Is there a relation between weight loss surgery and type 2 diabetes? Yes, there is and a very promising one. Many diabetics may not know this but a key hole procedure called metabolic/ bariatric surgery can help resolve type 2 diabetes.

It s scientifically proven that these surgeries can normalize blood sugar levels and control diabetes in most patients. This means that you may not need any medicines post such a surgery. One long-term study which tracked 400 people with type 2 diabetes showed that six years after bariatric surgery, 62% diabetics showed normal blood sugar levels. Apart from this, they also showed better blood pressure, cholesterol and blood triglyceride levels that can cause heart disease.

Should you get a metabolic/bariatric surgery done? You are a fit candidate for bariatric surgery if your:

BMI is 27.5 or higher
And if are finding it difficult to maintain blood sugar with medicines & lifestyle changes.
Your doctor will give you a physical exam to check whether you are fit for a major surgery and if you are emotionally ready to commit to necessary lifestyle changes like eating healthy and exercising regularly.

Types of weight loss/diabetes surgery:

The most popular type of weight loss surgery is one in which the size of your stomach is reduced so that you feel full even after small meals. Other types of bariatric surgeries change the way your body absorbs calories and nutrients and vitamins. A few other types of bariatric surgeries do both.

Gastric Bypass: In this surgery, your surgeon makes a small stomach pouch by dividing the top of the stomach from the rest. This small pouch is connected to intestine so other part of stomach is bypassed. So, when you eat, food goes into this small pouch, which makes you feel full faster and also makes it possible for your body to absorb fewer calories. This is a very promising type of bariatric surgery for diabetics as up to 80% of people have normal blood sugar after it. And they also lose 60% to 80% of their extra weight on an average.
Gastric Sleeve: In this surgery, your surgeon will remove a major part of your stomach. When your stomach is small, you will feel full faster. It also reduces hunger pangs. This type of surgery is also very effective in reducing diabetes and losing weight.
Adjustable Gastric Band: In this surgery, your surgeon puts an inflatable band around the top of your stomach. This forms a small pouch which makes you feel full faster. The good point is that your stomach is not cut and your intestines are not shifted. There are thus lesser complications. It also helps in controlling diabetes. The con is that you lose less weight in this type of surgery.
Biliopancreatic Diversion: This is an uncommon surgery but most effective for diabetics. In this the doctor removes a large part of your stomach and also changes the way the food goes to your intestines. This helps in losing weight but also affects digestion long term.
As with any major operation, all bariatric surgeries come with potential risks of bleeding, infection, and leaks in the digestive system. It is necessary to change lifestyle to avoid weight regain.

Is There A Relation Between Weight Loss Surgery & Type 2 Diabetes?

If you are experiencing pain in the muscles and joints, an enhanced craving for salt, symptoms of low glucose in the blood or low blood pressure, you could be suffering from adrenal insufficiency (AI). The outer layer or cortex of our adrenal gland produces three forms of steroid hormones. In adrenal insufficiency, the cortex fails to produce enough steroid hormones. Some people do not know that they have been affected with adrenal insufficiency until they experience a sudden worsening of symptoms. This is called an adrenal crisis.

Causes
The different types of adrenal insufficiencies occur because of different reasons. Primary AI is commonly caused by autoimmune diseases in which our body s defence system destroys the body s tissues. Bleeding in glands, genetic diseases and infections are other likely causes.

Secondary AI occurs because of problems with the pituitary gland. The pituitary gland produces a hormone named adrenocorticotrophic hormone (ACTH) because of which the adrenal glands produce cortisol. In the case of secondary AI, the pituitary glands stop sending ACTH to the adrenal glands, and cortisol is hence not produced. This may occur by taking certain prescribed medicines.

Diagnosis
A patients s medical symptoms and medical history are observed. The blood levels of cortisol, sodium, potassium and glucose are checked for the detection of AI. The adrenal glands and the pituitary gland are observed by imaging tests. X-rays, ultrasound, and CT and MRI scans may be required.

