It is an extremely embarrassing situation to have a bladder leakage. Social life could be altered, with reduced socialising for fear of losing control in the presence of others. Though not discussed frankly, it is an extremely common issue and about 25 million people in the United States suffer from this, with 75% of these being women.

Treatment depends on the type of incontinence, such as stress, urge, overflow, functional, or mixed. It starts with least invasive methods like lifestyle changes moving over to surgical approaches.

Ways to manage it

With trips to the toilet increasing considerably when you have urinary incontinence, simple measures can help manage leakage.

Bladder training: Train your bladder to control the urge for another 10 minutes. This happens by voluntarily contracting the muscles and holding up the urge to go to the toilet. Gradually, it will help increase the frequency of the visit to 4 to 6 hours.
Scheduled toilet trips: Whether or not there is an urge, visit the toilet every 4 to 6 hours.
Double emptying: Even after you have voided, force yourself to void one more time. The residual urine, which is almost always present in the bladder, also gets emptied.
Food/diet modifications: Stress incontinence is worsened by alcohol, spicy foods, acidic foods, and caffeine. Avoiding these can help reduce bladder leakage.
Kegel exercises: The simple repetition of contracting the pelvic floor muscles, holding it in place, and releasing it can do wonders for strengthening the pelvic floor. This can be done anywhere and any time of the day and is very effective for improving bladder control.
Catheters: These can be used if the incontinence is short-lived; the person would need to learn how to safely insert and remove it.
Absorbent pads and medical devices: The absorbent pads are helpful in preventing embarrassment during social situations. On the other hand, medical devices like pessary are inserted into the vagina to support the bladder neck and thereby prevent leakage from the bladder.
Drugs: Anticholinergics/antimuscarinics are useful to control a leaking bladder. Botox injections can help paralyse the overactive bladder muscles and provide a solution. Topical oestrogen may be used in small amounts to improve tone and reduce incontinence. Alpha blockers are also used in some people with good results. There are muscles that relax the bladder and increase the amount of urine it can contain.
Surgery: In the event that all these measures are not useful, surgical correction is possible. Sling procedure where an artificial mesh is used to support the urethra. Bladder neck suspension is where the bladder neck is given support to prevent leakage. If there is a pelvic organ prolapse, that is corrected to rectify the bladder leakage.

 Bladder Leakage - Solutions To Help You Manage It!

Ovarian Cancer, as the name suggests, is a cancer that affects the ovaries. It leads to the abnormal growth of cells, which eventually spreads over to other parts of a woman s body, such as the stomach, uterus and vagina. The risk of ovarian cancer is greater in women who have experienced the process of ovulation many times in their lifetime. It also includes those women who attain menopause at a much later stage in their lives or those who start ovulation at an early age. The different types of tumors, which develop in ovarian cells are more often than not, benign or non-cancerous and do not spread beyond the ovaries. 

Therefore, they can be easily treated by either removing a part or the whole of the ovary. But malign tumors have the ability to spread to other parts of the body and can prove to be fatal.

What are the causes of ovarian cancer

1. Family History: If someone in your close relation like mother, sister or daughter has developed ovarian cancer, then the risk of becoming susceptible to the disease also increases. If any of your close relatives have developed the disease earlier at a young age, then it s quite likely that it was due to some inherited faulty gene. BCRA1 and BCRA2 are known to be the faulty genes that are connected to ovarian cancer.

2. Age: You become more susceptible to developing ovarian cancer at a postmenopausal stage.

3. Hormone Replacement Therapy (HRT): Women who go for hormone replacement therapy put themselves at a greater risk of developing the disease. Nevertheless, if you stop undergoing the sessions of HRT, your risk of suffering from this fatal condition eventually decreases.

4. Obesity/overweight: This is also one of the important factors behind the increased risks of developing ovarian cancer. So, the more obese you are, greater is the risk involved.

What are the symptoms associated with ovarian cancer?

1. Symptoms at an initial stage include pelvic or abdominal pain, postmenopausal vaginal bleeding or irregular menstruation.

