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!

An apple a day keeps the doctor away, but Minions seem to disagree. An apple being the fruit of choice for millions of households across the world, recent studies show that apples may not be as good for you as you ve been led to believe. For starters they have high sugar content, for the calorie conscious, which might be a bad revelation. The really high fiber content of apples is known to induce stomach aches. Studies show that most apples in the regular market are laden with pesticides, which are harmful for human consumption. Apples are known to cause allergies too and not to forget, apple seeds contain trace amounts of cyanide.

So if not apples, what is supposed to keep the doctor at bay? The world is going ga ga over bananas. Bananas and papayas are two easy to resource, lower priced alternative as the household fruit of choice. Here s why.

Papayas and Bananas contain fewer carbohydrates and more protein than Apples and hence instantly making them a better choice for calorie conscious.
High levels of Tryptophan, make bananas and papayas a natural antidepressant and stress buster.
Both are rich in Anti oxidants which helps in preventing and fighting cancer.
Bananas protect an individual against type 2 diabetes and aid in weight loss in this new age of morbid obesity that makes it quite a selling point.
Both fruits being rich in vitamin C are known to boost immunity.
Papayas are rich in flavonoids, vitamin A and beta carotene, which protect the mucus membrane of the eye and are known to prevent age related retardation of eye sight.
Bananas and Papayas help prevent swelling of joints and work well to prevent arthritis.
Both fruits are known to help ease menstrual cramps.
Papaya is rich in vitamin E, vitamin C and antioxidants like beta-carotene which helps prevent your skin from free radical damage keeping wrinkles, marks and signs of ageing at bay.
Papaya is known to encourage hair growth and fight against hair fall.
The duo is known to improve overall digestion as well.

Why Is Banana or Papaya Healthier Alternatives for Apple?

Rectal problems in women are quite common. It is experienced by many women in some form or the other such as rectal itching, pain or bleeding. Rectal problems are more common in women than in men. These conditions need to be attended to immediately as severe rectal problems may cause several health problems. There are many ways to deal with rectal problems in women.

Treating rectal itching: Rectal itching is a common rectal problem. These can be treated by

    Improve hygiene: You should clean the rectum area gently using cotton balls moistened with water. You should apply mild ointments to prevent irritation and soothe the skin.
    Unscented toilet paper or unscented lotions and creams: You should use white toilet paper that does not have any scent. Scented soaps, creams or lotions should be avoided as it may cause further irritation. You can also apply ointments containing 1% hydrocortisone.
    Control excessive sweating: Rectal problems may occur due to excess sweating. You should avoid sweating too much by wearing light clothes and using talcum powder for the absorption of moisture.

In case of excessive itching, you should follow the following tips:

    Do not scratch the area as scratching may lead to further itching. You can take an oral antihistamine during the night to get better sleep.
    You can take a warm sitz bath after every bowel movement, for at least three days, every day. The anus should be dried properly after the bath.
    Abstain from foods that stimulate rectal itching like tea, coffee, aerated drinks, alcohol, chocolate, spicy food, tomatoes and excess vitamin C, for a period of two weeks.
    You must maintain short fingernails to avoid injuries during scratching. To prevent unconscious scratching during sleep, wear cotton gloves.
    Stress should be managed as increased stress may lead to enhanced rectal itching. When you are anxious, do not scratch the rectal area.

Treating rectal bleeding: Rectal bleeding is another problem, which may be accompanied by other rectal problems. In case of rectal bleeding, avoid taking aspirin or any other non-steroidal, anti-inflammatory drug. These drugs may cause bleeding in the digestive tract. This will increase the blood amount in your stool. Bleeding hemorrhoids can worsen by the intake of these medicines. For soothing pain, opt for an acetaminophen. Constipation and diarrhoea may also lead to rectal bleeding. However, it is advised to consult a doctor before consuming any medicine.

Prevention
For prevention of rectal problems, you must have a good sense of hygiene. Keep the rectum region clean and avoid sitting in the toilet for a long time. You should have a fiber-rich diet including fresh fruits and vegetables. Avoid food items, which may cause rectal problems. General rectal problems are not very serious and can be treated using simple measures. Maintaining proper rectal hygiene is very important to avoid rectal problems. It is highly recommended to visit a doctor if the problem persists.

