Bariatric surgery is unlike other surgeries, as its effects are not instant but gradual and are seen over the months. Like any other surgery, it is not without complication. But again unlike all other surgeries, the complication rate can be negligible if a strict protocol is followed. Moreover, the factors like technology advancements, development in the field of advanced laparoscopy, enhanced skillset of the bariatric surgeon, dedicated management of bariatric and metabolic surgeries by bariatric surgeons, play a vital role in the reduction of complication rate which eventually results in safe surgery.

As the procedure is done laparoscopically, the pain is just for a day and is minimally managed by analgesics.

The fear of increasing incidence of incisional hernias while operating an obese patient is so negligible or nil, as the procedure is performed through tiny key holes and all precautions are taken to suture the sheath through which the ports are put to perform the surgery.

Reduced hospital stay and early resuming to work is one of the biggest benefits of this laparoscopic bariatric procedure.

Sometimes, problems that may be faced are:- 

Post-operative bleeding: Normally, this a nearly bloodless surgery involving 5 to 10ml loss of blood. However bleeding from the staple edges is known, but this can be managed well by the surgeon, by choosing the right size of the cartridge as well the right technique of application of the cartridge.

Dehydration: We are normally accustomed to drinking water at long intervals (a few hours) as we can consume nearly 200 to 400ml at one go. Following bariatric surgery, gulping or drinking water in one go is not possible in the first 2 to 4 weeks, due to reduced capacity of the gastric pouch. Hence, care needs to be taken to drink small quantities of water at frequent intervals to avoid dehydration. This is possible only if the patient is counselled about this prior to surgery and is fully aware of this. Also, the patient needs to be given good and clear post operative instructions regarding the quantity and frequency of liquid consumption, not forgetting the type of liquids. Coffee taken frequently could be another cause for dehydration. Family members and colleagues and friends at work play a major role in reminding tthe patient about consuming water frequently. Special care needs to be taken in people who are not accustomed to consuming adequate quantities of water prior to surgery as a general habit.

Vomiting/Fullness/ Discomfort/Indigestion: Following bariatric surgery, soft food is introduced in the diet in the third week, after the first 2 weeks of taking liquids. Due to the reduced capacity of the gastric pouch, the morsel size is significantly reduced and one has to chew the morsel well and eat slowly, giving a gap of 40 to 50 seconds between the morsels. This prevents distension or overdistension of the gastric pouch and thus avoids vomiting. This again requires good counselling prior to the surgery and on the follow up visit too before stating soft food. There is a subjective difference when we say small morsels and we cannot reach a standardization as the morsels size of each individual varies prior to the surgery itself. The best way to avoid this confusion is to make the person have the first soft food meal before you where in you can physically show the way food is expected to be eaten. However, by mistake, there is a chance that one can have a regular sized morsel as over years one is used to eating in that manner. If this happens, the person will vomit , and this will be a reminder to gauge the morsel size the next time the person eats. Following the vomiting, there could be a burning sensation in the stomach which will subside afer taking an antacid. If one follows the instructions of small morsel size, chewing properly and eating slowly, there is no chance that there will be vomiting. Another reason for vomiting could be keeping the stomach empty for a longer duration or having sicy food on an empty stomach. Avoid nuts, seeds, fried foods and processed foods. Very rarely vomiting could be due to reduced size of the joint between the gastric pouch and the small intestine. This could require an Endoscopy and necessary treatment.

Vitamin and mineral deficiency: It is seen that many of the obese patients are seen to have vitamin B12, vitamin D, iron and protein deficiencies in their blood tests that are done prior to surgery. With the significant reduction in the amount of food consumed after bariatric surgery, the existing deficiencies are bound to increase. Hence, it is necessary to do these tests, before surgery and rectify the deficit prior to the surgery.  

Gall bladder stones: Significant weight loss which is consistant over a short duration could lead to the formation of gall bladder stones, be it with or with out surgery in a small percentage of patients. To avoid this there are two schools of thought, one is have a prophylactic removal of the gall bladder along with the bariatric surgery and another is to put the patient on ursodeoxycholic acid (a tablet) for the first few months after surgery during which there is significant weight loss.

Skin sagging: In the morbidly obese, when the skin is overstretched beyond a certain point, it tends to sag once significant weight is lost. This sagging is influenced by a number of factors like age of the patient, the BMI, pre existing sagging, pre-existing muscle tone and protein supplements taken during weight loss and exercises done during the weight loss period. Skin sagging is less if the age is less than 45, BMI less than 45, good protein intake during weight loss and good toning exercises done during the weight loss period.

