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


Feeling a lump on your breasts can be a terrifying moment. 'Cancer' is the first thing that comes to mind but in reality, most lumps in the breast are not caused by cancer. Apart from cancer, breast lumps can be caused by non-cancerous growths, injuries and infections. The only way to correctly diagnose the cause of a lump in the beasts is through a biopsy. Hence, this is the first step towards treating a breast lump. From here on, treatment will depend on the cause identified.

Mastitis or Breast Infection

Mastitis is a painful infection of the breast tissue often faced by women who are breastfeeding. It can be treated with heat treatment and antibiotics. Massaging the breast while taking a warm shower or applying a warm compress. This will open up the milk ducts and should be followed by nursing the baby or using a breast pump to relieve the swelling and pain.

Abscess

Antibiotics are the first line of treatment against an abscess but this is effective only if given in the initial stage of the infection. In later stages, an abscess will need to be surgically drained.

Fibroadenomas

This is a non-cancerous tumour often found in young women. It is often difficult to distinguish between a Fibroadenoma and a cancerous tumour and hence these are usually surgically removed.

Fibrocystic Changes

In some cases, the breast itself is composed of knotted, rope like tissue. This is known as having fibrocystic breasts. If a new lump presents itself on fibrocystic breasts, a mammogram and an ultrasound are performed to evaluate the lump. In most cases fibrocystic changes do not require any medication or surgery.

Breasts Cysts

Cysts can be defined as fluid filled lumps. In some cases, these cysts become apparent at the time of ovulation and disappear after the period. In other cases, it may need to be drained with a thin needle. Cysts often recur and need to be re-drained.

Fat Necrosis and Lipoma

Fat necrosis is a lump caused by an injury to the fatty tissue in the breast. Lipoma is a fatty growth within the fatty tissue. In both these cases, no treatment is required but if it causes any problems, it can be removed.

Breast Cancer

If the biopsy reveals the presence of a cancerous tumour, you must immediately consult an oncologist. Treatment options for breast cancer include chemotherapy, radiation, surgery and hormone treatment.

Treating Lumps and Pain in Breasts of Women

From time to time each person tends to get dyspepsia which is basically a mild discomfort in the upper belly or abdomen. Dyspepsia which is also known as indigestion affects millions of people on a daily basis. It s mostly caused by over eating, eating greedily or worse conditions such as stomach ulcer, irritable bowel syndrome or gastrointestinal disease. 

Medically dyspepsia is defined as difficult digestion that is sometimes accompanied with symptoms such as vomiting, heartburn, nausea and bloating. A treatment plan for the patient is usually determined by what causes the indigestion. Below are some of the treatment options available to patients.
Antacids, h-2-receptor antagonists and ppls (proton pump inhibitors)

These three type of drugs all work to reduce the levels of acid in the stomach. Doctors tend to prescribe antacids as the first drug which are usually over the counter and require no prescription. In spite of antacids working fast, h-2-receptor antagonists tend to last longer. However, h-2-receptor antagonists tend to have side effects such as nausea and diarrhea. The other drug option is ppls which is very effective for patients with dyspepsia and also suffer from gastroesophageal reflux disease. 

They are stronger than h-2-receptor antagonists.

Prokinetics and antibiotics: This medication is usually prescribed to treat indigestion and works if the stomach empties slowly. Antibiotics on the other hand are used when indigestion is a result of peptic ulcers caused by Helicobacter pylori.
Antidepressants: There are a lot of factorsthat cause dyspepsia. However, if the doctors cannot find any cause of a patient s indigestion and no other drug has been effective, they tend to prescribe antidepressants. This medication is used to lessen the level of discomfort that comes with dyspepsia thereby reducing pain.
Home remedies: There are a few studies on natural remedies that can help treat dyspepsia. One of the remedies is to use baking soda to neutralize the stomach acid. This remedy is said to be more effective than antacids. Then there is ginger which while not mentioned to be effective in treating indigestion, helps in relieving nausea and has no side effects. Also peppermint has an effect on how the gastrointestinal tract works and helps with irritable bowel syndrome. However, it does not have a large effect on dyspepsia.
Diet and lifestyle changes: Indigestion is mostly caused by what we put into our bodies or eat and one way of treating it is by controlling our diet. This will especially work if you have mild symptoms that do not occur often. It s advisable to consume foods that are low or reduced in fat content and to, avoid or limit alcohol, chocolates and caffeine. You should also get enough sleep.
A healthy lifestyle goes a long way in helping to relieve indigestion.

