If your doctor ever diagnoses you with chronic kidney disease, he/she will give you two options to choose from. The first option is to undergo dialysis for the rest of your life, while the other option is to undergo a kidney transplant. While you may prefer avoiding a major surgery, such as a transplant, dialysis is not the best solution for your condition.

Here are some reasons why you should consider kidney transplant surgery over dialysis if you are looking for better health for the long-term:

1. Increases your life expectancy: What you may not know is that people on dialysis treatment have a severely reduced life expectancy. For instance, if you are 30 years old when dialysis starts, the treatment will keep you alive at most for 15 more years. Therefore, you may not even survive until your fifties with dialysis treatment for your damaged kidneys.

However, if you transplant a healthy kidney your life expectancy increases by 30 to 40 years. Keep in mind that kidneys from living donors are better and will help you live longer.

2. Eliminates the need for undergoing dialysis: If you choose dialysis over transplant surgery, you will need to undergo the treatment on a daily basis. This is not only costly but also affects your quality of life. For instance, a patient on dialysis will need to make special arrangements if he/she wants to go on a vacation with family so that his treatment continues even during the trip.

With a kidney transplant surgery, once you recover from the operation, you can live a normal life, without the need for daily treatment.

3. Lower cost of treatment: While you may think kidney transplant surgery is the costlier option between it and dialysis, you would be wrong to assume so. In kidney transplantation surgery, you pay a hefty amount at the time of the operation. However, in the case of dialysis, you pay smaller sums over very long periods. When you add up these small sums over 10-15 years of dialysis, you will find that transplantation is the cheaper option.

If you are young and have a long life ahead of you, kidney transplantation should be the first and foremost choice of treatment for chronic kidney disease. You can undergo dialysis while you wait for a donor and then receive a healthy organ.

Why Kidney Transplant Should Be Preferred Over Dialysis?

A hernia occurs when a weakened area of muscle in the abdominal wall gives way and the internal organ/tissue bulges out through this weakened are or  defect'. This can happen in many different areas of the abdomen. A hernia that develops in the groin region is called "inguinal hernia". It may be very painful especially if a part of the intestine gets trapped in the bulge.

The only treatment option is surgical repair as the weakened area "defect" needs to be repaired and will likely need reinforcement by a prosthetic material called a "mesh". Doctors may resort to Open Surgery or Laparoscopic Inguinal Hernia Repair depending on his/her evaluation of the patient. 

Who is a candidate for Laparoscopic surgery?

Laparoscopic surgery is the preferred treatment option for most people with inguinal hernia. Special situations in which laparoscopic surgery is much superior to open are

  Failure of a previous open surgical repair. Laparoscopic surgery is performed from "behind" the hernia and abdominal wall in comparison to open surgery which is performed from "the front". So, in case of failure of the open surgery, laparoscopic surgery is done through a fresh, non-scarred area and is technically safer and easier than doing an open surgery once again.

  If there are hernias on both sides and both need to be repaired at the same time, laparoscopy has a great advantage as both the hernias can be tackled and repaired through the same three tiny cuts, and two separate large incisions need not be made. 

Who is Not a Candidate for Laparoscopic Surgery?

The person is not a candidate for Laparoscopic Surgery if he has:

  Some patients who have undergone previous Abdominal Surgery or prostate surgery may not be suitable candidates for laparoscopic inguinal hernia surgery.

  Some underlying medical conditions, that make him unfit for general anaesthesia, as usually laparoscopic surgery can only be done under general anaesthesia.

How Laparoscopic Inguinal Hernia Is Carried Out?

In a Laparoscopic Intervention, two to three small incisions are made in the lower abdominal area. The laparoscope is passed through one of these incisions and the surgical instruments are inserted through the other incisions. The abdominal cavity is inflated using Carbon Dioxide to help the surgeon visualize the lower abdominal area clearly. Using the laparoscope, the surgeon visualizes the Hernia and uses long instruments to operate on it. She covers the hernia with a mesh and may fix the mesh to abdominal muscles using either stitches or stapler-like instruments.

