Anti-reflux surgery (Fundoplication) is a procedure for treating gastroesophageal reflux disease (GERD) incorporated in hiatus hernia operation. GERD occurs when stomach contents reflux and enter the lower end of the esophagus (LES) due to a relaxed or weakened sphincter or a hiatus hernia. GERD is very much treatable and can cause serious complications if left untreated. 

GERD symptoms
The main symptom of GERD is heartburn or indigestion, along with other symptoms, such as 

Acidic sour taste in the mouth
Burning pain in the throat
Difficulty in eating
Bloating and belching
Stomach pains
Regurgitating food
Nausea
Vomiting blood
Dark tarry stools
Laparoscopic Anti-Reflux Surgery
Laparoscopic surgery reinforces the lower oesophageal sphincter s ability to prevent gastroesophageal reflux from occurring. The surgery involves wrapping the top part of the stomach around the lower end of the esophagus and suturing it in place. Since the esophagus passes through the hiatus, suturing is done to narrow the hiatus as it helps in the prevention and treatment of concurrent hiatal hernia.

Laparoscopic Surgery Procedure
A laparoscope, a long, narrow telescope with a light source and a video camera at the end, is inserted through a tiny incision into the abdomen. Images from the camera are projected onto a large high definition monitor for the surgeon to view enlarged images as it helps the surgeon perform surgery with precision.

The patient is placed under general anesthesia
The surgeon makes a small incision in the upper abdomen and inserts the laparoscope into the abdomen.
The surgeon introduces carbon dioxide into the abdominal cavity near the belly button to expand the viewing area of the abdomen giving the surgeon a clear view and room to work.
Additional small incisions are made for a variety of surgical instruments to be used during the procedure.
After the identification of critical structure, the hole in the diaphragm, through which the esophagus passes, is then tightened with sutures.
The surgeon wraps the upper part of the stomach around the lower esophagus guided by the images on the laparoscope, then creates a valve which is precisely sutured in its place.
The laparoscope and other instruments are removed and the gas is released.
The tiny incisions are closed and covered with waterproof dressings to avoid any kind of infections.
The patient is usually discharged within 1-2 days of the surgery.
Post-surgery, hospitalization is required just for one day - no bed rest is required after that. The patient can quickly return to all normal activities and immediate relief from symptoms also happen. 

Laparoscopic Surgery - How It Can Help With Anti-Reflux and Hernia?

The gall bladder, which sits just below the rib cage to the right of the stomach, is very tender to touch. It is a little sac or storage compartment for bile, which is produced by the liver. The gallbladder emits bile into the small intestines via a duct referred to as the cystic duct. The entire process is meant to break down foods (namely fatty foods). 
Gallbladder attack symptoms may include one or more of the following:
1.Pain in the back right shoulder blade:
Sometimes, pain radiates through to the back shoulder blade on the right side or in the middle between the shoulder blades. This is pain from the gallbladder affecting the back of the shoulder. This back shoulder blade chest pain is one of the most common yet unknown symptoms of a gallbladder disorder. This can come and go or be constant. It may be sharp, excruciating or dull. It may also occur especially at night. A gallbladder attack will typically last for one to four hours.
2. Pain in the stomach: 
The most common symptom of a gallbladder problem is pain. This pain usually occurs in the mid to upper-right section of your abdomen. It can be mild and intermittent, or it can be quite severe and frequent. In some cases, the pain will begin to radiate to other areas of the body, including the back and chest.
3. Nausea or Vomiting: 
Nausea and vomiting are common symptoms among all types of gallbladder problems. But only a chronic gallbladder disease may cause digestive problems, such as acid reflux, gas, nausea, and vomiting.
4. Diarrhea:
Having more than four bowel movements a day for at least three months may be a sign of chronic gallbladder disease.
5. Fever or Chills:
An unexplained fever may signal that you have a bile duct infection. If you have an infection, you need treatment before it worsens and becomes dangerous. The infection can become life-threatening if it's allowed to spread to other parts of the body.
6. Unusual Stools or Urine: 
Lighter-colored stools and dark urine are possible signs of a common bile duct block.

