Bariatric surgery is a surgery performed on the stomach and is usually recommended for people who are obese. If you have a BMI value more than 40, then this surgery is a very good option. Along with those having an obesity problem, this surgery is also said to be ideal for those people who are suffering from type 2 diabetes and having a BMI value between 35 to 40.

There are many studies which show that there is a great improvement in people with type 2 diabetes after bariatric surgery. Even the cholesterol and blood pressure levels can also be controlled with the help of this surgery. Post-surgery, you will have to take fewer medicines or in some cases, you need not have to take medicine at all.

How does the doctor decide if you need bariatric surgery?
Basically, there are two things that will be considered by the doctor. The first one is the BMI value, which should be above 35. And the second parameter to consider is if you have tried any other methods to lose weight but did not succeed. Based on these and if you are ready to face the mental and physical challenges after the surgery, you will be advised to go through this surgery. You should make sure that you are doing regular exercise and also eat less.

Types of bariatric surgeries for type 2 diabetes

Gastric bypass: In this kind of surgery, the stomach is divided into two parts. One small part at the top is separated from the lower part of the stomach. Whatever you eat, will go into this small part of the stomach and that makes you feel full faster. Also, fewer nutrients and calories are absorbed into the body. After this kind of surgery, more than 80 percent of diabetes patients showed no signs of diabetes at all.
Gastric sleeve: In this surgery, a large portion of the stomach is removed and hence you will be able to eat less. This also reduces the amount of ghrelin, the hormone responsible for making you feel hungry, produced. This is successful in 60 percent of people with type 2 diabetes.
Adjustable gastric band: A small inflatable band is placed around the stomach. This will look like a small pouch at the place where the food goes in. This pouch will get full a lot quicker and hence you will not be able to eat too much.
Does it help?
Some surgeries show 80 percent success rate and some show 60 percent success rate, but that is in terms of diabetes levels. Due to less food, the body will not get the required minerals and vitamins, which will result in other health complications. Some surgeries are also irreversible. So, it is your doctor who understands the surgery and your health better and they will always suggest the best option for you.

Bariatric Surgery For Type 2 Diabetes - Does It Help?

Adrenal cancer is a rare and aggressive disease that causes abnormal cell growth inside the adrenal cortex. This cancer usually appears as tumors at the outermost layer of the adrenal glands and gradually develops cancerous cells. In the majority of the cases, adrenal cancer is diagnosed only after it has been growing for several years.

Symptoms
While most of the adrenal cancer patients have the common symptoms, often some people feel just fine, unless until their doctors find the presence of cancerous cells in the adrenal cortex through CT scan. Generally, the symptoms of this life-threatening disease depend on three factors, which are:

The particular type of overproduced hormone
The tumor producing hormones excessively
And, type of the tumor
However, it is the overproduction of particular hormones, that makes the majority of the symptoms visible. Below are the common symptoms of adrenal cancer, depending on hormone types that are overproduced during the presence of this disease.

Symptoms of cortisol overproduction
When the presence of adrenal cancer leads to excess production of the cortisol hormone, people start experiencing different types of symptoms. The accumulation of fat behind the shoulders and neck, gradual weight gain in the stomach and chest portions irregular periods, and hair growth on the chest, face and back (in women) are the most prominent ones. One can also suffer from depression, weakness in legs, and easy bruising as other signs of cortisol overproduction.

Symptoms of aldosterone overproduction
As a result of the overproduction of the aldosterone hormone, people generally have feelings of excessive thirst, feelings of tiredness and weakness and sometimes high blood pressure. The desire of urinating frequently and painful muscle cramps too become evident due to the excessive production of aldosterone.

Symptoms of testosterone overproduction
When as a result of malignant tumors in the adrenal cortex the production of the testosterone hormone goes to higher than normal levels, it is considered to be overproduction. The voice becoming deeper, excessive invasion of acnes, irregular periods become prominently visible symptoms of this kind of adrenal cancer. Even, excessive growth of body hair or the facial hair and heightened muscle mass are some of its common symptoms.