2. Loss of appetite or feeling full quickly

3. Other typical symptoms are diarrhea, constipation, nausea or changes in bowel movements.

4. Feeling of mass pressure at your lower back or pelvis

Treatment available for it

Treatment for ovarian cancer generally consists of a combination of surgery and chemotherapy:

1. Surgery: Treatment usually entails removal of the ovaries, uterus and fallopian tubes, including the surrounding lymph nodes as well as the fatty abdominal tissue, which often gets affected with ovarian cancer. This surgery may help you to retain the ability to conceive.

2. Chemotherapy: Chemotherapy is a procedure that follows a surgery and is performed to destroy the remaining cancer cells, if any. Chemotherapy drugs are either inserted into your vein or directly into the abdominal cavity and if need be, into both.

Ovarian Cancer - Are you at a risk?

Even though Prostate cancer is one of the most common types of cancer among men and a lot of research has been conducted towards its understanding, it still remains one of the least talked about forms of cancer. This can lead to a lot of confusion and misinformation that gives rise to a number of myths associated with the disease. Some of the most common myths about prostate cancer are:

1. It occurs only in old men

Although the risk of developing prostate cancer does increase with age, especially after 60-65 years of age, it can develop at any age in a man s life. Ageing cells are more susceptible to mutations and hence more susceptible to cancer but other factors such as genetics, geographic location, overall health, lifestyle, etc. can play a major role in whether someone stands a chance to get prostate cancer.

2. It is a slow-growing cancer

Research has discovered 29 different types of prostate cancers, each of which behaves a little differently from others   some are very fast growing and aggressive while others are slower in developing. Prostate cancer also tends to be more aggressive in younger men than older men; aggressive cancers metastasize faster, i.e. spread to other parts of the body quicker and progress rapidly. Therefore, it is important not to ignore any initial symptoms and consult a doctor as quickly as possible to have the best shot at successful treatment.

3. You can t get prostate cancer if no one in your family had it

While having a family history of prostate cancer does significantly increase the risk of a man developing prostate cancer himself, it can also be diagnosed in men who have no genetic history or predisposition. It depends not only on genetics but also on a number of other factors which can contribute to prostate cancer.

4. If you don t have any symptoms, you don t have cancer

Prostate cancer is known to be one of the most asymptomatic forms of cancer and even when symptoms are present, they are very often misinterpreted as something else. The most common symptoms are: needing to urinate frequently, difficulty in urinating, blood in urine or semen, erectile dysfunction and pain in the pelvic area. Although all of these symptoms don t always mean cancer, it is best to go to the doctor in case you experience these symptoms.

5. Prostate cancer is inevitable   you can t prevent it

It is true that genetics, ethnicity and age do increase the risk of prostate cancer in men. However, research has shown that lifestyle changes such as avoiding red meat in your diet, regular exercise and preventing stress, do have an effect on the genes that regulate growth of tumours.

Hence, you should stop believing everything you hear or read on the internet, they may not always be true. Any symptoms out of the ordinary should be immediately checked out by your doctor. Do not ignore unusual symptoms   they might prove to be very costly later in life.

Prostate Cancer - 5 Most Prevalent Myths About It! 

Achalasia is a serious disorder of the esophagus in which your nerves and muscles fail to work properly. This disorder causes problems in your body such as chest pain, difficulty to swallow food and excessive coughing. 

You will also face problems in breathing in case the food enters in to the lungs. There is a valve in your lower esophageal splinter, which closes the esophagus from your stomach. If you have problems like achalasia then perhaps your lower esophageal splinter fails to open while swallowing food it can lead to accumulation of food in esophagus. In this condition the nerves in your body gets damaged and hence cause health complications.

You are at risk of achalasia when you are middle aged, but it can also occur during childhood. Auto immune disorder often places you at risk for achalasia.

Symptoms of achalasia:
The major symptom of achalasia is dysphagia in which you face problems while swallowing food. You may feel that the food is struck in your esophagus which causes choking and problems when you breathe. There may be other symptoms of achalasia which includes:
1. Loss of weight
2. Heart burn
3. Discomfort or pain while you eat food
4. Chest pain
5. Risk of esophagus cancer

Treatment for achalasia:
Esophageal manometry is a technique your doctor may use, if he suspects achalasia when the symptoms include difficulty while you eat and swallow foods. A tube measures the muscular activity in your stomach and reports about the functioning of your esophagus. Another way to diagnose is through X- ray of the esophagus or endoscopy.

