Over the past several years, the prevalence of GERD (Gastro-oesophageal reflux disease) has increased in our communities due to unhealthy lifestyle and that can potentially lead to serious medical complications if left untreated. 

GERD is characterized by symptoms and/or tissue damage that results from repeated or prolonged exposure of the lining of the esophagus to acidic contents from the stomach and occurs when the lower esophageal sphincter (LES) does not seal off the esophagus from the stomach.

The two most frequently reported symptoms of GERD are heartburn, which can be described as a burning discomfort that begins behind the breastbone and radiates to the neck and throat, and acid regurgitation, which is characterized as a bitter, sour tasting fluid. One out of five people experience heartburn or acid regurgitation on a weekly basis and two out of five people experience heartburn or acid regurgitation at least once a month.

However, some patients may present with atypical symptoms such as a cough, asthma, laryngitis, or chest pain, and other patients with GERD experience no symptoms at all. 

Causes

1) Eating food while not feeling hungry
2) Eating in haste and in indigestion
3) Eating stale food
4) Eating spicy, hot  & tangy, fermented, stale food on a regular basis.
5) Excess consumption of tea, coffee
6) Sleeping immediately after meals
7) Drinking alcohol & smoking in excess
8) Mental stress
9) Staying awake at night, disturbed
sleep
10) Eating late at night.

Signs and symptoms:

Difficulty in swallowing
Regurgitation of food
Belching
Bitter taste in mouth
Discomfort or pain in upper abdomen
Dry cough
Anorexia ( loss of appetite )
Excessive thirst
Heartburn especially after meals and at night
Loss of taste
Nausea & vomitting
Bloating
Giddiness
Treatment in Ayurveda focuses on:

1) Improving appetite
2) Help nourishment of body
3) Regulating the acid metabolism in the body
4) Improve the ability of digestion & absorption
5) Treat inflammation and cause healing of the digestive tracts
6) Protecting the intestinal layers from ill effects of acid 

Do's & Don'ts for GERD:

Do's

1) Eat light to digest food
2) Eat only when one is hungry
3) Gap between two meals should not be more than 6 hrs
4) Eat fruits  daily 
5) Food good for GERD - Old caged rice, Jowar roti, Moongdal, Bittergourd, pumpkin, dates, pomegranate, Indian gooseberry,  Lemon, mint, mangosteen, turmeric, coriander, cumin, asafoetida, coconut, cowghee, cow milk, fresh buttermilk .
6) Drink lukewarm water half hour after meals
7) Walk after every meal
8) Daily exercise for atleast 45 min

Dont's
1) Very spicy & hot, excessive consumption of chillies & curd
2) Excess tea, coffee & fermented food
3) Excess stress & negative thinking
4) Sedentary lifestyle
5) Excess smoking & drinking
6) Drinking excessive water 
7) Sleeping immediately after meals
8) Sleeping in the afternoon
9) Staying awake late night

Symptoms of GERD are very commonly found in the population. If it is not taken care of, it can lead to complications like Barrett's oesophagus, oesophagitis, ulcers, Ca oesophagus, bleeding, scarring and difficulty in swallowing. Ayurveda has a complete holistic approach in treating GERD. Treating on time helps in avoiding complications in future.

Gastroesophageal Reflux Disease And Ayurveda!

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!

Colon cancer is a medical condition where malignant cancerous growths mainly originate in the colon or the large intestine. Believed to be the sixth most common type of cancer prevalent in India (As per the Rajiv Gandhi Cancer Institute & Research Centre), the colon cancer can metastasize and affect the other healthy body parts and organs.

The symptoms that may be indicative of colon cancer include:

Irritable Bowel Syndrome.
A person may suffer from anemia (triggered by iron deficiency).
Rapid and unexplained loss of body weight.
There may be rectal bleeding (blood may also appear in the stool). There may also be pain and discomfort during the bowel movement.
A person may experience extreme weakness and fatigue.
Frequent diarrhea or constipation.
A person may complain of abdominal pain and cramps.
There may be a change in the consistency of the stool.
Unfortunately, in most cases, the symptoms associated with colon cancer may not appear in the initial stages, thus complicating the situation.

Prevention and management of Colon Cancer
A little alertness on your part can help to prevent colon cancer.

