Gastric (stomach) cancer occurs when malignant cells form in the lining of the stomach. By far, it is known to be the second most common cause of cancer-related deaths not only in Asia but also worldwide. Though it can affect both male and female populace, it is seen more commonly in men and in people aged 50 years or older.

Type: Gastric cancers can present as one of the following types - 

Adenocarcinoma: Begins in the glandular cells lining the inside of the stomach. This forms a majority of the stomach cancers.
Lymphoma: Begins in immune system cells present in the walls of the stomach. Occurrence of lymphoma, in the stomach, is rare.
Carcinoid Tumor: Begins in hormone producing cells of the stomach.  Occurrence of carcinoid cancer, in the stomach, is rare.
Gastrointestinal Stromal Tumor (GIST): begins in nervous system cells of the stomach. Occurrence of GIST, in the stomach, is rare.
Gender: It affects both male and female populace.

Etiology: The factors that are associated with increased risk of gastric cancer include the following mostly  

 Helicobacter Pylori  bacterial infection in the stomach is a common cause of gastric cancer of both the intestinal (expanding) & diffuse (infiltrative) type. Furthermore, studies indicate that high salt intake is synergistic with H. Pylori infection in the manner that it is likely to increase the risk of gastric cancer that is induced by H. Pylori bacteria.
Smoking, consuming alcohol, red meat, salty/ smoked/ processed foods, low intake of fruits and vegetables, diets rich in nitroso compounds, eating foods contaminated with aflatoxin fungus etc all.
Atrophic gastritis characterized by chronic stomach inflammation is known to increase the risk multi-fold. Chronic gastric inflammation can lead to atrophy of the gastric mucosa, metaplasia, dysplasia and finally carcinoma.
History of pernicious anaemia, gastric ulcers, adenomatous gastric polyp etc all.
Family history of gastric cancer. Several familial syndromes that have been associated with a pre-disposition to gastric cancer include familial adenomatous polyposis, Lynch syndrome, Peutz-Jeghers syndrome and e-cadherin mutation (diffuse type)
Blood group A, Obesity etc all are known to be associated with diffuse or cardia gastric cancer.
Low socioeconomic status - persistent lifestyle issues/ irregularities including high stress coupled with an improper diet/ dietary pattern.
Epidemiological evidence is indicative of a risk or pre-disposition to gastric/ stomach cancer for people suffering from diabetes mellitus (DM).
Very high dose ionizing radiation exposure is an uncommon risk for gastric cancer.
Features: There are often no early stage symptoms. Early stage symptoms, if any, are non-specific and are likely to be ignored, thus delaying the diagnosis most often. Hence, gastric/ stomach cancer is often detected at an advanced stage where the disease is either locally advanced or metastatic. The various presentations (of signs & symptoms), by stage (early or advanced), of gastric cancer are as enumerated below:

Early Stage   can present with one or more of the following non-specific symptoms/ signs -

Dyspepsia (Indigestion),
Stomach/ Epigastric discomfort,
Bloated feeling after eating,
Mild Nausea/ Vomiting,
Blood in Vomit (Haematemesis),
Heartburn,
Weight loss (Cachexia)
Anaemia,
Occult blood in stool/ Melaena,
Advanced Stage   presents with one or more of the following symptoms/ signs -
GI Bleeding with black tarry stools (Melaena),
Persistent Nausea/ Vomiting,
Blood in Vomit (Haematemesis),
Early Satiety,
Anaemia,
Loss of Appetite (Anorexia),
Weight loss (Cachexia),
Persistent pain in the abdomen,
Fluid build-up in the peritoneal cavity (Ascites),
Edema of the lower extremities,
Liver Enlargement (Hepatomegaly)/ Jaundice,
Difficulty swallowing food (Dysphagia)
Screening: Is generally recommended for asymptomatic populations in high incidence areas or as surveillance for high risk individuals. The goal of screening, as usual, is to be able to detect & diagnose gastric cancer at an early stage which is potentially curable. It is mostly endoscopic/ radiologic.
Diagnosis: Following are the diagnostics employed in gastic cancer - 

