GERD or gastroesophageal reflux disease is a chronic digestive disease which occurs when the stomach acid and at times the contents in your stomach flows backwards into the food pipe. The backwash or reflux irritates the esophagus's lining and hence causes GERD. Individuals may manage GERD's discomfort by changing their lifestyle and by taking over-the-counter or OTC medications. But, certain people might also require stronger medications or surgery for reducing the symptoms.

Some of the basic signs include chest pain, burning sensation in the chest, dry cough, difficulty in swallowing, sore throat, etc. If you experience such symptoms at least twice a week or if your physician notices damage in your food pipe, then you might undergo diagnosis. Though drugs are the primary GERD treatment yet, an individual can manage it by following certain tips which may give relief.

Few ways to manage GERD- self-care tips:

One of the effective ways to help yourself is by consuming smaller meals. Instead of taking three big meals regularly, you may try having smaller meals frequently and avoid stuffing.
Almost all individuals tend to have dinner just half an hour before sleep, but this might affect GERD patients. It is best to eat 2 hours before going to bed as by doing so your stomach will get enough time to digest the food.
Due to a hectic schedule and fast paced lifestyle, people tend to eat as quickly as possible. To manage GERD, one must eat slowly and put down the spoon or fork in between each bite.
Changing the daily diet by striking off the trigger foods is beneficial in managing GERD symptoms. Though the food triggers vary from one person to another yet, it includes coffee, chocolate, peppermint, alcohol, tomato, citrus juices, onions, spicy and high- fat foods, etc.
Sleeping with the head end of the bed elevated by 6 inches is a very effective way of reducing night time reflux. It is also advisable to sleep on your left side . Never sleep on the right side as this position promotes reflux. Medications to reduce acid production are the mainstay of the medical treatment. 
One always has to ensure that they are following the various lifestyle changes along with the medication. Other medications include pro kinetic medicines which help the stomach empty. Surgery always remains the last resort in the treatment of GERD. Endoscopy is required for the diagnosis or GERD Prior to any surgery a Manometry and 24 hr ph merry test is compulsory.
If you are suffering from GERD symptoms frequently, then you may maintain a diary for figuring out which foods are giving you trouble.

When is a surgery required?
If lifestyle changing tips and other medications fail to provide any relief, then physicians recommend undergoing surgery.

Surgery is done for strengthening lower esophageal sphincter and also for reinforcing it. The surgery for reinforcing lower esophageal sphincter is performed by surgeons laparoscopically. The surgeon inserts instruments like a tiny camera and flexible tube by making 3-4 incisions in the abdomen. This surgery for managing GERD may be quite effective.
Experts state that candidates who undergo GERD surgery are those who are unwilling to take GERD drugs or are not getting relief from them. While choosing a surgeon, it is better to consider one who possesses huge experience of the particular operation which you need and also with a good track record.
So, you must visit a doctor if you experience frequent gastroesophageal reflux disease symptoms. It won't be a good decision to take OTC medications without your doctor's recommendation if you notice arm or jaw pain along with difficulty in breathing as these are signs of heart attack.

Gastroesophageal Reflux Disease - How Best Can You Manage It?

Feeling acidic after eating a heavy meal can often make you regret those last few morsels. This acidic sensation is known as acid reflux or Gastroesophageal reflux disease, better known as GERD. GERD occurs when the functioning of the lower oesophagus muscles is restricted. This makes the undigested food in the stomach and stomach acids leak back into the oesophagus. 

Thankfully, this is not something you have to live with and a few simple lifestyle changes can help resolve the situation.

