Renal Tubular Acidosis is a medical condition. When the kidney is unable to acidify urine, it leads to the accumulation of acid in the body. Usually, when blood is filtered by the kidney, it passes through the tubules of the nephrons (the functional unit of the kidney).

Before it flows into the bladder from the kidney, the urine undergoes an exchange of salts, acids and other solutes. Renal tubular acidosis results in the formation of excessive amounts of acid because the kidneys cannot drain them. This may happen because the kidneys cannot reabsorb the alkaline bicarbonate ions from the urine in the early segment of the nephron or because of inadequate production of acidic hydrogen ions in the latter half of the nephron.

Renal Tubular Acidosis is simply associated with abnormal urinary acidification. Other functions of the kidneys remain unimpaired.
There are several different types of renal tubular acidosis-

  Distal Renal Tubular Acidosis (RTA)
This is the most fundamental form of RTA. It is characterized when the hydrogen ions are not secreted into the lumen of the nephron by the alpha-intercalated cells of the medullary collective duct of the distal nephron. When this happens the pH of urine cannot be brought down below 5.3. Renal excretion is inhibited and hydrogen ions are not eliminated which leads to academia. At the same time, Potassium ions cannot be absorbed by the cell which leads to hypokalemia. The end result is protein retention and potassium excretion. Distal RTA can lead to the urinary stone formation, calcium deposits in the kidney, rickets and osteomalacia and Sjogren s syndrome.

  Proximal RTA
When proximal tubular cells reabsorb 85% of filtered bicarbonates and 60% of filtered sodium from the urine, then this again leads to academia. The distal intercalated cells, however, function normally and so the academia is not as severe as in case of Distal RTA. The alpha-intercalated cells can acidify urine to a pH of 5.3 or less because they produce hydrogen ions. Proximal RTA is also associated with Fanconi Syndrome which is characterized by aminoaciduria, uricosuria, glucosuria, and tubular proteinuria.

  Combined distal and proximal RTA
Inherited carbonic anhydrase II deficit leads to combined distal and proximal RTA. This is accompanied by osteopetrosis, cerebral calcification, and renal tubular acidosis. Cases of combined distal and proximal RTA are very rare.

How is RTA understood?
The following steps are applied to analyze Renal Tubular Acidosis-
  Determining the anion gap in acidosis. The normal Anion Gap is 8-12 (4-6 mEq/L)
  Separating the renal from the extrarenal causes of normal anion gap acidosis
  Classifying the types of RTA
  If it is distal RTA, further tests will be necessary to support the diagnosis

How is RTA diagnosed?
Three types of tests can reveal if a person is affected by Renal Tubular Acidosis-
  Urine test
  Acid load test
  Physical examination

Treatment of RTA-
Doctors prescribe either or both of the following two types of therapies-

  Alkali therapy- The pH level of urine is restored and electrolytes are balanced
  Vitamin D supplements- If RTA leads to bone deformities or rickets, your doctor will prescribe vitamin supplements to strengthen your bones.

Timely diagnosis can prevent the effects of Renal tubular Acidosis from becoming compounded. With the right medication, a person can lead a healthy normal life.

What Should You Know About Renal Tubular Acidosis?

The human body is an intricate mechanism that functions amazingly. And when there is any trouble it does not fail to show signs of trouble, and all we need to do is, to notice it and solve our problems. This is applicable to all types of health issues, including a perianal abscess.

What is Perianal abscess?
Perianal abscess is an extremely painful condition of anal abscess that occurs when one cavity in the anus starts getting filled up with pus. Very often it appears as a painful swelling similar to boil just near the anus. Usually, it appears red in color as well as slightly warm to touch. If the location of the anal abscesses is in the deeper tissue, then it might be less visible and it occurs in people suffering from inflammatory bowel disease.

The worst part is that in certain cases, anal abscesses might lead to more painful anal fistulas. Generally, fistulas occur only if the abscesses fail to heal and break open on the skin s surface. Therefore, it is important that the abscess heals properly or else it may lead to intolerable pain and may even require surgery.

Symptoms of Perianal Abscess
The immediately noticeable and probably the most common anal abscess symptom is constant and throbbing pain around the anal area. Swelling accompanies the pain and its rate increases during bowel movements.

Various common signs of Perianal abscess are:

bleeding or rectal discharge
constipation 
fatigue
Swelling or tenderness,
Skin irritation all around the anus.
Patients with deeper abscess might also show symptoms such as chills, fever, malaise, etc. Various reports state that certain people also feel a lump or nodule at their anus s rim. Facing difficulty while urinating might also be experienced by some people affected by perianal abscess.

HOW TO DIAGNOSE PERIANAL ABSCESS?
One must immediately seek medical if they experience any of the above-mentioned signs or symptoms. Clinical evaluation along with digital rectal exam is sufficient for the proper diagnosis. But, in some cases, patients might need other tests to screen for rectal cancer, diverticular disease, inflammatory bowel disease and sexually transmitted infections. Your physician might also suggest a CT scan, an MRI, or an ultrasound.

HOW DO YOU TREAT PERIANAL ABSCESS?
Just after the diagnosis, prompt surgical drainage would be carried out by the doctor before the abscess erupts. A deeper or larger abscess might require hospitalization as well as an anesthesiologist s assistance. In most cases, patients are prescribed certain medications for pain relief just after the procedure. Antibiotics are mainly given to those people who have comparatively weaker immunity or suffer from diabetes.

Know More About Perianal Abscess!

Colorectal surgery deals with the disorders of the rectum, anus and colon. Another name of colon is  large intestine . These three body parts form the last stages of the digestive process. When the human waste passes through the colon, its salt and water are extracted before it exits the body as human excreta.