Physical Examination: May be remarkable for palpable abdominal mass, weight loss (cachexia), abdominal distension, ascites, hepatomegaly, lower extremities edema and lymphadenopathy for gastric cancers in the advanced stage. For early gastric cancers, however, physical examination is largely uninformative.
Blood: Hb- may be low, ESR   raised, tumor markers CEA & CA-19-9 could be raised sometimes in adenocarcinoma but are not frequently elevated. Abnormal blood test results may be indicative of malignancy, but a follow-up gastroscopy/ biopsy is always the gold standard for accurate diagnosis.
Stool: Occult blood may be +ve
Barium Meal X-Ray: Could show a filling defect at the site of the carcinoma/ cancer growth.
Gastroscopy/ Biopsy: Clinches the diagnosis.
Endoscopic Ultrasound: Maximizes tumor staging as it helps determine the depth of invasion of the tumor.
CT Scan: Of chest, abdomen & pelvis helps detect metastatic disease, if any, and also helps stage the disease (TNM) appropriately.
Bone Scan: Helps detect osseous metastasis (bone mets), if any.
Treatment: Conventional treatment includes surgery, chemotherapy and radiotherapy as contextually appropriate. Surgery (i.e. gastrectomy either sub-total or total), with an adjuvant chemotherapy and/ or radiotherapy as contextually relevant, is the only treatment that is known to cure the disease in light of the prognostic indicators as briefly enumerated in the section below. Chemptherapy and/ or radiation alone cannot be curative. Mostly, it can improve symptoms, and may prolong survival. Simultaneously, an adjunctive or integrative naturopathic treatment with suitable complementary & alternative medicines (CAM) too can help improve clinical outcomes and facilitate recovery as feasible contextually.
Prognosis: For gastric cancer is variable. Preventive measures, earlier diagnosis and right early treatment is key for an effective therapeutic management & better prognosis. Like most other cancers, the chances of cure for an early stage gastric cancer are more. The cure/ recovery chances are influenced by the grade, stage of cancer, recurrence and the patient s general health & vitality etc all. Distal tumors are known to be cured more often than the proximal ones. Again, intestinal-type gastric cancers are known to have a better treatment outlook in comparison to the diffuse-type gastric cancers.

Prevention: Rightly said, prevention is always a better choice. Although genetic risks are difficult to modify, still an adherence to a relative Mediterranean diet, maintaining an ideal body weight and an active lifestyle with due emphasis on regular exercising, de-stressing and relaxation is highly recommended for reducing the risks of many cancers including gastric cancer. A healthy eating plate comprises essentially a low fat diet, fibre rich foods including whole grain cereals, green leafy vegetables cooked using healthy vegetable oils, fresh fruits of all colours as seasonally available and healthy proteins/ fats including fresh fish, poultry, beans, nuts etc all. The consumption of alcohol, if any, has to be strictly in moderation, and is best avoided in a high risk scenario. Smoking is to be avoided too. Again, red meat, butter, refined grains, sweets, sugary drinks including carbonated beverages and other high calorie foods etc all, if any, are to be taken sparingly. Not only it is important to eat healthy, but also it is equally important to eat properly. Insufficient chewing, eating until full, eating meals within a short time etc all are best avoided so as to ease off digestive burden on the stomach/ other organs in the GI tract. Last but not the least, consumption of clean and filtered water, natural probiotics like freshly prepared yogurt/ butter milk, maintenance of cleanliness & hygiene including oral hygiene etc. all can help guard against H. Pylori infections. Breastfeeding is known to be protective against H. Pylori infections too.

Gastric Cancer - In a Nutshell!

High fever is common in kids and a common worry for parents as well. If you are a parent, you need to know when the fever is serious, and when you should worry about it. Fever is a defence mechanism of the body. Body temperature rises if any foreign body (or antigen) attacks your body. As a defence, body temperature rises making it an unfavourable condition for the antigen. Fever means 100.4 degree Fahrenheit. Normally for kids, thermometer is placed under the armpit to record the temperature. You need to add an extra degree for accuracy. Paediatricians recommend treatment for fever if it's more than 101 degree F.

When to Call a Doctor

If the kid is less than 4 months old and has a fever of 100.4 degree F with other mentioned symptoms as highlighted, one must see the doctor as an emergency situation.
If a kid has 104 degree F fever, rush to the doctor. Such a high fever in children could lead to seizers.

You must call a doctor if the kid has a fever along with the following symptoms:

    Looks very dizzy
    Has a deteriorated immune system or even any other medical condition
    Has a seizure
    Has symptoms such as rashes, painful throat, annoyance, rigid neck or ear pain

Medication Side Effects:

At times, if you treat your children with some medication that does not suit them, it may lead to high fever. In case fever in a kid aged less than 2 years lasts for more than one day, it's time to see a doctor. And lastly, remember that normal body temperature is 98.6 degree F.

