Problems of the large intestine are very common and patients should usually consult gastroenterologists for the proper diagnosis and treatment

1. Bleeding per rectum: Bleeding through the anal canal or rectum is usually the most common problem of the patients. It can be due to following reasons: 

A. Piles also known as Hemorrhoids: Hemorrhoids are dilated venous channels of the anal canal. They occur due to long term constipation or chronic cough or due to less fibre intake in the diet. Sigmoidoscopy or proctoscopy is required for diagnosis. Treatment options include medicines and high fibre intake, Injection therapy(Sclerotherapy) for stopping bleeding from piles and Stapler hemorrhoidectomy if the piles are large.

B.  Polyps: Polyps are soft tissue growths seen in the large intestine. They are usually silent but can present with bleeding or anaemia. Polyps usually grow slowly in size and large polyps can turn into cancer of large intestine also known as colorectal carcinoma. Colonoscopy is required for the diagnosis. The gastroenterologists can diagnose the presence of polyps by colonoscopy. Smaller polyps can be removed by polypectomy by gastroenterologists without the need for open surgery. However large polyps or those polyps with suspicion of cancer require surgery.

C. Large intestine Ulcer: They can occur due to early cancer, SRUS, Infections or drugs. They require colonoscopy for the diagnosis. The gastroenterologists usually take Biopsy from the ulcer to know the cause of the ulcer. The mere taking of biopsy does not mean cancer and biopsy samples are seen in the microscope for better diagnosis.

D. Ulcerative Colitis and Crohn s disease: Ulcerative colitis is one form of Inflammatory bowel disease (IBD). The other IBD is known as Crohn s disease. Whereas ulcerative colitis involves only large intestine, Crohn s disease can involve any part of the gastrointestinal tract including small intestine. Ulcerative colitis and Crohn s disease present with Loose stools(diarrhea), bleeding , abdominal pain, weight loss, Anemia and Perianal fissures and  fistula. The diagnosis of IBD is challenging and involves blood tests, CT Scan abdomen, Colonoscopy with biopsy and clinical history. Management includes Medicines which control the inflammation such as Pentasa, Rowasa, Mesacol etc. Severe disease requires additional drugs such as Azathioprine and Anti TNF sich as Infliximab and Adalimumab. Occasional cases require surgery such as those with tight stricture of the intestine, severe dilatation of Large intestine (also known as Toxic megacolon), excessive bleeding, the disease not responding to medical management, or presence of cancer with IBD.

E. Anal fissures: Cut in the anal skin (fissure) causes severe pain in the anal area during passing motions. It is usually due to constipation or straining. It is usually treated by Gastroenterologists initially by medicines and ointments. If the pain continues Surgery is required named as Lateral internal sphincterotomy (LIS).

2. Loose motions or Diarrhea: Excessive passing of liquid motions is known as diarrhea or commonly lose motions. It is usually due to Infections caused by contaminated food and water. It is usually self-limiting. Severe cases with dehydration require admission for IV fluids and antibiotics for the infection. Loose motions for more than 6 to 8 weeks is known as chronic diarrhea. It is evaluated by blood tests and colonoscopy. Usual causes include tuberculosis, celiac disease, ulcerative colitis, microscopic colitis, Malabsorption such as chronic pancreatitis and small bowel bacterial overgrowth.

3. Irritable bowel syndrome (IBS): IBS is very common and at least 20 to 30 percent of Indian patients suffer from it. Symptoms include altered bowel habits such as diarrhoea or constipation, abdominal pain which is usually relieved or increased by defecation. Weight loss or bleeding is not the feature of IBS. Few simple blood tests are required and good medicines are now available for IBS. Few cases may require colonoscopy to rule out alternative causes of the symptoms.

Understanding colonoscopy: Colonoscope is a flexible tube with a camera at its tip to see the inside of the large and small intestine. Bowel preparation is required at least 8 hours before the procedure so that the inside of the large intestine can be seen clearly without the interference of stools.colonoscopy is an OPD based procedure where the patients are discharged the same day. A colonoscopy helps in evaluation symptoms of the large intestine such as loose stools, bleeding and abdominal pain.

In Detail About Colorectal Disorders!

When tissues that usually grow inside the uterus, start growing outside the organ, it is called endometriosis. Painful periods, pain during sex, pain while urinating or bowel movements, extreme bleeding, fatigue, infertility, diarrhea, bloating and nausea are some of the symptoms of endometriosis.

