Do you bleed or feel pain during bowel movements, or the skin around your anus feels sore or itches? Or maybe there's a lump in or around your anus, or you feel as if your bowels haven't emptied completely? Then you may be suffering from piles. Piles or hemorrhoids are essentially swollen veins and muscles in your anal canal or around your anus. And they may stay inside your anus or come outside depending on the severity of the affliction.

Often, piles can be successfully treated with high-fiber diet, proper hygiene, and topical medicines or ointments. But in situations where non-surgical methods don't achieve desired results, surgery becomes the only option. And this may be particularly necessary for those suffering from large painful or bleeding hemorrhoids. The different surgical options are given below:

Hemorrhoidectomy - In this procedure, the surgeon makes incisions around the anus to remove the piles formations. Local or general anesthesia is offered during the operation, and you can usually return home on the same day. After the procedure, the area might require stitches and commonly remains very tender and painful for quite some time.
PPH or Procedure for Prolapse and Hemorrhoids - This method is minimally invasive and makes use of a stapler-like machine for repositioning the hemorrhoids and cutting off their blood supply. So eventually, the piles shrink and die without blood supply and your pain diminishes greatly. With this process, you can expect a faster recovery, less itching and bleeding, and minimal complications, if any.
Laser - An accurate and special laser beam is used in this method, to burn off the hemorrhoids.
Rubber Band Ligation - This procedure can be used for areas with fewer pain receptors. In this, a rubber band is tied around the base of hemorrhoid to stem the blood supply and destroy the affected tissue.
Sclerotherapy - This method involves the injection of a chemical solution around the blood vessel which supplies the hemorrhoid tissues, to shrink and kill them. Though non-invasive methods are preferred by many since they create less pain, hemorrhoidectomy may provide more long-lasting benefits. Here are some other aspects you need to consider regarding piles surgery:
Risks - Infection, bleeding, reaction to anesthesia, trouble with urination, fecal incontinence are some of the risks involved, though the surgery is usually quite safe.
Ways of treating pain - Pain, especially during and after a bowel movement, can be an issue for several days after the surgery. But it can be dealt with by taking prescribed pain medications, stool softeners, and soaking in a warm bath. Recovery can take up to 3 to 6 weeks after the procedure.
Avoiding recurrence - Following a high-fiber diet, maintaining good hygiene, taking lots of fluids, and avoiding straining or constipation can prevent piles from coming back.

What You Should Know About Piles Surgery

Sugar is the generic name that represents sweet-tasting, soluble carbohydrates, many of which are used in food. 

What Happens When Concentrated Sugar Enters the Body?
Sugar is a poison when concentrated because it causes swelling of joints, liver, and brain. Sugar will hamper the healing of your body if you have an injury or chronic illness. Sugar acts as a source of energy for cancer cells and all infectious diseases. Sugar blocks the absorption of the nutrients you are eating, especially all of your minerals.

Harmful Effects of Sugar on the Body

It is a true silent killer: A study in 2008 linked excess fructose consumption to an increase in leptin resistance. Leptin is a hormone that tells you when you have had enough food. For some people, leptin simply does not work, leaving the person with no signal whatsoever that the body had enough food leading to over-consumption of food and consequently, obesity. As all this happens without symptoms or warning bells and you can t quite figure out why you ve gained weight in the past year  sugar  is labeled as SILENT KILLER.
It can damage your heart: In 2013, the Journal of the American Heart Association displayed strong evidence that sugar can actually affect the pumping mechanism of your heart and could increase the risk for heart failure. A molecule from a sugar called glucose metabolite glucose 6-phosphate (G6P) is responsible for the changes in the muscle protein of the heart leading to heart failure.
It promotes belly fat: Excess fructose intake (but not glucose intake) actually causes visceral fat cells to mature leading to a big belly and higher risk for heart disease and diabetes.
It has toxic liver effects on the body: Fructose and glucose in excess can have a toxic effect on the liver as the metabolism of ethanol, the alcohol contained in alcoholic beverages, has similarities to the metabolic pathways like fructose.
It saps brain power: Study shows that excess sugar consumption was linked to deficiencies in memory and overall cognitive health.
Quick Facts!

