Benign prostatic hyperplasia or BPH is a condition where the prostate gland gets enlarged. This is mostly common in men who are ageing. When the prostate gland gets enlarged, the flow of urine through the urethra gets blocked, and hence, several problems related to urination may occur. BPH occurs as a result of hormonal imbalance. If untreated, BPH can lead to severe bladder and urinary health conditions.
There are several symptoms and signs of benign prostatic hyperplasia. Here are 7 common symptoms:

1. A frequent need for urination: Men affected by BPH feel an increased need to urinate frequently. This gets enhanced during the night and is called nocturia. The patient may even need to urinate more than eight times a day. Due to the enlarged prostate gland, more pressure is put on the urethra, which leads to uncontrollable urination.
2. Urinating difficulties: The act of urination becomes difficult. Because of enhanced pressure on the urethra, the flow of urine to the penis from the bladder gets blocked. This makes a urine stream hard to start. The urine stream gets weak and interrupted, and more difficulty may be experienced during the end of urination.
3. Pain during urination and ejaculation: Due to pressure on the urinary tract and reproductive system, pain can accompany urination and ejaculation. Some patients tend to push urine out, which results in pain. The pain may also occur because of infection during BPH.
4. Blood in urine and an unusual color/smell: Urine may take a dark color and have an unusual smell due to urinary retention. Unpleasant urine smell signifies urinary tract infection. Blood in the urine may also result because of dilated veins present on the surface of the enlarged prostate.
5. Urinary retention: When a patient is unable to pass any urine, it is called urinary retention. Such a condition requires immediate treatment, and you need to consult a doctor immediately.
6. Urinary tract infections: Bacteria may start growing in the bladder when the bladder is not fully emptied of urine. This bacterial infection causes darkening of the urine, and emission of a foul odor.
7. Bladder stones: Bladder stones may develop because of the inability of the bladder to empty itself completely. This is a major symptom of BPH. Hard lumps of minerals or bladder stones are formed when the urine present in the bladder gets highly concentrated, which causes the crystallization of minerals. Bladder stones may cause infections, result in blood in urine, cause bladder irritation and may also block urine flow.

So you see that benign prostatic hyperplasia involves the enlargement of the prostate gland, and results in several problems related to urination and different symptoms. Hence, immediate treatment is advisable.

7 Symptoms of Benign Prostatic Hyperplasia

GERD is a digestive disorder that affects the lower esophageal sphincter, which is the ring of muscle between the esophagus and stomach. Gastroesophageal reflux is the backward flow of acids from the stomach into the esophagus. Doctors believe that some people usually suffer due to a condition called hiatal hernia. Pregnant women usually suffer from heartburn or acid indigestion caused by Gastroesophageal Reflux Disease.

The primary goals in the treatment of this disease are relief from symptoms, healing of erosive esophagitis and prevention of complications of esophagitis. The symptoms include heartburn and regurgitation. The setting includes a proton pump inhibitor (PPI). Patients suspected due to GERD with non-cardiac chest pain are recommended to have diagnostic evaluation before institution of therapy. For diagnosing GERD, barium radiographs should not be used.

The other points that must be remembered to diagnose GERD are
1. Endoscopy is recommended only in case of alarming symptoms. Even in typical symptoms, the upper endoscopy is not recommended.
2. For preoperative evaluation, esophageal manometry is recommended, but it has no role in diagnosing GERD.
3. Ambulatory reflux monitoring is a test that can assess association of reflux symptoms.

Management:
The suggested lifestyle modifications for the patients with GERD are

    Weight loss is recommended for patients who are overweight. So, avoid large meals and decrease dietary fat intake.
    Avoid alcohol, chocolate, onions, garlic, acidic foods and peppermint.
    Do not lie down within 3 to 4 hours after meal (recommended for nocturnal GERD patients).
    For symptom relief and to heal erosive esophagitis, a 8-week course of PPIs is the therapy of choice.
    Medications that help in potentiating GERD symptoms, including alpha-adrenergic agonists, nitrates, calcium channel blockers and theophylline should be avoided.
    For patients without diagnostic evaluation, therapy for GERD other than acid suppression, including prokinetic therapy should not be used.
    For patients with partial response to PPI therapy, additional symptom relief can be achieved by increasing the dose twice daily or switching to a different PPI.
    It is recommended to elevate the head of the bed 10 to 20 cm.
    Avoid wearing clothes which are tight around the waist.
    If patients experience heartburn relief, Histamine-receptor antagonists (H2RA) therapy can be used as a maintenance option in patients without erosive disease.