Recognizing The Symptoms Of A Gall Bladder Attack

Piles or haemorrhoids might cause severe bleeding in the anal region due to an abnormal enlargement of the rectal veins. The bleeding occurs as a result of a sudden increase of pressure in the rectal area.

The haemorrhoids, which tend to grow on the exterior part of the anus, are usually severely painful as compared to the internal haemorrhoids (which are invisible and grow on the insides of the rectal area).

What are the possible causes?
The major causes of haemorrhoids are genetic factors, pelvic tumours, excessive alcohol consumption, obesity, lack of regular physical exercise, undiagnosed and chronic gastric disorders such as dysentery, diarrhoea or constipation and a significant increase in weight of the uterus during pregnancy.

Major Signs:
The signs and symptoms of this disease might include intense pain and irritation in the rectal area along with the presence of blood in the faeces and abnormal swelling of the affected area.

Homeopathy For Piles:

When it comes to alternative or complementary treatments for piles or hemorrhoids, Homeopathy offers the best treatment for piles. It is the best not only because the cure rate is exceptionally good but also because Homeopathic treatment for piles offers several more advantages. It is very economical when compared to any other alternative or complementary treatment for piles. At the same time, the homeopathic medicines do not have any side effects. This is one of the biggest advantages of Homeopathy over any other system of medicine. While you are under treatment of any other system of medicine, you run the risk of getting one or the other side effect while Homeopathic treatment for piles is absolutely safe. That is why I say that Homeopathy is the best when it comes to alternative or complementary treatment for piles or Hemorrhoids.

If taken in a prescribed dosage, homeopathy can be very effective to cure piles. The most beneficial homeopathic preparations for piles are:

Nux vomica: This homeopathic preparation is useful to cure piles that exhibit the symptoms of extreme irritability and intolerance towards cold weather. If the reasons behind piles include the consumption of spicy foods, excessive intake of alcohol and smoking, this particular remedy can work wonders. 
Hamamelis: This preparation is used to address such a condition if the symptoms exhibited include blood in the feces along with continuous discomfort and contusion (an area of injured tissues).
Ratanhia: This preparation provides an effective remedy for severely painful hemorrhoids (which cause complications during excretion) along with the symptoms of severe pain that persists even after several hours of excretion and a burning sensation in the concerned area.
Graphites:  This medicine works especially well for the fairer sex if the symptoms happen to include chronic constipation, skin eruptions in the rectal area and menstrual abnormal menstrual cycles. 
Aesculus HIppocastanum:  This homeopathic preparation provides an effective remedy for non-bleeding hemorrhoids that exhibit symptoms of severe back pain and pain in the anal regions.
Arsenic Album: This homeopathic offering eases the symptoms that worsen with any sort of movement. Severe bleeding of the hemorrhoids can also be treated with this medication. 

Role of Homeopathy in Hemorrhoids

Anal fistula, a challenge for modern surgery, but can be cured with grade ksharsutra in Ayurveda (Indian system of medicine).  Anal fistula is a disease for which different methods of treatment have been advocated time to time, even today when we are talking about robotic surgery, this disease has no satisfactory method of treatment in modern surgery. The latest method of video assisted anal fistula treatment (VAAFT) is not satisfactory due to high incidences of recurrence after the surgery. But at Sushruta Anorectal Institute New Delhi; with the help of Graded KsharsutraTM all these patients of complex Anal fistula are being successfully treated.

In Ayurveda about 2000 yrs ago Acharya Sushruta has indicated ksharsutra treatment to treat fistula-in-ano. Late professor P J Deshpandey at the faculty of Ayurveda Institute of Medical Sciences B H U; had done extensive research in this field and established a treatment module to cure this disease. In 1990 Indian council of medical research has clinically evaluated this Ayurvedic treatment module at four premiere institutes in our country including AIIMS Delhi & PGI Chandigarh. Subsequently, it was concluded by I.C.M.R. that in the patients of fistula in ano, ksharsutra treatment is more effective& convenient as compared to modern surgery.

Ksharsutra is a thread coated with certain Ayurvedic medicines known for their antiseptic, debridement & healing properties. After u v sterilization this medicated thread (ksharsutra) is used under complete aseptic precautions in the patients. The patient is routinely investigated with special reference to any other associated disorder like hypertension, diabetes mellitus, tuberculosis etc. The next step lies in the proper identification& evaluation of the fistulous tract. It is mandatory to define the fistula tract wrt its depth, direction & branching pattern. This may be achieved by careful probing under expert hands using malleable probes& if required help may be taken from other investigations like x-ray fistulogram or MRI fistulogram. 