Treating endometriosis usually depends on the following factors

Age
Severity of symptoms
Severity of the disease
Future plans for children
Depending on these the doctor might opt for any of the following treatments

Medication for Pain: If the symptoms are mild, then the doctor will prescribe some pain killers like Nonsteroidal anti-inflammatory drugs. 
Hormone Therapy: Hormone therapy is effective, but once you stop them, your symptoms may come back. Some of the hormone therapies include: 
Hormonal Contraceptives: Birth control pills, vaginal rings and patches are useful in controlling the hormones that are responsible for tissue build-up outside the uterine cavity. 
Medroxyprogesterone: This drug stops menstruation, which in turn stops the tissue build-up and put an end to all the symptoms. But on the other hand, gaining weight, low bone production and depression are some of the common effects of this drug. 
Gonadotropin-releasing hormone (Gn-RH) antagonists and agonists: Hormones that stimulate ovaries are blocked by these. They bring down oestrogen levels and hence prevent menstruation. 
Danazol: This drug prevents menstruation and symptoms of endometriosis by blocking the hormones that stimulate the ovaries. However, Danazol may not be a favourable option because of its side effects. The drug should be avoided during pregnancy.
Conservative Surgery: If you are trying to get pregnant, but you already suffer from endometriosis, then removing endometriosis surgically is a viable solution. Your uterus and ovaries will be preserved, which might increase your chances of becoming pregnant. Even suffering from severe pain might find relief from conservative surgery. 
Hysterectomy: In extreme cases, the only way to deal with the symptoms is to completely remove the uterus, ovaries and cervix. Since a hysterectomy means you cannot have children, it is kept as the last option for women in their reproductive age.

Management of Endometriosis

Daljindar Kaur's inspiring story of motherhood: How IVF became her savior

The success of In vitro fertilization continues in India as a septuagenarian woman gives birth to a baby boy. Even after 46 years of marriage, the couple from Amritsar was childless. Daljinder Kaur, along with her 79-year-old husband, Mohinder Singh Gill, had been visiting National fertility and the Test Tube Baby Centre in Hisar since 2013 and did not give up even after two failed IVF cycles. They had faced ridicule for their inability to have a baby and yet they kept their hopes up.
On the 19th of April, the couple was blessed with a baby boy who is nothing less than a miracle. The groundbreaking achievement of the embryologists from Hisar has been an inspiration and a beacon of hope for couples all across the country. Once again, IVF has proved to be one of the most successful procedures to have babies for couples with fertility issues. Following are some of the advantages of In vitro fertilization, which you should know about-
1. It can be used by anybody
In-vitro fertilization is not necessarily used by the going to be a mother. It can be used by gestational carriers or by a surrogate as well. So it depends on whether the parents want to take the help of a surrogate or themselves want to be involved in the pregnancy. IVF gives an opportunity to single women and same-sex couples to become parents.
2. Use of donated eggs and sperms
There might be circumstances when the doctor can recommend using donated sperms or eggs. In that case, the eggs can be fertilized manually in the lab and the fetus developed can be used for in vitro fertilization. This increases the chance of pregnancy by a fair amount.
3. Control over timing
In vitro fertilization is a solution for couples who have a very engaging professional life, and can be an option for people who want to have babies after a certain point of time. Eggs and embryos can be preserved for future use. It is also helpful for couples who already have a child and plan to have another later.
4. Decreases chances of miscarriage
Genetic abnormality is one of the primary causes of miscarriage. The technique of preimplantation genetic diagnosis (PGD) is used to ensure the viability of the embryo much ahead of time so that the mother can have an uncomplicated pregnancy and carry her baby full term.



Daljindar Kaur's inspiring story of motherhood: How IVF became her savior

On an average a person consumes nearly 800 calories daily from added sugar. This does not just include natural sugar found in fruits or milk but the processed sweet sugar as well, that is added to cakes, tea, coffee, confectionery and even pasta sauce and salad dressing. However, it is possible that you can limit your sugar intake or even quit it to get some truly amazing benefits.

When you take this hard decision, you may experience withdrawal symptoms such as mild depression, anxiety or restlessness. But if you remain adamant and continue with your decision, your body will soon show some incredible results that you couldn't have imagined.

Here are a few of them:

1.&nbsp;Your heart will beat happily

Sugar raises insulin levels that activate the responses of sympathetic nervous system thereby elevating your bp and heart rate. When you cut down on sugar, your ldl cholesterol will decrease by 10% and triglycerides will reduce by 20-30%. And your risk of heart attack will reduce manifold.

2.&nbsp;Your weight fluctuations will be gone

With the exception of fruits, sugar is mostly present in processed or high-carb foods that contain loads of other unwanted constituents like fat etc.

So when you quit sugar, your body has to no longer worry about those unwelcome calories and your weight will stop moving right and left across the scale.

3.&nbsp;Digestion will become efficient

When you quit sugar, the digestive system becomes more efficient. Since your stomach and intestines have to no longer worry about those difficult to digest processed foods, their abilities and functioning improves. Even your colon begins to work better, may be you take more trips to the restroom, so things get even more on track.

4.&nbsp;No more acne troubles

Sugar triggers acne troubles. When you cut it down, you will no longer be troubled by those zits that dampen your looks. Your skin will actually clear up, cracks will disappear and you will get a healthier skin.

