Pelvic pain is generally referred to as the pain in the lower abdominal region. Pelvic pain might be acute, sudden, or chronic, recurrent, cyclical in nature. It may present as central or lateralized pain and might spread to the thighs and buttocks. Pelvic pain might be an indication that something is wrong with the internal reproductive organs located in the pelvic region such as ovaries, fallopian tube, uterus and vagina in which case occurrence of pain may be related to particular time in menstrual cycle.

Pelvic pain can be indicative of a pelvic infection or related to the pelvic bones/spine problems.

Also it may indicate that there is something wrong with the digestive system or urinary system.

Causes-

The causes are as follows:

Pelvic pain occurs commonly in disorders of the internal reproductive organs such as ovarian cysts or pelvic inflammatory disease (where in sexually transmitted bacteria spread through the reproductive organs and cause infection) or pain during ovulation.

Pelvic pain might also occur due to endometriosis (a form of disorder where the endometrial tissues that are located inside the uterus tend to grow outside the uterus resulting in severe pain), adenomyosis (a disorder wherein the endometrial tissues which line the wall of the uterus tend to grow within the uterus), , pelvic adhesions or ectopic pregnancy (when the fertilized egg gets inserted somewhere else other than the main uterine cavity),

Pelvic pain can occur due to bladder disorders, kidney stones, infection in the urinary tract, constipation, flatulence,inflammatory bowel disease, irritable bowel syndrome and chronic hernia.

It can also be a symptom in some cancers such as ovarian cancer, colonic cancer, advanced ovarian , endometrial and cervical cancer.

The following symptoms might occur along with pelvic pain:

Sustained pain in the hips and the groin

Sudden fever

Severe pain while urinating , passing stools or during sexual intercourse (dysparuenia)

Vaginal bleeding or vaginal discharge .

Blood in stool

Severe menstrual pain ( dysmenorrhoea)

Repeated instances of constipation or diarrhoea

Increase In pain with stress and physical movements

Investigations-

The Gynaecologist will do physical examination including bimanual internal examination. Also, complete blood count, urine for microscopy, vaginal swabs if discharge, stool examination. Ultrasound examination of the pelvis is an important investigation.

Treatment-

If the pain is gynaecological and depending on the cause doctors might suggest different therapies. In cases where pain is due to an ovarian cyst or endometriosis, doctors may prescribe birth-control pills. In cases of suspected pelvic infection, antibiotics are prescribed. Also, laparoscopic surgery might be advised in cases of acute pain due to cyst, endometriosis, or pelvic adhesions: for confirmation of diagnosis and excision or removal of cysts and endometriotic implants and division of adhesions respectively. In some cases of chronic pain, the gynaecologist may manage the case with inputs from gastroenterologist and pain consultant.

Causes and Symptoms of Pelvic Pain

Fertility is a potential for reproduction. In other words, fertility is an ability to have babies or to reproduce. When fertility rate in a community, increases more babies are born. To produce an offspring it depends on age, health and other factors of the woman. When we talk about fertility rates it means the number of births that happen during a certain time period in a specific location. On the other end, lack of ability to reproduce is termed as infertility. There are various treatments to deal with fertility issues and one of the ancient and natural as well as a trusted treatment is Ayurveda.

Causes
Female infertility is caused due to structural problems like blocked fallopian tubes, a defect in cervical canal, uterine fibroids or polyps. Hormonal imbalance leading to ovulation problems too can cause infertility. In males. infertility may have anatomical, psychological, hormonal or lifestyle related causes. The cause of infertility in approximately 20% of couples can't be determined using the currently available methods of investigation. From Ayurvedic perspectives, shukra dhatu can get affected by various physical, mental causes and even by serious diseases. Poor quality shukra dhatu can cause infertility in males & females.

Symptoms

Failure to reproduce

Ayurveda For Infertility

Ayurveda is one of the world's oldest holistic healing systems. It is based on the belief that health and wellness depend on a delicate balance between the mind, body and Spirit. The primary focus of Ayurvedic medicine is to promote good health, rather than fight disease. Fertility problems are increasing these days for many young couples. There are many factors which account for this like Lifestyle, delayed marriages, diet, etc. But Ayurveda not only does explain how to increase fertility with herbal supplements, but it also focuses on how to have healthy children.

For a pregnancy to be healthy and successful, a couple needs to take care of the following four essential factors:

Sperm/Ovum (Seeds)
Uterus (Soil)
Nourishment (Water)
Time for Conception (Timing of Sowing)
Reproductive health, in both men and women, depends on the health of the reproductive tissue or shukra dhatu. In women, shukra creates the ovum as part of the monthly cycle, and in men, the semen is formed due to sexual stimulation. The shukra is created as part of a long chain of metabolic transformations. It starts with the digestion of food, then goes on to the transformation of food to nutrient fluid, blood, muscle, fat, bone, bone marrow, and finally, to shukra tissue. Healthy shukra tissue, then, according to Ayurveda, depends on the health of all the other tissues in the body.