Benefits of Laparoscopic Surgery

1. Two or three tiny cuts (5-10 mm in size), hence there is less pain after laparoscopic surgery

2. Better cosmetic results

3. Quicker recovery

4. Early return to daily activities like walking, working, etc

5. Shorter hospital stay 

Role of Laparoscopic Surgeon In comparison to many other minimally invasive surgeries:

Laparoscopic Inguinal Hernia Repair is more demanding in terms of technical capability of the surgeon. In general, Laparoscopic Inguinal Hernia Repair is more difficult to carry out in obese people than others. However, if the doctor is well trained and technically advanced with long experience, he can carry out such minimally invasive surgeries smoothly irrespective of the BMI of the patient. Everybody is not a candidate for Laparoscopic Inguinal Hernia Repair.

It is the doctor who decides if a particular patient is suitable for such surgery or not. However, the conclusive factor in any such repair is the experience and expertise of the doctor. This is why there are not many Laparoscopic Surgeons who carry out Laparoscopic Inguinal Hernia Repairs. Owing to the complexity of this procedure, it is important to get it done from an expert surgeon only.

Laparoscopic Inguinal Hernia Repair !

Bladder cancer refers to a  cancer, which arises from the epithelial lining or the urothelium of the urinary bladder. In the most common form of bladder cancer, the normal histology of the urothelium is recapitulated. It is called transitional cell carcinoma. Bladder cancer is a serious form of cancer that leads to many deaths too.

Treatment:
There are several modes of treatment for bladder cancer. They are:

1. Bladder cancer surgery: Surgeries are common for treating bladder cancer. 

2. Transurethral resection of bladder tumor or TURBT: This mode is used for determining the presence of bladder cancer and to find out if it has invaded the bladder wall muscle layer. This treatment mode is generally used in the early stages of bladder cancer.

3. Cystectomy: A cystectomy is undertaken when bladder cancer is very invasive and parts of the bladder or the whole of it has to be removed. There are two types of cystectomy.

Partial cystectomy is used when the cancer invades the bladder muscle layer in a small area. It can be removed without the whole bladder being taken out.
A Radical cystectomy is undertaken in case the cancer affects a large area and is present in multiple areas of the bladder. This surgery removes the bladder entirely and all its nearby lymph nodes.
4. Intravesical therapy: In intravesical therapy, a liquid drug is put directly into the bladder via a catheter instead of injecting it or consuming it orally. The cells lining the bladder are affected without causing any harm to other body parts. This therapy is usually used after TURBT in non-invasive cases of bladder cancer to prevent recurrence.

5. Chemotherapy: Chemotherapy is an effective treatment for bladder cancer. Chemotherapy may be used in two ways:

Intravesical chemotherapy, where the chemo drug is put directly into the bladder and is applicable only for early treatment stages.
Systematic chemotherapy, which involves the injection of chemo drugs into the vein or muscle and can also be administered in the form of pills. The drug reaches all parts of the body via the bloodstream and affects all cancer cells.
6. Radiation therapy: This treatment procedure for bladder cancer involves the use of high energy radiation for killing cancer cells. It is used in early phases of treatment and is the primary remedy for people who cannot have a surgery. It is combined with chemotherapy to make the radiation effective. The most common type of radiation therapy for treating bladder cancer is called external-beam radiation therapy where radiation occurs from an outside source.

Bladder cancer is a severe form of cancer. Proper and ideal treatment is required among the several treatment methods available.

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

Bladder Cancer and How It Can Be Treated

Gastroesophageal reflux disease (GERD) is also called as acid reflux. It is a long-term digestive disorder that affects the lower esophageal sphincter, the ring of muscle between the esophagus and stomach which causes the stomach contents to come back up into the esophagus resulting in either symptoms or complications. Gastroesophageal reflux disease is mild acid reflux that occurs at least twice a week or moderate-to-severe acid reflux which occurs at least once a week.