Symptoms of estrogen overproduction
The growth of the breast in males and the early puberty in females are the most common symptoms of adrenal cancer where the malignant tumors overly produce estrogen hormone. Even decreased sex drive or impotence in males can be considered as its other serious symptoms.

Apart from the above mentioned adrenal cancer symptoms, in some cases, the adrenal tumors become so big that they start pressing the nearby organs which leads to signs of abdominal pain or feelings of fullness in the belly. The moment one identifies having any one of the signs discussed here, he or she should look for medical attention immediately.

Adrenal Cancer - What Are The Symptoms?

It is an extremely embarrassing situation to have a bladder leakage. Social life could be altered, with reduced socialising for fear of losing control in the presence of others. Though not discussed frankly, it is an extremely common issue and about 25 million people in the United States suffer from this, with 75% of these being women.

Treatment depends on the type of incontinence, such as stress, urge, overflow, functional, or mixed. It starts with least invasive methods like lifestyle changes moving over to surgical approaches.

Ways to manage it

With trips to the toilet increasing considerably when you have urinary incontinence, simple measures can help manage leakage.

Bladder training: Train your bladder to control the urge for another 10 minutes. This happens by voluntarily contracting the muscles and holding up the urge to go to the toilet. Gradually, it will help increase the frequency of the visit to 4 to 6 hours.
Scheduled toilet trips: Whether or not there is an urge, visit the toilet every 4 to 6 hours.
Double emptying: Even after you have voided, force yourself to void one more time. The residual urine, which is almost always present in the bladder, also gets emptied.
Food/diet modifications: Stress incontinence is worsened by alcohol, spicy foods, acidic foods, and caffeine. Avoiding these can help reduce bladder leakage.
Kegel exercises: The simple repetition of contracting the pelvic floor muscles, holding it in place, and releasing it can do wonders for strengthening the pelvic floor. This can be done anywhere and any time of the day and is very effective for improving bladder control.
Catheters: These can be used if the incontinence is short-lived; the person would need to learn how to safely insert and remove it.
Absorbent pads and medical devices: The absorbent pads are helpful in preventing embarrassment during social situations. On the other hand, medical devices like pessary are inserted into the vagina to support the bladder neck and thereby prevent leakage from the bladder.
Drugs: Anticholinergics/antimuscarinics are useful to control a leaking bladder. Botox injections can help paralyse the overactive bladder muscles and provide a solution. Topical oestrogen may be used in small amounts to improve tone and reduce incontinence. Alpha blockers are also used in some people with good results. There are muscles that relax the bladder and increase the amount of urine it can contain.
Surgery: In the event that all these measures are not useful, surgical correction is possible. Sling procedure where an artificial mesh is used to support the urethra. Bladder neck suspension is where the bladder neck is given support to prevent leakage. If there is a pelvic organ prolapse, that is corrected to rectify the bladder leakage.

 Bladder Leakage - Solutions To Help You Manage It!

Problems of the large intestine are very common and patients should usually consult gastroenterologists for the proper diagnosis and treatment

1. Bleeding per rectum: Bleeding through the anal canal or rectum is usually the most common problem of the patients. It can be due to following reasons: 

A. Piles also known as Hemorrhoids: Hemorrhoids are dilated venous channels of the anal canal. They occur due to long term constipation or chronic cough or due to less fibre intake in the diet. Sigmoidoscopy or proctoscopy is required for diagnosis. Treatment options include medicines and high fibre intake, Injection therapy(Sclerotherapy) for stopping bleeding from piles and Stapler hemorrhoidectomy if the piles are large.

B.  Polyps: Polyps are soft tissue growths seen in the large intestine. They are usually silent but can present with bleeding or anaemia. Polyps usually grow slowly in size and large polyps can turn into cancer of large intestine also known as colorectal carcinoma. Colonoscopy is required for the diagnosis. The gastroenterologists can diagnose the presence of polyps by colonoscopy. Smaller polyps can be removed by polypectomy by gastroenterologists without the need for open surgery. However large polyps or those polyps with suspicion of cancer require surgery.

