Gastroesophageal reflux disease is a condition which occurs due to unhealthy food habits and sudden lifestyle changes. This condition causes the stomach acid to travel in a reverse direction and enter the esophagus. If changes in your food habit and lifestyle do not cure you of this condition, then a surgical procedure is recommended.

What are the different surgical methods of treatment for gastroesophageal reflux disease?
The different forms of surgery that can be used to treat this condition have been explained below:

Fundoplication: Fundoplication is one of the most common surgical methods recommended to patients suffering from gastroesophageal reflux disease. The lower esophageal sphincter or LES is tightened with the help of this surgery. The strengthening procedure is accomplished by wrapping the upper part of the stomach around the outer part of the lower esophagus. Both open and laparoscopic surgical options are available for this surgery.
Transoral Incisionless Fundoplication or TIF: In this surgical procedure you do not have to undergo any incisions. A barrier is made between the esophagus and the stomach. This barrier will work to prevent the acid of the stomach from entering the esophagus. A special device is inserted through the mouth of the patient which helps in creating several folds at the base of the esophagus, these folds form a new valve or barrier. Thus you do not have to undergo any incisions at all if you opt for this procedure. Those who are looking for a non-invasive method to treat their gastroesophageal reflux disease, this procedure is no doubt one of the best.
Bard EndoCinch System: This is a special type of surgery that is accomplished with the help of an endoscope. Although it is not one of the common methods to treat the problem. In this procedure, several stitches will be made in your lower esophageal sphincter so that they result in the formation of valves.
Stretta Procedure: This procedure is also performed with the help of an endoscope. But this is an outpatient procedure and you will be discharged on the same day. A flexible tube is inserted into your esophagus and the other end of this tube has an electrode. This electrode will help in heating the tissues of your esophagus. It will also form small cuts in it. The scar tissue that results from this procedure helps in stopping the acid from flowing in the reverse direction. It also strengthens the muscles that are present in the surrounding area.
These surgical procedures are very successful and have the ability to give you long-term results. Many complications such as the inflammation of the esophagus, can be avoided if you opt for a surgical treatment as a cure for gastroesophageal reflux disease. 

Gastroesphageal Reflux Disease - How Surgery Can Be Of Help?

Commonly people believe that you can understand your blood pressure is high if you are feeling dizzy suddenly or you are not able to sleep at night. Also sweating profusely is often related to having hypertension. But, to be honest, hypertension usually does not have any symptoms, which might help you get alert and take action to control it. This actually imposes a great threat to your well-being as you do not understand if you have hypertension. It is extremely important for you to keep checking your blood pressure level in order to avoid developing hypertension and hence developing a risk to your heart.

Although there aren't any major or very noticeable symptoms, here is a list of some rare symptoms which you can follow:

1. Headaches: If you are suffering from dull headaches almost regularly, it might be because you blood pressure has increased. The headaches can be a dull buzz or a severe migraine like ache. Keep monitoring your headaches and consult your doctor as soon as possible.

2. Dizziness: You might suddenly feel dizzy or you might feel you are about to pass out if your blood pressure increases. Make sure you refer to a doctor as soon as something like this happens.

3. Nosebleeds: A sudden occurrence of nosebleed might also be a symptom of a sudden increase in your blood pressure.

4. Severe anxiety: Severe anxiety or a panic attack is often referred to as a symptom of hypertension. If you have a sudden panic attack with no apparent reason, it may be because your blood pressure has suddenly risen.

5. Shortness of breath: High blood pressure may often cause a shortness of breath. You might experience it during various every day activity like walking, climbing stairs, etc.

6. Nausea: A sudden increase in blood pressure might make you feel nauseous. You might even vomit when this happens. Make sure you consult your doctor if this happens.

Hypertension: Symptoms that Can Control it on Time

For a long time cholesterol in totality was seen as a bad thing for your body although the truth was a little more complicated than that. Cholesterol primarily is divided into two types, one of which can be categorized as bad cholesterol and the other as good cholesterol. Let's have an in-depth look at both the categories.

Ldl or low density lipoprotein aka bad cholesterol: cholesterol is a wax like chemical which is found all over the body and it has important functions to perform. Cholesterol is carried all over the body by lipoproteins. The low density lipoproteins are denoted as bad cholesterol as they can accumulate on the walls of the blood vessels and cause blockages resulting in many ailments. Ldl levels of 190 and above are considered dangerous. 

