The kidneys are responsible for the elimination of waste from the body. The blood is filtered in the kidneys and all toxic wastes are filtered out and excreted through urine. When this filtration does not happen effectively, a lot of waste can be found in the blood, which affects normal body function.

Kidneys may lose their functioning either due to age, injury, or disease conditions. Whatever the reason, when kidney function is hampered, the body suffers. If there was an injury or congenital problem, it could be unilateral and the non-affected kidney could still do the function. However, if it is infection or old age, normally both kidneys are affected and then replacement should be looked for externally. This is where a kidney transplant comes into the picture.

What is it?

It is a surgery where a healthy, functioning kidney is placed into the body. The donor could be

Living: These donors have to be related or unrelated. Related is often termed someone, who is a family member and is willing to donate one kidney (one kidney is sufficient for normal, healthy individuals) to the diseased person.
Cadaver: If a person is willing to donate kidneys post death, these are used for transplant, within a specified time.
Identifying the right donor and recipient:

Blood type and tissue type should be matched; a good tissue type match improves the chances of success
Overall health of the donor to ensure there is no heart disease, lung disease, or diabetes
The recipient also should be healthy
What to expect during surgery?

Once a donor is identified, in living donors, the surgery to remove the kidney and to transplant it are done simultaneously
The surgery usually takes about 3 to 4 hours
Antibiotics are given prior to the surgery to prevent infection
The blood vessels and ureter are connected back to the kidney after the transplant
Hospital stay can range from 5 days to 2 weeks, depending on the overall health of the patient and the anticipated risk of rejection.
Most transplanted kidneys work effectively almost immediately. A kidney stored from a cadaver may take a little longer compared to a fresh kidney from a living donor
People who have had transplants are put on immunosuppressants on a chronic basis to reduce chances of rejection. The new kidney will always be recognised by the body as a foreign body, and so this is essential.
Kidney transplant success rates are quite high, and more and more people are opting for transplants as opposed to dialysis.

Kidney Transplant - What To Expect From It?

A hernia occurs when a weakened area of muscle in the abdominal wall gives way and the internal organ/tissue bulges out through this weakened are or  defect'. This can happen in many different areas of the abdomen. A hernia that develops in the groin region is called "inguinal hernia". It may be very painful especially if a part of the intestine gets trapped in the bulge.

The only treatment option is surgical repair as the weakened area "defect" needs to be repaired and will likely need reinforcement by a prosthetic material called a "mesh". Doctors may resort to Open Surgery or Laparoscopic Inguinal Hernia Repair depending on his/her evaluation of the patient. 

Who is a candidate for Laparoscopic surgery?

Laparoscopic surgery is the preferred treatment option for most people with inguinal hernia. Special situations in which laparoscopic surgery is much superior to open are

  Failure of a previous open surgical repair. Laparoscopic surgery is performed from "behind" the hernia and abdominal wall in comparison to open surgery which is performed from "the front". So, in case of failure of the open surgery, laparoscopic surgery is done through a fresh, non-scarred area and is technically safer and easier than doing an open surgery once again.

  If there are hernias on both sides and both need to be repaired at the same time, laparoscopy has a great advantage as both the hernias can be tackled and repaired through the same three tiny cuts, and two separate large incisions need not be made. 

Who is Not a Candidate for Laparoscopic Surgery?

The person is not a candidate for Laparoscopic Surgery if he has:

  Some patients who have undergone previous Abdominal Surgery or prostate surgery may not be suitable candidates for laparoscopic inguinal hernia surgery.

  Some underlying medical conditions, that make him unfit for general anaesthesia, as usually laparoscopic surgery can only be done under general anaesthesia.

How Laparoscopic Inguinal Hernia Is Carried Out?

In a Laparoscopic Intervention, two to three small incisions are made in the lower abdominal area. The laparoscope is passed through one of these incisions and the surgical instruments are inserted through the other incisions. The abdominal cavity is inflated using Carbon Dioxide to help the surgeon visualize the lower abdominal area clearly. Using the laparoscope, the surgeon visualizes the Hernia and uses long instruments to operate on it. She covers the hernia with a mesh and may fix the mesh to abdominal muscles using either stitches or stapler-like instruments.