Some surgical options
1. For long-term therapy for patients suffering with GERD, surgical therapy is the best treatment option.
2. In patients who have no evidence of erosive esophagitis, preoperative ambulatory pH monitoring in mandatory.
3. Gastric bypass is the preferred operation for patients who are suffering with obesity and are contemplating surgical therapy for GERD.

Apart from these, there are potential risks that are associated with PPIs such as switching them can be considered in setting of side effects and the therapy can be a risk factor for Clostridium difficile infection.

Management of Gastroesphageal Reflux Disease (GERD)

Top 10 Everyday Skin Care Hacks

You skin needs just a little care daily. There are some very simple ways in which we can provide that much needed affection and get back radiance and softness. And all this without any extra effort!

Try these everyday regimes for the glow.

1. Adopt Hydration - The first thing your skin needs to stay beautiful is adequate 'hydration,' or what they call in plain terms as plenty of water. So bottoms up to at least two liters of water daily.

2. Avoid Dehydration  - While you are busy hydrating your skin, remember to be careful and not dehydrate by staying out under the harsh sun for longer than 10-15 mins at a stretch. Ditch the caffeine habit (Soda, coffee, tea) as it dehydrates your body on the cellular level, inviting the onset of those dreaded wrinkles early than anticipated. 

3. Apply Lesser Layers - Your skin is your body's largest organ and it needs to breathe. So try and not swathe it under layers of heavy makeup and pore clogging chemical body butters on a regular basis.

4. Give It Fresh Air - To get your skin breathing truly fresh, put on your exercise gear and head outdoors to spend some quality time with Mother Nature at the nearest park or maybe you can take that long pending weekend trip out of the city!

5. Don’t Stress - Do not be stressed all the time unnecessarily. Learning how to manage stress effectively can take away years from your skin. 

6. Exercise - Run. Jump. Dance. Get moving, in short. The more your skin sweats, the better will it look and the elasticity would improve dramatically too. 

7. Get Nutrition - Get in the habit of starting the day with plenty of fruits and a healthy breakfast with the right amount of protein, carbs and essential fats. Fats are required by your skin to lubricate and moisturize from the inside. But make sure you stick to good fats found in olive oil, eggs, yogurt (the ones without any additives or artificial sugars), and whole grain breads etc.

8. Go Smoke-free - Just stop smoking and you would see a dramatic improvement in your skin tone within a few weeks (yes, it takes time to reverse that kind of damage) 

9. Wear Sunscreen - Slather on the sunscreen before you leave the house but make sure it's SPF index must be 30 and above for it to be effective under the harsh Indian sun.

10. Exfoliate & Detox - Scrub-rub-a dub every week. NOT every day though.. Make sure you use organic scrubs made with rice granules or sugar grains instead. Use a natural face mask such as Banana mash or a Tomato-Cucumber-Honey paste every alternate day to detoxify, cleanse and moisturize your face and body. 

If you would like to consult with me privately, please click on 'Consult'.

From Lybrate: If you found this tip useful, please thank the doctor by clicking on the heart icon below. Also, spread good health by sharing this tip with your loved ones over WhatsApp, Facebook and other media.


10 Only Skin Care Hacks You Will Ever Need

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 laryngitis
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 Should You Know

Laproscopic Bariatric Surgery allows Surgeons to perform minimally-invasive treatments to obese patients who have had repeated failure in losing weight through diet change and exercise. Bariatric Surgery is a procedure that does not require any incisions. Patients can return home within 2-3days without much discomfort. In this procedure, inserting operative instruments through multiple holes along with a camera which displays video images on monitor without making a single incision. The camera allows the Surgeons to witness the internal condition and perform the procedure safely. The three most well-known Laproscopic bariatric surgery procedures include gastric bypass, gastric sleeve, and mini-gastric bypass. 