Rectal Problems in Women - Doctor Recommended Tips

How to Manage Piles at Home and with Medication

Piles or hemorrhoids can be a debilitating disorder of the rectum and anus where passing stool becomes painful. It is the swelling of the veins in the anus and the rectum, which may then be bruised by hard stool passing through it or due to excessive pressure being put on it. This can be a very painful and embarrassing condition for many people to go through.

Remedies for piles at home

There are many remedies that you can try at home to reduce the pain and swelling and even reduce the hemorrhoids themselves over time. Let's look at a few of the options.

Radish for treatment: In this treatment, a radish should be crushed and mixed with appropriate amounts of milk to form a thick paste, which is to be applied on the anus twice daily, and washed off after 15 minutes. This should relieve the symptoms in a few days.

Cumin seeds paste: You can take a tablespoon of cumin seed powder, make it into a paste after adding water and then put it on the affected area. After leaving it for 15 minutes or so, it should be washed away with water. Repeating this twice daily will help with the symptoms and reduce pain.

Diet: Lack of a balanced diet can be problematic for those with piles, and thus, it is recommended that enough roughage such as green leafy vegetables and fruits are included in the diet as well.

Figs: Dried figs are also another great weapon against piles. Soaking some dried figs in warm water overnight and then having them in the morning is known to be good for smooth bowel movements, thus, relieving pressure on the rectal veins.

Some Ayurvedic Medications that May Prove Effective with Piles:

Some of the specific ayurvedic medication that are known to be helpful in treating piles are:

Hareetaki: This is the fruit peel of Harad and if taken with 1 cupful of jaggery, it can reduce the symptoms of constipation as reported by many patients.

Castor oil: Mixing a small teaspoon of castor oil with a glass of milk can also help soften the stool and reduce the stress on the rectal walls.

Nagakesara: This is also an ayurvedic medicine, which is usually prescribed as oral medication three times daily and has proven its effectiveness many times over.

Abhayarishta: 30 ml of this ayurvedic herb is also given to patients after food with equal parts water and has been known to be very effective.

Kasiaditaila: This is an oil, which should be applied externally and it can help reduce the inflammation and itching caused by piles.

10 Best Home Remedies to Treat Piles  - Natural Treatment

Piles are uncomfortable and painful. It can also be embarrassing and for this reason, many people delay their treatment. Piles usually affect middle aged people but at times, it can also affect younger men and women. Chronic constipation is one of the most common factors that can trigger piles. This is a condition where the veins near the anal opening in the rectum get inflamed. Any pressure that is put on the rectum puts pressure on these veins which may lead them pain and bleeding.

Luckily this is not a condition you need to live with and it can easily be treated with Ayurveda. Ayurveda approaches the treatment of this disease in multiple ways through dietary and lifestyle changes, medication, exercises and even massage therapy. It has negligible side effects and the potential to greatly improve the quality of your life even if you already have painful piles.

Dietary changes: Preventing constipation can prevent the development of piles. Hence, include plenty of fiber in your daily meals and cut down on starchy food. Adding sesame and mango seeds can also help prevent constipation. Fruits like jambul, papaya and dried figs are natural stool softners and should be eaten regularly.
Lifestyle changes: Along with eating the right food it is also essential to drink plenty of water. This helps the digestive system work smoothly. Avoid sitting in the same position for extended periods of time and only use soft, cushioned seats. Set aside at least an hour every morning for regular exercise such as walking, swimming, cycling or yoga. Certain yoga positions such as the downward facing dog and seated twist can make the process of eliminating waste easier. Scheduling a colon cleanse once in a while can also help treat piles.
Medication: Ayurvedic medication is based on herbs which have negligible side effects. Nagakesara is one such herb that is used to treat piles associated with bleeding. Haritaki and jimikand are two Ayurvedic herbs that can also help regulate your digestive system and treat piles. Abhayarishta is another herb that is often prescribed to treat piles. Kasiaditaila is an Ayurvedic medication that can be applied externally to help shrink piles and manage itching. It can also help relieve pain and bleeding. 
Though they have no major side effects, Ayurvedic medication should never be self-prescribed. Consult a qualified Ayurvedic doctor who will be able to prescribe the right medication in the right dosage for your problem.

How Ayurvedic Remedies Are Good For Piles?

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

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