Dyspepsia - 4 Best Ways It Can Be Treated!

GERD or acid reflux is caused by the regurgitation of acidic liquid stomach contents back up into the esophagus. It is a long-term condition where stomach contents come back upwards from the gastro-intestinal tract resulting in either symptoms or complications. It is a commonly occurring digestion condition. A burning sensation in the chest is usually caused by acid reflux which radiates up from the stomach to the mid-chest or throat. This condition is also known as the heartburn. A sour taste in the back of the mouth is a common experience amongst the patients. Long term reflux of gastric contents causes the condition to become chronic which can lead to difficulty in swallowing. In some cases the erosion of the tract lining can also cause breathing problems.

Symptoms:

Heartburn is a burning sensation felt in the retrosternal area. Most commonly it occurs post-prandial or nocturnally. Consumption of fatty foods, spicy foods, acidic foods aggravates the condition. Burning sensation is relieved with antacids, water or milk.
Perception of gastric content reflux in the mouth or hypopharynx is termed as acid regurgitation. It is also known as water brash. A bitter or acidic taste is felt in the mouth.
Other symptoms include dysphagia, odynophagia, nausea, chest pain, dyspepsia, epigastric fullness, bloating, frequent belching
Extra-esophageal symptoms like chronic cough, hoarseness, laryngitis, dysfunction of the vocal cords, bronchospasm can also be observed.
Complications:

Peptic stricture
Ulcers of the esophagus
Metaplastic disease (Barrett s esophagus)
Dysplastic disease (Adenocarcinoma)
Laryngitis or bronchitis
Pulmonary disease
Fluid in the sinuses and the middle ear
Diagnosis:
The diagnosis of GERD is made by its most commonly presenting symptom- heartburn. To confirm the diagnosis of GERD, the physicians treat patients with medications for suppression of the production of acid by stomach. If heartburn diminishes to a large extent by the medications, diagnosis of GERD is considered confirmed.

Conditions like an ulcer caused by bacterial infection, mimic the symptoms of GERD. To get a clearer diagnosis, an endoscopy is then performed. The common diagnostic modality for GERD is Upper intestinal gastro-endoscopy. A tube containing an optical system for visualization is swallowed, the tube progresses down the gastrointestinal tract, and then the lining of the esophagus, stomach, and duodenum can be examined. A normal esophagus is observed in most patients with symptoms of reflux. 

However, sometimes the lining of the esophagus appears inflamed. If erosions (superficial breaks in the esophageal lining) or ulcers (deeper breaks in the lining) are seen, a diagnosis of GERD can be made definitely. Other complications of GERD like ulcers, strictures, and Barrett's esophagus are also identified. Biopsies also may be obtained. Other common problems that may be causing GERD like symptoms can be diagnosed (for example ulcers, inflammation, or cancers of the stomach or duodenum) with EGD. Previously, barium meal x-ray was undertaken to diagnose GERD. It is now discontinued.

Other tests that are carried out are esophageal acid testing, esophageal motility testing, gastric emptying studies and acid perfusion test.

Treatment:

Lifestyle modifications   Avoiding acidic foods, quitting smoking, weight loss, abstaining from alcohol consumption improves symptoms in people with GERD.
Medications   Proton pump inhibitors (Pantoprazole, Omeprazole, Rabeprazole), H2 receptor blockers (Ranitidine, Cimetidine) and antacids.
Surgery   In cases where the proton pump inhibitors are unsuccessful in relieving symptoms of GERD, a surgical procedure called Nissen fundo-plication is done.

GERD - Complications Associated With It!

