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

Being overweight is becoming a common sight. However, opting for bariatric surgery is not the first option for everyone who is obese. Also to remember is that morbid obesity is not an isolated condition. It affects a person s overall physical and mental health in various ways, and therefore bariatric surgery becomes an option only as a last resort. 

Some defining criteria for this surgery would be:

A male who is at least 100 pounds overweight for his height or a female who is at least 80 pounds overweight for her height. This puts them at a body mass index (BMI) of more than 40.
If the BMI is in the range of 35 to 39 and if there are significant health issues like metabolic syndrome, then bariatric surgery can be done. For BMI less than 35, other conservative measures are usually tried before resorting to a surgical approach.
Most people with BMI in the range of 35 and above will have health issues like sleep apnoea, heart disease, lipid disorders, and metabolic syndrome.
Conservative measures to lose weight including diet changes and exercise have failed to produce any desired results.
The person, in addition to physical health, should also be emotionally strong to undergo the demands of bariatric surgery. There are changes involving almost all body systems including digestive, respiratory, cardiac, and musculoskeletal, and so the person needs to be prepared for a lifestyle change.
Strict lifestyle changes including diet and exercise are required, so the person needs to be counseled and convinced about these. A person who can see the long-term benefits will be willing to take the effort.
It is also essential that the person has a strong social support system. For immediate post-op care when skin flaps need to be managed, and for long-term emotional support to manage emotional issues, it works wonders if there is a strong social network. The results are usually better in such people.
A person s overall health would be screened to make sure the lab tests are well within acceptable limits before surgery. It would be unreasonable to get these numbers within limits, if they are way too beyond acceptable limits.
Not the least consideration, but bariatric surgery is an expensive affair. It requires not just surgical costs, but also post-op costs. The good thing, however, is that overall healthcare costs would come down, once the results are visible.
Identifying the right candidate for a bariatric surgery is very essential, as doing this extensive surgical approach on an unsuitable candidate would be a failure.

Bariatric Surgery - Who Is Eligible For The Same?

Prostate cancer is a cancerous tumor in a man s prostate gland, a small gland that is responsible for producing the seminal fluid which transports and nourishes the sperm. It is a very common type of cancer among men. A few cases of prostate cancer tend to develop slowly while others may progress very fast.
Symptoms-
In the initial stages, prostate cancer may not show any symptom. However, in the latter stages, there may be symptoms such as:
Pain in the bones.
Erectile dysfunction.
Urination can get troublesome.
Presence of blood in the semen.
Pain and discomfort in the pelvic region.
Causes-
The exact causes of prostate cancer are not known. It starts to develop when certain cells in the prostate gland start to mutate. These mutations cause these cells to multiply at a very fast rate and thus, soon form tumors. Although the causes are not known, certain factors tend to aggravate this condition; them being:
Color: According to certain medical reports, a darker skin may mean increased chances of suffering from prostate cancer.
Age: The risk of developing prostate cancer tends to increase with age.
Genetics and Family History: Faulty genes could be another cause of this condition. Also, having some member in the family who is diagnosed with this type of cancer only increases the risks of you suffering from them.
Obesity: If you are obese, then you are more likely to develop prostate cancer.
Treatments-
The treatments for prostate cancer include:
Radiation Therapy: In this procedure, high energy rays are used to target and destroy cancer cells. Usually X-rays or protons are used to treat the cancer cells.
Hormone Therapy: Hormone therapy is a type of treatment wherein certain medications are administered to prevent your body from producing testosterone.
Surgery: If the other treatment methods do not produce desired results, then a surgery is carried out for the removal of the prostate gland. In addition to the prostate gland, some adjoining lymph nodes and tissues are also removed.
Chemotherapy: Chemotherapy is method of destroying cancer cells by injecting chemicals into the body. The medicines are injected into the veins in the arms. 

All About Prostate Cancer

Bariatric surgery is unlike other surgeries, the success is defined after 6-18months later. It is not without its complications. But complications managed well by Bariatric surgeons and the introduction of Laproscopy, it gives advantages of reduced post-op pain to less incisional hernias and less post-operative hospital stay. 

Sometime problems may happen like- 

Post-operative bleeding: Managed well by the surgeon. 
Dehydration: Chances of dehydration, therefore, one of the main post-op instructions, would be to increase water intake significantly, after the first week of course, when water is included in the diet. For someone who is not used to drinking lots of water, this can be difficult. 
Indigestion: Difficulty digesting food after the surgery is very common. There could be a burning sensation in the stomach. This is often managed by dietary changes like avoiding fatty foods, eating small frequent meals, avoiding too much sugary food items, etc. Too much fruits and vegetables should not be introduced early on, as fibre can be difficult to digest. Avoid fruits like nuts, seeds, fried foods, processed foods, etc. Gradually moving from water to pureed diet to semi-solids to solids can help in getting the stomach used to it. 
Vitamin and mineral deficiency: With the drastic cut in the amount of food consumption, there could be multiple problems including skin rashes, weak bones, dental issues, hair loss, gallstones, kidney stones, etc. All these are due to deficiency of various essential minerals like calcium, potassium, etc. This can be managed through minor diet modifications to ensure the body gets the required minerals and vitamins, even if they are in the form of supplements. 
Dumping syndrome: With a reduced size of the stomach, the food moves from the stomach into the smaller intestine much faster. Therefore, the sugar levels increase rapidly, producing various symptoms like bloating, diarrhoea, nausea, weakness, and anxiety. This is managed by eating less amount of sugars and fats and spacing out the meals through the day. Five to six small meals are preferred over 2 to 3 large meals. Some people also get relief from lying down after eating. 
Hernias: Less after laproscopic surgery but sometime it may happen. 
Diet changes: Whether it is medications or foods, some substances have to be knocked off your list. A detailed diet plan should be made with the doctor, as some can affect the stomach in an adverse manner. 
Altered bowel habits: Some people may have diarrhoea, others have constipation. Looking into one s diet and making suitable changes will help. Therefore, it is very important that you must keep regular follow-up and consultation with your surgeon, in order to avoid complications.

Bariatric Surgery - 8 Complications It Can Cause!

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

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

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