High Fever: When It Should Raise Alarm for Parents

Common ear infections: What you should know about them

The most common ear infections happen because of bacterial or viral growth in the middle ear, the part which lies just behind the ear drum. Middle-ear infections can be very painful and children are most commonly reported in children. Most of these infections are caused by the blockage of the Eustachian tube, which connects the ear and the throat, causing the build-up of fluids and swelling. Here is a guide to the most common forms of ear infections and their symptoms, ranging from the acute to the chronic.

Acute infections have intense symptoms but can be cured with time and treatment. They generally last for shorter durations.

In Chronic cases of infections, the patient complains of recurrent symptoms multiple times. Chronic ear infections have the potential of causing permanent damage to the ear.

Symptoms reported by most patients with Ear infections:

1. Pain in the ear (Mild to severe):

This is caused due to increased pressure owing to the blockage of the Eustachian tube. Collection of fluid inside the ear would increase the intensity of pain in most cases. Children will keep tugging at their ear and most likely be cranky.

2. Redness and swelling:

Both of these are inevitable accompanying symptoms in case of any infection in the body.

3. Oozing of the fluids:

The blockage leads to the fluid being released from the ear which can be watery, thick yellow or mixed with blood depending on the severity and type of infection.

4. Fever

5. Difficulty in sleeping.

6. In some cases when the infection spreads, difficulty in balancing the body is experienced as body balance is maintained by ears.

7. The patient might also experience increased irritability.

8. Ear infections can also cause a hearing problem if the condition continues to go untreated.

Ear infections should be promptly dealt with to prevent long-term damages. So here is what should be done when you have ear pain symptoms.

1. Consult an ENT who will prescribe pain medication as the first line of treatment.

2. After the necessary tests are done, antibiotics are prescribed in most cases by the doctor. Other medications for palliative treatment (to ease the symptoms) are administered. However in a few rare cases, the infection might be because of non-bacterial causes in which antibiotics might not cure the state.

3. In case the problem keeps recurring, one must visit the doctor again and get further tests and treatment done.

As prevention is always better than cure, care should be taken to avoid all chances of carrying the infection to your ear. Maintain cleanliness in and around, especially in the case of children.

For further queries; we'd be happy to help!

Common ear infections: What you should know about them

Sweating during warm weather is very common, but if a person wakes up from bed soaked in sweat, it is not a pleasant feeling. It does not allow for a sound sleep, and may not always be related to warm weather.
There is no serious underlying medical issue, but it is always advisable to see a doctor to get this corrected. The following are some common reasons that could lead to night sweats.

Menopause: The hot flashes that are so popularly associated with menopause is one of the main reasons for night sweats. The presenting factors (woman, age, and other symptoms) should help arrive at this diagnosis. Hormonal levels can be checked to confirm if required. Even puberty and pregnancy can cause night sweats, due to hormonal level alterations.
Infections: Most infections present with fever and night sweats are very common. Tuberculosis, osteomyelitis, endocarditis, influenza and even HIV can cause night sweats and hamper a person s sleep. Most infections cause an increase in temperature, which is worse at night.
Obstructive sleep apnea: The walls of the windpipe get narrowed, and the person might have short periods where the breathing just stops. These people are three times more likely to develop night sweats.
Hypoglycemia: One of the most common symptoms of low blood sugar is night sweat. When the sugar drop happens during the time the person is sleeping, it is very common for the person to wake up soaked in sweat.
Cancer: For some cancers, night sweats are one of the first warning signs. These cancers include lymphoma, and presence of symptoms like unexplained weight loss, fatigue, etc. should be addressed to rule out the possibility of cancer.
Side effect of medications: Antidepressants, psychiatric drugs, anti-pyretic drugs, anti-virals, steroids, anti-diabetic medications, hormones, etc. can lead to night sweats. Suspected cases of night sweats should have their medications reviewed to see if any drug is causing the night sweats.
Gastro-esophageal reflux disease: GERD, as it is popularly known, can cause night sweats in addition to heartburn. They would also have other symptoms of indigestion, which will help in identifying the problem.
Neurologic disorders: Stroke, neuropathy and anxiety disorders can cause night sweats and would require psychotherapy in addition to medications.
Idiopathic: And despite all these possible reasons, if there is no identifiable reason, it is known as idiopathic hyperhidrosis (increased sweating). The person produces too much sweat without any known underlying cause and can even wake up at night soaked in sweat.
Management: Identifying the underlying cause is the first step in treatment. It may require hormonal corrections, changing or withdrawing the causative medications, treating associated conditions, etc., as the case may be.

Sweating While Sleeping - 9 Reasons Behind It?