Your brain lights up with sugar just like it does with heroin or cocaine. Sugar is eight times more addictive than cocaine.
Sugar has empty calories meaning you can consume a lot of it and feel full, but receive no nutritional value.
It is certainly one of the leading causes of early death and chronic illnesses, including diabetes, obesity, and heart disease.
Food companies try to hide sugars in their food by using other forms of sugar. This leads to addiction of their products (e.g. high-fructose corn syrup).
Sugar in itself offers absolutely no nutritional value what so ever to the body. It is often coined with the term empty calories.

Sugar: A Silent Killer!

Do you need vitamin supplements? Here's how to find out

Taking vitamin and mineral supplements is increasingly becoming common these days. People generally opt for these supplements to ensure good health as their diets are usually lacking in vitamins due to the pursuit of a hectic lifestyle.

But before you begin consuming vitamin supplements, it's necessary for you to know whether your body actually needs them. According to nutritionists, you should plan your diet appropriately to fulfil your nutritional needs and not depend on vitamin supplements to do so. If your diet includes foods like fruits, green vegetables, whole grains, low-fat dairy products, legumes, fish and lean meat, you won't need vitamin supplements.

So, when exactly do you need vitamin supplements?

You might need vitamin supplements in the following cases:

- If you are above the age of 50, you can take vitamin b-12 supplement. Additionally, you may consider eating food items fortified with vitamin b-12, like fortified cereals.

- If your diet does not meet the normal requirement of 1, 600 calories a day, you should consider dietary supplements. Moreover, the diet of people who do not consume red meat usually lacks in zinc and iron, which can be supported by vitamin supplements.

- If you are a woman whose menstrual cycle is associated with heavy bleeding, you might need vitamin supplements.

- If you suffer from a disorder that has a negative impact on the nutrient absorption process of your body, you need to take vitamin supplements. These conditions include chronic diarrhoea, food intolerance, food allergies or any disease related to the liver, pancreas, intestines and gall bladder.

- If your body has difficulty in absorbing and digesting nutrients because of a surgery of the digestive tract.

- If you are a woman who is planning to have a child. Women who want to get pregnant should consume 400 mg folic acid, which can be obtained from dietary supplements or fortified foods.

- If you are pregnant, you should include a prenatal vitamin in your daily diet. This vitamin should contain iron. You may also fulfil this iron requirement by consuming a separate iron supplement.

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

Do You Need Vitamin Supplements?

The intervertebral discs are made-up of two concentric layers, the inner gel-like Nucleus Pulposus and the outer fibrous Annulus fibrosus. As a result of advancing age, the nucleus loses fluid, volume and resiliency and the entire disc structure becomes more susceptible to trauma and compression. This condition is called as degeneration of the disc. The disc then is highly vulnerable to tears and as these occur, the inner nucleus pulposus protrudes through the fibrous layer, producing a bulge in the intervertebral disc. This condition is named as herniated disc. This can then cause compression to the spinal cord or the emerging nerve roots and lead to associated problems of Sciatica radiating pain from back to legs in the distribution of the nerve. Other symptoms could be a weakness, tingling or numbness in the areas corresponding to the affected nerve. Sometimes bladder compromise is also present, which is made evident for urine retention and this need to be taken care as an emergency.
Excessive weight, bad postures, undue movements, improper weight lifting and other kinds of traumas may weaken the intervertebral discs. When this occurs the pulpous nucleus will bulge against the annulus, or even be squeezed through it (extruded disc).

The first steps to deal with a herniated or prolapsed lumbar disc are conservative. These include rest, analgesic and anti-inflammatory medication and in some cases physical therapy. At this point, it is convenient to have some plain X-rays done, in search of some indirect evidence of the disc problem, as well as of degenerative changes on the spine.

If in a few days these measures have failed, the diagnosis has to be confirmed by means of examinations that give better detail over the troubled area, as the MRI, CT which will show the disc, the space behind it and in the first case, the nerves. In some instances, the EMG (electromyography) is also of great value, as this will show the functionality of the nerves and muscles.

Once the diagnosis has been confirmed, one of the best alternatives existing today is the Ozone Discolysis as the results obtained are excellent and practically has no complications. This novel treatment avoids the use of surgery in 80% of those who needed it. In most patients left with painkillers as the only treatment, the symptoms eventually disappear, only that this could take weeks to months. Ozone speeds up these developments, see the same result in a few weeks. The problem has to be seen and approached integrally and frequently the combination of therapies has to be used, most frequently physiotherapy. Also, it has to be known that those who had a herniated disc have 10 times more chances of having another herniation than the rest of the population.