Epidemiology

In western populations, GERD affects approximately 10% to 20% of the population and 0.4% newly develop the condition. In developed nations, the prevalence rate of GERD is associated with age; with adults aged 60 to 70 being the most commonly affected.

Signs and Symptoms

Esophageal symptoms include:

Heartburn
Regurgitation of food or sour liquid
Dysphagia
Sensation of a lump in the throat
Extraesophageal symptoms include:

Coughing and/or wheezing
Hoarseness, sore throat, or 
Otitis media
Noncardiac chest pain
Enamel erosion or other dental manifestations
New or worsening asthma
Disrupted sleep
Risk Factors

Obesity
Pregnancy
Hiatus hernia
Scleroderma and systemic sclerosis
The use of medicines such as prednisolone 
Delayed stomach emptying Zollinger-Ellison syndrome which can show an increase in gastric acidity because of gastrin production
A high blood calcium level which can increase gastrin production, leading to increased acidity
Visceroptosis or Gl nard syndrome, in which the stomach has sunk in the abdomen upsetting the motility and acid secretion of the stomach.
Factors that can increase acid reflux involve:

Smoking habit
Eating heavy meals or eating late at night
Eating fatty or fried foods
Drinking certain beverages, such as alcohol or coffee
Medications, such as aspirin
Tight clothes
Increased intra-abdominal pressure
Differential Diagnosis

Heart disease causing chest pain
Laryngopharyngeal reflux OR extraesophageal reflux disease
Infection
Peptic ulcer
Esophageal spasm
Complications

Narrowing of the esophagus (esophageal stricture): Stomach acid causes the formation of a scar tissue which narrows the food pathway.
An open sore in the esophagus (esophageal ulcer): Acid causes an open sore which bleeds, causes pain, and makes swallowing difficult.
Precancerous changes in the esophagus (Barrett's esophagus): Damage from acid can cause changes in the tissue lining the lower esophagus
Anemia
How to arrive at the diagnosis?

Upper gastrointestinal endoscopy/esophagogastroduodenoscopy
Esophageal manometry
Ambulatory 24-hour pH monitoring
Treatment

The goals of treatment are controlling symptoms, healing esophagitis, and prevention of recurrent esophagitis or other complications. Lifestyle modifications include the following:

Losing weight (if overweight)
Eating small and frequent meals instead of large meals
Waiting 3 hours after a meal to lie down
Elevating the head end of the bed by 8 inches
Avoiding bending or stooping positions
Medications

H2 receptor antagonists (ranitidine, cimetidine)
Proton pump inhibitors (omeprazole, pantoprazole)
Prokinetic agents (aluminum hydroxide)
Antacids (magnesium hydroxide)
Surgery

Transthoracic and transabdominal fundoplication
Placement of a device to augment the lower esophageal sphincter

Gastroesophageal Reflux Disease - What Causes It?

Gastric bypass, one of the weight loss surgeries bring about many changes and alterations (physiological, metabolic, hormonal) in your body. The gastric bypass surgery rearranges the stomach into an upper pouch (the smaller part) and a relatively larger lower part. It is the small pouch that is connected to the small intestine, where the absorption of nutrients and minerals from the ingested food takes place. The surgery plays a significant role in limiting the intake of food. Thus, post-surgery, a person's body reacts differently than it used to before the surgery. Many, if not all, people experience difficulties in coping up with the changes.

Patients are often advised to refrain from alcohol consumption after the gastric bypass surgery. Surprisingly, and quite alarming, cases of alcohol abuse increases post the surgery. According to a survey by the American Society for Metabolic and Bariatric Surgery, few people, who had no prior history of alcohol abuse developed one after the weight loss surgery. What triggers the alcohol abuse in some patients is still a debatable issue.

