An anal fistula, is also called as fistula- in -ano, it is a small channel that develops between the end of the large intestine called the anal canal and the skin near the anus. This is a painful condition, especially when the patient is passing stools. It can also cause bleeding and discharge during defecation.

Genesis of fistula-in-ano
Almost all anal fistulae occur due to an anorectal abscess that begins as an infection in one of the anal glands. This infection spreads down to the skin around the anus causing fistula-in -ano. The anorectal abscess usually leads to pain and swelling around the anus, along with fever. Treatment for anorectal abscess involves incising the skin over the abscess to drain the pus. This is done usually under local anesthesia. A fistula-in-ano happens when there is failure of the anorectal abscess wound to heal completely. Almost 50% of patients with an abscess go on to develop a chronic fistula-in-ano.

Symptoms

Pain- Constant pain which gets worse when sitting down
Irritation around the anus, like swelling, redness and tenderness
Discharge of blood or pus
Constipation or pain while evacuation
Fever
Diagnosis
A clinical evaluation, including a digital rectal examination under anesthesia, is carried out to diagnose anal fistula. However, few patients may be advised screening for rectal cancer, sexually transmitted diseases and diverticular disease.

Treatment
The only cure for an anal fistula is surgery. The type of surgery will depend on the position of the anal fistula. Most patients are treated by simply laying open the fistula tract to flush out pus, called Fistulotomy. This type is used in 85-95% of cases and the fistula tract heals after one to two months.

Seton techniques: A seton is a piece of thread (silk, plastic) which is left in the fistula tract to treat anal fissures. This is used if a patient is at high risk of developing incontinence after fistulotomy.
Advancement flap procedures: When the fistula is considered complex, carrying a high risk of incontinence, then this advanced technique is used.
Other techniques like Fibrin glue and Bioprosthetic plug are also used to surgically treat anal fistulas. In the Fibrin glue technique, glue is injected into the fistula to seal the tract, after which the opening is stitch closed. Bioprosthetic plug is a cone shaped plug made from human tissue, which is used to block the internal opening of the fistula. After this stitches are used to keep the plug in place. 

Whatever the surgical technique, one can experience minor changes in continence. Patients usually don t require antibiotics after surgery but have to take pain medication. They may also have to use gauze to soak up drainage from anus. After surgery, patients should seek help if they have increased pain or swelling, heavy bleeding, difficulty in urination, high temperature, nausea or constipation.

Fistula-in-Ano or Anal Fistula - How It Can Be Treated?

Umbilical hernia refers to a condition where your intestine protrudes through the opening of the belly button. This condition generally affects infants, but some people may suffer from it in adulthood as well. Umbilical hernias are common but do not cause any health issues in most cases. However, in some instances, the disorder leads to problematic symptoms.

Symptoms of umbilical hernia:

If you or your child suffers from the symptoms mentioned below, you should seek treatment.

  Pain
  Nausea/vomiting
  Discolouration and swelling at the region of the hernia

If one or more of these symptoms appear, seeking treatment at the earliest is necessary to avoid further complications.

Complications from umbilical hernia:

Even though complications from the disorder are rare in infants, they are not unheard of. The most common complication occurs when the portion of the intestine protruding from the belly button is trapped. In such a case, blood supply to this region is cut. This can lead to tissue death or gangrene. The infection slowly spreads to the rest of the digestive system, causing a life-threatening situation.

Adults who have umbilical hernia are more likely to suffer from complications of the condition.

Treatment for umbilical hernias:

Treatment differs based on the age of the patient. In most infants, the umbilical hernia does not produce any symptoms. In fact, such hernias typically disappear on their own after a year or two. A doctor may also be able to push the hernia in during a routine check-up. However, you should not try to do this yourself.

When is surgery needed for an umbilical hernia?

An infant requires surgery for the hernia if he/she experiences the following traits-

  Pain
  The hernia has a diameter larger than half an inch
  The hernia is large and does not decrease in size in the first two years of the child s life
  Does not disappear even when the child reaches the age of four
  The external portion of the intestine sticks out and gets trapped.

However, in the case of umbilical hernias affecting adults, a doctor will always recommend surgery to avoid possible complications arising from the disorder.

How is the surgery performed?
For both infants and adults with an umbilical hernia, the surgical procedure remains the same. The surgeon makes a small incision at the base of the belly button. The doctor uses this opening to return the external part of the intestine inside the abdominal cavity. Once this is complete, the doctor stitches the incision.

In adults, a supportive mesh is also used to ensure that the intestine does not protrude once more through the belly button.