Benefits of Laparoscopic Surgery

1. Two or three tiny cuts (5-10 mm in size), hence there is less pain after laparoscopic surgery

2. Better cosmetic results

3. Quicker recovery

4. Early return to daily activities like walking, working, etc

5. Shorter hospital stay 

Role of Laparoscopic Surgeon In comparison to many other minimally invasive surgeries:

Laparoscopic Inguinal Hernia Repair is more demanding in terms of technical capability of the surgeon. In general, Laparoscopic Inguinal Hernia Repair is more difficult to carry out in obese people than others. However, if the doctor is well trained and technically advanced with long experience, he can carry out such minimally invasive surgeries smoothly irrespective of the BMI of the patient. Everybody is not a candidate for Laparoscopic Inguinal Hernia Repair.

It is the doctor who decides if a particular patient is suitable for such surgery or not. However, the conclusive factor in any such repair is the experience and expertise of the doctor. This is why there are not many Laparoscopic Surgeons who carry out Laparoscopic Inguinal Hernia Repairs. Owing to the complexity of this procedure, it is important to get it done from an expert surgeon only.

Laparoscopic Inguinal Hernia Repair !

The gall bladder is a very small organ located behind the liver. This organ stores the bile created by the liver and releases it whenever needed. We rarely pay attention to this organ until there is a problem and most gallbladder related problems are very painful. Unknowingly you may be harming your gall bladder by eating certain types of food like red meats and saturated fats. On the other hand, eating some types of food can improve your gall bladder health. Some such foods are:

Fiber-rich foods: Fruits and vegetables are rich sources of fiber and a must in a balanced diet. Fiber helps keep the gall bladder healthy and also helps prevent gallstones from developing. An easy way to add more fibre to your diet is to incorporate a salad with your lunch and dinner.
Water: Water not only helps hydrate the body but also helps maintain the water levels required in bile. Ideally, a person should drink 8 glasses of water a day. This should not all be drunk at one time but should be spaced out through the day. Drinking too much water at one time will result in the body expelling it in the form of urine instead of absorbing it.
Foods rich in Pectin: Pectin is a dietary fiber that binds cholesterol in the stomach and helps in its removal from the body. Since cholesterol is one of the major causes for gall stones, eating pectin-rich foods helps reduce the risk of gallstones. Some foods that are rich in pectin include citrus fruits, strawberries and apples.
Flaxseeds: Eating just one tablespoon of flax seeds a day can boost your health in a number of ways. One of the many benefits of including flaxseeds in your diet is a healthy gall bladder. Flax seeds contain mucilaginous fiber or fiber that forms a gel. This type of fiber aids in the liver s synthesis of bile acids and thus keeps the gall bladder healthy.
Omega 3 Fatty Acids: Not all fats are bad for the body. Omega three fatty acids play an important role in producing anti-inflammatory compounds. Some rich sources of omega 3 fatty acids include olive oil, avocados and flax seeds.
Citrus fruits: Citrus fruits are very rich in vitamins like vitamin C. a deficiency of this particular vitamin can cause gall stones. For this reason, eat plenty of citrus fruits and other fruits and vegetables such as bell peppers and broccoli that are rich in vitamin C. 

Gallbladder Health - Foods that Can Help maintain it!

Epithelial Ovarian Cancer is a condition in which malignant tumor emerges from the tissue lining in the outer surface of the ovary. Epithelial tumors are usually benign, but this form of malignancy has been found to be the most common type of ovarian cancer. Moreover, it cannot be diagnosed until in its advanced stage. Medical research shows that factors such as multiple pregnancies, delayed childbirth and early menarche seem to raise the risk of ovarian cancer, while dietary and environmental factors also play a significant role in it.

Symptoms
1. A majority of the patients have been observed to have extensive intra-abdominal growth.
2. They may experience discomfort or swelling of the abdominal region.
3. The feeling of being bloated, lack of appetite, unnatural weight alteration, dyspepsia, malaise, and urinary problems are frequently reported symptoms.
4. Patients also experience constipation and other gastrointestinal problems.

Treatment
The first step towards treatment of ovarian cancer is to diagnose the condition. A thorough pelvic examination (consisting of an examination of the vagina, uterus, ovaries, fallopian tubes, and cervix) will help to pin point any abnormality of the ovary. If the doctor notes nodularity, firmness or lack of tenderness during the examination, these can be taken as symptoms of malignancy of epithelial ovarian tumors. Ultrasound examination of the abdominal region will also help to locate abnormality in the tissues on the outer surface of the ovary. The next logical step towards treatment is getting a biopsy. During this procedure potentially malignant cells are removed and then diagnosed by a pathologist to conclude if the cells are cancerous or not. The process of removal is known as laparotomy.