Regular health checkups and screening: Whether the symptoms appear or not, health check-ups at regular intervals are a must. In addition to preventing colon cancer, regular health check-ups can also help to avert a host of other health complications. The screening tests for colon cancer are necessary for people who have a family history of colon cancer and also those who are above 50 years of age. The various screening tests for colon cancer include:
Colonoscopy (used to examine the inside of the colon for any abnormalities).
Fecal Occult Blood Test (FOBT)/Fecal Immunochemical Test (FIT) (These tests are carried out to detect the presence of blood in the feces).
The screening may also be done using Virtual Colonoscopy or Flexible Sigmoidoscopy.
Forget the unhealthy lifestyle habits: Smoking and drinking (excessive) can be the chief contributors triggering colon cancer. Limiting your alcohol intake and quitting smoking will not only keep you healthy but also keep colon cancer at bay.
Shed the extra pounds: The harmful effects of obesity are known to all. Obesity is considered to be one of the underlying factors that can trigger a colon cancer. A healthy body weight can go a long way in preventing colon cancer and keep you fit and active. Minimum 30 minutes exercise daily is all that you need to stay fit and healthy.
Make healthy changes in the diet: If you want to prevent colon cancer, make your diet as healthy as you can. Enrich it with fruits, vegetables and food items that are rich in fibers, minerals, vitamins, and antioxidants. Dietary fats (red meat or any other processed meats) are a strict no. Choose whole grain products over refined ones.

Colon Cancer - How To Prevent It?

You will definitely face many complications after a hernia surgery, but certain measures can lead you to a speedy recovery. Your main aim must be to ensure you don t get any infection. Avoid any jerking like sneezing or coughing. Some of the tips for speedy recovery are mentioned below:

Apply ice to reduce pain: If you experience any form of swelling or pain, ice will help reduce it. Apply ice for 10-20 minutes in a day, and you will get your results. However, refrain from applying ice for too long. It might make the condition worse. Also, wrap up the ice in plastic or a piece of cloth and then apply it to the intended portion.
Take regular medication: Patients experience fever and pain after a hernia surgery. To combat these, you can take prescribed medications from your doctor. Medications also aim in improving your immunity so that you do not get infections easily. Hence, the medications are not to be missed.
Keep your wounds clean: The operated area must always be kept clean to prevent any form of infection. You must dress the wound daily and keep the incision points clean and dry. Change the dressing as your doctor has advised you to do. You can apply any antiseptic or any other cream but take your doctor s permission first.
Keep a pillow near you: When you get an urge to sneeze or an urge to a cough, just cover your incision with the pillow and do it.
Maintain a proper diet: A proper diet plays a significant role in the recovery process. Consume fruits to replenish your storehouse of nutrients. Include high-fiber food in your diet so that you don t have to suffer from constipation. You need to avoid constipation as much as you can. If food doesn t work, you can take stool softeners. Constipation will lead to extra pressure on the cuts which can lead to bleeding.
Wear loose clothing: Don t wear tight pants or clothing that will stick to your skin. The waistbands must be loose and not tight.
Avoid lifting weights: Don t lift weights. Lifting weights will cause stress at the cuts and may even lead to rupture so avoid doing strenuous activities.
Go for a small walk: As soon as you feel a bit better go for a little walk. You need to move your muscles otherwise they will become stiff.
Don t smoke: Avoid smoking after the surgery as it will hamper your breathing and circulation process.
Check out for warning signs: Always keep an eye on your wounds. Report to your doctor as soon as you see bleeding or anything abnormal.
Follow the tips mentioned above, and you will see how fast you will recover.

Hernia Surgery - 10 Effective Tips For Speedy Recovery!

A hysterectomy is an operation to remove the uterus and, usually, the cervix. The ovaries and tubes may or may not be removed during this procedure, depending on the reasons for the surgery being performed. If the ovaries are removed, you will commence menopause. A hysterectomy is a major surgical procedure with physical and psychological consequences.

Why is a hysterectomy performed?

Common reasons include painful or heavy periods, pelvic pain, fibroids or as a part of therapy for cancer. You should have a clear understanding of your reason for this surgery.

How is this done?