Most common types of Laparoscopic bariatric surgery: 

Gastric sleeve: This is a more drastic mode of surgery and is a new addition to the bariatric endoscopic surgery procedures. Through this procedure, 90 percent of a patient s stomach is removed to facilitate the loss of hunger. This also helps in portion control of food. 
Gastric bypass: This is the most widely used bariatric procedure to cut down fats and control hunger across the globe. The digestive system is re-routed to suppress the hunger of the patient in this procedure. It also contains minimal risk to a healthy individual. 
Mini-Gastric bypass: Similar to Gastric bypass but shorter procedure with approximately equal results in comparison to gastric bypass. 
Other procedures for weight loss are: EndoBarrier therapy and Intra-gastric balloon The procedure is decided by the Surgeons and depending on which types of the procedure will suit you the most. 
Bariatric Surgery allows doctors to perform minimally-invasive treatments to obese patients who have had repeated failure in losing weight through diet change and exercise. Bariatric Surgery is a procedure that does not require any incisions. Patients can return home within the few day without much discomfort. A keyhole procedure involves inserting camera and instructions within abdominal cavity and operations performed by viewing over the monitor. The camera allows the doctor to witness the internal condition and perform the procedure safely. 

Benefits of Laparoscopic Bariatric Surgery: 

Being a minimally-invasive procedure, laparoscopic bariatric surgery has its own advantages. Since minimal incisions are made, the risk of operative complications is easily mitigated. Bariatric surgery is also a long-term solution.

Most Common Types Of Laparoscopic Bariatric Surgery!

A breast lump is a restricted swelling, projection, lump or knot in the breast that doesn't feel like a breast tissue. There are diverse reasons why breast lumps occur.

Not all lumps are cancer. These can also be breast conditions that are not harmful and which can be easily curable.Knots that feel harder or are not the same as the rest of the breast need to be checked. This kind of irregularity might be an indication of breast cancer.

A self-examination should be your starting point. This is how you can detect a lump on your own:

Step 1: Begin by taking a look at your breast in the mirror. Keep your shoulders straight and your arms on your hips.

This is what you need to search for:

    Breasts that are their typical size, shape, and shading
    Breasts that are uniformly formed without distortion or swelling

In the event that you see any of the changes mentioned below, convey them to your doctor:

    Dimpling, puckering, or protruding of the skin
    A nipple that is not in its initial position
    Redness, rash or swelling

Step 2: Now, raise your arms and look for the changes mentioned above.

Step 3: While you're in front of the mirror, search for any indications of liquid or blood discharge from the nipples.

Step 4: Next, examine your breasts while resting.Use Your right hand to feel your left breast and use your left hand to feel your right breast. Cover the whole breast from your collarbone to the highest point of your mid-region, and from your armpit to your cleavage to search for any lumps.

Step 5:Examine your breasts while either standing or sitting. Many women find that the easiest approach to examine their breasts is when their skin is wet, so this step could be done while taking a bath as well.

Diagnosis:

    Mammogram: Mammography is a technique using X-rays to diagnose and locate tumours of the breasts.
    Breast ultrasound: Breast ultrasound utilises sound waves to create pictures of the breasts from the inside.
    Breast MRI:This involves using an effective and attractive field, and radio frequency pulses to create photos of the insides of the breasts.
    Ultrasound-guided biopsy: During this sort of biopsy, utilising ultrasound imaging to discover the bump, a radiologist will give you anesthesia and afterward insert a needle into the lump to evacuate some tissue for assessment under a magnifying lens. Stereotactic biopsy and an X-ray-guided biopsy may also be used.

Possible treatments:

    In case the knot turns out to be cancerous, surgery is typically performed.
    You may have a few discussions with different doctors for additional treatment, including radiation treatment and chemotherapy or hormone treatment.

What You Should Know About Breast Lump Detection

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