A Gastroenterologist is a physician with dedicated training and unique experience in the management of diseases of the gastrointestinal tract and liver. If you are planning to visit one, you most likely have a problem in one or many organs like esophagus, stomach, small intestine, colon and rectum, pancreas, gallbladder, bile ducts and liver. 

Visit your doctor to understand the severity of your condition and the course of treatment, as it is obvious that during this time you must be suffering from anxiety and you may not ask the questions arising in your mind. That is why you need to prepare in advance for your first visit with a gastroenterologist. Being an active partner in the doctor patient relationship is bound to have its benefits. Here are some handy tips:

1. Come mentally prepared: Don't let the anxiety get to you. If you need some extra help calming down, try yoga or meditation. You can simply go out on a walk alone to help you focus your thoughts. This is just like any other doctor visit. The good part is that you are taking the first step in easing your discomfort and starting treatment, so go with a positive mind.

2. Maintain a diary of symptoms: It is likely that you are experiencing discomfort from past few days or weeks before you finally realize the need to seek out a specialist. Try to remember as much as possible about the symptoms you experienced in a chronological order. Write down any over the counter medicines you've tried or anything unusual that you may have consumed in the past week. 

3. Take stock of your medical history: It is likely that your doctor may want to know about any historic conditions you've suffered that may or may not relate to your present condition. Many ask you to fill out forms during your first time patient registration which includes many minor details about your medical past. List down any allergies, especially food allergies you have. 

4. Take stock of your recent medical tests: Bring your latest blood tests and imaging tests (X-rays, ultrasounds, MRIs, and CT scans) with you for the doctor's visit. If you have a pre-existing condition like diabetes, thyroid or you suffer from other chronic conditions like increased uric acid, carry your most recent medical reports with you. 

5. Make a list of questions for the doctor: In most cases, the first visit is a crucial factor in determining whether you want to continue the course of treatment with a particular doctor. This comes out of your ability to trust the doctor, his knowledge and diagnosis and an overall comfort level that comes with how well he handles your questions. Start by making a list of questions you want to ask about your specific condition and course of treatment and see if you get satisfactory answers. 

6. Brace yourself: If you want to suggest a treatment option, make sure you read up all about it before you tell the doctor.

6 Tips For Your First Visit With A Gastroenterologist

The word colic directly refers to the colon. Colic pain is a sharp abdominal pain followed by bouts of crying usually occurring in infants below the age of one year. The pain only last for a short period of time ranging from a few weeks to a couple of months. Very few number of babies will cry endlessly indicating towards an underlying condition.

It is mainly characterized by sharp crying for supposedly no apparent reason, irregular sleep patterns, and restlessness or owing to deviation from normal postures. The apparent causes of colic pain include indigestion and negative reaction of the sensitive gut to the breast or formula milk, although no concrete cause of the state has been discovered.

Doctors often suggest home remedies such as swaddling, pacifiers, holding and comforting the baby and more frequent feedings to reduce the condition. Since it is so common among infants and relatively less harmful, no proper medication is usually given. Physicians suggest mothers to reduce the content of caffeine, alcohol or spice in their diet. Sometimes a warm bath, burping the baby or going on more frequent walks is useful. Background music draws the attention of the baby and hence drives their focus, away from the abdominal pains.

Colic pains are mainly treated by care rather than medicine. The baby is made to feel comfortable and the distress is reduced just by being around the infant. The primary care giver plays an important role in consoling the child and helping them get through the sudden pain which further plays a significant role in personality development. Colic pains are extremely short lived and probably one of the first few challenges of parenthood. They are primarily dealt with care and feeding except in extreme cases where medicinal cures such as lactase drops and simethicone drops are used to treat the abdominal pain.

Colic Pain - How To Treat It

Piles or haemorrhoids are swollen veins in the rectum or anus. They can have a lot of possible causes, but the exact reason is still unknown. The one most common reason that researchers cite is the excessive straining during bowel movement and increased pressure on the veins during pregnancy. Some of the common signs of this condition include discomfort, bleeding, and itching. A clot can be witnessed occasionally. There could be swelling around the anus as well.

How is a pile diagnosed?
Doctors often recognize this condition just by doing a physical exam of the rectum. By lubricating the glove and inserting a finger into the rectum, a doctor can gauge any unusual growth around the rectum area. A doctor might also use a sigmoidoscopy or a proctoscopy to witness the lower portion of the colon. Apart from this, a doctor might prescribe a colonoscopy, if he fathoms that there is a possibility of colorectal cancer or a disease related to the digestive system.