Some of the risks associated with it are:
1. Heart disease
2. Stroke
3. Atherosclerosis
4. Peripheral artery disease among many others

Hdl or high density lipoprotein aka good cholesterol - this is a form of cholesterol which is usually desired in higher quantities as it removes ldl from the system by dislodging it from the arteries and then carrying it through the bloodstream into the liver. The liver then breaks it down and removes it from the body. Thus, higher number of hdl cholesterol is always desirable. Some of the ideal numbers for hdl cholesterol within the body are:

For women - ideal: 60 mg/dl, dangerous: 50 mg/dl or lower
For men - ideal: 60 mg/dl, dangerous: 50 mg/dl lower

The role of triglycerides
Good and bad cholesterol levels also depend on the levels of triglycerides within the body and not just ldl or hdl cholesterol. Triglycerides are another type of fat which are used to store energy within the body, but can also affect your health. It is most associated with atherosclerosis when the levels of triglycerides are high within the body. 

Some habits that contribute to high levels of it are
A. Lack of physical activity
B. Obesity or being overweight
C. Excesses in alcohol consumption
D. Smoking
E. Bad diet and others

Thus the good cholesterol vs bad cholesterol war also includes other factors, most of which can be easily changed by making subtle changes in lifestyle and incorporating healthier habits. This will increase the good cholesterol and the other relevant elements and reduce the bad.

Good Cholesterol Vs Bad Cholesterol

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

The  Roux en Y Gastric Bypass  surgery was first performed by Professor Mason in 1966. Being done in the conventional way (i.e by open surgery) earlier and later laparoscopically, the Gastric Bypass has stood the test of time over the last 52 years.

Over 50 years the Gastric bypass surgery is being performed across the globe. It has given excellent results in terms of significant and long-standing weight loss in the morbidly obese, as well as remission of Type 2 diabetes in properly selected patients. Selection of the patient to undergo this procedure is paramount. 50 years of successful results are enough to term this procedure as the GOLD Standard.

Obesity and Diabetes have been a menace over the last 2 decades world over. In India obesity is growing in such a rampant way that we can equate it to an epidemic.

As we all know, India is considered to be the Diabetic Capital of the world. Type 2 diabetes contributes to the major chunk of diabetes affected population. We Indians get affected by diabetes at very early ages and hence complications are seen at very early ages among us. Strikingly important to notice is that Diabetes is seen not only in the obese category of people but also in the normal weight people.

Diabetes is feared of only because of the complications it is capable of causing affecting the vital organs like the brain, heart, eyes, kidneys.

Intermittent or elevated surges in the blood sugars levels during the course of the day are responsible for causing microangiopathies ( damage to the small vessels supplying blood to the vital organs).

We have seen that diabetes is accompanied by high blood pressure and dyslipidemia in most of the cases. So, when a person has diabetes, high blood pressure and dyslipidemia, we label them as having the metabolic syndrome.

Oral hypoglycemic agents (OHA) and insulin form the mainstay of treatment in getting sugars under control. But these are not able to avoid these surges in high sugar levels. This does not mean that OHA s and Insulin are not the right way to treat diabetes- they indeed are.

We are going a step higher, in an attempt to get control of diabetes without OHA and insulin. Not only this, we are trying to tackle not just diabetes, but the metabolic syndrome on the whole i.e one procedure that will take care of diabetes, dyslipidemia and hypertension. This procedure is popularly known and referred to as the  Gastric Bypass  or the  Roux en Y Gastric Bypass . Thus, In short, the gastric bypass surgery offers ICE BURG treatment.

Now, the first question is that  Is this possible . The answer is YES. The second question is that is this procedure applicable for all diabetics. The answer is NO. Only Type 2 diabetics are the beneficiaries of this procedure where insulin resistance has a major role to play. (This procedure does not benefit Type 1 diabetics) Reasons for this will be explained later. The third and important question is that,  Is the Gastric bypass going to give remission of diabetes in all type 2 diabetics?  The answer is NO.

