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!

When an organ residing in a cavity such as the abdomen tries to push through the muscular layer it resides, it is called as hernia.

Though said to be genetic, hernias can be caused by things such as improper heavy lifting, incorrect posture, or chronic constipation and as a result of surgical complication or injury. Factors like obesity, pregnancy, smoking, chronic lung disease aggravate the severity of the hernia. It is believed that about 27% of all males and 3% of females can have a hernia during their lifetime.

Types of hernias:
Inguinal hernia - The groin is the most common area, where the abdomen pushes through a weak spot in the lower abdominal wall, causing a protrusion into the inguinal canal. More common in men than women.

Hiatal hernia - The abdomen has the diaphragm separating it from the thoracic cavity in the upper border. When it pushes through the diaphragm, a hernia is caused and there is almost always associated food reflux in these cases. Though the most common cause is associated old age, due to muscle weakness, there also are cases of congenital hiatal hernias.
Umbilical hernia - The abdomen finds a weak layer along its length and protrudes through the skin on the stomach. Most commonly seen in babies around the bellybutton, it gradually corrects itself on its own. Quiet rare in adults, seen during pregnancy and in chronic obese people.
Incisional - These are post-surgical, and happen when the organ protrudes through the weakened wall due to surgery. The abdomen is again the most common area and the hernia can happen either onto the external surface or internally, when they are called ventral hernias.
These are the most frequent types, though hernia affects other organs like the spine, brain, appendix, etc.

Treatment - This includes a combination of constant monitoring followed by a decision to do surgical treatment. Hiatal hernias and umbilical hernias can be monitored for a while before deciding on surgery. Inguinal hernias may require surgery earlier in the stage. Post-surgery, a mesh is placed to hold back the tissue in its corrected place. The umbilical hernia in children could be self-limiting. If it does not get auto-corrected in the first year of life, that also would qualify for a surgical treatment.

Dependent on each patient, hernias need to be managed under medical supervision.

Hernia - What Should You Know?

These Gallstones don t cause any problems in most cases. But prompt treatment is required if stones block ducts and cause infections and inflammation in the pancreas. This may lead to the removal of the gallbladder through a surgery, known as cholecystectomy, which further includes techniques such as laparoscopic (keyhole) cholecystectomy or open surgery.

Although it is a less vital organ, the body can cope up even after removal.

Procedure of surgery:

The surgery involves removal of gallbladder and gallstones through several incisions in the abdomen. In order to see clearly, the surgeon inflates the abdomen with air or carbon dioxide.
A lighted scope attached to a video camera is inserted into one incision near the belly button. The video monitor is used as a guide for inserting other surgical instruments into the other incisions to remove the gallbladder.
Intraoperative cholangiography is the X-ray procedure which shows the anatomy of bile ducts. This is done before the surgeon removes the gallbladder.
Bile flows from the liver through the common bile duct after the surgery into the small intestine. As the gallbladder has been removed, the gallbladder can no longer store bile between meals but has no effect or little effect on digestion.
In case of open surgery, the surgeon reaches the gallbladder through a large, single incision in the abdominal wall.
Complications after gallbladder surgery:

This surgery carries some degree of risk like any other surgery. Complications such as internal bleeding, infection, injury to nearby digestive organs, injury to the bile duct and injury to blood vessels.

Types of gallstones:

There are three main types of gallstones. They are

Mixed stones: They are made up of cholesterol and salts. They tend to develop in batches.
Cholesterol stones: Mainly made of cholesterol, which is crucial to many metabolic processes. They can grow large enough to block the bile ducts.
Pigment stones: The colour of bile is greenish-brown, due to some particular pigments.
Medical factors to consider before cholecystectomy:

The most important factor is a consideration of your medical history. This is because the pre-existing conditions influence decisions on surgery and anaesthetic and information about any bad reactions or side effects from any medications would be helpful for surgery.

Self-care after the surgery:

Taking rest is the most important thing after surgery. Avoid things such as heavy lifting and physical exertion. The usual recovery period after the surgery is one week.