Foods to Nourish All Seven Dhatus (Bringhana)

Fresh, organic fruits and vegetables
Dairy proteins, including milk, lassi, and panir (a fresh cheese made of milk)
Whole grains
Mung dhal
Soaked almonds or soaked walnuts
Dried fruits such as dates, figs, and raisins
Sweet, juicy fruits such as mangoes, peaches, plums, and pears
If your digestion is strong, eat urad dhal (available at Indian grocery stores) cooked with equal parts turmeric, cumin, coriander, and fennel.
A banana cooked in ghee, cinnamon and cardamom is a tasty and wholesome dessert for people with strong digestion.
Foods to Enhance the Reproductive Tissue (Vrishya)

Asparagus
Broccoli
Milk
Date-milk shake
Mango milkshake
Rice pudding
Spices such as ajwain powder, cumin (which purifies the uterus in women and the genitourinary tract in men), turmeric (to improve the interaction between hormones and targeted tissues), and black cumin.
In general, it's important to eat a wide variety of foods in order to receive all the essential nutrients. Keep trying new vegetables and fruits, and rotate your menus to make sure you're not eating the same thing day after day.

Infertility - Ayurvedic Remedies are the Solution!

Ulcerative Colitis is a chronic inflammatory disease that affects the lining of the intestine and the rectum. It is located just above the anus. Patients suffering from ulcerative colitis tend to have small ulcers in their rectum and the colon. These eventually flare up leading to diarrhea, bloody stools, anemia and abdominal pain. The inflammation starts from the rectum and eventually, spreads to the colon. Ulcerative Colitis tends to flare up and remit in an alternate phase. The remission can last from few weeks to few years.

Methods adopted to diagnose Ulcerative Colitis-
Ulcerative Colitis is very similar to an inflammatory bowel disease known as Crohn s disease. The only differentiating factor is the fact that, ulcerative colitis affects the colon whereas, Crohn s disease affects the digestive system and the small intestine. A doctor might prescribe certain tests such as the colonoscopy, blood tests, CT scan, pill camera, stool sample tests etc.

Why is surgery necessary to treat Ulcerative Colitis?
An estimated 40 percent of all Ulcerative Colitis patients need to undergo surgery to recover completely. The reason surgery becomes necessary to treat ulcerative colitis are the following:

Drug therapy and medication become ineffective.
Without undergoing surgery, the condition might increase the risk of developing cancer.
The colon has the risk of getting ruptured if surgery is not performed on time.
There could be excessive bleeding.
Toxic megacolon might set in.
Types of surgery available to treat Ulcerative Colitis
A procedure where the entire colon is removed is known as the colectomy. In case both the colons are removed, the procedure is termed as proctocolectomy. In this procedure, an external pouch needed to be attached to the stoma that collects the stools. There is another method known as pouch surgery. 

Pelvic pouch or ileal pouch is also termed as IPAA. This procedure doesn t involve permanent stoma. In this procedure, both the colon and the rectum are eradicated from the body. The small intestine is then used to form a J-shaped pouch, that serves as the new rectum. The pouch is then connected to the anus. The whole procedure is done via two surgeries.

What are the surgical complications of this procedure?

There could be an excessive bowel movement.
There are instances where an inflammation of the pouch is observed. This condition is known as pouchitis.
There could be a situation of intestinal blockage from adhesion due to surgery.
There could be pouch failure that can happen inside within 5 few years. This is observed in 4 out of 100 patients who are treated. In this case, the patient should go for a permanent ileectomy.

Ulcerative Colitis - What You Need To Know?

Urinary Tract Infection (UTI) happens when germs infect your urinary system. It includes the kidneys, bladder, and the connecting tubes. Bladder infections are normal and not a huge risk if treated immediately. Further, if the disease spreads to the kidneys, it can bring about very serious problems. In case you're a woman, your chance of getting a urinary tract disease is higher. Experts rank your lifetime danger of getting a UTI as one in every woman. Many women might even have repeated infections.

UTIs are a key reason why we are frequently advised to wipe ourselves from front to back while or after using the bathroom. That is because of the urethra - the tube that carries the urine outside the body. It is found near the anus. If the infection isn't dealt with, the kidneys are likely to be affected.