Hairfall: Significant weight loss either by diet and exercise, aerobics, bariatric surgery, will entail hair loss. But this can be minimised to a greater extent by ensuring good protein intake during the weight loss period and adequate supplements in terms of vitamins and minerals.

Dumping syndrome: With a reduced size of the stomach, the food moves from the stomach into the smaller intestine much faster. This causes the pancreas to release excessive amount of insulin, leading to very low blood sugar levels , producing various symptoms like abdominal cramps, bloating, diarrhoea, sweating, dizziness, nausea, weakness, and anxiety. This is managed by eating less amount of sugars and fats and spacing out the meals through the day, having four to five small meals compared to  2 to 3 large meals. Having a high protein diet and avoiding liquids during meals is also an option.

Bariatric Surgery - Know Problems Of It!

Obesity is a medical condition where the body accumulates excess fat to the extent that it adversely affects your health. People having a Body Mass Index (BMI) equal to or greater than 30 are considered obese. BMI is the measure of your body fat based on your height and weight. While some people may have a genetic background of being obese, others may gain excess weight due to underlying health conditions.

What causes obesity?
People who do not take part in physical activities or exercise on a regular basis are prone to excess weight gain. Those who have a family history of obesity are likely to be obese. Consumption of high-fat and high-calorie food like processed/fried food, pulses, rice, potatoes, red meat etc. Lack of sleep and sedentary lifestyle also play a huge part in unhealthy weight gain. As you age, your body undergoes many hormonal changes and loses muscle mass as a result of which metabolic rate becomes slower. This makes it easier for you to gain weight. A number of medical conditions like Polycystic Ovary Syndrome (PCOS), diabetes, hypothyroidism (underactive thyroid gland), Prader-Willi Syndrome etc also cause your body to gain excess weight.

What are the symptoms of obesity?
People who are obese, experience symptoms such as- tiredness, fatigue, exhaustion, shortness of breath, increased sweating, inability to keep up with physical activities etc. These symptoms, if not paid attention to, can lead to serious health issues such as sleep apnea, heart ailments, high blood pressure.

Role of homeopathy in treating obesity-
Homeopathy can proficiently manage the symptoms of obesity, and also prevent the condition from relapsing. Homeopathic remedies are extracted from different plants, herbs and natural substances that are absolutely safe for you. This branch of medicine attempts to improve your metabolism, correct your digestive system and easily eliminate waste products- which are the three basic prerequisites for weight loss. Homeopathic medicines, unlike conventional medications which restrict nutrient absorption and promote a feeling of fullness, aim to cure the symptoms responsible for excess weight gain naturally. The homeopathy component most commonly used to treat obesity is impure calcium derived from the middle layers of the shells. Homeopathic components like Clubmoss plant extract and sodium chloride are prescribed to those who have excess fat accumulated in the buttocks and thighs.

One major advantage of homeopathy is that they are non-addictive, and can be adopted by people even when they re on other conventional treatment medications.

Obesity - How Homeopathy Can Help?

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!

Adrenal cancer is a rare and aggressive disease that causes abnormal cell growth inside the adrenal cortex. This cancer usually appears as tumors at the outermost layer of the adrenal glands and gradually develops cancerous cells. In the majority of the cases, adrenal cancer is diagnosed only after it has been growing for several years.

Symptoms
While most of the adrenal cancer patients have the common symptoms, often some people feel just fine, unless until their doctors find the presence of cancerous cells in the adrenal cortex through CT scan. Generally, the symptoms of this life-threatening disease depend on three factors, which are:

The particular type of overproduced hormone
The tumor producing hormones excessively
And, type of the tumor
However, it is the overproduction of particular hormones, that makes the majority of the symptoms visible. Below are the common symptoms of adrenal cancer, depending on hormone types that are overproduced during the presence of this disease.

Symptoms of cortisol overproduction
When the presence of adrenal cancer leads to excess production of the cortisol hormone, people start experiencing different types of symptoms. The accumulation of fat behind the shoulders and neck, gradual weight gain in the stomach and chest portions irregular periods, and hair growth on the chest, face and back (in women) are the most prominent ones. One can also suffer from depression, weakness in legs, and easy bruising as other signs of cortisol overproduction.

Symptoms of aldosterone overproduction
As a result of the overproduction of the aldosterone hormone, people generally have feelings of excessive thirst, feelings of tiredness and weakness and sometimes high blood pressure. The desire of urinating frequently and painful muscle cramps too become evident due to the excessive production of aldosterone.