The treatment for achalasia generally starts with oral medications. Sphincter nitrates and calcium blockers often help to relax the muscles. Botox can also help to relax your sphincter and help you swallow food.
Esophagomyotomy also helps to treat achalasia in which your doctor can use an incision to access the sphincter and also alter it to enable better flow into the stomach. It s a generally successful procedure, but sometimes can cause gastro esophageal reflux disease (GERD) which causes heart burn and would require intensive care. Sometimes surgery can also help to give relief but it can also cause acid reflux, respiratory problems, tearing of esophagus along with other serious complications.

Laparoscopic surgery is a simple and effective way of treating this problem .The tight lower esophageal sphincter is released to make way for easy passage of food.The patient recovers in one day and is discharged home following this operation.

Achalasia - Symptoms + Treatment

Bariatric surgery is unlike other surgeries, as its effects are not instant but gradual and are seen over the months. Like any other surgery, it is not without complication. But again unlike all other surgeries, the complication rate can be negligible if a strict protocol is followed. Moreover, the factors like technology advancements, development in the field of advanced laparoscopy, enhanced skillset of the bariatric surgeon, dedicated management of bariatric and metabolic surgeries by bariatric surgeons, play a vital role in the reduction of complication rate which eventually results in safe surgery.

As the procedure is done laparoscopically, the pain is just for a day and is minimally managed by analgesics.

The fear of increasing incidence of incisional hernias while operating an obese patient is so negligible or nil, as the procedure is performed through tiny key holes and all precautions are taken to suture the sheath through which the ports are put to perform the surgery.

Reduced hospital stay and early resuming to work is one of the biggest benefits of this laparoscopic bariatric procedure.

Sometimes, problems that may be faced are:- 

Post-operative bleeding: Normally, this a nearly bloodless surgery involving 5 to 10ml loss of blood. However bleeding from the staple edges is known, but this can be managed well by the surgeon, by choosing the right size of the cartridge as well the right technique of application of the cartridge.

Dehydration: We are normally accustomed to drinking water at long intervals (a few hours) as we can consume nearly 200 to 400ml at one go. Following bariatric surgery, gulping or drinking water in one go is not possible in the first 2 to 4 weeks, due to reduced capacity of the gastric pouch. Hence, care needs to be taken to drink small quantities of water at frequent intervals to avoid dehydration. This is possible only if the patient is counselled about this prior to surgery and is fully aware of this. Also, the patient needs to be given good and clear post operative instructions regarding the quantity and frequency of liquid consumption, not forgetting the type of liquids. Coffee taken frequently could be another cause for dehydration. Family members and colleagues and friends at work play a major role in reminding tthe patient about consuming water frequently. Special care needs to be taken in people who are not accustomed to consuming adequate quantities of water prior to surgery as a general habit.

Vomiting/Fullness/ Discomfort/Indigestion: Following bariatric surgery, soft food is introduced in the diet in the third week, after the first 2 weeks of taking liquids. Due to the reduced capacity of the gastric pouch, the morsel size is significantly reduced and one has to chew the morsel well and eat slowly, giving a gap of 40 to 50 seconds between the morsels. This prevents distension or overdistension of the gastric pouch and thus avoids vomiting. This again requires good counselling prior to the surgery and on the follow up visit too before stating soft food. There is a subjective difference when we say small morsels and we cannot reach a standardization as the morsels size of each individual varies prior to the surgery itself. The best way to avoid this confusion is to make the person have the first soft food meal before you where in you can physically show the way food is expected to be eaten. However, by mistake, there is a chance that one can have a regular sized morsel as over years one is used to eating in that manner. If this happens, the person will vomit , and this will be a reminder to gauge the morsel size the next time the person eats. Following the vomiting, there could be a burning sensation in the stomach which will subside afer taking an antacid. If one follows the instructions of small morsel size, chewing properly and eating slowly, there is no chance that there will be vomiting. Another reason for vomiting could be keeping the stomach empty for a longer duration or having sicy food on an empty stomach. Avoid nuts, seeds, fried foods and processed foods. Very rarely vomiting could be due to reduced size of the joint between the gastric pouch and the small intestine. This could require an Endoscopy and necessary treatment.