Once the tract has been clearly defined the Ksharsutra is placed in it with the help of certain instruments, under local anesthesia. This entire procedure is usually completed in ten to fifteen mins. As there is no cutting of tissues hence no bleeding, no pain & patients can go home after half an hr rest in the daycare room. The medicine-coated on the thread is gradually released in the tract. The cumulative effect of the coated drugs exerts a powerful debridement effect on the fistula tract & induces healing by the fresh & healthy granulation tissues. Thus Ksharsutra is the mechanism of drug delivery precisely at the tissues involved. 

Every seventh or tenth day the old sutra is replaced with a new Ksharsutra till there is a final cut through. It has been observed that the tract heals @ 0.5-1 cm per week. The post-operative complications like recurrence of the disease, fecal incontinence, bleeding is not seen with Ksharsutra treatment. Further, this therapy is performed as an OPD procedure. No general anesthesia & no hospitalization is required. Patient maintains his normal routine activities as usual during the treatment period. 

 At Sushruta Anorectal Institute; Rohini - New Delhi, we have been working on this disease including piles fissures & pilonidal sinus for the last 30 yrs. Here we have developed the concept of Graded KsharsutraTM which has given us a more effective & convenient way to treat anal fistula. At Sushruta Anorectai Institute we have treated on record thousands of patients of anal fistula from different states including overseas patients. We have records to prove that the patients of high anal complex fistula, those have been operated two or three times but failed to heal were successfully treated at this institute.

How to Treat Anal Fistula Naturally without Surgery

A fistula is an abnormal, tube-like connection, a passage or hole that forms between two organs or an organ in your body and your skin. There are various types of fistulas that can develop in different parts of your body but the most common types are-

1. Obstetric Fistulas: This is the name given to a hole between the vagina and rectum or bladder. A vaginal fistula that opens into the urinary tract is called a vesicovaginal fistula and one that opens into the rectum is called a rectovaginal fistula. 

A woman with obstructed labour or labour that is not attended by a doctor or a midwife, can suffer labour pain for up to six or seven days. And as the labour produces contractions that push the baby s head against the mother s pelvic, the soft tissues between the baby s head and the pelvic bone are compressed and do not receive adequate blood flow between the mother s bladder and vagina and/or between the rectum and vagina.
This means that a hole forms on the vaginal wall between the urinary tract and her rectum. The urine and faeces thus start to leak from the vaginal opening causing soiling and foul smell.

Apart from labour, hysterectomies that damage the vaginal wall can also cause such types of fistulas.

Enterovaginal   A woman may have gas and foul smelling fluids leaking out of her vagina due to an enterovaginal fistula which is a hole between the vagina and the digestive tract. It s usually caused due to inflammatory bowel disease or IBD and ulcerative colitis.

2. Anal fistula

These are fistulas that form between the end of the bowel and skin near the anus.

An anal fistula usually develops due to a previous or current anal abscess. An anal abscess is an infected cavity filled with pus found near the anus due to an acute infection in the internal glands of the anus.

Common symptoms are:

Pain in the anorectal area
Swelling
Redness
Fever
Rectal bleeding
Urinary symptoms, such as trouble initiating urination or painful urination
Causes:

Inflammatory bowel disease   a chronic condition of the GI track which causes inflammation
Diverticulitis   An infection in the large intestine
Tuberculosis, HIV
Surgery near the anus
Anal abscess and likewise anal fistula are treated by surgical drainage in which an incision is made in the skin near the anus to drain the infection causing an anal abscess. Hospitalization may be required for patients who have impaired immunity like diabetics.

Anal fistula though has no medical treatment and surgery is almost always necessary to cure it.

If the fistula is straightforward which means one that involves minimal sphincter muscle, a fistulotomy may be performed. This involves cutting open the whole length of the fistula so it heals.
Seton is another procedure in which a surgical thread called a seton is placed in the fistula and left there to help it heal.

Different Types of Fistula and Treatments!

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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