking the pancreatic duct can cause pancreatitis followed by intense abdominal pain.
Blockage in the bile duct- if the gallstones create a blockage in your bile duct, the outcome may be an infection or jaundice.
Gallbladder cancer- people, who have a history of gallstones, are more likely to develop gallbladder cancer.
Treatment of Gallstones-
Gallstones can certainly be treated, if diagnosed early in time. To confirm the diagnosis, your doctor may perform a CT scan, X-ray, Ultrasound or an ERCP. Once the condition is diagnosed, your doctor will recommend a surgery to remove the stones in the gallbladder (known as Cholecystectomy). The preferred choice of surgery includes the following-

Laparoscopic removal- In most of the cases, the doctor adopts this minimally invasive approach to remove gallstones. First, he makes a small incision in the abdomen. He will then insert a tube-like instrument with an attached camera into the gallbladder to have a clear sight of the gallstones, and surgically remove them from the gallbladder.
Open surgery- This is performed under general anesthesia. During this procedure, a single, long incision of roughly 3-6 inches is made on the upper side of your right abdomen. The tissues and muscles are pulled back to divulge the gallbladder. The gallstones are then removed, and the incision stitched up. Open surgery is performed when laparoscopic surgery is not suitable for the patient.
Gallstones cannot be managed with just diet and medications. A surgery is usually needed to remove the stones and cure the patient. For Laparoscopic surgery, the rate of success is nearly over 95%. Identify the symptoms before it aggravates, and consult a doctor for treatment.

Gall Stones - Is Surgery The Only Treatment?

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!

The human body with its multiple organs is a highly complicated structure and one or more organs often malfunction for various reasons. However, for some, no reasons are identified for this problem. One such is irritable bowel syndrome or IBS as it is commonly referred to.

It is a common disorder affecting the large intestine leading to alternate bouts of diarrhea and constipation, abdominal cramps and a feeling of fullness. It is common in people younger than 45 years of age, affects women more than men, and though the exact reason is not known, the following are attributed.

Physical/Physiologic reasons:

1. Signal issues between the brain and intestines: For various or even unknown reasons, the brain may not be able to send the right signal to the stomach to process food, making the stomach to be hyperactive and have an increased sense of pain or sensitivity or discomfort. Neurotransmitters, which are chemicals responsible for sending signals to various organs also could be involved.

2. Hormonal connection: Menstrual periods tend to aggravate symptoms of IBS, while postmenopausal women are largely free of IBS symptoms.

3. Genetics: People with a family history of IBS are more likely to develop IBS too.

4. Aggravating foods: Foods rich in carbohydrates, spicy foods, fatty foods, caffeine and alcohol aggravate IBS symptoms. Ability to absorb sugar could be a cause too.

5. Infections: Some people with IBS have certain bacteria identified in their gut which produces excessive gas and this could lead to altered bowel movements.

6. GI Motility Issues: Alterations in the way the food passes through the stomach can lead to either constipation (slow movement) or diarrhea (quicker movement). There could also be spasms and contractions after eating, especially if the stress levels are high.

7. Psychological issues: Panic disorder, anxiety, depression, and posttraumatic stress disorder are common in IBS patients. It is possible that they are not able to express their psychological stress, it manifests as physical symptoms. Stress increases symptoms of IBS and vice versa.

Management:

1. Manage stress: Meditation, yoga, support groups, medication and even hypnosis in severely stressed people helps control stress, providing great relief in IBS symptoms.

2. Lifestyle changes: Reduce alcohol and smoking

3. Dietary changes: Avoid aggravating foods, increase the amount of fiber if you have diarrhea and space out meals to avoid intestinal overload

4. Herbal remedies: Probiotics, peppermint oil and a variety of herbal medicines are available.

5. Symptomatic medications: Based on presenting symptoms, different medications including antibiotics for infections and motility drugs can be used. Anti anxiety and antidepressants are also prescribed to manage the psychological issues.

In terms of causes, symptoms, or treatment, IBS requires a very individualized approach and your doctor is the right person to discuss this with and decide.

Irritable Bowel Syndrome - Symptoms and Management

What is Colitis?
Colitis is a chronic bowel disease that causes inflammation in the lining of your colon i.e. the large intestine.

Prevalence in India -
Once prevalent in Western countries, colitis is on the rise in India among other Asian countries. The causes for this rise are mainly the degrading environment and the consequent changes in your genes. Colitis brings many changes to your lifestyle. Therefore, it is important to arm yourself with all the information about the disease to better manage it and lead the life you want.

What are the causes?
The common causes of colitis are -

Infection due to virus, bacteria and parasites
Decreased blood supply
Allergic reactions
What are the signs and symptoms of Colitis?
The signs and symptoms of colitis include the following-

Extreme pain before, during or after diarrhoea in the lower abdomen
Aches in joints and muscles
Tender abdomen
Swelling of colon
Redness on the colon surface
Bleeding from stool
Diarrhoea or constipation
Loss of appetite
Weight loss
Fever, fatigue
Dehydration
Eye and skin inflammation
What can you do to prevent it?
In order to prevent the occurrence of colitis, you can adopt a few steps. Precautionary measures mostly include dietary changes. You should avoid intake of certain foods to eliminate the symptoms of the disease.