There is strict selection criterion or eligibility criteria to select a patient for The Roux en Y Gastric Bypass surgery. Best results of the Gastric Bypass surgery are seen when it is confirmed that the person is suffering from Type 2 diabetes, duration of diabetes is less than 5 years, the pancreatic reserve is good and showing good levels of C -peptide in the blood, the person has a family history of diabetes, Insulin was not required to control sugar levels within the first 5 years of onset of diabetes and person should not be underweight( BMI > 27.5 preferred).

Losing weight is not easy and even if we lose weight, weight regain is very common. Most of us would have already experienced it. When we are tackling just the weight issue, we are talking into consideration only the morbidly obese people who have a BMI > 37.5. In the morbidly obese, at first, it is very difficult to lose significant weight by the normal method of diet and exercise. Even if weight loss does occur, weight regains or bouncing back is sure.

Here we bring in the trump card   The  Roux en Y Gastric Bypass  that helps the :

 Morbidly Obese  (BMI >37.5) to lose significant weight and reach their ideal weight.
 Obese  (BMI >32.5) who also have comorbidities (like diabetes, hypertension, dyslipidemia, sleep apnea, obesity-induced infertility) not only to lose significant weight and reach their ideal weight but also to get control of the associated comorbidities.
 Type 2 Diabetics  (BMI > 27.5) to get Remission from type 2 Diabetes.
 Metabolic Syndrome  (BMI > 27.5) to get remission from type 2 diabetes, dyslipidemia and Most cases hypertension.
Type 2 diabetics can be offered this procedure even if they are not morbidly obese, is what I would like to bring it to notice.

Exposure to Type 2 diabetes for long years can lead to potential complications like coronary heart disease, chronic kidney failure, brain stroke, gangrene of the lower limbs.

In some, in spite of talking OHA s, Insulin, sugars are not under control. In these cases, the gastric bypass can be offered to those who fulfil the eligibility criteria.

Remission of diabetes after the gastric bypass procedure is very quick, ranging from a week to a month in most of the cases. However, in some, The sugar levels come to normal the very next day after the surgery in some without the OHA and /or insulin.

Gastric bypass is done through laparoscopy i.e through tiny holes over the tummy, requiring 3 days hospital stay. Supplements need to be taken following the procedure on a daily basis. Following the procedure, intake is reduced to a great extent which increases over few months as the gastric pouch stretches.

Gastric Bypass - Be It Bariatric Or Metabolic Surgery, Get Amazing Results!

High blood pressure can lead to hypertension, which is known to cause a variety of debilitating side effects or symptoms in the life of the patient. It can also lead to a number of related ailments which can affect the various organs of the body. The eyes are one of the organs that are most susceptible to this kind of spike in the body s blood pressure. Let us learn more about the connection between the two.

Retina: When high blood pressure goes untreated for a prolonged period, it can easily start to affect the blood vessels that can be found in the retina. The retina is the third or the inner most layer of the eye which is sensitive towards light and usually helps in refraction. This is where the light reaches so that one can focus clearly on an image. When the blood pressure of the patient stays high for a prolonged basis, there is significant pressure on the blood vessels in this part of the eye which can lead to an eye disease known as hypertensive retinopathy.

Symptoms: Symptoms of this eye disease include lack of clarity and focus when the eye comes to rest on an object, as well as headaches and other vision problems that typically spring from eye strain that one will go through while trying to focus even harder. It may be seen that the symptoms do not appear in the very early stages of this disease.

Diagnosis: The diagnosis of the condition is usually done by an ophthalmologist who will use an ophthalmoscope in order to project light towards the specific part of the eye so that the back of the eyeballs can be examined. The signs that the doctor will look for during the examination include narrowing of the blood vessels in this part of the eye, inflammation of the macula which is the central portion of the retina, and bleeding in the back of the eye. Also, the doctor will check for spots in the retina with the help of cotton swabs and exudates.

Treatment: The best and only way of treating this condition is by keeping one s blood pressure in control with the help of medication prescribed by the doctor.

Prevention: There are many ways of preventing the onset of this disease, including losing weight so that there is less pressure on the body. Also, one must stick to a healthy diet and exercise regularly after taking recommendations on the appropriate exercises from the doctor. Additionally, it is also important to see a doctor on a regular basis so that there is constant monitoring and regulation of the medicines and the blood pressure.

Blood Pressure - How it Affects Your Eye Sight?

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