Know Everything About Gallstone Surgery!

The gallbladder is a small organ in the abdomen that stores bile. Bile is necessary to digest fat that people take with food.

Unlike other cancers, Gallbladder cancer is not very common. It is also treatable in the early stages. However, in most cases, Gallbladder Cancer is detected in late stages. At these stages, the chance of a recovery is remote. What makes early diagnosis uncommon is the absence of specific signs or symptoms.

However, there are some signs that people need to look out for.

Signs of Gallbladder Cancer

Though there are not many specific symptoms, following signs can indicate a broad range of abnormalities, including some cancers.

Pain in the upper right quadrant of abdomen

Bloating

Fever

Weight loss

A feeling of nausea

Yellowing of the skin and eyes (sign of jaundice)

Many of these symptoms may involve other organs or indicate completely different ailments. This is why people need to see the symptoms in light of other concomitant symptoms and gauge the seriousness of the problems. If a person feels that a particular symptom is not solely a gastrointestinal problem, rush to the doctor immediately.

Causes of Gallbladder Cancer

Causes of Gallbladder Cancer are not entirely clear. However, in most cases, cancer spreads from the glandular cells of the gallbladder. These cells are found in the inner body of the gallbladder. This is also known as Adenocarcinoma. Slowly, it spreads from the inner body to other organs of the body.

Risk Factors

Though the reasons for Gallbladder Cancer are not yet known, certainly there are some factors that exacerbate the risk:

Gender
More women than men suffer from Gallbladder Cancer.

Age
The risk of Gallbladder Cancer increases with age.

History of Gallbladder Stone
It has been observed that most of the Gallbladder Cancer patients have had a history of gallbladder stones. However, this does not mean that Gallbladder Cancer is common in people with a history of gallbladder stone.

Chronic gallbladder infection, gallbladder polyps, etc. can increase the risk of Gallbladder Cancer.

Stages of Gallbladder Cancer

Gallbladder Cancer is categorized into different stages in accordance with its spread:

Stage I
If cancer is confined within the glandular cells of gallbladder, it is put in this stage.

Stage II
If cancer has grown out of the inner layers and has invaded the outer layer of the organ, it is put in the second stage.

Stage III
If cancer has grown to such an extent as to invade nearby organs like liver, stomach, small intestine, etc., Gallbladder Cancer is put in this stage.

Stage IV
The last stage of Gallbladder Cancer is characterized by large tumors, taking into their fold multiple organs in the vicinity. Tumors may also spread to distant parts of the body.

Treatments of the Gallbladder Cancer

The treatments depend a lot on the stage of cancer and overall health. The primary goal is to remove the diseased gallbladder. It may also be possible to resect part of the liver and bile duct along with the gallbladder.

However, if that is not possible, doctors may need to resort to other therapies to prevent the disease from spreading. This may involve Radiation Therapy or Chemotherapy or a combination of both.

There are many treatments available for Gallbladder Cancer depending upon the severity of the cancer. This is why it is important to consult a doctor before opting for any treatment.

Gallbladder Cancer - Signs, Causes & Treatment Of It!

Do you feel extremely tired many times in a day? Are you experiencing sudden weight gain, chills at night and hair loss? Is your neck a bit bloated up? If you are experiencing any of the mentioned symptoms, it might be that your body regulator- Thyroid- is unbalanced. Quick 3 tests can help you detect any abnormality - TSH, T3 and T4. Women were three times more likely to be affected by thyroid dysfunction than men. 1 in 10 adults in India suffers from hypothyroidism, with 50 per cent being women.

What is the thyroid gland?
The thyroid is a butterfly shaped gland in the front of the neck. It produces hormones that control the speed of your metabolism - the system that helps the body use energy. Thyroid disorders can slow down or rev up your metabolism by disrupting the production of thyroid hormones. When hormone levels become too low or too high, you may experience a wide range of symptoms.

