Anal Fistula is a tunnel like communication structure between anal canal and outer skin. There are certain glands in anus whose secretions keep the anal passage lubricated. If due to any reason infectious agent invades these glands abscess formation occurs which subsequently spreads towards the skin and bursts outside forming an external opening.

So Anal Fistula presents itself as a nodular swelling in area surrounding anal opening. Intermittent pus discharge is seen from this swelling. When pus has accumulated there will be swelling and pain which subsides once the pus has been discharged and this cycle goes on.

Anal Fistula Treatment:

Anal Fistula cannot be treated by oral medicines only - Homeopathic/ Allopathic or Ayurvedic whatever it may be. Continuing oral medicines in hope for fistula treatment only worsens the problem. Different surgical options have been tried to treat Anal Fistula like Fistulectomy/ VAAFT/ Laser/ LIFT etc. but not satisfactory results have been found. A high incidence of recurrence around 20-25 % has been observed with these procedures. 

Besides this other complications like stool incontinence etc. are also seen if there is some damage to sphincter muscles. However Anal Fistula can be completely treated by Graded KsharsutraTM Treatment. Clinical trials conducted by Indian Council of Medical Research (ICMR) at AIIMS new Delhi; PGI Chandigarh and other premier institutes of medical sciences; have proved that Ksharsutra treatment is more convenient and more effective than Surgery in patients suffering from Anal Fistula.

In this treatment; first of all Fistula tract is defined with respect to depth, direction and branching pattern by careful manual probing and MRI Fistulogram. Once the Fistula tract has been defined properly; Graded KsharsutraTM - a specialized medicated thread is placed in Fistula tract. Medicine released from KsharsutraTM debrides the Fistula tract and induces healing. This medicine works for 5-7 days so old Ksharsutra needs to be replaced by a new thread at week or 10 days interval.

No. of Ksharsutra changes required for complete healing of Fistula depends on length of Fistulous tract. It has been observed that a Fistula tract of 3 cm length usually requires 4-5 Graded KsharsutraTM sittings at weekly intervals for complete healing. Thus with this recent concept of Graded Ksharsutra treatment of Anal Fistula has become more easy and more effective.

Anal Fistula - How Non Surgical Treatment Is Better Than VAAFT/Surgery?

Many women experience a temporary encounter with hemorrhoids when they are pregnant. Quite surprisingly, most people tend to experience this in their daily lives. By the age 50, majority of people have encountered one or more symptoms of this ailment, including rectal pain, bleeding, itching and may be prolapse where the hemorrhoids protrude out of the anal canal. Though this ailment can be rarely detrimental, it can be a painful intrusion. But thankfully, there are a lot of things we can do about them.

How may this be diagnosed?
Hemorrhoids are usually diagnosed from a plain medical history and health exam. External hemorrhoids, more commonly known as piles, are normally apparent, particularly if a blood clot is formed. Your physician shall perform a digital rectal test to detect blood in the stool. Then the physician may also inspect the anal tube with the aid of an anoscope, which is a short plastic channel interjected into the rectum with illumination. If he finds any evidence of microscopic blood or rectal bleeding in the stool, then there may be a need to perform colonoscopy or flexible sigmoidoscopy to determine the probable causes of bleeding like cancer or colorectal polyps, specifically in women aged over 50.

Is it possible to treat hemorrhoids at home?
Most of the common symptoms of piles can improve drastically with simple in-home measures. If you are suffering from occasional flare-ups, you may try the following:

    Eat a lot of fibre: It is recommended to add fibre in the diet; may be a fibre supplement like Citrucel, Fibre con, etc. When you drink a lot of water along with loads of fibre, stools get softened making them effortless to pass, which will reduce the pressure on the swollen veins. Eating broccoli, wheat, oats, beans, fresh fruits every day will help in decreasing bleeding caused due to piles. It also reduces swelling and inflammation. If you feel digestive issues with a sudden splurge of fibre in your diet, you may start slowly and gradually increase the amounts.
    Take a sitz bath: A sitz bath is a lukewarm water bath for the lower back portion of the body, which can help in relieving irritation, itching as well as spasms occurring in the sphincter muscle. You can either get small plastic tubs for a sitz bath or sit in a normal bath tub. Most physicians suggest a half an hour sitz bath after every bowel movement. Then tenderly dry the area and avoid wiping it hard.

There are several invasive treatments that can be opted if these conservative treatments are not able to help your condition. In such an instance, it is always wise to seek advice of a medical practitioner. 

How to Deal with Hemorrhoids?

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?

Gallstone Pancreatitis is the result of a blockage in the pancreatic duct by a gallstone. Due to the blockage in the pancreatic duct, inflammation occurs and causes the problem to begin.

This can be a life-threatening situation and should be immediately checked. If the stones from the gallbladder travel down the common bile duct and get stuck at the sphincter, it can stop the outflow of all materials from the pancreas as well as the liver and become quite severe. There are a lot of risks involved when a person suffers from this issue. Rapid weight loss, high cholesterol levels, diabetes are a few of the risks of the disease.

Symptoms of Gallstone Pancreatitis
There are a number of symptoms like pangs of pain in the upper left abdomen and the back, swollen and tender abdomen, vomiting and nausea, increase in the heart rate, fever and more can be seen in a patient suffering from gallstone pancreatitis. Any individual who notices any of the following symptoms should get themselves checked immediately. Any pain in the upper abdominal area can be aggravated by eating foods which are high in fat as well.