The procedure is normally performed under a general anesthetic and takes approximately one hour. To commence your anesthetic a drip is inserted into your arm. Once you are asleep, you will have a urinary catheter inserted. The importance of the catheter is to reduce the size of your bladder, keeping it away from the operation site and reducing the risk of complications.

There are three ways to remove the uterus:

Vaginal hysterectomy - The removal of the uterus and the closing of the wound is performed through the vagina. There is no cut in the abdomen. 
Laparoscopic hysterectomy - About four small keyhole cuts are made in the abdomen to divide the attachments of uterus, ovaries, and tubes in the pelvis. The uterus is usually then removed through the vagina.
Abdominal hysterectomy - The uterus is removed through a cut in the lower abdomen. The cut is about 15 20 cm in length and runs across your abdomen, usually below the bikini line. Less commonly, it may be necessary to have a cut that runs from the belly button down to the pubic area.
What are the risks of undergoing this procedure?

Although the risks associated with hysterectomy are low, you should be aware that every surgical procedure has some risk. This may also depend upon the type of surgery you have. 
Severe bleeding from large blood vessels around the uterus or top of the vagina. This is not common. A blood transfusion may be required to replace blood loss. A vaginal pack may also be used to control the bleeding.
Infection in the operation site, pelvis or urinary tract.
Nearby organs such as the ureter (tube leading from kidney to bladder), bladder or bowel may be injured expected to happen to approximately one in every 140 women. Further surgery will be needed to repair the injuries.
The bowel may not work well after the operation; this is usually temporary. Treatment may include a drip to give fluids into the vein and no food or fluids by mouth.
Things to do before you come to the hospital

It is important for you to have all the tests ordered at your outpatient clinic appointment completed prior to coming to the hospital these include blood tests and an ECG and chest X-ray, if you are more than 50 years old

You may be required to have a bowel preparation, which will empty your bowel prior to the surgery.

You should stop eating and drinking at the following times on the day of your surgery unless otherwise notified

At midnight if your procedure is in the morning

At 6 am if your procedure is in the afternoon.

You will need to shower and dress in clean clothes prior to coming into hospital. It is important that you do not shave your operation site as this increases the risk of wound infection.

Please remove all body jewelry.

After your surgery

When you wake from the anesthetic, you will be ready to be transferred, in your bed, for recovery.

Having an anesthetic can make you feel sick and may cause vomiting. You will have a drip in your arm which is necessary to maintain fluid intake and provide pain relief. This will remain in until you can tolerate food and fluids and your pain control is changed to oral medication.

Your nurse will take frequent observations of your vital signs e.g. temperature, pulse, blood pressure.

You may have small amounts of water or ice to suck, then progress from fluids to a normal diet as tolerated.

If you have pain or nausea, please tell your nurse. Effective pain management is important.

You will have a urinary catheter in place. The catheter will normally be removed the day following your surgery.

Recovering at home

What to expect

You may have a blood-stained vaginal discharge which is similar to a light period. This will gradually reduce to nil over 4-6 weeks as your internal wounds heal

You may need to take some simple analgesia for pain/discomfort, especially on waking and settling at night

You may feel fatigued

You may require up to four to six weeks off work. You should have returned to normal activity by two to three months, depending on the type of surgery, although full recovery may take longer

After the operation, you will no longer have a period

For the majority of women, hysterectomy surgery does not have a negative effect on sexual function

What to avoid

For the first two to three weeks lift nothing greater than two kilograms. Increase gently as tolerated over six weeks.

It will take about three weeks before you should drive a car. Only when you know you can act confidently with emergency breaking should you attempt driving the car.

Avoid sexual intercourse for six weeks to allow healing to take place.

Avoid inserting anything into the vagina for six weeks to allow time for healing to take place (e.g. use sanitary pads and not tampons).

It is important to avoid constipation and straining immediately after your surgery as this will assist healing and improve your comfort.

Contact your doctor if you develop any of the following complications:

Your wound becomes red or inflamed, painful.

You have heavy vaginal bleeding heavier than a normal period.

You have offensive vaginal discharge.

You develop a fever i.e. temperature of about 38  C, or you are feeling unwell.

You have pain that is not relieved by simple analgesia.

You are having difficulty passing urine or opening your bowels.

 In case you have a concern or query you can always consult an expert & get answers to your questions!

Surgery For Womb Removal - What You Need To Be Aware Of?

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 !

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