5.&nbsp;You will no longer have sweet craving

With sugar, there is a huge negative, as you enjoy sweets, you crave for more sweets. But if you quit sugar, slowly you will begin to avoid foods that contain sugar and as a result, whenever you will eat anything that has sugar, it will taste over sweet and you will not be able to have large portions. This means no more cravings for sugar!

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

5 Wonderful Things That Happen to Your Body When You Quit Sugar!

Intrauterine insemination (IUI) and in vitro fertilization (IVF) are two commonly used methods of fertility treatment, which increase a couple s chance of becoming pregnant.

The Procedure

IUI- IUI is a procedure during which processed and concentrated motile sperm are inserted directly into a woman s uterus. This procedure is timed according to a woman s ovulation, and may be performed one to two times in the days immediately following the detection of ovulation. After ovulation a woman s egg is picked up by the fallopian tube and waits there for the sperm. Since the IUI procedure deposits higher concentrations of good quality sperm close to where the egg is waiting, the chances that the egg and sperm will find one another are increased.

IVF- IVF is the most successful method of fertility treatment utilized today to help couples to conceive. The basic components of the IVF process include stimulation of the ovaries to produce multiple eggs at a time, removal of the eggs from the ovary (egg retrieval), fertilization of the eggs in the laboratory, and subsequent placement of the resulting embryos into the uterus (embryo transfer). The chance of pregnancy from IVF depends primarily on the age of the woman, the cause of infertility, and factors related to the quality of the IVF laboratory.

Success Rates

IUI Treatment: There is a marked difference between IVF and IUI pregnancy rates. IUI has a success rate between 5% and 20%, but it can even be as low as 1-2 %, depending on the woman s age and fertility levels. The chances of conceiving through IUI is higher if fertility drugs are administered along with the treatment.

IVF Treatment: IVF has a high success rate   between 20% and 35% and it can even go as high as 40%. This may not seem like a lot, but it is very high, considering that an average young and fertile couple has only a 15-20% chance to conceive in a month. It is important to understand what IVF and IUI success rates mean and the factors that affect it before deciding on a fertility treatment. You can also use any reliable online IUI vs IVF comparison tool to determine your approximate success rates with each of these treatments, depending on your age, lifestyle, and medical history.

You should use online sources of information to understand more about fertility problems, how age affects fertility levels, and whether freezing your eggs is a good option for you. However, discuss all these issues with your doctor to ensure that you have the right information and that you have understood it correctly. Fertility specialists provide you with personalized fertility plans based on your health which is why you should always talk to them before you make any decision.

IVF or IUI - Which One Should You Opt for?

Cradle cap is a slick, yellow scaling or crusting on a child's scalp. It is regular in children and can be effortlessly treated. Cradle cap is not a part of any ailment and does not indicate poor care of the child. It is the usual development of sticky skin oils, scales, and sloughed skin cells. It is not harmful to your child and generally leaves by an infant's first birthday. Some of the recommended ways to treat cradle cap are listed below:


Baby shampoo: Shampoo might be the absolute best approach to treat cradle caps in babies. Regular shampooing can get rid of a flakey scalp and make it a smooth one. Abstain from getting the shampoo in your child's eyes. In case you are uncertain about using it, ask a doctor or specialist for guidance. Do not utilize shampoos that contain groundnut oil or shelled nut oil on children under five years of age.
Olive oil: Olive or almond oil is regularly used to heal cradle cap. Try rubbing it on the infant s hair and give it a chance to sit for some time, then delicately rub with a soft toothbrush. 
Coconut oil: Every mother uses coconut oil for many reasons. It is the most effective treatment. It smells astounding as well. Put a little on your child's head every evening and wash it over the next morning with an infant brush. 
Vaseline: A considerable number of mothers use Vaseline. Apply it on the hair around evening time and by morning, the cradle cap will be a little improved.
Fine-toothed comb: This is a lice brush and is very useful. However, with a little oil, this is most likely one of the least demanding and quickest approaches to evacuate those flakes. 
Shea butter: Applying Shea butter on the scalp is a great approach. Rub it on the hair, then brush it off gradually. It brings about the ideal result, as indicated by a few mothers. 
Home treatment is normally all that is required for support. Here is how one needs to do it:
An hour prior to shampooing, rub your child's scalp with infant oil petroleum gel to lift the coverings and flakey scales. 
Before applying the shampoo, first get the scalp wet, then tenderly rub the scalp with a delicate swarm brush (a delicate toothbrush would work too) for a couple of minutes to remove the scales. You can attempt to tenderly remove the flakes with extreme attention to detail. 
At that point, wash the scalp with baby shampoo, flush well, and tenderly towel dry. 
In case that your child's cradle cap gets to be swollen or infected, a course of anti-infection agents or an antifungal cream or cleanser such as ketoconazole might be recommended by a specialist. A gentle steroid cream such as  hydrocortisone may likewise be suggested for an irritant rash.

Infant Cradle Cap - How You Can Get Rid of Them?

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