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

Gall bladder is a very important digestive gland, which is located on the right side of your abdomen, just beneath your liver. Its main function is to collect, store and release bile, a digestive fluid produced in your liver, essential for metabolizing fats, into your small intestine.

Sometimes, small hard stones comprising of cholesterol, bile pigments and calcium salts in the shape of a pebble, can form in your gall bladder. Gallstones may cause no symptoms but when the gallstone lodges in ducts and blocks the flow of bile, it can cause persistent high-intensity pain which requires gallstone surgery.

Surgery is then prescribed to remove the gall bladder. This surgery is called cholecystectomy. It s done when there are

Gallstones in the gallbladder
Gallstones in the bile duct
Gallbladder inflammation
Inflammation in pancreas
Gallstone surgery or cholecystectomy is a common surgery, and it comes with only a small risk of complications and you can walk out of the hospital on the day of the surgery itself.

Procedure

Minimally invasive or laparoscopic cholecystectomy
During this procedure, the surgeon makes 4 tiny incisions in your abdomen and inserts a tube with a tiny video camera inside it.
Through a video monitor, the surgeon watches while he inserts surgical tools through the other 3 incisions to remove your gallbladder.
After the surgery, the surgeon confirms that there are no gallstones left. Once this is done, he sutures your incisions and you are taken to the recovery area. A laparoscopic cholecystectomy takes just 2 hours or so.
But the problem with this procedure is that it  not appropriate for everyone. Sometimes, what happens is that, the surgeon may start with a laparoscopic surgery and then may decide to go for an open gallstone surgery because of scar tissue or complications.
Traditional or open cholecystectomy
This procedure requires a bigger incision of about 6-inches in your abdomen, below your ribs on the right side. The liver and gallbladder are exposed and the surgeon removes the gallbladder.
An open cholecystectomy takes one or two hours.
Single-incision Laparoscopy Surgery

Traditional laparoscopic surgeries use a telescopic rod attached to a video camera called a laparoscope, which is inserted through a small incision. Apart from this, 3 to 5 additional small cuts are made to insert the other surgical instruments to perform the surgery.

However, single-incision laparoscopy surgery (SILS) is a revolutionary minimally invasive surgical procedure conducted through a single incision. It provides a better cosmetic outcome, as a small incision is made through the patient s navel or belly button, resulting in an almost scarless outcome.

Indications

Most patients who are good candidates for laparoscopic surgery are eligible for single-port procedures. Some of the surgeries that single incision laparoscopy is indicated for include cholecystectomy (removal of gall bladder), appendectomy (removal of appendix), splenectomy (removal of spleen), hepatectomy (removal of liver) and adrenalectomy (removal of adrenal glands). SILS can also be used for diagnostic purposes.

However, patients who have previously undergone multiple major surgeries to the abdominal region and those who are morbidly obese are not considered for SILS.

Procedure

Single Incision Laparoscopy is usually performed as day surgery either in the hospital or outpatient surgery center under general, regional, or occasionally local anesthesia depending on the type of procedure performed and the surgeon s preference.

The patient is made to lie down in a tilted position so that the feet are placed higher than the head. The surgeon makes a single incision of about 3/4th of an inch at the belly button and injects a harmless gas to expand the area and obtain a clear view of the operative site. A tube called a trocar or port is placed through the incision, through which the laparoscope (a narrow telescope having a light source and camera) and tiny surgical instruments are inserted. The laparoscope guides your surgeon with images of the abdominal contents that can be viewed on a large screen. Once the diseased organ is excised, your surgeon removes the instruments, releases the gas, and closes the incision with a small bandage.

Recovery

Common post-operative guidelines following Single Incision laparoscopy include the following:

You will need someone to drive you home after you are released as the anesthesia may make you feel groggy and tired
Do not remove the dressing over the incision for the first two days and keep the area clean and dry.  No showering or bathing during this time.  The incision usually heals in about 5 days
Your surgeon may give you activity restrictions such as no heavy lifting. It is very important that you follow your surgeon s instructions for a successful recovery
You may feel soreness around the incision area. Your surgeon may give you a prescription pain medicine or recommend NSAID s (non-steroidal anti-inflammatory drugs) for the first few days to keep you comfortable
If the abdomen was distended with gas, you may experience discomfort in the abdomen, chest, or shoulder area for a couple days while the excess gas is being absorbed
Diet

You must be very careful with your diet after gallstone removal as your body will not be able to digest fats well. You will of course be sticking to a liquid diet for a week or two and then introduce solids back into your diet. When you do so, you have to stick to a low fat diet. Stay off fried foods and gas-forming foods. Also make sure that you consume no more than 60 gm of fats per meal to avoid discomfort. Stay off spicy foods to avoid bloats and abdominal pains.