Do not lie down after eating: When your body is in a horizontal position, there are higher chances of food being regurgitated into the oesophagus. To avoid this, finish your meals at least 3 hours before going to bed. Sit upright while eating and do not lie down or slouch immediately after eating. This gives the food time to be digested and move out of the stomach.
Limit your food intake: Overeating is one of the most common triggers of GERD. Cutting down your portion sizes can instantly reduce the number of GERD occurrences. Instead of eating large, heavy meals, shorten the duration between meals and have more frequent small meals.
Avoid foods that trigger acidity: With time, you will soon realise which types of foods trigger an acidic reaction. Some common triggers are onions, peppermint, caffeine, citrus fruits etc. Keeping a diary can help identify such foods and ease your problem.
Quit Smoking: Nicotine not only harms your lungs, but can affect your digestive system as well. It is responsible for weakening the muscles that control the opening between the stomach and oesophagus. This allows stomach acids and food from the stomach to re-enter the oesophagus. Alcohol can also worsen GERD symptoms and hence it is better to avoid alcohol is you suffer from frequent bouts of acid reflux.
Lose weight: Overeating, obesity and acid reflux go hand in hand. Being overweight can put extra pressure on your stomach and abdomen, thus pushing food and gastric juices into the oesophagus. Losing this extra weight should effectively resolve your acid reflux problem if you are overweight.
Look at your medications: Some types of medication too can cause acid reflux by interfering with the digestive system and irritating the oesophagus. These types of medication include blood pressure medication, asthma medication, Non-steroidal anti-inflammatory drugs, bisphosphonates, sedatives and painkillers. Do not simply stop taking these medications, but talk to your doctor about replacing them with something else.

GERD - 6 Ways You Can Manage It!

When blood clot blocks one or more arteries in your lungs the condition is known as pulmonary embolism. It can cause a decrease in the oxygen levels in your blood, damage to your lungs due to sudden restrictions in the flow of blood along with adverse effects on other parts of your body. Life threatening blockage can cause death if left untreated and you should immediately contact your health care provider to get proper diagnosis. Pulmonary embolism requires various lab tests and generally requires short time to resolve.

Symptoms:
The symptoms of pulmonary embolism mainly depend upon many factors pertaining to your previous medical history. Pulmonary embolism varies with the size of your lungs, the size of the clots formed in your blood, and any other underlying history of the heart or lungs. That said, pulmonary embolism has symptoms which are not similar to any two persons and will vary accordingly.

The common symptoms however may include the following and you are advised to opt for a health checkup if these are persistent in your body:
1. Cough along with bloody sputum is a common symptom.
2. Shortness of breath, which will become worse as the days passes by. They will appear suddenly and cause huge discomfort in breathing.
3. Chest pain which may give you the feeling of a heart attack. The pain will intensify when you sit to eat or cough. Deep breath will cause problems too and will not go away easily with exertion.
4. Some other symptoms include fever, excess sweat, irregular heartbeat and dizziness.

Pulmonary embolism can be diagnosed by the following methods:
1. Electrocardiography (also known popularly as ECG) to measure your heart's electrical activity and functioning.
2. CT plumonary angiography is gold standard for diagnosing pulmonary embolism.
3. Chest x ray, which is a common and non invasive test to check your heart and lungs as well as the problems with any bones surrounding them.
4. ECHO can detect secondary changes in heart due to pulmonary embolism.

Treatment of pulmonary embolism can be done with medicines if it is detected at an early stage or also if the clot is small. However, if the size of your clot is problematic and blocks the blood flow to your lungs or heart then surgery may be necessary. Open surgery and clot removal surgery are common in the treatment of pulmonary embolism and will require good regular follow up check ups. Regular leg exercises will also reduce the chances of any underlying disease and you should hence consult your doctor.

What Is Pulmonary Embolism?

Surgery is basically the most important treatment for majority of kidney cancer and without undergoing surgery, the chances of survival for the patient are very small. Surgery for kidney tumor is also beneficial for the people who has cancer in different other organs of the body. People also live longer with the help of the removal of the kidney which contains cancer thus even if cancer has spread beyond just the Kidneys, the doctor might suggest kidney surgery.

The removal of kidney tumor can also be used to prevent or reduce symptoms like abnormal bleeding or pain. Some of the tissues surrounding the kidney or the entire kidney might be removed depending on the location or other factors involving the tumor for cancer.