Gastroesophageal reflux disease or GERD is a chronic condition that can cause discomfort and a burning sensation in the chest. This is caused by stomach acids or bile that flows backward into the food pipe. If this happens more than twice a week, the patient may be diagnosed with GERD. Mild cases of GERD may be treated with lifestyle changes, antacids, diet changes and proton pump inhibitors. In more serious cases, surgery may also be needed. This aims at repairing or replacing the lower esophageal sphincter (LES). This valve is responsible for the backward movement of acids from the stomach to the food pipe.

Types of Surgery for GERD
Surgery is usually the last option for doctors treating GERD. This relieves symptoms of GERD and eliminates the need for long-term medication. There are many different types of surgical treatments. Some of the factors that determine the best type of surgery suited to a patient include the patient s age, weight, overall health etc.

Fundoplication: This surgery focuses on tightening the LES. Fundoplication may be performed as an open surgery or as a laparoscopic surgery. In both cases, the stomach is wrapped around the lower esophagus to reinforce and strengthen the LES. Fundoplication is the most common surgical procedure used to treat GERD and has a high success rate.
Stretta Procedure: This is an outpatient procedure that is performed using an endoscope. The doctor will pass a thin tube with an electrode at one end down the patient s esophagus. The electrode heats the tissue in the esophagus and makes tiny cuts. These cuts will then form scar tissue that strengthens the muscles surrounding the esophagus and blocks acid reflux. This is a fairly new procedure and hence the long-term results are still not clear.
Bard EndoCinch System: This procedure is not very common. It involves the use of an endoscope that is used to make stitches in the esophagus so as to create pleats in the LES. This helps strengthen the valve and prevent acid reflux.
Linx Surgery: This is a minimally invasive surgery where a special device called a linx is wrapped around the LES. A linx can be described as a small ring of magnetic titanium beads. This ring allows food to pass through but otherwise keeps the opening between the esophagus and stomach closed. Linx surgery is a relatively new procedure that has shown good results.
Recovering from Surgery for GERD
Recovering from surgery for GERD depends largely on the type of surgery undergone. Laparoscopic procedures have a short recovery time and are associated with less pain as compared to traditional open surgeries. Open surgery usually takes 2 weeks for full recovery while a patient may recover from laparoscopic surgery within a week.

Surgery For GERD - Types, Results and Recovery

Dysentery is the inflammation of the intestine that causes appearance of blood and mucous in stool. It is caused by bacteria or parasites. In this condition, the patient passes semi liquid stool many times in a day. It is a contagious disease and is transmitted via the faecal oral route. Thus, a group of people like a family living together or students in a hostel are more prone to picking up the infection. This infection is also transmitted via anal sex. 

Ayurveda is a herbal medicinal treatment, originated in India. It is known to have cure for various health problems. Usually Diarrhoea cures itself through diet change, but in case of dysentery, medication is required to combat bacteria and parasites. Some ways to treat Dysentery with Ayurvedic remedies are as follows:

Isabbael for Chronic Amoebiasis: Isabbael is a formulation that treats dysentery caused due to Amoebiasis. When the stool contains mucus and the infected patient feels a cramp before passing stool, it is considered an Amoebiasis infection. Isabbael is very good for bacillary dysentery as well. It is advised to consume 1 teaspoonful twice daily with water for 5 to 7 days for best results. 
Ambimap for dysentery: Ambimap herbal formulation possesses a multi-purpose approach to control and cure dysentery (Pravahika). It is known to treat and cure all types of parasitic infection and provides immediate relief. For best results, 1 or 2 tablets should be taken 2 to 3 times a day with water.
Churna for dysentery: Churna is a polyherbal Ayurvedic medicine in powdered form and is high beneficial in treating dysentery.
You can also opt for Ayurvedic remedies that can be formulated at home. They are as follows:

Combine powdered dry ginger root, amla powder, long and black pepper in equal proportions. It is advisable to store this dry mixture in a glass container. For best results, consume one teaspoon of this mixture with lukewarm water two times a day. 
Another great way to combat dysentery is to drink buttermilk. Just add a bit of rock salt as well as powdered roasted cumin seeds. Drink this mixture two times a day preferably with breakfast and at lunchtime. 

Dysentery - 3 Ayurvedic Home Remedies to Help Treat it 

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