Avoid the consumption of dairy products
Avoid eating spicy foods
Avoid including vegetables like cabbage, dried beans, peas in your diet
Refrain from drinking alcohol, caffeine and carbonated drinks
Instead, include white bread, white rice, pureed vegetable soup, canned fruits, etc
Depending on the diagnosis and the treatment, people do get better. Many people can build successive careers after getting treatments. However, initially, the symptoms will cause a problem in your daily life. It is important to know how you can identify the early signs and what you can do to manage or prevent them.

Know More About Colitis!

Peptic ulcer disease is a form of disease in which painful sores or ulcers are developed in the lining of the stomach or in the duodenum, which is the first part of the small intestine. Complications include severe blood loss and perforation of the stomach and intestines.

What can cause peptic ulcers?
Ulcers occur due to the imbalance of digestive fluids in the stomach or duodenum. Usually, ulcers are caused by the infection due to bacteria known as Helicobater pylori.
Here are the factors which may lead to peptic ulcer:

    One can use painkillers, which are known as nonsteroidal, anti-inflammatory drugs, by the likes of aspirin, naproxen, ibuprofen and several others.
    These kinds of ulcers may also occur due to excessive production of acid from gastrinomas.
    Excessive alcohol consumption may also cause peptic ulcer.
    Smoking cigarettes and chewing tobacco may cause such ulcers.
    Sometimes serious illness may cause peptic ulcer as well.
    Radiation treatment of the affected area may also lead to peptic ulcer.

What are its signs and symptoms?
There are several symptoms of peptic ulcer. They include the following:

    People experience a sensation of burning or gnawing pain in the upper or middle part of the stomach, between meals and during night time.
    Bloating is experienced.
    A feeling or sensation of heartburn.
    Nausea and vomiting are likely to be accompanied.
    In severe cases of peptic ulcer, dark or black stool is produced because of bleeding.
    The patient may vomit blood.
    Weight loss and abdominal pain are indicated, especially in the upper to mid abdomen region.
    Indigestion and change in appetite are also noticed.
    There is pain in the chest.

How to treat them?
Peptic ulcers can be treated in various ways, which include medication, lifestyle changes or surgery.
1. Lifestyle changes: Elimination of substances which lead to peptic ulcer should be avoided. Smoking and drinking should be restricted. Certain NSAIDS may lead to ulcer, and they should be stopped.
2. Medication: Proton pump inhibitors help in reducing acid levels, which allow healing of the ulcer. Different types of PPI are esomeprazole, dexlansoprazole, omeprazole, pantoprazole and iansoprazole.

Several antibiotics may also be used when a patient has helicobacter pylori infection. Several combinations of antibiotics may be used for the treatment. Bismuth may be used as well.
Upper endoscopy can be done as a part treatment of ulcer to cure bleeding ulcers. In case the ulcer creates a hole in the stomach s wall, surgery is required. Peptic ulcer is a serious health condition and if not treated properly, it can cause several health hazards. There are several treatment options for peptic ulcer, and you should opt for the one that suits you the best.

Peptic Ulcers - 6 Possible Reasons Behind them

Celiac disease is an autoimmune disease caused due to intolerance to the protein called gluten found in common foods like wheat, barley, and rye. The exact reason for the disease is not known, but gluten attacks the small finger-like projections in the intestine called the villi, which help absorb nutrients during the digestion, leading to malnourishment.

Onset of the disease is usually once the child has started on solid foods and can include diarrhea, abdominal discomfort, underweight, skin rashes, anemia, mouth sores, etc.
Diagnosis usually happens with a detailed discussion and checking the level of antibodies against gluten in the blood. In rare cases, an intestinal biopsy may also be required. Once confirmed, the following are ways to manage celiac disease-

Dietary changes: avoiding gluten-containing foods is the first step to treating celiac disease. These are common food substances like wheat and barley. In some cases, the entire family may choose to or need to take this diet, just to provide moral support to the child.
1. Breads, cakes (made from wheat)
2. Creamed or breaded vegetables
3. Processed meats
4. Dry roasted nuts (as agents used in processing could have wheat)
5. Fried chicken
6. Pastas
7. French fries (that are coated in flour)
8. Spreads, soft cheeses, and dips
9. Salad dressings
10. Gravies and sauces (including some tomato and meat sauces)
11. Soup mixes and canned soups
12. Crab or other seafood
13. Malt or malt-flavored drinks (usually made from barley)
14. Modified food starch (modified corn starch is ok; modified wheat starch is not)
15. Nondairy creamer
16. Soy sauce and soy sauce solids (may be fermented with wheat)
17. Wheat-free products (may contain barley or rye flour)
18. Yogurts containing wheat starch
Read the labels of foods to ensure they are free of gluten. Organic/natural food stores and health food stores contain wide range of gluten-free products that can be used with minimal effect on the child's food habits.

Eating out: just because the child has celiac disease, eating out is not ruled out. Carefully choosing what to eat is suggested. Also, letting the chef know is a good idea, as most chefs will prepare something safer for the child.

Cross-contamination: avoid cross-contamination: in schools or in cases where the child could potentially eat from other children's boxes, make sure the child is well informed and ensure he does not eat from other kids' lunch boxes. It is also a good idea to keep the class teacher and a couple of his close friends informed of the child's condition.

Most children are easy to educate and adapt well to the changes required, knowing very well that it is for their own good.

Tips to Deal With Celiac Disease in Children

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