Symptoms of testosterone overproduction
When as a result of malignant tumors in the adrenal cortex the production of the testosterone hormone goes to higher than normal levels, it is considered to be overproduction. The voice becoming deeper, excessive invasion of acnes, irregular periods become prominently visible symptoms of this kind of adrenal cancer. Even, excessive growth of body hair or the facial hair and heightened muscle mass are some of its common symptoms.

Symptoms of estrogen overproduction
The growth of the breast in males and the early puberty in females are the most common symptoms of adrenal cancer where the malignant tumors overly produce estrogen hormone. Even decreased sex drive or impotence in males can be considered as its other serious symptoms.

Apart from the above mentioned adrenal cancer symptoms, in some cases, the adrenal tumors become so big that they start pressing the nearby organs which leads to signs of abdominal pain or feelings of fullness in the belly. The moment one identifies having any one of the signs discussed here, he or she should look for medical attention immediately.

Adrenal Cancer - What Are The Symptoms?

GERD or acid reflux is caused by the regurgitation of acidic liquid stomach contents back up into the esophagus. It is a long-term condition where stomach contents come back upwards from the gastro-intestinal tract resulting in either symptoms or complications. It is a commonly occurring digestion condition. A burning sensation in the chest is usually caused by acid reflux which radiates up from the stomach to the mid-chest or throat. This condition is also known as the heartburn. A sour taste in the back of the mouth is a common experience amongst the patients. Long term reflux of gastric contents causes the condition to become chronic which can lead to difficulty in swallowing. In some cases the erosion of the tract lining can also cause breathing problems.

Symptoms:

Heartburn is a burning sensation felt in the retrosternal area. Most commonly it occurs post-prandial or nocturnally. Consumption of fatty foods, spicy foods, acidic foods aggravates the condition. Burning sensation is relieved with antacids, water or milk.
Perception of gastric content reflux in the mouth or hypopharynx is termed as acid regurgitation. It is also known as water brash. A bitter or acidic taste is felt in the mouth.
Other symptoms include dysphagia, odynophagia, nausea, chest pain, dyspepsia, epigastric fullness, bloating, frequent belching
Extra-esophageal symptoms like chronic cough, hoarseness, laryngitis, dysfunction of the vocal cords, bronchospasm can also be observed.
Complications:

Peptic stricture
Ulcers of the esophagus
Metaplastic disease (Barrett s esophagus)
Dysplastic disease (Adenocarcinoma)
Laryngitis or bronchitis
Pulmonary disease
Fluid in the sinuses and the middle ear
Diagnosis:
The diagnosis of GERD is made by its most commonly presenting symptom- heartburn. To confirm the diagnosis of GERD, the physicians treat patients with medications for suppression of the production of acid by stomach. If heartburn diminishes to a large extent by the medications, diagnosis of GERD is considered confirmed.

Conditions like an ulcer caused by bacterial infection, mimic the symptoms of GERD. To get a clearer diagnosis, an endoscopy is then performed. The common diagnostic modality for GERD is Upper intestinal gastro-endoscopy. A tube containing an optical system for visualization is swallowed, the tube progresses down the gastrointestinal tract, and then the lining of the esophagus, stomach, and duodenum can be examined. A normal esophagus is observed in most patients with symptoms of reflux. 

However, sometimes the lining of the esophagus appears inflamed. If erosions (superficial breaks in the esophageal lining) or ulcers (deeper breaks in the lining) are seen, a diagnosis of GERD can be made definitely. Other complications of GERD like ulcers, strictures, and Barrett's esophagus are also identified. Biopsies also may be obtained. Other common problems that may be causing GERD like symptoms can be diagnosed (for example ulcers, inflammation, or cancers of the stomach or duodenum) with EGD. Previously, barium meal x-ray was undertaken to diagnose GERD. It is now discontinued.

Other tests that are carried out are esophageal acid testing, esophageal motility testing, gastric emptying studies and acid perfusion test.

Treatment:

Lifestyle modifications   Avoiding acidic foods, quitting smoking, weight loss, abstaining from alcohol consumption improves symptoms in people with GERD.
Medications   Proton pump inhibitors (Pantoprazole, Omeprazole, Rabeprazole), H2 receptor blockers (Ranitidine, Cimetidine) and antacids.
Surgery   In cases where the proton pump inhibitors are unsuccessful in relieving symptoms of GERD, a surgical procedure called Nissen fundo-plication is done.

GERD - Complications Associated With 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!

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