If despite the ozone therapy the symptoms persist, Drill Discectomy/ Laser Discectomy are good alternatives before open surgery (Discectomy) which has to be contemplated in those true emergencies, as mentioned above, this is possibly the first choice.

Once the conservative treatment fails:

Early aggressive treatment plan of pain has to be implemented to prevent peripherally induced CNS changes that may intensify or prolong pain making it a complex pain syndrome. Only 5% of total LBP patients would need surgery & 20% of discal rupture or herniation would need surgery. Nonoperative treatment is sufficient in most of the patients, although patient selection is important even then.

Depending upon the diagnosis one can perform & combine properly selected percutaneous fluoroscopic guided procedures with time spacing depending upon pt`s pathology & response to treatment.

Using precision diagnostic & therapeutic blocks in chronic LBP, isolated facet joint pain in 40%, discogenic pain in 25% (95% in L4-5&L5S1), segmental dural or nerve root pain in 14% & sacroiliac joint pain in 15% of the patients. This article describes successful interventions of these common causes of LBP after conservative treatment has failed.

LESI: Lumbar Epidural Steroid Injection

Indicated in   Acute radicular pain due to irritation or inflammation.

Symptomatic herniated disc with failed conservative therapy
Acute exacerbation of discogenic pain or pain of spinal stenosis
Neoplastic infiltration of roots
Epidural fibrosis
Chronic LBP with acute radicular symptoms
Epidural- lumbar injection
ESI Treatment Plan

Compared to interlaminar approach better results are found with a transforaminal approach where drugs (steroid+ LA/saline +/- hyalase) are injected into anterior epidural space & neural foramen area where herniated disc or offending nociceptors are located. Whereas in interlaminar approach most of drug is deposited in posterior epidural space.Drugs are injected total 6-10 ml at lumbar, 3-6 ml at cervical & 20+ ml, if caudal approach is selected. Lumbar ESI is performed close to the level of radiculopathy, often using paramedian approach to target the lateral aspect of the epidural space on involved side. Cervical epidural is performed at C7-T1 level.

SNRB- Selective Nerve Root Block 

Fluoroscopically performed it is a good diagnostic & therapeutic procedure for radiculopathy pain if

There is minimal or no radiological finding.
Multilevel imaging abnormalities
Equivocal neurological examination finding or discrepancy between clinical & radiological signs
Postop patient with unexplainable or recurrent pain
Combined canal & lateral recess stenosis.
To find out the pathological dermatome for more invasive procedures, if needed
Intradiscal Procedures 

Provocative Discography - Coupled with CT

A diagnostic procedure & prognostic indicator for surgical outcome is necessary for the evaluation of patients with suspected discogenic pain, its ability to reproduce pain(even with normal radiological finding), to determine type of disc herniation /tear, finding surgical options & in assessing previously operated spines.

Percutaneous Disc Decompression (PDD)

After diagnosing the level of painful offending disc various percutaneous intradiscal procedures can be employed

Ozone Discolysis: Ozone Discectomy a revolutionary least invasive safe & effective alternative to spine surgery is the treatment of choice for prolapsed disc (PIVD) done under local anaesthesia in a daycare setting. This procedure is ideally suited for cervical & lumbar disc herniation with radiculopathy. The total cost of the procedure is much less than that of surgical discectomy. All these facts have made this procedure very popular at European countries. It is also gaining popularity in our country due to high success rate, less invasiveness, fewer chances of recurrences, remarkably fewer side effects meaning high safety profile, short hospital stay, no postoperative discomfort or morbidity and low cost.

Dekompressor: A mechanical percutaneous nucleosome cuts & drills out the disc material somewhat like morcirator debulking the disc reducing nerve compression.

Epidural Adhenolysis or Percutaneous Decompressive Neuroplasty for Epidural Fibrosis or Adhesions in Failed Back Surgery Syndrome (FBSS)

A catheter is inserted in epidural space via caudal/ interlaminar/ transforaminal approach. After epidurography testing volumetric irrigation with normal saline/ L.A./ hyalase/ steroids/ hypertonic saline in different combinations is then performed along with mechanical adenolysis with spring loaded or stellated catheters or under direct vision with epiduroscope.

Procedures That Can Help Treat Slip Disc & Sciatica!