Vitamin and mineral deficiency: It is seen that many of the obese patients are seen to have vitamin B12, vitamin D, iron and protein deficiencies in their blood tests that are done prior to surgery. With the significant reduction in the amount of food consumed after bariatric surgery, the existing deficiencies are bound to increase. Hence, it is necessary to do these tests, before surgery and rectify the deficit prior to the surgery.  

Gall bladder stones: Significant weight loss which is consistant over a short duration could lead to the formation of gall bladder stones, be it with or with out surgery in a small percentage of patients. To avoid this there are two schools of thought, one is have a prophylactic removal of the gall bladder along with the bariatric surgery and another is to put the patient on ursodeoxycholic acid (a tablet) for the first few months after surgery during which there is significant weight loss.

Skin sagging: In the morbidly obese, when the skin is overstretched beyond a certain point, it tends to sag once significant weight is lost. This sagging is influenced by a number of factors like age of the patient, the BMI, pre existing sagging, pre-existing muscle tone and protein supplements taken during weight loss and exercises done during the weight loss period. Skin sagging is less if the age is less than 45, BMI less than 45, good protein intake during weight loss and good toning exercises done during the weight loss period.

Hairfall: Significant weight loss either by diet and exercise, aerobics, bariatric surgery, will entail hair loss. But this can be minimised to a greater extent by ensuring good protein intake during the weight loss period and adequate supplements in terms of vitamins and minerals.

Dumping syndrome: With a reduced size of the stomach, the food moves from the stomach into the smaller intestine much faster. This causes the pancreas to release excessive amount of insulin, leading to very low blood sugar levels , producing various symptoms like abdominal cramps, bloating, diarrhoea, sweating, dizziness, nausea, weakness, and anxiety. This is managed by eating less amount of sugars and fats and spacing out the meals through the day, having four to five small meals compared to  2 to 3 large meals. Having a high protein diet and avoiding liquids during meals is also an option.

Bariatric Surgery - Know Problems Of It!

Screening for cancer of the colon or large intestine and rectum is a proven way of saving a person from the impacts of colorectal diseases. This is partly because colon cancer is something that can be prevented if detected at an early stage and the polyps which may advance to cancer are removed properly. Thus if you are turning 50 soon, be prepared to present yourself for a screening colonoscopy that will help you ensure good health and well-being. It may sound uncanny, but do you know that 50,000 people across the world die from colorectal cancer every year, and it is ranked second in terms of cancer-centric deaths.

Understanding the importance of having colonoscopy
You may wonder how a painful, invasive, embarrassing, uncomfortable and time-consuming health test may be called a present. There are reasons enough. A screening colonoscopy is able to expose a cancerous tumour that's presently under way and cast light on the chances and risk factors that may precede it. When you choose to intervene early, you have the power to nip those risks at their budding stage, much before those malicious cells become malignant.

Spreading of the colorectal cancer
Your large intestine is really a big and last organ of the gastrointestinal system where the small intestine discontinues. Its primary function is to remove the water out of the leftover solids of digestion and get rid of them in the form of stool. Cancer may start to develop anywhere within the tube that expands 5 feet long and squares the vacant area of the abdomen. The large intestine expands up towards the right side, i.e. the ascending colon and then turns left through the liver, i.e., the transverse colon, bending down right at the spleen on its left, i.e. descending colon and loops to the middle, i.e., the sigmoid colon before it runs across the rectum and ends at the anus.

People who need a colonoscopy
To simplify matters, it can be said that all adults are at a potential risk of the colorectal cancer, including those people who lead a healthy life. But some people are at a higher risk. Those individuals have a specific gene mutation that predisposes them to develop into numerous polyps. The risk is also high with people who are first-degree relatives of a person diagnosed with cancer before the age of 50. People with Ulcerative colitis, various types of inflammatory bowel diseases and Crohn's disease are also at a higher risk.

Colorectal cancer is a serious ailment and screening colonoscopy is a feasible means of detecting any polyps that may be cancerous in the future. Speak with a reputed gastroenterologist today to stay ahead of the disease.

When Should You Start Having Colonoscopies?

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