Gallbladder Surgery - Aftercare Tips To Help You Recover Better!

Kidney transplant surgery is a surgical procedure where a healthy kidney is used to substitute a diseased one. The healthy kidney is obtained from either a deceased donor or a family member who has a good blood type match with the recipient. Usually, the recipient receives one kidney if the donor is alive and/or both the kidneys from a deceased donor.

Certain reasons for going for a kidney transplant surgery might include:
1. Kidney failure due to diabetes
2. Infections in the urinary tract
3. Autoimmune disorders such as lupus (an autoimmune disorder)
4. Polycystic kidney disorders
5. Obstructions in the kidney
6. Glomerulonephritis, where inflammation occurs in the kidney

Preparation for the surgery
Before the procedure, certain tests are carried out to determine your suitability for the procedure. The tests start with a psychological evaluation followed by blood tests and diagnostic tests to check for health problems. Once the tests are done, you will be placed on the waiting list for kidney recipients. Once the donor is available, you will be asked to get ready for the surgery.

Procedure: The procedure begins with you being administered general anesthesia. An incision is made in the lower part of the stomach, through which the donated kidney is inserted in the body. The next step involves attaching adjacent blood vessels to the kidney so that it has a proper supply of blood. Finally, the ureter of the kidney is linked with the bladder, facilitating normal disposal of bodily wastes. A plastic tube, known as a stent, is placed in the ureter to facilitate urine flow. This is later removed by a procedure called cystoscopy. Once the surgery is completed, the incision is closed by stitches.

Aftercare: After the procedure is completed, you will be given painkillers to ease the pain. Immunosuppressant medications will be prescribed to prevent your immune system from destroying the cells of the donated kidney. Usually, the duration of stay at the hospital post-surgery is about a week. 

Kidney Transplant Surgery and What You Should Know About It

What is an ovarian cyst?
If a follicle present in the ovaries grows beyond 2cm in size, it is called an ovarian cyst. In an ovarian cyst, fluid accumulates inside a thin wall in the ovaries. The size of the ovarian cyst varies in size from person to person. It is most common in women during their fertile period, but it can happen anytime.

What is the cause of an ovarian cyst?
Follicles are produced in the ovaries under normal conditions. One of these follicles matures into an egg every month. It is a very normal process and happens spontaneously in most cases. However, under certain circumstances and conditions, these follicles fail to rupture and turn into a fluid filled cyst. In rare cases, dermoid reactions caused by entrapment of sebum follicle or hair follicle can cause ovarian cysts as well. It is common for most women to have at least one cyst in their lifetime.

What are the symptoms of an ovarian cyst?
Sometimes, an ovarian cyst does not present many symptoms. The most common symptoms include:

Increase in weight
Painful intercourse
Headache and fatigue
Pain in the abdomen
Heaviness and fullness in the stomach
An increase in the frequency of urination
Increase in bowel movements as a result of pressure
Back pain
Ayurvedic treatment for ovarian cyst

Shilajit: It is the most common herb for enhancing male libido and induces strength and vigour. Hence, this herb is indicated in women to increase agility so that they are able to get on with their daily schedule without much interference due to the fatigue.
Commiphora mukul: It is a very potent drug and has immense rejuvenating properties. The cells of the body are revitalised and rejuvenated by these. It is also effective in people who are anaemic or have low haemoglobin levels in the blood.
Emblica Officalis (Amlaki): Amlaki  is known for its rejuvenating properties as well. It has great anti oxidant properties and helps to neutralise the free radicals in the body. It is also effective in increasing immunity in the body and enhancing metabolism.

Ovarian Cysts - Ways Ayurveda Can Help You Treat It!

Rectal bleeding is the collective name associated with all the conditions that cause blood to pass into the stool. Blood may appear in the form of small flecks in the stool, or clots, or a lot of liquid mass. It can also appear on the toilet paper, instead of in the pot. The blood may be coming from the anus, colon, or rectum itself.

Causes of Rectal Bleeding

The causes are multiple, and they include-

  Swelling and irritation of the anal veins, a condition known as haemorrhoids. Piles are the more common name for this phenomenon.
  Constipation (inadequate and painful passing of stools)
  Tears or scratches in the anus (fissures), sometimes as a side effect of constipation.
  Anal cancer
  Colon cancer
  Rectal cancer
  Diarrhoea
  As a side effect of radiation therapy, used in the treatment of diseases like cancer

Ayurveda believes that such a condition occurs due to the imbalance of the three doshas - fire (Pitta), water (Kapha) and air (Vata). Therefore, the aim of Ayurveda is to restore the dosha balance in your body and improve the condition. The help of a medical professional must be sought immediately after you notice this phenomenon occurring with you.