Laparoscopic hernia repair is suitable for all types of a hernia such as an umbilical hernia. Just like an inguinal hernia, A camera is placed into the abdomen through the muscles. Two small incisions are made for the operating instruments to get through. This is followed by the cutting of the tissue that is placed between a hernia and the intestine. The hole thus gets exposed. Through one of the laparoscopic ports, the hernia mesh gets rolled and is placed into the abdomen. A hernia is then pulled up and the mesh gets secured with 4 sutures. A special device is used to fix healthy muscle.

Umbilical Hernia - Everything You Should Know About It!

Gastroesophageal reflux disease, or gerd, as it is commonly known is a digestive disorder that is caused primarily due to intestinal distress. Gerd is caused in the muscle that lies between the oesophagus and the stomach, when the acid is produced in the stomach, it starts to flow backwards. For patients suffering from gerd, the acids flow back into the oesophagus instead of the stomach, causing symptoms like severe heartburn, chest pain and nausea, amongst others. So what does one do to deal with gerd? here's a brief list!

Obesity: being overweight and obese are two of the most important factors that contribute to discomfort in gerd patients. Working towards a healthier weight is a sure shot way of dealing with this ailment.

Alcohol and smoking: the muscle ring that can be found between the stomach and the oesophagus relaxes with the intake of alcohol or with smoking, which prevents it from closing to stop the stomach's juices from reaching the oesophagus. So, giving up both substances would be a good idea if you are a gerd patient.

Go gluten free: adopting a gluten free diet can help you cut out ingredients including grains and dairy products that contain more protein than what your digestive tracts can handle.

Other dietary measures: in order to handle gerd effectively, you will need to remove or reduce chocolate, fatty food, spicy food, and even oily and fried food from your diet. You may need the help of food with extra fibre, like fruit so that it can pass through the digestive tract faster.

Smaller and well timed meals: eating meals regularly and dividing them into smaller meals that can be digested quickly and more efficiently is one of the best ways of dealing with gerd to prevent the onset of backward flowing of stomach acids.

Exercise: ensuring that you do not take a nap or lie down right after a meal and putting in a small amount of exercise everyday will also help in doing away with the uncomfortable and painful symptoms of this disease.

Making lifestyle changes is one of the best ways to deal with gerd. Yet, it would be best to see a doctor regarding severe cases where the symptoms do not abate and medication may be required.

How To Deal With GERD

What do we mean by a hiatal hernia?

The hiatus is an opening in the diaphragm (the muscular wall) which separates the chest cavity from the abdomen. Normally, the esophagus (food pipe) goes through the hiatus and attaches to the stomach. In a hiatal hernia, the stomach bulges up into the chest through that opening.

What does statistical data say about a hiatal hernia?

Statistically, approximately 60% of individuals who are above age 50 or older have a hiatal hernia.

In which age group is hiatal hernia very common?

The incidence of hiatal hernias increases with age. It is commonly seen in the older age people specifically in people who are above 50. 

What are the causes of hiatal hernia?

The most common risk factors are as follows: 

Obesity Congenital deformities, such as scoliosis
Certain types of surgery
Major trauma
Conditions which causes an increase in abdominal pressure within the abdomen, such as heavy lifting, or bending over, frequent or violent coughing, violent sneezing, violent vomiting, and straining during bowel movements
What are the types of a hiatal hernia?

There are four types of a hiatal hernia and they are as follows:

Sliding hiatal hernia: This is the most common variant of a hiatal hernia. It occurs when your stomach and esophagus slide into and out of your chest through the hiatus. It is usually asymptomatic.
Fixed hiatal hernia: It is also known as a paraesophageal hernia. In a fixed hernia, part of the stomach pushes through diaphragm and stays there.
Type III hiatal hernia: In this type, as a hernia goes on increasing, the phrenoesophageal ligament stretches and displaces the gastroesophageal junction above the diaphragm
Type IV hiatal hernia: Type IV hiatal hernia includes a large defect in the phrenoesophageal ligament causing other organs, such as colon, spleen, pancreas and small intestine to enter the hernia sac.
What are the sign and symptoms of hiatal hernia?

Common symptoms include:

Heartburn
Chest pain or epigastric pain, coughing
Difficulty in swallowing
Belching, eructation, and hiccups
How to diagnose the condition?