Symptoms: To recognize a UTI, watch out for the following side effects:

1. Burning sensation while urinating
2. A regular urge to urinate, despite the fact that little turns out when you do
3. Pressure in your belly
4. Pain in the lower abdomen
5. Dark, bleeding or odd smelling urine
6. Feeling drained or shaky
7. Fever or chills (a sign the disease may have come to your kidneys)

Home Remedies: Some of the home remedies for UTI are:

1. Drink lots of water

One of the main things to do when you have a urinary tract infection is drink a lot of water.

2. Load Up on Vitamin C for a Healthy Urinary Tract

Getting a lot of vitamin C is important, since a lot of vitamin C make your urine more acidic. This prevents bacteria from developing.

3. Cure UTI Pain with Heat

Applying a warming cushion can calm the region.

4. Cut Bladder Irritants from Your Diet

Avoid caffeine, liquor, nicotine, carbonated beverages, and fake sweeteners.

5. Empty Your Bladder Again

Each time you exhaust your bladder - regardless of the possibility that it's only a little, you get rid of bacteria every time. So continue making those washroom runs.

6. Consider Herbal Remedies

You may discover some relief from taking the herb uva ursi (bearberry leaf)

7. Switch to Healthier Habits

Change in lifestyle can make a lot of difference. For instance, quit smoking and wear cotton clothing.

Other Treatment: In case, you have 3 or more UTI bouts in a year, request your specialist for a special treatment plan. Some treatment choices include:

You can take an anti-toxin in low dosage, over a more extended period to avoid repeated infections.

You can also take a single dosage of anti-biotic after sex, as prescribed by your specialist.
A patient can also take anti-toxins for 1 or 2 days as the symptoms show up. The treatments should be only be taken after concerning the specialists. You can also use an at-home urine test kit when you see the symptoms appearing.

Urinary Tract Infection (UTI): Prevention and Cure

Trigeminal neuralgia is specified by the condition of a chronic pain that influences the trigeminal nerve. This nerve transfers sensation from one s face to his/her brain. If a person is suffering from trigeminal neuralgia, then a gentle stimulation of face (sourced from brushing teeth or applying makeup) might generate a fright of agonizing pain. The affected person might experience short and mild attacks initially. However, the trigeminal neuralgia might progress and generate more-frequently and longer attack of severely critical pain. Women get affected by this situation more than men get and it is more prominently occur in individuals older than 50 years.

Trigeminal neuralgia does not mandatorily mean that you need to experience a lifelong pain. Various types of treatment alternatives are available and so doctors can usually handle the particular condition effectively by taking help of injections, medications or surgery. Various types of triggers might cause the pain regarding trigeminal neuralgia, such as eating, drinking, shaving, brushing teeth, touching face, smiling, washing face etc.

Symptoms

The symptoms of trigeminal neuralgia might comprise of one or more patterns and some of these are described below:

Sequences of serious, jolting or shooting pain that might generate as an electric shock
Spontaneous pain attacks or attacks stimulated by different activities like face touching, speaking, chewing, or brushing teeth. Pain attacks last from a few moments to some minutes.
It is not a comprehensive list because Trigeminal neuralgia hosts various other symptoms as well. If a person feels facial pain, specifically recurring or prolonged pain or if the person does not get relief through the utilization over-the-counter pain relievers, then that person must consult a doctor.
How does Radiofrequency Ablation treat Trigeminal Neuralgia?

Trigeminal Neuralgia is a chronic and painful condition that involves the trigeminal nerve. There are two separate trigeminal nerves on both sides of the face, which carry the sensations like pain from the face to the body. Each nerve has three branches- forehand, midface and chin and trigeminal neuralgia can cause intense pain in any of these areas.

Causes-

This occurs when the trigeminal nerve functioning is disrupted. When the blood vessel/artery and the trigeminal nerve at the base of your brain come in contact, it puts pressure on the nerves and causes pain.
It also occurs as a result of ageing or multiple sclerosis
A disorder that damages the myelin sheath protecting the nerves can trigger pain
Sometimes pain occurs from tumors, which compresses the trigeminal nerves
Surgical strokes, facial trauma or strokes can also be the root cause of excruciating pain
Triggers-

Shaving
Touching your face
Eating and drinking
Putting on makeup
Brushing
Washing your face
Symptoms-

The pain can be mild and for a shorter duration or it can happen frequently for longer durations. Some experience the pain in cycles where it can come and go for days or even for weeks. Gradually the intensity of the pain lessens.

Cure by Radio-frequency Ablation

The treatment of trigeminal neuralgia is often a challenging process in clinical practice. When medicines do not prove as effective, surgery is the desired option.

