Gastroesophageal reflux disease is a condition which occurs due to unhealthy food habits and sudden lifestyle changes. This condition causes the stomach acid to travel in a reverse direction and enter the esophagus. If changes in your food habit and lifestyle do not cure you of this condition, then a surgical procedure is recommended.

What are the different surgical methods of treatment for gastroesophageal reflux disease?
The different forms of surgery that can be used to treat this condition have been explained below:

Fundoplication: Fundoplication is one of the most common surgical methods recommended to patients suffering from gastroesophageal reflux disease. The lower esophageal sphincter or LES is tightened with the help of this surgery. The strengthening procedure is accomplished by wrapping the upper part of the stomach around the outer part of the lower esophagus. Both open and laparoscopic surgical options are available for this surgery.
Transoral Incisionless Fundoplication or TIF: In this surgical procedure you do not have to undergo any incisions. A barrier is made between the esophagus and the stomach. This barrier will work to prevent the acid of the stomach from entering the esophagus. A special device is inserted through the mouth of the patient which helps in creating several folds at the base of the esophagus, these folds form a new valve or barrier. Thus you do not have to undergo any incisions at all if you opt for this procedure. Those who are looking for a non-invasive method to treat their gastroesophageal reflux disease, this procedure is no doubt one of the best.
Bard EndoCinch System: This is a special type of surgery that is accomplished with the help of an endoscope. Although it is not one of the common methods to treat the problem. In this procedure, several stitches will be made in your lower esophageal sphincter so that they result in the formation of valves.
Stretta Procedure: This procedure is also performed with the help of an endoscope. But this is an outpatient procedure and you will be discharged on the same day. A flexible tube is inserted into your esophagus and the other end of this tube has an electrode. This electrode will help in heating the tissues of your esophagus. It will also form small cuts in it. The scar tissue that results from this procedure helps in stopping the acid from flowing in the reverse direction. It also strengthens the muscles that are present in the surrounding area.
These surgical procedures are very successful and have the ability to give you long-term results. Many complications such as the inflammation of the esophagus, can be avoided if you opt for a surgical treatment as a cure for gastroesophageal reflux disease. 

Gastroesphageal Reflux Disease - How Surgery Can Be Of Help?

The cancer of the bladder (an organ in the pelvic region that stores urine) is known as bladder cancer. This cancer begins in the cells that line the inner portion of the bladder. Though it usually affects the aged, bladder cancer can develop in people across other age groups as well. It is important to undergo frequent check-ups even after the condition has been cured, as there always remain chances of a relapse.
There are three types of bladder cancer:
1. Squamous cell carcinoma: Squamous cells appear in the bladder in response to any infection, which, with time, can become cancerous.
2. Transitional cell carcinoma: These cells are present in the lining of the bladder. They contract when the bladder is empty and expand when it is full. These cells are also found in the urethra, hence there are chances for the cancer to develop in the urethra as well.
3. Adenocarcinoma: Adenocarcinoma forms in the mucus secreting cells in the bladder.

The symptoms of bladder cancer are:
1. You may urinate frequently
2. Frequent backaches
3. You may experience pain during urination
4. Pain in the pelvic region
5. There may be presence of blood in the urine

There is no known cause of bladder cancer. However, certain factors such as smoking, infection and exposure to chemicals are known to trigger it. The risk factors of bladder cancer are:
1. Age: The risk of bladder cancer increases with age, it usually affects people who are above 40 years of age.
2. Smoking: Smoking releases toxins in the body that get stored in the urine. These can damage the inner lining of the bladder and lead to bladder cancer.
3. Gender: Men are more likely to develop bladder cancer as compared to women.
4. Chemical exposure: Exposure to certain chemicals such as arsenic increases your risk of bladder cancer.
5. Chronic inflammation of the bladder: If you suffer from chronic infection of the bladder, then the risk of squamous cell carcinoma increases significantly.

Bladder Cancer - 5 Things That Put You at Risk

The kidneys are responsible for the elimination of waste from the body. The blood is filtered in the kidneys and all toxic wastes are filtered out and excreted through urine. When this filtration does not happen effectively, a lot of waste can be found in the blood, which affects normal body function.