BPPV or Benign paroxysmal positional vertigo is a major cause of vertigo. This is a condition that gives a sensation of head spin all of a sudden. It also results in dizziness in brief episodes. The severity level can vary from intense to mild. BPPV is triggered with certain changes of the head position. Although BPPV is bothersome, it isn t serious unless there is a chance of a person falling abruptly because of the head spin. There are ample treatment options available to address this problem.

Symptoms of BPPV
BPPV includes some of the following symptoms:
a. Loss of balance
b. Dizziness
c. Feeling of the surrounding spinning
d. Vomiting and nausea
e. Rhythmic movement of the eye

When to seek medical attention?
If dizziness is accompanied with one of the below-mentioned symptoms, it is time to urgently seek medical attention and get vertigo addressed for good:

Hear loss
Tingling or numbness
Fever accompanies with severe headache
Arm or leg weakness
Problems with vision
Difficulty in walking
Becoming unconscious
Causes of BPPV:
If there is on known cause associated with BPPV, the condition is termed as idiopathic BPPV. In most of the cases, though, BPPV is associated with a severe to minor blow to the head. Other causes include an injury to the inner ear, prolonged sitting position in a fixed posture, even migraine pain is at times associated with BPPV.

What are the risk factors?
Benign paroxysmal positional vertigo is likely to occur in the age group of 50 and above, this being said it can happen at any age in case of any injuries. Statistically, it is found that the likelihood of BPPV is more in women than men. Head injury of any sort is by far the most likely reason of BPPV.

What are the tests and diagnosis involved?
A doctor is likely to perform a physical examination followed by a series of tests. Some typical signs that a doctor looks for include the following:
Ability to control eye movement- especially side to side movement

Symptoms of dizziness
In case it is difficult to spot the symptoms, a doctor might suggest video- nystagmography or electronystagmography. It helps to track irregular eye movement. An MRI can also be prescribed to study the cross-sectional images of the body and the head.

Treatments associated with BPPV:
BPPV mostly go away within months or weeks on its own. If however, it still persists, a doctor can suggest Canalith Repositioning- series of small movements that helps to counter BPPV. For extreme cases, a doctor might advise a surgery for blocking the portion of the inner ear that might be causing the problem. It guarantees close to a 100 percent fix to BPPV.

Vertigo / Dizziness - When To Seek Medical Attention?

Have you been coughing so often that it is intervening with your daily routine? Drop that bottle of cough syrup that gives you an instant relief but along with a feeling of drowsiness. Though coughing may appear to be a simple issue, it is very harassing and can lead to various severe problems. Ayurveda has the power to alleviate the suffering to a considerable degree. The Pranavaha Srotas show how the  vata  that controls the respiratory systems in the body can be balanced with Ayurvedic means so that you are relieved.

Symptoms and their mistreatments
There are two types of cough, one with the phlegm that s termed as wet cough and creates congestion, due to which you are unable to breathe. The other type of cough is the dry one, which hurts your throat and forms a pressure on the chest area while you cough. Well, whether dry or wet, a simple disease related to coughing is powerful enough to deprive you of your night s sleep. If you are a patient of bronchitis or any other respiratory disease like sinus, then you are required to deal with the nagging problem of cough.

Ayurveda offers a great way of relieving cough.

Gargles: Whenever you feel soreness around your neck, take a glassful of warm water and add a pinch of salt in it and start to gargle. The salt would help to drain out the excess fluids from the inflamed areas, thus, reducing the symptoms. It also helps in removing the mucus and thinning of the mucus. Gargling with salt should be avoided by patients suffering from hyper-tension. Such people can use simple warm water without salt.
Take honey: It is not feasible to gargle anywhere and everywhere and in such cases, you can have a spoonful of honey as it is believed to soothe the irritation in the throat area. If you have a particular tendency to cough during the night time, then a glassful of warm milk with some honey can relieve your suffering. Diabetic patients should avoid honey.
Turmeric remedies: A traditional Indian remedy to alleviate soreness of the throat region is to drink hot milk mixed with honey. You may even opt for turmeric gargles where you will have to mix half teaspoon of turmeric along with the same quantity of table salt in a glassful of lukewarm water and gargle with it. To get rid of dry cough, alternately, you can mix some turmeric powder in a spoonful of honey and take it thrice in a day.
Allopathic and synthetic medicines are generally loaded with numerous side-effects including nausea and drowsiness. In the worst case, it may lead to dependence and addiction as well. Thus, embracing Ayurveda can help you get out of the ailment permanently.

Cough - 3 Easy Home Remedies for Treating it!

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