Risks or Side-effects of the Surgery
Surgery of any type might have some risks which can be short term like abnormal bleeding, blood clots which will eventually lead to infection. Majority of people does tend to have pain after undergoing the operation which usually could be benefited with the help of pain medicines. Some other possible risks are:

Some internal organs such as spleen, pancreas, large or small bowel or some blood vessels might be damaged after undergoing the operation.
Internal organs might observe some bulging near the area of surgery because of the issues with the healing of the wound which is known as incisional hernia
If the remaining kidney is unable to operate then there might be the risk of Kidney failure.
Is the chest cavity lets in unwanted air then there is a risk of Pneumothorax.
There is always a risk of urine leaking into the abdomen.
Advantages of Kidney Surgery
Transplantation surgery tends to have some benefits. Which minimises the need for dialysis and helps the patients enjoy life at its best which more freedom productivity and energy. Although majority of the patients before being first evaluated for surgery are on dialysis. But the patients who are undergoing end stage renal disease might be referred for surgery even ahead of dialysis.

A successful kidney surgery can provide you with more than just your health back. It can also provide you with an even better quality of life. There are several cases where the majority of patients return home and also good work and still lead a quality life after the transplantation therefore this treatment is preferable for several patients.

Surgery For Kidneys - Know The Benefits!

One of the most common problems faced by ageing men is benign prostatic hypertrophy. Prostate is the gland at the base of the urethra near the bladder and when it enlarges it can lead to symptoms, mostly related to urination.

1. Frequent urge to pass urine
2. Prolonged urination
3. Frequent nocturnal visits to the toilet
4. Intermittent urination
5. Difficulty to start urinating
6. Inability to completely empty the bladder
7. Urinary tract infections

There are medications available to manage this, but offer only temporary relief. Many men therefore prefer to have the surgery undergone to manage these bothersome symptoms. However, like any surgery, the risks and benefits need to be considered along with other conditions like age, overall health status, other comorbid conditions, etc.

Surgical removal of the enlarged prostate gland is a more definitive approach to manage these symptoms. In addition to providing a quick cure, it also is used in the following cases:

1. Patients who do not respond to medications
2. Presence of blood in the urine
3. Associated bladder stones
4. Frequent infections of the urinary tract
5. Associated damage to the kidneys

Procedure of Surgery
During the procedure, a tube is passed through the tip of the penis into the urethra towards the bladder neck. Once it is in the desired position, laser is passed through it to deliver energy that acts on the prostate to either completely or partially destroy it. There are two methods by which laser acts on the enlarged prostate and making way for free flow of the urine.

1. Ablation: Excess prostate tissue is melted away by the laser by using photosensitive vaporization of the prostate. This is also known as Greenlight laser therapy or KTP laser vaporization. Alternately, Holmium can be used as the source of laser energy to ablate the prostate tissue.

2. Enucleation: Excess prostate tissue is cut and teased out through the urethra. Holmium laser is used to resect the prostate into smaller pieces, which are then removed out through a resectoscope. Another technique uses a tissue morcellator which grinds the enlarged prostate into smaller pieces to enable easy retrieval.

More men now opt for laser prostate removal as it has the following advantages:

1. Reduced risk of bleeding: This becomes essentially important in patients who are on blood thinners.
2. No hospitalization: This can be done either as an outpatient or with minimal one day stay at the hospital
3. Immediate symptom relief: As compared to medications, the relief is felt almost immediately after the surgery
4. No catheter: With laser surgery, a catheter may be required for less than 24 hours unlike in open surgical cases.

As noted above, as with any surgery, once enlarged prostate symptoms set in, have a detailed discussion with your doctor to identify if you are a suitable candidate for laser surgery.

