The liver has a significant role to play in metabolism and digestion. The failure of a liver can lead to significant health issues. There are some causes for liver failure, which cannot be treated with medications. In these people, a transplant, which is replacing the diseased or injured liver with another liver, is the only definitive treatment option.

Some conditions which can require a liver transplant are:

Severe cirrhosis with a life expectancy of less than a year
Severe liver failure
Non-alcoholic steatohepatitis (NASH)
Liver cancer
Chronic hepatitis C
Biliary atresia in children
Types of transplant:

Living donor transplant: In some patients, partial liver can be removed from a close family member and transplanted into the affected individual. The liver is known for its regeneration ability, and over time, will grow in the recipient.
Cadaveric transplant: Immediately after death, a liver can be removed and transplanted.
While the concept of a transplant sounds quite convincing and appealing for those with a severe liver disease, it is also important to note that not all would qualify for a liver transplant. The conditions which would disqualify a recipient are discussed below:

Significant heart disease: Those with severe coronary artery disease, valvular disease, cardiomyopathy, aortic stenosis, and cardiomyopathy are not candidates for a liver transplant.
Severe lung disease: Those with poor lung perfusion do not qualify for a liver transplant.
Advanced age: Greater the age, lesser the survival rates. So, people aged more than 70 are usually not considered for a transplant.
Obesity: A person with a BMI of more than 35 is often not a good candidate for a transplant. The overall health should be managed in these people.
Malnutrition: On the other extreme, severely malnourished individuals are also not considered for a transplant.
HIV infection: A person who is HIV-infected does not qualify for a liver transplant.
Substance abuse: Anyone who is actively abusing alcohol and/or substances is definitely removed from the list for a transplant.
Metastasis: If a patient is looking for a liver transplant due to hepatic cancer, it is essential that the cancer is contained. If it has spread to various parts, then containing it would be difficult, and a transplant may not succeed.
Multisystem organ failure: Other than heart and lungs, even people with poor renal function are not ideal candidates for a liver transplant.
A detailed liver recipient evaluation assessing the severity of liver disease, chances of survival, and overall health are done before a person is listed for liver transplant. This evaluation ensures a better success rate with the transplant.

Common Surgical Complications That One Should Be Prepared For?

Obesity is a major problem across the world. In India, fast foods and an unhealthy lifestyle have led to widespread obesity as well. While following a proper diet and leading a healthy life can help manage obesity and weight gain in most cases, severely obese people require surgeries to lose weight.

Weight loss surgery, known as bariatric surgery, aims to reduce hunger and appetite in extremely obese people. However, simply undergoing surgery does not guarantee positive results. In fact, the lifestyle changes post-surgery is the most important factor to keep the extra weight off your body.

Recovery post bariatric surgery:

If you undergo a bariatric surgery, your lifestyle changes will depend on the procedure of the surgery. For instance, in laparoscopic bariatric surgery, the recovery period is short. In this surgery, the doctor will make 5-6 very small incisions on your stomach. He will then insert a tube-like equipment with a camera in your stomach and carry out the surgery.

Since very small incisions are made instead of a large cut, you will be discharged within a week. Furthermore, you can return to your normal routine within a month.

Lifestyle changes to follow:

1. Eating healthy: Post the surgery, you will need to follow a low sugar and low-fat diet. If this is a break from your usual diet then you need to get used to this diet, since you will need to stick to it for a long time. Immediately after the surgery, you will need to stick to a liquid diet, so that your stomach can adjust to the food.

Once your stomach starts adjusting to the sudden change, consume soft proteins. You will be able to return to solid foods around six months after your surgery. In the initial six months, it is essential to avoid foods such as white bread, pasta, and potatoes. Furthermore, you need to consult your doctor before consuming certain medicines such as painkillers.

2. Exercise daily:

Exercise becomes vital in your long-term goal of losing excess weight after the surgery. Your doctor will first need to clear you to take part in light activities, which will help enhance your body s metabolism. Joining a gym is helpful in this regard   you will have access to trainers and training equipment to help you exercise correctly. However, make sure to inform your instructor of your surgery before beginning an exercise regimen.

Most people fail to understand that you do not magically lose weight after bariatric surgery. You will need to maintain a healthy lifestyle if you want to achieve an ideal body mass and stay in shape. Therefore, you need to be committed to the procedure for the rest of your life.

Lifestyle After Bariatric Surgery!