Apart from a handful of stage one patients, most women with epithelial ovarian cancer receive chemotherapy. The standard treatment for this type of ovarian cancer is the surgical elimination of tumor. This includes total abdominal hysterectomy, a surgery in which the uterus and cervix is removed through an incision in the abdomen. Post surgical treatment consists of taxane-platinum chemotherapy. Patients with minimal residual cancer undergo external radiation therapy or intraperitoneal chemotherapy (radioactive liquid is channelled into the abdomen with the help of a catheter).

A lot of research has been done in this field and a variety of clinical trials are available for a patient, if he/she wishes to be a part of it. Leading methods are immunotherapy and targeted therapy are also available. Immunotherapy uses the immune system of the patient to battle cancer. Bodily substances or substances created in the lab are used to restore and boost the body s natural defence mechanisms against cancer. Targeted therapy, on the other hand, uses substances to identify the cancer and attack the malignant cells without jeopardizing non-cancerous cells.

Epithelial Ovarian Cancer - 4 Major Signs that Indicate it 

Colorectal cancer is otherwise known as cancer of the colon or the rectum. This can affect both men and women with age being a major risk factor. Majority of such cancers are seen to occur after age of 50 years.

Type: colorectal cancers can present as one of the following types: 

Adenocarcinomas are the most common type of colorectal cancers. These cancers begin in the cells making mucous and other fluids. Certain colorectal cancers begin as adenomatous polyps (adenomas) that turn cancerous over a period of time. This is precisely why the adenomas are regarded as pre-cancerous or pre-malignant.

Gastrointestinal (GI) carcinoid tumors, GI stromal tumors, primary colorectal lymphoma, leiomyosarcoma, melanoma & squamous cell carcinoma are certain other colorectal cancers

Carcinoid tumors: start in specialized cells that produce hormones, in the intestine.

GI Stromal tumors: start in the interstitial cells of Cajal (ICC), in the wall of the colon.

Lymphomas: start typically in the lymph nodes but they may also start in colon or rectum.

Sarcomas: can start in the muscle and the connective tissue in the walls of the colon and rectum.

Gender: it affects both male and female populace.

Etiology: mostly, the factors that are associated with increased risk of colorectal cancer include the following  

Age exceeding 50 years.

Racial & ethnic background such as African Americans, in the USA, are known to have the highest incidence of colorectal cancer, and mortality rates.

Low fibre and high fat diet. Excessive consumption of red meat (e.g. goat meat, beef, pork, lamb, or liver), processed meats, butter, refined grains, sweets, sugary drinks etc all can increase the risk of colorectal cancer.

Personal history of inflammatory bowel disease (IBD) (e.g. ulcerative colitis), Crohn s disease, adenomatous colorectal polyps, colorectal cancer etc all.

Family history of colorectal cancer or adenomatous polyps etc all.

Inherited syndromes such as familial adenomatous polyposis (FAP) and Lynch syndrome (hereditary non-polyposis colon cancer or HNPCC).

Sedentary lifestyle/ associated Obesity.

Type 2 diabetes.

Tobacco and alcohol abuse.

Features or symptoms can vary from person to person depending on the size and location of the tumour. Following are the signs & symptoms mainly -

Changes in bowel habits, diarrhea or constipation or an alternating diarrhea and constipation.

Occult/ blood in the stool, and 

Problems related to blood loss (e.g. anemia, weakness, fatigue, intolerance to exercise, shortness of breath, increased heart rate, chest pain etc all),

Abdominal discomfort (frequent gas/ flatulence, bloating, fullness, cramps, and pain), vomiting etc.

Unexplained weight loss,

Pain with bowel movement,

Feeling that bowel does not empty completely,

Stools are narrower than usual.