Many patients experience an emotional breakdown, stress, anxiety, and depression after the surgery. People who needed no reason to binge on food are suddenly expected and made to consume a limited quantity of food. Unable to do what they loved doing the most, people look for an alternate solution. As expected, in most cases, alcohol becomes the much-needed solution. What started as a means of distraction gradually becomes an integral part of life. Hormonal changes associated with the surgery can also result in panic attacks, stress, and anxiety.

Incidences of alcohol abuse may also be high in patients who had a history of drinking (regular or occasional) and smoking before the gastric bypass. Under normal circumstances (before the weight loss surgery), there is a partial enzymatic breakdown of the consumed alcohol in the stomach before it passes into the small intestine. However, post-surgery, the small size of the stomach does not facilitate such enzymatic breakdowns. Thus, the alcohol passes into the intestine, where it gets rapidly absorbed. As a result, a person gets into an inebriated state at a faster rate.

It is because of this reason that doctors advise the patients to keep away from alcohol as much as possible after the surgery. To keep away from or reduce the instances of alcohol abuse after the gastric bypass surgery,

Look for healthier and low-calorie food options when you get an urge to eat.
Meditate, go for morning and evening walks. These physical activities act as great stress busters.
If you are feeling low or going through an emotionally low phase, share it with your loved ones. Do not suppress your emotions.
Consult your attending physician in case of any physical discomfort

Alcohol & Gastric Bypass - Can They Be Mixed?

Ovarian Cancer, as the name suggests, is a cancer that affects the ovaries. It leads to the abnormal growth of cells, which eventually spreads over to other parts of a woman s body, such as the stomach, uterus and vagina. The risk of ovarian cancer is greater in women who have experienced the process of ovulation many times in their lifetime. It also includes those women who attain menopause at a much later stage in their lives or those who start ovulation at an early age. The different types of tumors, which develop in ovarian cells are more often than not, benign or non-cancerous and do not spread beyond the ovaries. 

Therefore, they can be easily treated by either removing a part or the whole of the ovary. But malign tumors have the ability to spread to other parts of the body and can prove to be fatal.

What are the causes of ovarian cancer

1. Family History: If someone in your close relation like mother, sister or daughter has developed ovarian cancer, then the risk of becoming susceptible to the disease also increases. If any of your close relatives have developed the disease earlier at a young age, then it s quite likely that it was due to some inherited faulty gene. BCRA1 and BCRA2 are known to be the faulty genes that are connected to ovarian cancer.

2. Age: You become more susceptible to developing ovarian cancer at a postmenopausal stage.

3. Hormone Replacement Therapy (HRT): Women who go for hormone replacement therapy put themselves at a greater risk of developing the disease. Nevertheless, if you stop undergoing the sessions of HRT, your risk of suffering from this fatal condition eventually decreases.

4. Obesity/overweight: This is also one of the important factors behind the increased risks of developing ovarian cancer. So, the more obese you are, greater is the risk involved.

What are the symptoms associated with ovarian cancer?

1. Symptoms at an initial stage include pelvic or abdominal pain, postmenopausal vaginal bleeding or irregular menstruation.

2. Loss of appetite or feeling full quickly

3. Other typical symptoms are diarrhea, constipation, nausea or changes in bowel movements.

4. Feeling of mass pressure at your lower back or pelvis

Treatment available for it

Treatment for ovarian cancer generally consists of a combination of surgery and chemotherapy:

1. Surgery: Treatment usually entails removal of the ovaries, uterus and fallopian tubes, including the surrounding lymph nodes as well as the fatty abdominal tissue, which often gets affected with ovarian cancer. This surgery may help you to retain the ability to conceive.

2. Chemotherapy: Chemotherapy is a procedure that follows a surgery and is performed to destroy the remaining cancer cells, if any. Chemotherapy drugs are either inserted into your vein or directly into the abdominal cavity and if need be, into both.

Ovarian Cancer - Are you at a risk?

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