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!

Gastroesophageal reflux disease or GERD is a chronic condition that can cause discomfort and a burning sensation in the chest. This is caused by stomach acids or bile that flows backward into the food pipe. If this happens more than twice a week, the patient may be diagnosed with GERD. Mild cases of GERD may be treated with lifestyle changes, antacids, diet changes and proton pump inhibitors. In more serious cases, surgery may also be needed. This aims at repairing or replacing the lower esophageal sphincter (LES). This valve is responsible for the backward movement of acids from the stomach to the food pipe.

Types of Surgery for GERD
Surgery is usually the last option for doctors treating GERD. This relieves symptoms of GERD and eliminates the need for long-term medication. There are many different types of surgical treatments. Some of the factors that determine the best type of surgery suited to a patient include the patient s age, weight, overall health etc.

Fundoplication: This surgery focuses on tightening the LES. Fundoplication may be performed as an open surgery or as a laparoscopic surgery. In both cases, the stomach is wrapped around the lower esophagus to reinforce and strengthen the LES. Fundoplication is the most common surgical procedure used to treat GERD and has a high success rate.
Stretta Procedure: This is an outpatient procedure that is performed using an endoscope. The doctor will pass a thin tube with an electrode at one end down the patient s esophagus. The electrode heats the tissue in the esophagus and makes tiny cuts. These cuts will then form scar tissue that strengthens the muscles surrounding the esophagus and blocks acid reflux. This is a fairly new procedure and hence the long-term results are still not clear.
Bard EndoCinch System: This procedure is not very common. It involves the use of an endoscope that is used to make stitches in the esophagus so as to create pleats in the LES. This helps strengthen the valve and prevent acid reflux.
Linx Surgery: This is a minimally invasive surgery where a special device called a linx is wrapped around the LES. A linx can be described as a small ring of magnetic titanium beads. This ring allows food to pass through but otherwise keeps the opening between the esophagus and stomach closed. Linx surgery is a relatively new procedure that has shown good results.
Recovering from Surgery for GERD
Recovering from surgery for GERD depends largely on the type of surgery undergone. Laparoscopic procedures have a short recovery time and are associated with less pain as compared to traditional open surgeries. Open surgery usually takes 2 weeks for full recovery while a patient may recover from laparoscopic surgery within a week.

Surgery For GERD - Types, Results and Recovery

Following are some common Gall Bladder and Biliary Disorders. Read on to know in brief about them. 

1. Gall stones: Gall stones also known as cholelitiasis is a condition in which gall bladder contains stones or calculi. Usually, these stones are asymptomatic and do not cause any trouble to the patients. Few patients experience recurrent right upper abdominal pain. This condition is known as biliary colic and if it persists, the patiet is adviced gall bladder removal surgery. Sometimes the patient presents with severe right upper abdominal pain with fever and deranged Liver function tests. This condition is known as acute cholecystitis. The surgery is minimally invasive and is called Laproscopic cholecystectomy. If there are dense adhesions, the surgeon may plan to convert the surgery to open cholecystectomy. The patient is usually discharged by day 3 of surgery.

2. Common bile duct stone or choledocholithiasis: Occasionally stone from the gall bladder slips into the common bile duct (CBD stone).This causes obstruction of the bile duct causing Fever, abdominal pain and Jaundice. This is called Cholangitis and is a medical emergency. The patient requires urgent hospitalisation and decompression of the bile duct by inserting a plastic stent in the CBD with the help of ERCP. Severe untreated cholangitis can be life threatenig.CBD Stones which are detected because of dull aching abdominal pain, deranged liver function tests or by ultrasonography also need removal. The CBD stone is removed by an endoscopic modality called ERCP, which is minimally invasive and needs no surgery.

3. Bile duct cancer or cholangiocarcinoma: Cancer of bile duct usually occurs in the elderly patients who present with gradually progressive jaundice. Because of the obstruction to the flow of bile, produced in the liver, the patient develops jaundice. Gastroenterologists examine the patient and CT scan abdomen with MRCP is required to fully evaluate the stage and extent of the tumour. The treatment is multimodality and requires the expertise of Radiologists, Surgeons, Oncologists and gastroenterologists. The Gastroenterologists can help in decreasing Jaundice by inserting plastic or a metal stent (SEMS self-expanding metal stent ) in the common bile duct. These are very aggressive tumours and very few patients are fit for surgery. Survival is very low for these tumours.

4. Gall bladder cancer: Gall bladder cancers are very aggressive and lethal cancers. The patients present with obstructive Jaundice and Itching all over the body. Definitive treatment is surgery but very patients present in the early stage. Advanced stage cancers are treated with palliative intent by metal stenting (SEMS for cancer of gall bladder) to reduce jaundice.

Learn More About Gall Bladder And Biliary Disorders!

The kidneys are two small organs located in the abdomen. The main function performed by these organs is filtering of the blood. Kidneys help remove waste from the blood which they turn into urine so that it may be excreted from the body. In doing this they also help regulate blood pressure, maintain the production of red blood cells, and sustain the electrolyte balance. When the kidneys do not function properly, the results could be fatal. 

Hence, it is important to be able to recognize the early signs and symptoms of Kidney failure.