To diagnose this condition following tests or procedures are included:

X-ray of the chest and abdomen Barium follow-through examination of gastrointestinal tract (GI) to visualize GI tract.
Upper endoscopy for examining the esophagus and stomach from inside Esophageal manometry for measuring the rhythmic muscular contractions of esophagus while swallowing, and also, measuring the force exerted by the muscles of esophagus.
What is the treatment available for it?

It includes medications and surgery which are as follows:

Antacids to neutralize stomach acid and to reduce acid production
Medications that heal the esophagus 
Surgery of opening of diaphragm to make it smaller and for reconstruction of an esophageal sphincter

Hiatal Hernia - How Is it Diagnosed?

Umbilical Hernia is a common condition in infants in which the intestine protrudes or pokes out through the abdominal muscles in the navel area, where generally the Umbilical cord is located. Umbilical Hernia is generally harmless if not sore and is evident when the bellybutton protrudes. During childhood, Umbilical Hernia closes on its own, but sometimes when it does not, it might require a surgical correction during adulthood. This condition is commonly seen in premature babies and can be diagnosed through physical examination alone.

Symptoms

Umbilical Hernia causes swelling or bulging near the navel and is generally visible under normal circumstances. However, in some cases, the protrusion occurs only when the baby strains, coughs or cries. Though this condition is painless, it can cause discomfort during adulthood. To avoid complications, it is advisable to seek professional help even if the condition initially seems harmless. There might be symptoms of pain, swelling, discoloration, and tenderness in the navel, accompanied by vomiting sometimes.

Causes

When the fetus is still unborn and in womb, the umbilical cord passes abdominal muscles of the baby through a small opening, which generally closes post birth. But in case muscles fail to completely join the midline of abdominal wall, this condition appears post birth, and sometimes later in life.

During adulthood, when there is too much pressure on the abdomen, it leads to this condition. This pressure might build up due to a number of causes like multiple pregnancies, obesity, previous abdominal surgery, ascites (fluid in the abdominal cavity), and long-term dialysis for kidney function.

Complications

Complications might be caused when the protruding part of the intestine gets incarcerated or trapped and fails to push itself back into the abdominal cavity, reducing the blood supply. This leads to tissue damage and umbilical pain. If the blood supply totally fails, tissue death leads to gangrene, causing infection, and posing a life-threatening situation. In such cases, surgery might have to be performed in an emergency.

Treatment

Most of the times, abdominal tissue pushes itself back but sometimes, it has to be done by an experienced medical professional. When this cannot happen, surgery has to be performed to correct the situation. The surgery can be open or laparoscopic.

A small incision is made at the base of the bellybutton during surgery, which is a small and quick procedure. The hernia is corrected and sutures close the incision. For adults, sometimes mesh is used for strengthening the abdomen during open surgery.

Take Away

Umbilical Hernia is a condition in which the intestine or abdominal tissue protrudes through the abdominal muscles in the navel area, where generally the Umbilical cord is located. It is a harmless condition but sometimes painful. Generally, it corrects itself but when it fails to do so, corrective surgery is required which can be open or laparoscopic.

 Umbilical Hernia - How To Manage It?

3 Foods to Avoid If You Have Hyperthyroidism

Hyperthyroidism causes the thyroid gland to produce excess hormones, which accelerates the metabolism, in turn affecting the heart, bone health, and mood. The symptoms of hyperthyroidism include increased heartbeat, insomnia, anxiety, heightened hunger, and weight loss, all of which can be controlled via medicines and a healthy diet plan.

However, there are certain foods that can worsen the condition and lead to the severity of the symptoms. These should be avoided at all costs by anyone suffering from hyperthyroidism.

- Caffeinated drinks

Caffeinated drinks can worsen hyperthyroidism symptoms by aggravating palpitations, anxiety and insomnia. These include energy drinks, coffee, black tea, alcohol, soda. It is advisable to replace these drinks with healthy herbal tea or lemon water, which are apt refreshments with multiple health benefits.

- Foods with high glycemic content

Processed refined grains lose their nutrients like vitamin B and become not only useless but harmful to the body. The high glycemic content in refined grains can cause fluctuations in your blood sugar level, which can trigger terrible mood swings. It is advised to swap these with whole grains, quinoa, oatmeal and wild rice.

- Trans fat and hydrogenated oil

Trans- fat and partially hydrogenated oil are the culprits of heart diseases. To ensure the health of your heart and reduce the chances of hyperthyroidism, it is important to minimize the consumption of all the foods that list hydrogenated oil in their ingredient list. These are cookies, margarine, cakes, donuts, French fries, crackers and many others.



3 Foods to Avoid If You Have Hyperthyroidism

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