Colorectal disorders

Swelling and inflammation of the veins in the anus (also called as Haemorrhoids)
Anal fissures- unnatural cracks and fissures in the anal area
Fistulas or the unnatural connections between the anus and other anorectal areas
Conditions of constipation
Incontinence in passing of faeces
When the walls of the rectum protrude through the anus- also called as Rectal prolapse
Birth defects such as imperforate anus
Anal cancer- this condition is rare
Colorectal cancer- cancer of colon and rectum
Any injuries to the anus
Removal of any objects inserted into the anus
Bowel habits after colorectal surgery
Many patients report cases of diarrhoea, leakage of stool or gas, urgency to use the toilet and a feeling of insufficient evacuation of faeces. Relax; these conditions are not going to last forever. Your rectum and anus are adjusting to new conditions after this surgery. These organs may take six to twelve months to adjust to new bowel habits.

Is there a need to take a laxative or stool softener?
There is no need to take laxatives after a colorectal surgery. Drink lots of water to make your stool softer and easy to pass. If there is a water deficiency in your body, then it may lead to your faeces becoming hard. In that case, take milk of magnesium, colace etc.

Activities post surgery
You can continue with your normal schedule after this surgical procedure. Carry on running, jogging, exercising, climbing up the stairs etc. even after your surgery. Gastroenterologists recommend that patients should desist from lifting loads weighing more than 10 pounds so that there are no post surgery complications.

Diet after colorectal surgery
Avoid spicy and heavy to digest meals after your surgery. Once the intestines begin working normally, you can continue having your spicy food. Chew your food well to aid its digestion.

Returning to work after colorectal surgery
Most people are back to their work after taking a break of 2-5 days. If the surgery is pretty detailed, you may have to take a break of up to a month. Patients undergoing laparoscopic surgery may have to take a rest of 2- 4 weeks before they report back to work. Take it easy before slipping into your regular schedule. If working hurts after your surgery, don t do it.

Colorectal Surgery - Disorders It Can Treat!

Colon polyps are growths that are typically found in the large intestine. Although the causes behind the occurrence of colon polyps are not known, this condition is usually seen to affect adults.
These colon polyps might turn into colon cancer over a period of time; the development of cancer can happen over a number of years.
Colon polyps are usually symptomless; hence it becomes difficult to diagnose the condition. They are commonly found as additional results of screening tests for colon cancers. Screening tests are conducted when there is a suspicion of a disease but it displays no significant symptoms. The symptoms can only be visible if the polyps are enlarged. Typical symptoms include:
Rectal bleeding.
Changes in bowel conditions such as diarrhoea and constipation.
Changes in urination patterns.
Change in appearance of stool.
As the presence of most polyps becomes evident only during colon cancer tests, it is recommended that regular tests for colon cancer be conducted for adults over the age of 50. Some of these tests include:
Colonoscopy: This is highly recommended for detecting colon polyps. A small tube used for viewing is inserted into the colon by the doctor.
Flexible Sigmoidoscopy: It is similar to colonoscopy with the only difference being that the tube is smaller.
Computed Tomographic Colonography (CTC): Also known as virtual colonoscopy, various computer systems and X-rays are used to create a detailed picture of the colon so that the doctor can search for polyps.
The size of the colon polyps helps to identify if the polyp is cancerous or not. Chances of the polyp being cancerous are high if the size of the polyp is higher than 1 cm or 0.4 inches. Hyperplastic polyps (smaller polyps) do not become cancerous and hence, do not need to undergo a colonoscopy. Another form of polyp is the sessile polyp which is usually a flat growth without a stalk and grows on the inner wall of the colon. Similar to other polyps, these polyps can be found and removed using a colonoscopy or a sigmoidoscopy.

Causes and Symptoms of Colonic Polyps

Colorectal surgery is the broad term for surgical procedures performed on the colon, the rectum and the anus. There are various different surgical procedures which fall under colorectal surgery and these are used to treat a vast array of disorders, such as:
1. Anal cancer
2. Colorectal cancer
3. Severe complications related to constipation
4. Anal injuries
5. Inflammatory conditions of the gastrointestinal tract
6. Congenital defects

Procedures
The surgeries under colorectal surgery are performed after diagnostic tests such as proctoscopy, sigmoidoscopy and defecating proctography. The most common diagnostic test is colonoscopy. These help to identify the origin and nature of the problem and decide which surgical procedure is to be followed. The procedures under colorectal surgery are as follows:

Colectomy
This procedure involves removal of a section of the large intestine. This is known as partial colectomy. In extreme cases, such as advanced cancer or severe gastrointestinal infection, the entire colon is removed and this is called total colectomy. Sometimes, the rectum is also taken out along with the colon and this is called proctocolectomy.

Colonic polypectomy
An abnormal growth of tissues in the inner lining of an organ is known as a polyp. Colonic polypectomy is done to eliminate polyps from the colon and rectum before they become malignant. This can be done endoscopically. Surgery is required in case of large polyps.

Strictureplasty
Chronic or repeated bowel inflammation causes scar tissue to accumulate in the large intestine. This results in the narrowing of the colon. Stricturoplasty removes the scar tissue so that proper flow of digestive contents is resumed.

Colostomy or ileostomy
A damaged section of the colon is removed and the shortened intestine is then attached to another opening (stoma) in the anterior wall of the abdomen.

Hemorrhoidectomy
This surgical process is used for swollen hemorrhoids or blood vessels, which form in the anal canal. Hemorrhoidectomy is extremely effective in removing hemorrhoids, but the surgery also involves a number of complications.

Anoplasty
Anoplasty or imperforate anus correction is done to correct birth defects in the rectum and the anus. The structural flaw does not allow the stool to pass properly from the rectum and so it is repaired through surgery.

All About Colorectal Surgery

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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