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!

Hernia are bulges protruding form a weak point on belly (abdomen) through which intestine and abdominal fat comes out to lie just below the skin. It can also be found in groin, upper thigh and chest. There are several types of hernia like inguinal hernia (direct and indirect), femoral hernia, umbilical hernia, umbilical hernia, epigastria hernia and incision hernia.

Who get hernia?

Conditions that lead to increased abdominal pressure are at more risk of developing hernia  

o Persistent cough

o Being overweight or pregnant

o Lifting, carrying or pushing heavy loads

o Straining on the toilet

What are the symptoms of hernia?

o Mostly they are asymptomatic/ no symptoms.

o People just notice a swelling or bulge which gets bigger while standing or straining and disappear while lying down/sleeping.

o Some might feel a dragging/aching sensation.

o The swelling tends to get bigger with time.

o Symptoms develop when there is a complication like strangulation. This happens when the content of abdomen (intestine) come out and can not go back. There will be severe pain in the region and vomiting. Overlying skin will become red. Urgent surgery is needed in this situation otherwise the blood supply to intestine gets cut-off and the intestine in hernia might die (gangrene).

How are hernia treated?

Surgery is the only treatment for hernia. Now a days, most of the hernias are operated laparoscopically (key hole or minimally access technique)

Minimally Invasive Hernia Repair - The surgery is done with a laparoscope which has a small tiny camera, hernia mesh and small tool with it. So the patient can return back to their normal routine earlier as the incision made is smaller.

Advantages of Laparoscopy:

Laparoscopy has clear advantage over open repair in the way of less pain, less complications like wound infection, small and more cosmetic scar, shorter hospital stay, early return to work and daily activities and less chance of recurrence (repeat formation of hernia after surgery).

Before undergoing hernia surgery:

* One week before surgery it is much essential to stop taking drugs that are causing the thinning of the blood. Drugs like Clpodogrel and Acitrome or Warfarin should be stopped with the doctor s advice. 
* Stop herbal supplements and check the fitness of your cardio and diabetes. 
* Gain adequate knowledge about surgery and be prepared for post surgical care.

After hernia surgery:

* Avoid heavy weight lifting, exercises, and physical works with excessive strain a few weeks after surgery 
* Cough or laugh loud only with support to the surgical site until one week after surgery

DO s & DON T s in patients of Hernia:

DO s:

1. Increased intake of fibers in diet. ( Fruits, vegetables and grains)

2. Drink plenty of water and other fluid to prevent constipation.

3. Exercise regularly: sweat and loose excess weight and toxins.

4. Eat small meals more frequently in place of one or two large meals

DON T s:

1. Stop smoking and drinking

2. Don t reduce the amount of food you eat

3. Avoid lying down or bending after meal

4. Avoid wearing tight clothes

5. Avoid food difficult to digest

6. Avoid strenuous activities like heavy weight lifting

Types of Hernias:

Incisional hernia:

This happens at the site of previous surgery. This occurs as a result of poor wound healing at the time of previous surgery or as a result of complications like in infection. It is rare after laparoscopic or key hole surgery.

Umbilical hernia:

This occurs through or around belly button (umbilicus). It can be present at the time of birth and needs no repair as most of them resolve by the end of one year. If it persists or appears after 5 years of age then operation is required.

Inguinal hernia:

These are most common hernias and occur in groin region. They are more common in men.

All You Need To Know About Hernia!

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!

Menorrhagia is a condition that is marked by heavy menstrual bleeding during the monthly menstrual cycles. Most women have a unique bleeding pattern during that time of the month with the flow going up and down over the first few days. Yet, for many women, the bleeding becomes consistently heavy during all the days of the period, during which the period itself may get extended by a few days. If this pattern continues to occurs, one must get it checked out by a doctor at the earliest. Here are a few ways in which this condition may be treated.