Treatment of piles

Medication: In case of mild discomfort, a doctor might prescribe over-the-counter pads, ointments, creams or suppositories. Products such as these contain lidocaine, witch hazel or hydrocortisone that can relieve a person from itching and pain. One should stop consuming over-the-counter medicine, if there is no change in the condition.
Haemorrhoid thrombectomy: If a clot has appeared along with a pile in the rectum, a doctor can remove it by making an incision and draining the clot. This can fetch instant relief. The best time to do this is within 72 hours of clot formation.
Minimally invasive procedures: 
Rubber band litigation: This form of surgery involves placing of a couple of rubber band at the base of the piles to cut off blood circulation. In due course, the haemorrhoids fall off. Although this form of treatment works for many people, the patient has the risk of bleeding within few days of placing the rubber band.
Sclerotherapy: This form of treatment involves injecting a chemical into the haemorrhoid. The chemical shrinks the piles within few days. There is hardly any pain involved with sclerotherapy.
Surgical procedure:
Haemorrhoidectomy: This is the process by which a surgeon eradicates the excess tissue that might be causing the piles. The patient is sedated before performing this procedure. Some amount of pain is experienced after the procedure is over. The temporary difficulty of urination can be faced by a patient after this procedure.
Stapled hemorrhoidopexy: This surgery is only performed for internal haemorrhoids. The process involves blocking the blood supply. The process of stapling has less pain compared to a Haemorrhoidectomy. On the flip side, studies have shown that this procedure has an increased chance of recurrence of haemorrhoids.


Piles - Diagnosis and Treatment

An anorectal abscess is a painful swelling near the anus or in the buttock. The swelling contains pus. 60% anorectal abscesses are superficial and resulting from infection in small anal glands present in between internal and external anal sphincters (intersphincteric space). They are known as a perianal abscess. 30% of anorectal abscesses are deep-seated and results in systemic infection. They are call Ischiorectal abscess. Submucous abscess, pelvirectal abscess and pilonidal abscess developed from versatile cause are comparatively less common. Inadequate and improper management of anorectal abscess may potentially cause complication like fistula formation.


Fast facts on Anorectal abscess-

* Anorectal abscess should be drained at the earliest.
* Conservative medical management almost invariably invites complication like fistula formation.
* Surgical drainage of pus reduces the chance of fistula formation by 50%.


What causes Anorectal abscess?

* Blocked and infected anal glands (cryptoglandular infection).
* Untreated anal fissure that becomes infected.
* Sexually transmitted infections.
* Penetrating injury of the perianal or buttock region.
* Crohn s disease.
* Colon cancer.
* Tuberculosis.



What are the symptoms of Anorectal abscess?

Superficial abscess-

* Constant and throbbing pain that worsens on sitting down.
* Swelling, redness and tenderness of the skin around the anus.
* Discharge of pus.
* Pain is often associated with bowel movement.

Deep abscess-

* All or some of the symptoms of a superficial abscess.
* Fever with chill and rigor.
* General weakness.
* Sometimes fever is the only symptom of the deep abscess.

The anorectal abscess should preferably be explored under general or spinal anesthesia. Medical management often fails and subsequently fistula is formed.

Anorectal Abscess - Know In Detail About It!

Colon cancer is believed to be one of the common types of cancer affecting people. As the name suggests, here, the point of origin of the cancer is the colon or the large intestine. Though colon cancer can affect anyone, people with unhealthy lifestyle (sedentary) and habits (excess smoking and consumption of alcohol), obesity, certain medical conditions like diabetes, or exposed to radiations (radiation therapy) are at a greater risk of colon cancer. Colon cancer may also be hereditary.

Colon cancer usually proceeds through five stages, stage 0 (zero), stage I, II, III and IV.

In stage 0, cancer remains in situ, (it remains confined within the innermost layer of the colon).
In stage I, cancer slowly starts spreading to the other layers (second and third) of the inner walls of the colon.
In stage II, cancer spreads further to the muscular walls of the colon (the lymph nodes, are, however, still not affected by this condition).
In stage III, cancer spreads outside the colon, affecting one or more lymph nodes.
Stage IV is more severe and metastatic. Here cancer has spread to and affected vital organs like the liver and the lungs.
Many of the symptoms do not appear at the initial stages. As a result, colon cancer mostly gets detected at a later (often metastatic) stage. Thus, a person should be alert. The initial symptoms, no matter how trivial, should be taken seriously. There is no harm in seeking medical help. It will only help you in the long run. 

The following symptoms are often the initial or first signs of something as big as colon cancer.

Unexplained poor appetite followed by sudden and rapid weight loss. Losing weight at an alarming rate without sweating it out needs thorough investigation. More than often, colon cancer interferes with the digestion process in a person. A person is not able to eat well. There is a feeling of being full (irrespective of how much you eat) all the time.
Constipation, gas or (and) diarrhea. Often overlooked and mistaken for common bowel disorder, these are some of the initial symptoms of colon cancer. The symptoms may be an outcome of polyps (abnormal tissue growths that can take place in any organs. These polyps are mostly benign in nature) or malignant tumors in the colon. Seek medical help if the conditions persist for more than a week. It is better to be safe than to be sorry.
A person feels exhausted, sleepy and weak all the time. The symptom may be an outcome of iron deficiency and anemia. Colon cancer can cause injury to the digestive tract. There may be bleeding followed by blood loss and hence the associated symptoms.
Mild to severe abdominal pain. The abdomen also appears tender than usual (in the case of metastatic tumor).
Stomach upset accompanied by pain, nausea, vomiting, cramps and at times, indigestion (an outcome of intestinal obstruction and inflammation).
There may be blood while passing stool.

Colon Cancer - What Signs You Must Watch Out For?

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

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