Procedure-

After applying local anaesthesia, the Pain Specialist carefully inserts a needle through the corner of your mouth to reach the trigeminal nerve
The doctors then wake up the patient after stimulating the nerves and ask them to feel the stimulation at the same place where they undergo pain. This confirms their targeted location
Once you fall asleep again, the Pain Specialist uses radiofrequency heat to injure the nerve enough to create numbness and removes the pain
How Effective is Radio-frequency Ablation?

The pain is cured almost in 98% of the patients. 50% of patients report a recurrence of pain after about two years. Hence the procedure can be repeated in the same patient if necessary.

In case you have a concern or query you can always consult a specialist & get answers to your questions!

Trigeminal Neuralgia And Radio-Frequency Ablation - What Causes It?

Myths about Total Knee Replacement

Myth#1 - Knee replacement is a surgery for old people. “I’m too young for a knee replacement.”
Fact - Candidacy for a knee replacement is not based on age, but on the person’s level of pain and immobility. Living with a painful joint that prohibits you from working or participating in normal life activities is an outdated way of thinking. Age is not necessarily a limiting factor. Often times, a patient is actually fearful about the uncertainty of surgery. Once they are able to resume many of the activities they enjoyed before the surgery, with increased mobility and with less pain, they are very happy they had the surgery. The quality of life one achieves by living without knee pain is priceless.

Myth#2 - “I should wait as long as possible to undergo knee replacement surgery” 
Fact - You don't need to suffer by waiting until the pain is intolerable. The longer life of joint replacements enables people to consider surgery earlier and at a younger age. Osteoarthritis is a degenerative disease that continues to damage the joint and delaying surgery makes both surgery and return to activity more difficult. Delaying surgery lowers a patients’ quality of life not only before the operation, but even for up to two years following surgery.

Myth#3 - “I should continue with medications as long as possible”
Fact - Medicines including painkillers just give symptomatic relief for a temporary duration and prolonged usage is riddled with serious side effects such as renal failure, peptic ulceration  etc. All these medicines are NOT curable.

Myth#4 - Alternative therapies such as acupressure, ozone treatment, massage beds, oils, laser therapy, magnetic therapy; braces will cure my advanced arthritis and knee pain.
Fact - Till date there is NO cure for advanced knee arthritis and these alternate therapies are not backed by established scientific data. All these modalities give temporary pain relief in early to moderate arthritis for some duration only and are NOT curative. Often times, a patient who is actually fearful about the uncertainty of surgery lands up trying these in order to avoid surgery. 

Myth#5 - After a knee replacement, it takes months to recover.
Fact - Depending on the activity, most patients who undergo knee replacement are able to perform routine tasks within a few weeks. A return to rigorous activity takes only a few months. One becomes independent for himself before discharge from hospital. There’s no prolonged best rest required after the surgery.


Myth#6 - After knee replacement, I’ll have to give up some activities and sports.
Fact - You have a high probability of getting back to activities like brisk walking or cycling in 6 to 12 weeks. It will take a bit longer to return to more rigorous activities and contact sports. Squatting and sitting cross legged though possible but at best should be kept to minimal.

Myth#7 - Knee replacement surgery leaves a large scar that is noticeable.
Fact - Scarring is minimal compared to traditional surgery. In fact, the scar is typically only 3 to 5 inches long. As time passes, the scar will fade and become less noticeable.

Myth#8 - Knee replacement is a very painful surgery. There is lots of pain in post operative period.
Fact - With modern day pain management such as in a multimodal approach, ensures that the patient does not feel any pain in post op period and has a smooth recovery.

Myth#9 - Knee replacement is done one at a time.
Fact - Both the knees can be operated at the same time if the patient does not have significant co morbidities and is deemed fit to undergo the procedure by the doctor.

Myth#10 - The new knee lasts for 5-6 yrs. only.
Fact - With modern day precision including computer assisted knee replacement and advancement in biomaterials, the survivorship has increased considerably. Today's joint replacements last 25 years or longer and, for most people, will last a lifetime.

Myth#11 - Knee replacement cannot be done a second time.
Fact - Knee replacement can be done multiple times what is called as a revision joint replacement surgery with good survivorship.

Myth#12 - “I am obese, I cannot undergo Knee replacement surgery.”
Fact - Knee replacement can be successfully done in an obese patient though the recovery is somewhat prolonged and might require additional implants. However, patients who are morbidly obese and have restricted mobility primarily due to obesity are better off after a bariatric procedure.

Myth#13 “I have diabetes or hypertension or heart ailment, so  I cannot undergo Knee replacement surgery.”
Fact  - diabetes hypertension or heart.



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 13 Myths About Total Knee Replacement (TKR), Busted!

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