Diagnosis: Following are the diagnostics employed. Abnormal blood test results may be indicative of malignancy, but a follow-up imaging/ biopsy is always the gold standard for accurate diagnosis.
Blood: fecal occult blood test, Carcinoembryonic Antigen (CEA) assay values are raised, Hb/ RBC counts may be low.
Imaging: Colonoscopy, Endorectal Scan/ CT Scan followed by Biopsy clinches the diagnosis and the nature of the disease.
Apart from the above-mentioned barium enema X-Ray, USG, Chest X-ray, PET CT scan etc all help detect metastasis, if any. An increase in level of the serum tumor marker  CEA  is indicative of metastatic spread/ proliferation that can be ascertained through a PET CT scan.
Treatment: Conventional treatment includes surgery, radiation and chemotherapy as contextually appropriate. Simultaneously, an adjunctive/ integrative naturopathic treatment with suitable complementary & alternative medicines (CAM)/ therapies too can help improve clinical outcomes and facilitate recovery as feasible contextually.
Prognosis: preventive measures, earlier diagnosis and right early treatment is key for better prognosis and efficient/ effective therapeutic management. Usually, the chances of cure for an early stage cancer are more. Above-mentioned apart, recovery chances are influenced by the grade, stage of cancer, recurrence and the patient s general health & vitality etc all too.

Prevention: rightly said, prevention is always a better choice. Although genetic risks are difficult to modify, still an adherence to a Mediterranean diet, maintaining an ideal body weight and an active lifestyle with due emphasis on regular exercising (for at least 30 minutes daily), de-stressing and relaxation is highly recommended for prevention or reducing the risks of colorectal cancer. A healthy eating plate comprises essentially a low fat diet, fibre rich foods including whole grain cereals, green leafy vegetables cooked using healthy vegetable oils, fresh fruits of all colours as seasonally available and healthy proteins/ fats including fresh fish, poultry, beans, nuts etc all. It is advisable to limit milk/ dairy, preferably of low fat content, to 1 to 2 servings max daily. Although alcohol is optional and is not for everyone, the consumption of the same, if any, has to be strictly in moderation, and is best avoided. Smoking is to be avoided as well. Again, red meat, butter, refined grains, sweets, sugary drinks including carbonated beverages and other high calorie foods etc all, if any, are to be taken sparingly or are best avoided too. Apart from the generic preventive measures as mentioned above, certain pre-malignant conditions, of which adenomas are the most common, can be successfully treated with complementary and alternative medicines too.

Colorectal Cancer - In a Nutshell!

If you have taken the big decision to go ahead with bariatric surgery, one thing you need to prepare for well in advance is the additional effort that is required after the surgery to ensure it is a success. The results will be evident only after a few months post the surgery. This period requires your constant attention. 

Listed below are some after-care measures that are essential for the success of a bariatric surgery.

Hospital stay: Most patients are advised hospital stay for four days, during which the hospital staff will ensure the sleeve is working fine. No food is allowed for 48 hours. Diet is gradually advanced from water to clear liquids, about 50 ml to 100 ml and then to 150 ml.
Wound care: Depending on whether a laparoscopic or open surgery was done, the number and location of incisions will vary. However, the wound should be maintained clean and it should be ensured that there is no infection of the site. Wound care should be done by the nursing staff if required. Suture removal, if required, should be done as per doctor s advice.
Pain management: Finish the course of antibiotics and pain killers to ensure infection is completely gone. Pain would continue, if the infection is not completely controlled.
Diet: The first two weeks would be a completely liquid diet. The next two weeks will consist of a pureed diet. After these four weeks, solid foods will be introduced.
Foods to avoid after a bariatric surgery include anything with a higher protein content and anything that has too much oil as the stomach s ability to digest these is reduced. Refrain from:

Carbonated beverages
Hard meat
Nuts and seeds
Fried foods
Food items to include post bariatric surgery include those which are easy on the stomach, including:

Liquids such as soups, broth, juice, and milk
Pureed cooked vegetables and eggs
Soft mashed food including meat and vegetables
Adherence to this will reduce complications. While eating, the patient should also remember to chew nicely, eat and drink slowly, increase water intake throughout the day, and avoid fats and sugar. It is advisable to eat three proper meals a day and avoid snacking during the day.

Remember that the need for bariatric surgery arose in the first place due to uncontrolled eating of oily food. After undergoing a bariatric surgery, diet pattern is definitely going to move to a healthier side with reduced fat and sugars. It is not an easy shift, but definitely required, if the surgery is to be a success. Imagine the new you and you will be able to do it!

Bariatric Surgery - Aftercare Tips You Must Follow!

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