Tiredness: A decrease in kidney functioning can cause toxins to build up in the body and blood. This can make a person feel more tired than usual and keep them from concentrating on simple tasks. Kidney failure is also associated with anemia which can also contribute to fatigue.
Trouble sleeping: Chronic kidney disease has been linked to obesity and sleep apnea. Both these conditions can make it difficult for a person to fall asleep and stay asleep. The buildup of toxins in the blood can also contribute to insomnia.
Dry skin: The skin is one of the first organs to show signs of internal organ failure. Thus, when the kidneys stop functioning as well as they are supposed to, the skin turns dry and itchy. This is because the production of red blood cells is reduced and the amount of minerals or nutrients in the body is unbalanced.
Increased urge to urinate: An increased urge to urinate frequently especially at night could be a sign of kidney disease. This may also be a sign of a urinary infection.
Blood in the urine: Urine should ideally be clear and pale yellow in color. Seeing blood mixed with urine should never be ignored. This is a sign that the kidneys have been damaged and blood is leaking into the urine. It could also be a sign of kidney stones, an infection, or a tumor in the kidney.
Foamy urine: Excessive foam in the urine that does not go away even after flushing could be a sign of protein in the urine. This foam may look similar to a beaten egg white as it is produced by albumin; the same protein present in eggs.
Swollen ankles: Swollen ankles are a sign of sodium retention. This is caused by the improper filtration of blood by the kidneys. The patient may also notice his or her feet getting swollen.

Kidney Failure - Recognising The Early Signs!

Obesity can shorten your lifespan by decades and also limit and reduce the quality of your life. Obesity cannot always be controlled by dieting and exercise and thus more complicated means such as bariatric surgery has to be employed.

Types of bariatric surgery
Most bariatric surgeries either limit your ability to consume food and thus make you feel fuller quickly or limit the absorption of nutrients from the food you eat. Certain surgeries use a combination of the two in varying degrees. Mentioned below are the most commonly employed forms of bariatric surgery  

Gastric Balloon   This is a form of surgery wherein a specially made balloon is inserted into the stomach. In certain cases even two balloons are inserted into the stomach to reduce the room left for food. This causes you to have less food resulting in weight loss over a period of time.
Gastric Sleeve   This is a form of surgery wherein a major portion of the stomach is removed through the procedure. Also known as Vertical Sleeve Gastrectomy, the surgeon creates a pouch within the stomach which essentially becomes a connecting tube between the esophagus and the large intestine. The reduced stomach size causes fewer hunger related enzymes and hormones to be secreted, causing less hunger and also reducing your food intake capability. This results in weight loss over a period of time.
Gastric Bypass   Gastric bypass uses the combination of two techniques, lesser absorption of minerals as well as reduced intake capacity. In this method, a part of the stomach is rearranged akin to the gastric sleeve. However the leftover portion of the stomach is not removed as it can continue to secrete stomach acids. Because of the reduced size of the stomach, you would eat less and if you happen to over eat, it would cause dumping syndrome (quick and repeated bowel evacuation) which would deter you from eating more.
Lap band surgery   This is one form of surgery where the stomach is not reduced or cut but rather limited by a band that is put around it. This band constricts the stomach and causes the upper part to become smaller. Hence you would feel fuller from eating less, thus resulting in weight loss.
V-bloc therapy   This is a very modern approach to bariatric procedures which works in a very similar way to a pacemaker. A device is placed just under your skin and two leads or wires are connected to the vagal nerve. This nerve is responsible for sending the hunger signals to the brain from the stomach. This device acts as a block to the nerve signals and thus ensures you eat less.
Duodenal switch   This surgery is also known as a Biliopancreatic Diversion wherein the surgeons cut out the part of the stomach similar to a gastric sleeve surgery but also make adjustments to the pancreatic chain and the small intestine to reduce the absorption of minerals.

6 Types Of Bariatric Surgery You Can Think of!

Ovaries are a part of a woman s reproductive system. The primary function of ovaries include producing  ova  or eggs and secreting hormones such as progesterone and estrogen. Cysts are fluid filled sacs that form the ovaries; they usually do not cause any symptom and are not painful.

There are primarily two types of ovarian cysts:

1. Follicle cysts: During a woman s menstrual cycle, the egg develops in a sac known as the follicle. Under normal circumstances, the sac breaks open and releases the egg. When this doesn t happen, fluids start accumulating in the follicle to form a cyst.

2. Corpus luteum cysts: Follicle sacs dissolve after releasing the egg, but in some cases, these sacs remain and the opening of the sacs gets sealed. It again results in fluid accumulation, leading to the formation of corpus luteum cysts.

Symptoms

Usually, cysts do not cause any symptom. If the size of the cysts increases, they may cause symptoms such as stomach pain, pain during bowel movements and sex as well as pelvic floor pain. The breasts may become tender and one may experience rapid breathing. Other symptoms of ovarian cysts are fever, nausea and dizziness. Usually, rupturing of a cyst leads to these symptoms surfacing; hence you would know when exactly to call the doctor.

Treatment

The treatment options for ovarian cysts are:

Laparoscopy: Laparoscopy is carried out if the cysts are small in size. An incision is made close to the navel, through which an instrument is inserted to get rid of the cyst.
Birth control pills: For chronic ovarian cysts, oral contraceptives are prescribed to stop the ovulation process in order to arrest the formation of cysts.
Laparotomy: In case of large cysts, this procedure is recommended. A relatively bigger incision is made in the abdomen, through which the cyst is removed.
Ovarian cysts, if left untreated, can certainly cause infertility. Pre-menopausal women and who suffer from frequent hormonal imbalances in the body are the most vulnerable to this condition.

Ovarian Cysts - 3 Ways it Can Treated

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