C. Large intestine Ulcer: They can occur due to early cancer, SRUS, Infections or drugs. They require colonoscopy for the diagnosis. The gastroenterologists usually take Biopsy from the ulcer to know the cause of the ulcer. The mere taking of biopsy does not mean cancer and biopsy samples are seen in the microscope for better diagnosis.

D. Ulcerative Colitis and Crohn s disease: Ulcerative colitis is one form of Inflammatory bowel disease (IBD). The other IBD is known as Crohn s disease. Whereas ulcerative colitis involves only large intestine, Crohn s disease can involve any part of the gastrointestinal tract including small intestine. Ulcerative colitis and Crohn s disease present with Loose stools(diarrhea), bleeding , abdominal pain, weight loss, Anemia and Perianal fissures and  fistula. The diagnosis of IBD is challenging and involves blood tests, CT Scan abdomen, Colonoscopy with biopsy and clinical history. Management includes Medicines which control the inflammation such as Pentasa, Rowasa, Mesacol etc. Severe disease requires additional drugs such as Azathioprine and Anti TNF sich as Infliximab and Adalimumab. Occasional cases require surgery such as those with tight stricture of the intestine, severe dilatation of Large intestine (also known as Toxic megacolon), excessive bleeding, the disease not responding to medical management, or presence of cancer with IBD.

E. Anal fissures: Cut in the anal skin (fissure) causes severe pain in the anal area during passing motions. It is usually due to constipation or straining. It is usually treated by Gastroenterologists initially by medicines and ointments. If the pain continues Surgery is required named as Lateral internal sphincterotomy (LIS).

2. Loose motions or Diarrhea: Excessive passing of liquid motions is known as diarrhea or commonly lose motions. It is usually due to Infections caused by contaminated food and water. It is usually self-limiting. Severe cases with dehydration require admission for IV fluids and antibiotics for the infection. Loose motions for more than 6 to 8 weeks is known as chronic diarrhea. It is evaluated by blood tests and colonoscopy. Usual causes include tuberculosis, celiac disease, ulcerative colitis, microscopic colitis, Malabsorption such as chronic pancreatitis and small bowel bacterial overgrowth.

3. Irritable bowel syndrome (IBS): IBS is very common and at least 20 to 30 percent of Indian patients suffer from it. Symptoms include altered bowel habits such as diarrhoea or constipation, abdominal pain which is usually relieved or increased by defecation. Weight loss or bleeding is not the feature of IBS. Few simple blood tests are required and good medicines are now available for IBS. Few cases may require colonoscopy to rule out alternative causes of the symptoms.

Understanding colonoscopy: Colonoscope is a flexible tube with a camera at its tip to see the inside of the large and small intestine. Bowel preparation is required at least 8 hours before the procedure so that the inside of the large intestine can be seen clearly without the interference of stools.colonoscopy is an OPD based procedure where the patients are discharged the same day. A colonoscopy helps in evaluation symptoms of the large intestine such as loose stools, bleeding and abdominal pain.

In Detail About Colorectal Disorders!

If you have taken the big decision to go ahead with bariatric surgery, one thing you need to prepare for well in advance is the additional effort that is required after the surgery to ensure it is a success. The results will be evident only after a few months post the surgery. This period requires your constant attention. 

Listed below are some after-care measures that are essential for the success of a bariatric surgery.

Hospital stay: Most patients are advised hospital stay for four days, during which the hospital staff will ensure the sleeve is working fine. No food is allowed for 48 hours. Diet is gradually advanced from water to clear liquids, about 50 ml to 100 ml and then to 150 ml.
Wound care: Depending on whether a laparoscopic or open surgery was done, the number and location of incisions will vary. However, the wound should be maintained clean and it should be ensured that there is no infection of the site. Wound care should be done by the nursing staff if required. Suture removal, if required, should be done as per doctor s advice.
Pain management: Finish the course of antibiotics and pain killers to ensure infection is completely gone. Pain would continue, if the infection is not completely controlled.
Diet: The first two weeks would be a completely liquid diet. The next two weeks will consist of a pureed diet. After these four weeks, solid foods will be introduced.
Foods to avoid after a bariatric surgery include anything with a higher protein content and anything that has too much oil as the stomach s ability to digest these is reduced. Refrain from:

Carbonated beverages
Hard meat
Nuts and seeds
Fried foods
Food items to include post bariatric surgery include those which are easy on the stomach, including:

Liquids such as soups, broth, juice, and milk
Pureed cooked vegetables and eggs
Soft mashed food including meat and vegetables
Adherence to this will reduce complications. While eating, the patient should also remember to chew nicely, eat and drink slowly, increase water intake throughout the day, and avoid fats and sugar. It is advisable to eat three proper meals a day and avoid snacking during the day.

Remember that the need for bariatric surgery arose in the first place due to uncontrolled eating of oily food. After undergoing a bariatric surgery, diet pattern is definitely going to move to a healthier side with reduced fat and sugars. It is not an easy shift, but definitely required, if the surgery is to be a success. Imagine the new you and you will be able to do it!

Bariatric Surgery - Aftercare Tips You Must Follow!

Since the development of modern medicine, doctors and health care professionals have always tried to come up with minimally invasive procedures for both diagnostic purposes as well as surgery. Endoscopy was developed to see inside a human body without the need for large incisions or surgery.

What is Endoscopy?
Endoscopy is a type of procedure wherein the doctor inserts a long thin tube into the body through an opening such as the mouth, anus or the urethra. Sometimes small incisions may be made on your body to insert the tube as well. The tube which is inserted within the body is fitted with a camera which allows the doctor to see what is wrong within your body, a specific section or organ. Doctors can even take images or videos of your organs which help them to determine a due course of action in your treatment. Endoscopy may also be used as a part of a laparoscopic operation to correct problems within the body, especially in cases wherein tissues have to be removed.

Types of endoscopy and its uses-
Although endoscopy could be used in any part of the body, there are certain areas where they are used more commonly than the others. Some of the types or endoscopies are mentioned below:

Colonoscopy   Used to examine your colon wherein the scope is inserted through your anus
Laparoscopy   This is one of the most common forms of diagnosis as well as surgery wherein the tube may be inserted through a small area in your abdomen or the pelvic area. This is not only used for imaging or diagnosis but is used in surgery as well.
Arthroscopy   Here, an incision is made on the joints of your body to check for problems
Cystoscopy   In this type, the tube is inserted through the urethral opening to check for problems in the urinary tract or the bladder. Another variation of this would be ureteroscopy.
Enteroscopy   This is an endoscopic examination of the intestines wherein the tube is inserted via the anus or the mouth.
Hysteroscopy   Here, examination of the uterus and the female reproductive organ is carried out wherein the endoscope is inserted into the vagina.
Bronchoscopy   It entails an examination of the lungs wherein the scope may be inserted through the nose or mouth to check the lungs
Upper gastrointestinal endoscopy - This is used for the examination of the esophagus and the upper intestinal tract.
Risks and safety-
Endoscopy is a widely performed and very reliable procedure. In the hands of a skilled doctor, endoscopy will be able to determine the cause of the problem and also correct the issues if surgery is also performed along with it. However, like any procedure, it does carry certain risks although the chances are fairly low. Some of the risks are mentioned as follows  

Perforation or other injuries to your organs such as scraping or bruising
Fever due to the introduction of foreign materials
Persisting pain in the specific area wherein endoscopy was performed
Swelling of the area wherein the tube was inserted
Infections after the procedure
Bleeding at the site of the incision or entry of the tube
However, these cases are rare and only occur in a very small section of the cases. Although there is minimal pain associated with the procedure, the benefits far outweigh the risks and inconveniences.

8 Types Of Endoscopies & For What They Are Used For!

Don't wait any longer, manage your General Surgeon online with a Lybrate doctor today

Consult for General Surgeon - Online and Easy!

FilterClear All

COMMON SPECIALITIES

COMMON ISSUES