Treatment
The treatment of adrenal insufficiency aims at ensuring proper levels of hormones in the body. You may require regular replacement of hormones for life. You have to take glucocorticoids for replacing the cortisol which your body does not provide anymore. Mineralocorticoids should be taken when the body does not produce aldosterone. Extra glucocorticoids may be required during times of intense stress such as a surgery or serious health conditions.

Glucocorticoid helps the body in coping with stress, injury and illness. It helps in the regulation of blood glucose levels and blood pressure levels. It performs the function of cortisol.
Mineralocorticoid helps in maintaining a proper balance of water and salt in our body. This is actually carried out by aldosterone.
Adrenal androgens, which are weak male sex hormones, present in both men and women, help in the regulation of pubic and armpit hair growth in women.
If you experience any symptoms of adrenal insufficiency, it is recommended that you visit a doctor immediately. Early diagnosis will enable early treatment, which is beneficial for you.

Adrenal Insufficiency (AI) - Ways It Can Be Treated!

A Gastroenterologist is a physician with dedicated training and unique experience in the management of diseases of the gastrointestinal tract and liver. If you are planning to visit one, you most likely have a problem in one or many organs like esophagus, stomach, small intestine, colon and rectum, pancreas, gallbladder, bile ducts and liver. 

Visit your doctor to understand the severity of your condition and the course of treatment, as it is obvious that during this time you must be suffering from anxiety and you may not ask the questions arising in your mind. That is why you need to prepare in advance for your first visit with a gastroenterologist. Being an active partner in the doctor patient relationship is bound to have its benefits. Here are some handy tips:

1. Come mentally prepared: Don't let the anxiety get to you. If you need some extra help calming down, try yoga or meditation. You can simply go out on a walk alone to help you focus your thoughts. This is just like any other doctor visit. The good part is that you are taking the first step in easing your discomfort and starting treatment, so go with a positive mind.

2. Maintain a diary of symptoms: It is likely that you are experiencing discomfort from past few days or weeks before you finally realize the need to seek out a specialist. Try to remember as much as possible about the symptoms you experienced in a chronological order. Write down any over the counter medicines you've tried or anything unusual that you may have consumed in the past week. 

3. Take stock of your medical history: It is likely that your doctor may want to know about any historic conditions you've suffered that may or may not relate to your present condition. Many ask you to fill out forms during your first time patient registration which includes many minor details about your medical past. List down any allergies, especially food allergies you have. 

4. Take stock of your recent medical tests: Bring your latest blood tests and imaging tests (X-rays, ultrasounds, MRIs, and CT scans) with you for the doctor's visit. If you have a pre-existing condition like diabetes, thyroid or you suffer from other chronic conditions like increased uric acid, carry your most recent medical reports with you. 

5. Make a list of questions for the doctor: In most cases, the first visit is a crucial factor in determining whether you want to continue the course of treatment with a particular doctor. This comes out of your ability to trust the doctor, his knowledge and diagnosis and an overall comfort level that comes with how well he handles your questions. Start by making a list of questions you want to ask about your specific condition and course of treatment and see if you get satisfactory answers. 

6. Brace yourself: If you want to suggest a treatment option, make sure you read up all about it before you tell the doctor.

6 Tips For Your First Visit With A Gastroenterologist

Dysphagia is the difficulty in swallowing food or liquid. Most people suffering from dysphagia are unaware of their medical condition and only realize it in later stages. When not diagnosed and treated in time, it may lead to aspiration pneumonia (lung infection occurring due to food particles or saliva entering the lung), weight loss, dehydration and malnutrition. Some of the symptoms include:

Heartburn
Choking
Drooling
Having the feeling of food getting stuck in the chest or throat.
Food or stomach acid coming back up into the throat
Regurgitation
Hoarseness of the throat
Gagging and coughing while swallowing
Experiencing pain while swallowing
There are two types of dysphagia:

Esophageal Dysphagia:
This is also known as low dysphagia and is the condition in which one can sense food getting stuck in the throat or chest area. The problem lies in the esophagus. Generally, the surgical procedure is required to solve the problem. Some of the causes of low dysphagia include-

Achalasia- lower muscles in the esophagus do not allow food to enter the stomach.
Diffuse spasm- Uncontrolled contractions of the lower esophagus after swallowing food.
Esophageal stricture- Narrowing of the passage of esophagus making it difficult for food to pass. It often leads to GERD (Gastroesophageal Reflux Disease).
Esophageal Ring- A narrowing of the lower portion of the esophagus
Scleroderma- Autoimmune disease where it leads to hardening and stiffening of body tissues.
Oropharyngeal Dysphagia:
This is also known as high dysphagia and is the condition where the throat muscles become weak making it difficult to swallow food. Some of the causes for high dysphagia include- stroke, Parkinson s disease, Zenker s Diverticulum (a condition in which food particles get accumulated inside a small pouch in your throat) and cancer.

Treatments:
Depending on the type of dysphagia, you will be advised any one of the treatment courses available. It can range from swallowing therapy, dietary changes, feeding tubes and medications to even surgery. The treatment is carried out by a multidisciplinary team. A multidisciplinary team includes- a speech-language pathologist, primary physician, gastroenterologist, dietitian, therapist, radiologist and pharmacist. The treatments for dysphagia include:

Swallowing Therapy- If you are suffering from high dysphagia, you will be referred to speech and language therapists. You will be taught a number of exercises to make the process of swallowing easier and simple.
Dietary Changes- In this method, you will be referred to a dietician or nutritionist. You will be advised a well-balanced and healthy diet that may include more liquid and semi-liquid food.
Feeding Tube- When swallowing becomes extremely difficult and the patient is at risk of suffering from malnutrition and dehydration, the patient is usually fed through a nasogastric tube which passes through the nose and into the stomach. PEG (percutaneous endoscopic gastronomy) tube which is directly implanted in your stomach.
Dilation- People suffering from low dysphagia have to undergo surgery. One of the methods is dilation. Through endoscopy, images of inside the throat is taken and a small balloon is inserted.
Botulinum Toxin (Botox) - One of the causes for low dysphagia is achalasia. In such cases, botulinum toxin is used to relax and weaken the stiff and hardened muscles of the esophagus.
These were some of the treatment options for dysphagia that prove it is treatable and can be cured easily. Generally, dysphagia occurs in older people and babies. Whatever may be the cause, the main purpose of the treatment of dysphagia is to make the patient go back to oral feeding.

5 Best Dysphagia ( Swallowing Problems) Treatment Options

On each side of the uterus, two ovaries are present. It is the size of an almond and produces ova or eggs in simple terms, along with the release of hormones like oestrogen and progesterone. When a cancerous growth or a tumour grows in the outer lining (epithelium) of the ovary, it is known as ovarian cancer. Ovarian cancer occurs in women who are aged above 65 years.

There are three types of tumour
Ovaries are made up of three kinds of cells and each kind is capable of developing different types of tumour.

Epithelial tumour- It develops from the cells that cover the ovary s outer surface.
Germ cell tumour- It develops from the cells that produce ova.
Stromal tumour- It develops from the tissue cell which is the structure holding the ovary together and produces oestrogen and progesterone.
Some tumours are non-cancerous and never spread beyond the ovary. Cancerous or ovarian tumours that are less malignant can metastasize to other body parts. The signs initially would be mistaken with premenstrual syndrome or poor bowel movement or a bladder problem, but if the problems are persistent then one must get an expert opinion. Ovarian cancer often goes undetected till it spreads within the abdomen or the pelvis. 