Chronic kidney disease or CKD is the decreased function of the function of the kidney for a minimum of three months or more. In this the end stage renal disease usually refers to the end of the kidney function where the kidneys work for less than 15% of what they are supposed to. The kidneys play a vital role in the human body and if they do not function properly then a person can die. The functioning of many organs depends on the kidneys. However, the main function of the kidneys is to remove the products and regulate blood and water, control blood pressure, promote healthy and strong bones, and produce hormones.

Here are 5 facts about kidney disease you should know about:

1. Causes of the kidney disease: There are two main common causes of the end-stage kidney disease. These are preventable causes. These are diabetes and high blood pressure, but then kidney disease can be caused by other inherited diseases such as infection, trauma or polycystic kidney disease.

2. Serious Stages: The kidney disease has five stages and stage 5 is known as the end stage renal disease; this is the point where patients usually need dialysis or kidney transplant to lead a sane life. The stages of kidney disease are:

Stage 1   Slight kidney disease
Stage 2   Mild decrease in kidney function
Stage 3   Moderate decrease in kidney function
Stage 4   Severe decrease in kidney function
Stage 5   End stage renal disease

3. Detection of the disease: Kidney disease is usually difficult to detect because of the presence of very few symptoms. Age, gender along with the blood test is one way to determine information regarding kidney function. The people who are at a risk of getting kidney disease are:

    Over the age of 55 years
    People who suffer from hypertension and diabetes
    Ethnic groups such as Asians, Africans, Americans, Pacific Islanders and Hispanics

4. Signs and Symptoms: CKD is usually considered to be a silent disease and many people don t know that they are suffering from the disease. The signs and symptoms of the disease are:

    Fatigue and weakness
    Nausea, vomiting and loss of appetite
    Dizziness
    Numbness and headaches in hand and feet
    Frequent urination

5. Renal Replacement Treatment: This is the treatment for the end stage of the kidney disease. Dialysis involves the replacement of some part of the lost function of the kidneys and is usually continued throughout life. There are 2 types of dialysis:

    Hemodialysis: This cleans the blood via an artificial kidney which is hooked to the machine
    Peritoneal Dialysis: This removes the excess water and waste products and cleans the blood of the body by using the peritoneal cavity as a filter. 

5 Facts About Kidney Disease You Should Know

Ovarian cysts are common and most women will have at least one during their life. In most cases they do not display any symptoms and are discovered only during routine physical exams and ultrasounds. In most cases, it is nothing to worry about but in rare cases it can lead to complications and hence it is best to get an ovarian cysts checked out by a doctor.

Ovarian cysts usually affect women in their child bearing years. They can be described as fluid-filled sacs that develop in either of the ovaries. In an ultrasound image, these can look like small bubbles. Problems usually arise when these cysts grow larger or rupture. 

In such cases, you may experience symptoms that include:

Pain in the lower abdomen
Painful intercourse
Irregular menstruation
Painful urination and bowel movement
Pelvic pain after exercising
Nausea and vomiting
Bloating
Spotting between periods
Heartburn and indigestion
If the doctor suspects ovarian cysts, an ultrasound is usually used to confirm the diagnosis. A pelvic ultrasound or a sonograph as it is also known is a non-invasive imaging technique that uses high-frequency sound waves to produce images of the body s internal structure. In some cases, an endovaginal ultrasound may also be required. This involves inserting a covered wand or probe into the vagina through which a clearer image of the ovaries can be seen.

If the cyst does not trigger any of the above symptoms, it usually does not require treatment. Instead a pelvic ultrasound may be scheduled after a month to check on the size of the cyst. In most cases, these cysts resolve themselves within a month or two. In the case of larger cysts, a biopsy may be required to rule out the chances of the cysts being cancerous. Birth control pills may be prescribed to address the pain associated with this condition. These pills are also used to stop ovulation and reduce the risk of developing further cysts.

Surgery is considered only if the cyst grows in size or continues to pain. In such cases, surgery can be of two kinds: laparoscopy or laparotomy. Laparoscopy involves the removal of cysts through a telescope like an instrument that is inserted through a small incision made in the abdomen. This is usually used to remove small cysts. Larger cysts and ovarian tumours are treated with a laparotomy. This involves making a bigger incision in the stomach and may also involve the removal of the ovaries, fallopian tubes and uterus depending on the tumour. 

Ovarian Cysts - 9 Symptoms About It!

Cover small intestine is very significant in maintaining proper digestive health by jogging nutrients are fluids that be eat or drink. Yourself in delivering the waste products in the large intestine. This surgery which is the small bowel resection is done to remove part or the entire small bowel. This is basically done when part of our small bowel as blockage or when the diseased.