What are the Symptoms?
Thyroid can be of 2 types - Hyper (Overactive) and Hypo (Underactive) Thyroid.
Low and Underactive Thyroid High and Overactive Thyroid
Fatigue Nervousness
Dry Skin & Hair Tremors - Hand Shaking
Brittle Hair Hair loss or thinning hair
Constipation Diarrhea
Low Pulse High Pulse
Weight Gain Weight loss without trying
Intolerance to cold temperature Intolerance to hot temperature
Depression Sweatiness
Swelling in lower part of neck Swelling in lower part of neck

The swelling in the neck is a major and most significant feature. Hence one should always do the Self Neck Test.

Who should be tested?
Women aged 35 and above or those with symptoms/risk factors/family history are the right candidates for screening. It has been estimated that 75% of the people suffering from thyroid are undiagnosed.

Diagnosing thyroid disorders - A simple blood test can provide an answer. TSH (Thyroid Stimulating Hormone) levels determine thyroid hypo and hyper function as it regulates the work of thyroid gland. Rarely an imaging study or biopsy is needed. Two additional tests may be required - T3 and T4.

What happens if Thyroid remains undetected?
As Thyroid disorders are hormonal imbalances, undetection can lead to a number of secondary complications:
Obesity
High Cholesterol and Hypertension
Hair Fall
Heart Disease
Complications in pregnancy

Understanding Thyroid Problems in Women: Did You Get the Test Done?

An anal fissure or fissure-in-ano is a small, cut in the skin in anal passage which results because of trauma to skin by passing hard stool in this region. Sometimes pain is so severe that patient tends to avoid passing stool in an attempt to stay away from pain.

Symptoms of Anal Fissure: 

  Pain in anal region while passing stool; it may be burning/pricking/Itching in nature.

  Bleeding may or may not be there.

  If untreated for long time; a skin tag known as Sentinel tag or Sentinel Piles develops from the lower end of fissure.

Causes 

The causes related to the emergence of an anal fissure include:

  Passing hard stool which causes frictional injury to inner lining of anal passage.

  Repeated bowel movement or diarrhea

  Trauma to anal canal like by enema nozzle 

Why non surgical treatment is better than Surgery:

Usually surgery (Lateral sphincterotomy) is advised in a view to relieve spasm in anal region so that Fissure starts healing but there are certain complications like stool incontinence etc. associated with this procedure which makes non surgical approach better than surgical intervention. Some of the reasons which make non surgical approach better than surgery for anal fissure are as follows: 

  Acute anal fissure can be conveniently treated by Graded Kshar Karma Treatment. In this treatment a specialized Ayurvedic medicine is applied in fissure region which debrides the fissure and promotes healing. In this way fissure heals completely. So, no need for any surgery at this stage and thus no complication like bleeding, pain, stool incontinence, etc.

  When Fissure is not treated at this stage; a skin tag known as sentinel piles develops from the lower end of fissure. This condition also can be managed by Graded Ksharsutra TM Treatment. In this treatment, Graded Ksharsutra TM - a specialized medicated thread is ligated at the root of sentinel piles and sentinel tag gets detached in 3-5 days. No hospitalization or bed rest is required in this treatment. So, at this stage also fissure can be managed without surgery.

  Delayed healing and Recurrence of Anal fissure are other complications seen after Anal Fissure surgery. Such complications are not seen in Graded Kshar Karma and Ksharsutra Treatment.

  In some case stool incontinence (inability to hold stool; which is far worse than Anal fissure itself) is also seen after Anal Fissure surgery. However, there is no harm to stool control in Graded Kshar Karma and Ksharsutra Treatment.

  No hospitalization or bed rest is required in Graded Kshar Karma and Ksharsutra treatment. Hospitalization and bed rest for a considerable time period is necessary in surgery.

  Graded Kshar Karma and Ksharsutra are more economical than surgery. With this discussion; it is for sure that non surgical treatment for Anal Fissure is far better than Surgery.

Anal Fissure - Non Surgical Treatment Is Better Than Surgery!

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