Causes of ovarian cancer
Cancer develops when the cells of the body divide and multiplies in an unregulated manner. Mutations that are genetic like BRCA1 and BRCA2 can be the cause often or if an individual is diagnosed with any other type of cancer before like breast, colon or uterine. There is a higher risk of being affected by this type of cancer if the person had undergone fertility treatment or is suffering from infertility. Hormone Replacement Therapy (HRT) is another cause of this type of cancer. Experts say that longer the HRT, higher the risk. Women who are obese or are overweight has more chances of being affected. Endometriosis or the disorder in which the growth of the tissue occurs outside the uterus, in such a case the risk is 30% higher.

The signs or symptoms of ovarian cancer differ from one woman to another. Some of the symptoms given below might as well be non-cancerous because since the ovaries are situated near the intestines and bladder, it might be often mistaken to be symptoms of gastrointestinal issues. It is advisable to consult a doctor if the symptoms are persistent.

Symptoms that occur at an early stage
Pelvic pain, Abdomen pain, Indigestion issues, Loss of appetite, Painful sexual intercourse, and Changed bowel movement are a few of the symptoms that occur during the early stages of the development of an Ovarian cancer.

Signs at a progressive stage
Loss of weight, Fatigue, Short of breath, and Nausea are the predominant symptoms when the Ovarian cancer has progressed more. Early diagnosis may lead to complete cure

Symptoms of ovarian cancer are similar to that of ovarian cysts. These ovarian cysts are often non-malignant but women with such cysts have a higher risk of being affected by cancer. Ovarian cancer can begin silently and are often detected at a later stage. Thus any individual undergoing these symptoms can avail medical assistance for further diagnosis.

Ovarian Cancer - Things You Need To Know!

Rectal bleeding is the collective name associated with all the conditions that cause blood to pass into the stool. Blood may appear in the form of small flecks in the stool, or clots, or a lot of liquid mass. It can also appear on the toilet paper, instead of in the pot. The blood may be coming from the anus, colon, or rectum itself.

Causes of Rectal Bleeding

The causes are multiple, and they include-

  Swelling and irritation of the anal veins, a condition known as haemorrhoids. Piles are the more common name for this phenomenon.
  Constipation (inadequate and painful passing of stools)
  Tears or scratches in the anus (fissures), sometimes as a side effect of constipation.
  Anal cancer
  Colon cancer
  Rectal cancer
  Diarrhoea
  As a side effect of radiation therapy, used in the treatment of diseases like cancer

Ayurveda believes that such a condition occurs due to the imbalance of the three doshas - fire (Pitta), water (Kapha) and air (Vata). Therefore, the aim of Ayurveda is to restore the dosha balance in your body and improve the condition. The help of a medical professional must be sought immediately after you notice this phenomenon occurring with you.

Treatment of rectal bleeding: Why Ayurveda is your best resort?

Ayurvedic treatment is the best possible alternative at your disposal. Besides being tailor-made to cater to your medical history, it is the only form of treatment that has negligible side effects. Hence, you might want to talk to an Ayurveda medicine specialist in the first place.

Rectal bleeding has a whole host of possible solutions within the fold of Ayurveda treatment. They are-

  Use laxatives, but natural ones. Laxatives are compounds that make stool less hard and easier to pass. The substances that can act as natural laxatives are coconut water, chia seeds, spinach, flaxseeds and prune juice.

  Foods that are rich in fibre should comprise a major chunk of your dietary intake during treatment. These foods include the peels of fruits and vegetables, and figs, beans and prunes.

  There are certain items you should not consume as well according to Ayurveda, like alcohol or fried foods. Also, to not further irritate haemorrhoids and exacerbate your condition, avoid hot and spicy foods like those flavoured with green chillies.

  Reduce time spent on sitting on the toilet seat, as this puts a strain on the muscles around that region.

Rectal bleeding is a common medical phenomenon that may require critical attention. While some of the reasons behind it may be easily treatable, there are some conditions with deep complications underlying it, like rectal cancer. You should get yourself checked immediately if you are experiencing rectal bleeding. After getting a primary diagnosis, you should try Ayurvedic remedies for the best results.

Rectal Bleeding - Causes & Treatments Of The Problem!

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