Know About Laser Prostate Surgery

Q1. What exactly is Laparoscopy?
Laparoscopy is an alternative to 'Open' surgery wherein the abdomen is opened by tiny 'key hole' incisions and surgery is done. 'Scopy' means the use of an endoscope or telescope to see inside the abdomen. This is attached to a camera and a light source and the inside of the abdomen is projected on to a monitor. The surgeon performs surgery looking at this screen. The surgeon makes a total of 2-4 small cuts on the abdomen ranging from half to 1 cm through which the telescope and other thin surgical instruments are passed into the abdomen. When the uterus is removed , known as hysterectomy, there is also a cut at the top of the vagina where the uterus is attached.
Q2. What kind of gynaecological surgeries can be performed by Laparoscopy?
Most surgeries done in gynaecology can now be performed by Laparoscopy and do not require the large incision as for open surgery. Laparoscopy can be done sometimes only for diagnosis and is called Diagnostic Laparoscopy, as in checking whether the tubes are open or not and to look for any causes of infertility or pain outside the uterus. In women who are unable to conceive, Diagnostic Laparoscopy is often combined with Hysteroscopy (endoscope inside the uterus, inserted from below, via the vagina). When laparoscopy is done to perform some surgical procedure inside the abdomen it is called Operative Laparoscopy. This may be for simple procedures like sterilization, minor adhesions, drilling ovaries; or for intermediate or major reasons like fibroids, endometriosis, removal of ovaries or tubes or both or removal of uterus, for staging of cancers or radical surgeries for cancer. However, about 5% of all surgeries including those for cancer or very large tumours may benefit from open surgery.
Q3. Why does an expert surgeon recommend Laparoscopy over Open Surgery?
Laparoscopic surgery has many advantages above open surgery: the incisions are much smaller (open surgery incisions are 8-10 cms long), therefore pain is much less; requirement for pain killers (which can have side-effects like sleepiness, impaired judgement) is lesser; hospital stay is shorter; complications fewer; requirement for blood transfusions infrequent; recovery in terms of physical, emotional and mental state is much better and quicker; return to work is faster with consequent lesser loss of working and earning days. Surgery with laparoscope is more precise because it is magnified view. Further vision is much better because it's like having your eye behind the structure because you can see with the telescope at places where the surgeon's eye cannot reach.
Q4. If the cuts on the abdomen are so small in Laparoscopic surgery, how do you remove the uterus or a large tumour from inside the abdomen?
Quite often if the tumour is not malignant and contains fluid, it is punctured to collapse it into a smaller size. If it is solid, it can be cut into smaller pieces inside the abdomen using a special instrument. The collapsed or cut structures can be removed gently through the 1 cm cut on the abdomen which may be increased a bit if required. After hysterectomy, the uterus can be removed easily from below, through the vagina.
Q5. Will there be much pain or discomfort after Laparoscopic Surgery?
There may be some pain and discomfort in lower abdomen for one day to few days after Laparoscopic surgery but this is much less as compared to open surgery because the incisions on the abdomen are much smaller and there is much less tissue handling inside the abdomen by fine instruments instead of rough, big, gloved hands which can cause tissue injury in open surgery. There may be some pain in the shoulder following laparoscopy. This is not serious and is due to the gas used in the surgery to make space for instruments.
Q6. When can I be discharged from hospital?
Following Diagnostic Laparoscopy or with simple Operative Laparoscopy you can expect to be discharged from hospital latest by the morning after surgery. In most other cases of intermediate or even major surgery, discharge is generally 1-2 days following the surgery unless there is some health issues prior to the surgery or any complication during the surgery. The complication rates for Laparoscopic surgery are not more than for open surgery and depend upon patient factors like anaemia, diabetes, obesity and skill of the surgeon.
Q7. When can I perform routine household activities or return to work after Laparoscopic Surgery?
Recovery after surgery depends upon many factors: presence of health problems before surgery; why the surgery is required; what surgery is being done; problems or complications of surgery, anaesthesia or blood transfusions. If all is well, one can perform routine household activities by 1 week, provided one doesn't feel tired. Although there may not be any harm, it may be unwise to be normally active within 48 hours of procedure. Following Diagnostic Laparoscopy or Operative Laparoscopy for simple procedures, one can return to work in 1 week. For other procedures, a 2-3 week off from work is reasonable. It depends on the type of work you are returning to. Avoid too rapid return to work if it is manually hard or requires standing for long durations of time. Sometimes a surgical procedure brings on a well needed rest and break from a lifetime of work. Mostly, when you return to work depends upon your own body and its signals of tiredness. You need to listen to those signals.


Know All About Gynae Laparoscopy Surgery

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