Diagnosis of Gallstone Pancreatitis
In order to be completely sure about having gallstone pancreatitis, a number of tests are performed. Blood tests are followed by abdominal CAT scan to check for the inflammation of the pancreas. This also shows how severe the inflammation of the pancreas is. Sometimes abdominal ultrasound is also suggested as CAT scans are sometimes not as sensitive in identifying the problem. Once the problem has been detected, immediate treatment is recommended by doctors.

The Treatment of Gallstone Pancreatitis
The best treatment for pancreatitis is done in the initial stage of the problem. By avoiding taking in liquids and solid food up until the inflammation subsides is one of the best treatments. If the inflammation is relatively modest, the swelling can reduce in a few days by intravenous delivery of fluids for a couple of days.

1. If a CAT scan or MRI of abdomen suggest that a stone in present in the Common bile Duct (CBD), the an Endoscopic treatment referred as ERCP (endoscopic retrograde cholangio-pancreatography) is done. 

2. After the acute pancreatitis episode settles down, patient must undergo a Gall Bladder removal surgery. This is done as gall bladder is the factory of gall stones and patient is at-risk to another episode of Acute Pancreatitis.

In case of severe inflammation, fever and persisting pain, intravenous delivery of food should continue if oral intake of food does not start within 5 to 7 days. Anti-nausea medications are used to treat severe nausea and vomiting along with nasogastric tube. In certain cases, it is important to remove the gallstones from the bladder immediately while in some cases doctors suggest waiting for a period of 24-48 hours before starting the removal procedure. Sometimes a surgical removal of the gallstones is also required but only if the stones do not pass out of the system on their own.

All You Need to Know About Gallstone Pancreatitis

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

Hemorrhoids, also known as piles, are swollen veins or blood vessels, which can be internal (located inside rectum) or external (located outside rectum). They might be managed by increasing fluid intake and a high-fiber diet. Sometimes, Hemorrhoids might get infected and irritated to an extent that they require surgical removal.

Causes of Hemorrhoids:

Hemorrhoids are caused by increased pressure in blood vessels around the anus, causing them to swell and inflame which might be caused by a number of reasons.

Prolonged constipation

Chronic diarrhoea

Obesity

Aging

Pregnancy as it increases pressure on pelvic blood vessels

Weight lifting

Family history of Hemorrhoids

Persistent cough

Vomiting repeatedly

Sitting continuously for a very long period of time.

Symptoms of Hemorrhoids:

Some of the common symptoms of Hemorrhoids are:

Internal Hemorrhoids might bleed painlessly after bowel movement, but are problematic if they bleed too heavily.

External Hemorrhoids might also bleed after bowel movement, but often become irritating and painful.

External Hemorrhoids can lead to blood clots inside the vessel, which can cause severe pain. Proper treatment for such Hemorrhoids involves  incision and drainage  procedure.

Itchy and sore bottom.

A lump hanging off the anus.

Types of Hemorrhoids:

The type of Hemorrhoids decides the course of action for treatment.

First degree Hemorrhoids are small swellings which develop on inner lining of anus, being invisible from outside.

Second degree Hemorrhoids are larger swellings which might come out of the anus during bowel movement before disappearing inside again.

Third degree Hemorrhoids are lumps hanging off the anus which can be pushed back inside.

Fourth degree Hemorrhoids are larger lumps hanging down from the anus but cannot be pushed back inside.

Surgeries without Anesthesia:

Banding or rubber band ligation involves using a tight band around the base of Hemorrhoid to cut off its blood supply. It takes two or more procedures to be performed about two months apart.

Having the best success rate for small and internal Hemorrhoids, sclerotherapy involves injecting a chemical into Hemorrhoids, causing them to shrink and stop bleeding.

Coagulation therapy or infrared photocoagulation uses infrared light (heat or extreme cold) to retract and shrink the Hemorrhoid and is usually performed along with an anoscopy.

Hemorrhoidal artery ligation (HAL) or transanal hemorrhoidal dearterialization (THD) locates blood vessels causing Hemorrhoids to close them off.

Surgeries with Anesthesia:

Hemorrhoidectomy is used for large and external Hemorrhoids which do not respond to non- surgical intervention. So, they are cut out. Anesthesia can be general, regional, or local in this procedure. It takes longer time to recover completely.

Hemorrhoidopexy or stapling requires general, regional, or local anesthesia, and is used to treat prolapsed Hemorrhoids. A surgical staple cuts off the blood supply to Hemorrhoids to make the tissue shrink and reabsorb. It takes relatively less time for a full recovery.

Post- Surgical Care:

Some of the post care instructions are as follows

Painkillers might be prescribed for rectal and anal pain.

Consumption of a high-fiber diet prevents constipation and recurrence of Hemorrhoids.

Staying hydrated helps a lot.

Avoid heavy weight lifting and pulling.

Sitz bath helps to deal with post- surgical discomfort.

Seek medical help if having painful urination, fever, or dizziness.

Non-surgical Management of Hemorrhoids:

Hemorrhoids can be managed non-surgically by reducing strain in and around the anus.

Consuming a high fiber diet including cereals, fruits, vegetables, pulses, nuts, seeds, etc.

Consuming healthy fluids like water but avoiding alcohol and caffeinated drinks.

No delaying the emptying of the bowels.

Preventing constipation.

Weight management to lose excess body weight.

Regular exercise.

Take Away:

Hemorrhoids, if not severe, can be managed non- surgically. But if they get very painful and severe, surgical intervention through a number of techniques might be required; each one of them being safe, depending upon the severity of the situation.

Surgery For Hemorrhoids - What Should You Know?

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