Importance of intestinal surgery or small bowel resection
There are several conditions which may affect our small bowel. Generally your doctor might advise you to remove a portion of your small bowel but in some cases a portion of your small Bible might have to be removed to confirm that a disease have been ruled out if tissue diagnosis might be required. Some situations where you may require surgery involves:

Severe ulcers that develops in the small bowel leads to bleeding and in some cases infection also
A situation where there is either a congenital blockage in the intestine or maybe from a scar tissue
Cancer is an obvious option
Some injuries to the small bowel is an obvious situation
In some cases there may be a pocket of intestines present there since birth
Several diseases which cause inflammation in the small bowel
Risks Involving Small Bowel Resection
It is very obvious that any kind of surgery has some potential risks so does the small Bowel resection, which includes which includes:

There maybe some difficulty in breathing
Infections are very common
There might be some damage in the structures surrounding it
There maybe case a of heart attack
Abnormal bleeding
Bleeding resulting in blood clots
Pneumonia
Bleeding in the stomach area
The abdomen might start collecting pass which is known as intra abdominal abscess
If the intestinal blockage is formed by a scar tissue then it requires more surgery
They might be problems while absorbing the vitamins and nutrients which is commonly known as short bowel syndrome
Due to some infections diarrhoea is always a frequent risk.
A Long-term Outlook after small bowel resection A majority of people have recovered well from the surgery. You can definitely resume your normal day to day activities even if you had ileostomy and you are required to carry a drainage bag. Diarrhoea might still be a concern for you if you had a big section of your bowel removed and you still might have problem in digesting foods. Inflammatory diseases might still require for the medication.

Intestinal Surgery - Know The Risks Involved!

GERD is a digestive disorder that affects the lower esophageal sphincter, which is the ring of muscle between the esophagus and stomach. Gastroesophageal reflux is the backward flow of acids from the stomach into the esophagus. Doctors believe that some people usually suffer due to a condition called hiatal hernia. Pregnant women usually suffer from heartburn or acid indigestion caused by Gastroesophageal Reflux Disease.

The primary goals in the treatment of this disease are relief from symptoms, healing of erosive esophagitis and prevention of complications of esophagitis. The symptoms include heartburn and regurgitation. The setting includes a proton pump inhibitor (PPI). Patients suspected due to GERD with non-cardiac chest pain are recommended to have diagnostic evaluation before institution of therapy. For diagnosing GERD, barium radiographs should not be used.

The other points that must be remembered to diagnose GERD are
1. Endoscopy is recommended only in case of alarming symptoms. Even in typical symptoms, the upper endoscopy is not recommended.
2. For preoperative evaluation, esophageal manometry is recommended, but it has no role in diagnosing GERD.
3. Ambulatory reflux monitoring is a test that can assess association of reflux symptoms.

Management:
The suggested lifestyle modifications for the patients with GERD are

    Weight loss is recommended for patients who are overweight. So, avoid large meals and decrease dietary fat intake.
    Avoid alcohol, chocolate, onions, garlic, acidic foods and peppermint.
    Do not lie down within 3 to 4 hours after meal (recommended for nocturnal GERD patients).
    For symptom relief and to heal erosive esophagitis, a 8-week course of PPIs is the therapy of choice.
    Medications that help in potentiating GERD symptoms, including alpha-adrenergic agonists, nitrates, calcium channel blockers and theophylline should be avoided.
    For patients without diagnostic evaluation, therapy for GERD other than acid suppression, including prokinetic therapy should not be used.
    For patients with partial response to PPI therapy, additional symptom relief can be achieved by increasing the dose twice daily or switching to a different PPI.
    It is recommended to elevate the head of the bed 10 to 20 cm.
    Avoid wearing clothes which are tight around the waist.
    If patients experience heartburn relief, Histamine-receptor antagonists (H2RA) therapy can be used as a maintenance option in patients without erosive disease.

Some surgical options
1. For long-term therapy for patients suffering with GERD, surgical therapy is the best treatment option.
2. In patients who have no evidence of erosive esophagitis, preoperative ambulatory pH monitoring in mandatory.
3. Gastric bypass is the preferred operation for patients who are suffering with obesity and are contemplating surgical therapy for GERD.

Apart from these, there are potential risks that are associated with PPIs such as switching them can be considered in setting of side effects and the therapy can be a risk factor for Clostridium difficile infection.

Management of Gastroesphageal Reflux Disease (GERD)

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