Factors considered during treatment

Before the treatment starts, and during the diagnosis stage, the doctor will take a look at a number of factors so that the correct form of treatment may be prescribed to the patient. To begin with, the doctor will take a complete medical history of the patient, including the family history to ascertain whether or not there may be a genetic problem at play. Further, the future childbearing plans of the patient will also be taken into consideration in such cases so that the treatment method does not hinder such plans. Also, the doctor will also try and understand the effect of the symptoms of this condition before prescribing any particular medication and surgery.

Medication

Iron supplements and non-steroidal anti-inflammatory medicines will be prescribed for the patient to bring down the level of inflammation and restore the production of blood, which will make up for the rapidly flowing blood from the body. This will also prevent the risk of anemia. Oral contraceptives, tranexamic acid, oral progesterone and hormonal therapy can also help in such cases.

Dilation and curettage

This procedure is also known as D&C, and it basically helps in dilation or opening up of the cervix so that the doctor may suction the tissue from the uterine lining. This tissue is usually known to bring about excessive bleeding.

Uterine artery embolisation

This is a procedure which shrinks any existing fibroids that may be the cause behind excessive bleeding. In this procedure, the uterine arteries are blocked and the blood supply to the same is cut off so that the fibroids do not get a chance to grow and cause unnecessary pressure that may lead to excessive bleeding.

Hysterectomy

This is a surgical procedure that removes the cervix as well as the uterus, and is usually the last resort followed by most doctors. In such cases, the doctor will first ascertain whether or not you plan to have any children in the future. Additionally, the ovaries may also be removed if the condition has spread too much to be contained sufficiently.

Ways to Treat Menorrhagia

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

Ovarian cysts are fluid-filled sacs that develop on a woman's ovary. A patient might experience abdominal and pelvic pain, abnormal bleeding, menstrual irregularities, pain during intercourse or irregular bowel movements. These symptoms indicate an ovarian cyst developing inside you. Ovarian cysts are common in women and may develop during menstruation. In many cases, symptoms are not observed, and you may get ovarian cysts without knowing. Usually being harmless, ovarian cysts may sometimes lead to severe health conditions.

Here are 7 important things you should know about ovarian cysts:
1. You should know the reason behind the formation of ovarian cysts. When the follicle does not release the egg, it may grow bigger in size and take the form of a follicular cyst. A corpus luteum cyst may also develop, which is a cavity that gets formed after the egg is ruptured and released from the follicle. The cysts may bleed and cause pelvic pain.

2. It is important for you to know if you have an ovarian cyst. Many ovarian cysts do not show symptoms and go away by themselves. Follicular cysts do not change your menstrual cycle, but corpus luteum cysts may cause bleeding.  

3. You should know how to detect an ovarian cyst. You should visit a gynecologist regularly for diagnosis. Bigger cysts can be diagnosed via a pelvic examination. Ultrasound is also used for detection.  

4. You should have an idea about all the symptoms associated with ovarian cysts. These include fever, nausea and vomiting. These symptoms indicate that you have an infection. Sometimes, a cyst might twist an ovary, which may cut off blood supply to the ovary, causing permanent damage.

5. In case you are at a risk of twisting of the ovaries, you have to undergo a surgery. Surgery is also considered when the cyst lasts longer than three menstrual cycles and it is bigger than four inches in size. The cyst may also pose the risk of being a tumor. The common surgical procedures for ovarian cysts are laparoscopy and laparotomy.  

6. You can prevent ovarian cysts be taking birth control pills, which help in suppressing ovulation and prevent the formation of a cyst. Birth control pills may help only if you are not pregnant.

7. Ovarian cysts are more common in premenopausal women. However, these are possible in postmenopausal women as well, especially in the early postmenopausal stage.  

Sometimes, there might be chances of an ovarian cyst being cancerous in nature, which may lead to ovarian cancer. The risk of cancerous ovarian cysts increases with age. It is recommended to consult a gynecologist for the proper diagnosis and treatment of ovarian cysts in women. Pain medications and heating pads are used as alternative treatment methods for less serious ovarian cysts.

7 Things You Should Know About Ovarian Cysts

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