Our ears are small in size, but  big  in the work they do. Not only do they help us hear, but also help us maintain our body s balance. They thus help us stand, walk, drive you just name it.

Ears are also much bigger in size than they actually are. The part of the ear that we see on our head is only the external ear, there is a middle ear and an inner ear too, silently carrying out complex functions related to hearing and balance. The middle ear that lies behind your ear drum is the seat of balance. And this part is hit hard at the time of an ear infection.

Ear infections cause the Eustachian tubes   small tubes that connect the middle ear to the back of your throat   to become swollen and blocked due to excess mucus. As a result of this, fluid builds up and inflammation takes root in the middle ear, thereby causing pain.

Ear infections can be acute or chronic. Acute infections clear up in a few days, but chronic ones reoccur frequently. If not managed, chronic ear infections can cause permanent damage to the middle and inner ear.

Causes of Eustachian tube blockage are as follows:

Allergies
Sinus infection
Cold
Extreme production of mucus
Smoking
Infected adenoid, which is a tissue near your tonsils that traps harmful bacteria and viruses
There are a few risk factors associated with ear infections. It can be said that young children are more susceptible to these infections. This is because their Eustachian tubes are short and narrow. It has also been seen that infants who are bottle-fed have a higher incidence of ear infections than breastfed babies.

Other risk factors are:

Changes in altitude
Changes in climate
Exposure to tobacco smoke
Use of pacifiers
Symptoms of ear infections:

Pain or discomfort inside the ear
A prolonged feeling of pressure inside the ear
Pus-like ear drainage
Hearing loss
What is also important to know is that the symptoms of an ear infection come and go. 

Symptoms can also occur in one or both ears. Chronic ear infection symptoms can be less noticeable than those of acute ear infections.

Hence, fever and ear ache should spur you to see a doctor. You should be extremely careful with babies younger than six months who have fever or ear infection symptoms.

Your doctor will diagnose an ear infection by checking if there is a draining of fluid from the middle ear, perforation in the eardrum or a collapsed eardrum.

Sometimes, ear infections can lead to the following serious complications:

Hearing loss
Speech or language delay in children
An infection in a skull bone called mastoiditis
Meningitis
Ruptured ear drum

Causes And Symptoms Of Ear Infections

Polio is a virus that has the potential to infect any parts of the body including, but not limited to nerves and muscles. Primarily there are 3 types of polio namely, non-paralytic, spinal paralytic and bulbar. This disease shows minimal to no symptoms in more than 90 percent of the cases. 5 percent of the cases can show symptoms such as nausea, diarrhea, vomiting, sore throat and abdominal pain. Polio is a communicable disease and can cause massive damage if a proper dosage is not taken. It can spread through air, physical contact with an infected person, coughs etc.

Polio can cause paralysis: Polio has a far-reaching permanent effect on the body. It can cause paralysis on any of the limbs leading to permanent disability. This severely alters a child s life. The far-reaching consequences of the virus can only be negated through vaccination.
Weak muscle: Polio can result in weak muscles, respiratory problems and loss of reflex. If the breathing muscle collapses, it can result in the death of a person. Any of the above-mentioned symptoms can lead to weak body development altering the fate of a child.
It can spread fast and quick: Polio spreads very fast through the air, physical contact, saliva and water. It not only affects a single life but put millions at risk of the disease. A 1916 outbreak of the disease killed 6000 people in the United States and left several thousands of people disabled.
It reduces the risk of infection: 3 dosages Polio vaccination under the age of 6 can save a baby from getting polio in future. The body successfully creates polio antibodies from the vaccines and gets enough ammunition to fight it if the virus attacks it in future.
Social responsibility: Massive amount of awareness campaigns have been run by countries all over the world to permanently eradicate polio from the face of the earth. As per the latest reports, only 3 countries are reported to have babies affected with polio; Afghanistan, Pakistan and Congo. It is, therefore, a social responsibility to take part in the mission of removing polio from the face of the earth once and for all.
Save future generation: Although polio is not known to be a disease which passes through heredity, there still lies a chance for the future generation to get this disease. In order to negate that from happening, it makes sense to get the vaccines on time.
Give your kid a head start: Every kid deserves to have an equal amount of privileges like others. One small mistake on part of the parents can heavily cost a child s future. In order to make sure your kids grow up with any apprehension of polio, it is very important to treat them with polio vaccines.

Polio Vaccination - Why Is It so Important?

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