Treatment of rectal bleeding: Why Ayurveda is your best resort?

Ayurvedic treatment is the best possible alternative at your disposal. Besides being tailor-made to cater to your medical history, it is the only form of treatment that has negligible side effects. Hence, you might want to talk to an Ayurveda medicine specialist in the first place.

Rectal bleeding has a whole host of possible solutions within the fold of Ayurveda treatment. They are-

  Use laxatives, but natural ones. Laxatives are compounds that make stool less hard and easier to pass. The substances that can act as natural laxatives are coconut water, chia seeds, spinach, flaxseeds and prune juice.

  Foods that are rich in fibre should comprise a major chunk of your dietary intake during treatment. These foods include the peels of fruits and vegetables, and figs, beans and prunes.

  There are certain items you should not consume as well according to Ayurveda, like alcohol or fried foods. Also, to not further irritate haemorrhoids and exacerbate your condition, avoid hot and spicy foods like those flavoured with green chillies.

  Reduce time spent on sitting on the toilet seat, as this puts a strain on the muscles around that region.

Rectal bleeding is a common medical phenomenon that may require critical attention. While some of the reasons behind it may be easily treatable, there are some conditions with deep complications underlying it, like rectal cancer. You should get yourself checked immediately if you are experiencing rectal bleeding. After getting a primary diagnosis, you should try Ayurvedic remedies for the best results.

Rectal Bleeding - Causes & Treatments Of The Problem!

What is Laparoscopic Gallbladder Removal Surgery (Laparoscopic Cholecystectomy)?

Gallbladder removal is one of the most commonly performed surgical procedures. Gallbladder removal surgery is usually performed with minimally invasive techniques and the medical name for this procedure is Laparoscopic Cholecystectomy or Laparoscopic Gallbladder Removal.

The gallbladder is a pear-shaped organ that rests beneath the right side of the liver. Its main purpose is to collect and concentrate a digestive liquid (bile) produced by the liver. Bile is released from the gallbladder after eating, aiding digestion. Bile travels through narrow tubular channels (bile ducts) into the small intestine. Removal of the gallbladder is not associated with any impairment of digestion in most people.

What Causes Gallbladder Problems?

Gallbladder problems are usually caused by the presence of gallstones which are usually small and hard, consisting primarily of cholesterol and bile salts that form in the gallbladder or in the bile duct.

It is uncertain why some people form gallstones but risk factors include being female, prior pregnancy, age over 40 years and being overweight. Gallstones are also more common as you get older and some people may have a family history of gallstones. There is no known means to prevent gallstones.

These stones may block the flow of bile out of the gallbladder, causing it to swell and resulting in sharp abdominal pain, vomiting, indigestion and, occasionally, fever. If the gallstone blocks the common bile duct, jaundice (a yellowing of the skin) can occur.

Diagnosing 

Ultrasound is most commonly used to find gallstones.
In a few more complex cases, other X-ray test such as a CT scan or a gallbladder nuclear medicine scan may be used to evaluate gallbladder disease.
Gallstones do not go away on their own. Some can be temporarily managed by making dietary adjustments, such as reducing fat intake. This treatment has a low, short-term success rate. Symptoms will eventually continue unless the gallbladder is removed. Treatments to break up or dissolve gallstones are largely unsuccessful.

Surgical removal of the gallbladder is the time-honored and safest treatment of gallbladder disease.

What are the Advantages of Performing Laparoscopic Gallbladder Removal?

Rather than a five to seven inch incision, the operation requires only four small openings in the abdomen.
Patients usually have minimal post-operative pain.
Patients usually experience faster recovery than open gallbladder surgery patients.
Most patients go home the same day of the surgery and enjoy a quicker return to normal activities.
Are you a Candidate?

Although there are many advantages to laparoscopic gallbladder removal (cholecystectomy), the procedure may not be appropriate for some patients who have severe complicated gallbladder disease or previous upper abdominal surgery. A thorough medical evaluation by your personal physician, in consultation with a surgeon trained in laparoscopy, can determine if laparoscopic gallbladder removal (cholecystectomy) is an appropriate procedure for you.


Laparoscopic Cholecystectomy - Laparoscopic Gallbladder Removal Surgery!

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