Kidneys may lose their functioning either due to age, injury, or disease conditions. Whatever the reason, when kidney function is hampered, the body suffers. If there was an injury or congenital problem, it could be unilateral and the non-affected kidney could still do the function. However, if it is infection or old age, normally both kidneys are affected and then replacement should be looked for externally. This is where a kidney transplant comes into the picture.

What is it?

It is a surgery where a healthy, functioning kidney is placed into the body. The donor could be

Living: These donors have to be related or unrelated. Related is often termed someone, who is a family member and is willing to donate one kidney (one kidney is sufficient for normal, healthy individuals) to the diseased person.
Cadaver: If a person is willing to donate kidneys post death, these are used for transplant, within a specified time.
Identifying the right donor and recipient:

Blood type and tissue type should be matched; a good tissue type match improves the chances of success
Overall health of the donor to ensure there is no heart disease, lung disease, or diabetes
The recipient also should be healthy
What to expect during surgery?

Once a donor is identified, in living donors, the surgery to remove the kidney and to transplant it are done simultaneously
The surgery usually takes about 3 to 4 hours
Antibiotics are given prior to the surgery to prevent infection
The blood vessels and ureter are connected back to the kidney after the transplant
Hospital stay can range from 5 days to 2 weeks, depending on the overall health of the patient and the anticipated risk of rejection.
Most transplanted kidneys work effectively almost immediately. A kidney stored from a cadaver may take a little longer compared to a fresh kidney from a living donor
People who have had transplants are put on immunosuppressants on a chronic basis to reduce chances of rejection. The new kidney will always be recognised by the body as a foreign body, and so this is essential.
Kidney transplant success rates are quite high, and more and more people are opting for transplants as opposed to dialysis.

Kidney Transplant - What To Expect From 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

Gastroesophageal reflux disease (GERD) is also called as acid reflux. It is a long-term digestive disorder that affects the lower esophageal sphincter, the ring of muscle between the esophagus and stomach which causes the stomach contents to come back up into the esophagus resulting in either symptoms or complications. Gastroesophageal reflux disease is mild acid reflux that occurs at least twice a week or moderate-to-severe acid reflux which occurs at least once a week.

Epidemiology

In western populations, GERD affects approximately 10% to 20% of the population and 0.4% newly develop the condition. In developed nations, the prevalence rate of GERD is associated with age; with adults aged 60 to 70 being the most commonly affected.

Signs and Symptoms

Esophageal symptoms include:

Heartburn
Regurgitation of food or sour liquid
Dysphagia
Sensation of a lump in the throat
Extraesophageal symptoms include:

Coughing and/or wheezing
Hoarseness, sore throat, or 
Otitis media
Noncardiac chest pain
Enamel erosion or other dental manifestations
New or worsening asthma
Disrupted sleep
Risk Factors

Obesity
Pregnancy
Hiatus hernia
Scleroderma and systemic sclerosis
The use of medicines such as prednisolone 
Delayed stomach emptying Zollinger-Ellison syndrome which can show an increase in gastric acidity because of gastrin production
A high blood calcium level which can increase gastrin production, leading to increased acidity
Visceroptosis or Gl nard syndrome, in which the stomach has sunk in the abdomen upsetting the motility and acid secretion of the stomach.
Factors that can increase acid reflux involve:

Smoking habit
Eating heavy meals or eating late at night
Eating fatty or fried foods
Drinking certain beverages, such as alcohol or coffee
Medications, such as aspirin
Tight clothes
Increased intra-abdominal pressure
Differential Diagnosis

Heart disease causing chest pain
Laryngopharyngeal reflux OR extraesophageal reflux disease
Infection
Peptic ulcer
Esophageal spasm
Complications

Narrowing of the esophagus (esophageal stricture): Stomach acid causes the formation of a scar tissue which narrows the food pathway.
An open sore in the esophagus (esophageal ulcer): Acid causes an open sore which bleeds, causes pain, and makes swallowing difficult.
Precancerous changes in the esophagus (Barrett's esophagus): Damage from acid can cause changes in the tissue lining the lower esophagus
Anemia
How to arrive at the diagnosis?

Upper gastrointestinal endoscopy/esophagogastroduodenoscopy
Esophageal manometry
Ambulatory 24-hour pH monitoring
Treatment

The goals of treatment are controlling symptoms, healing esophagitis, and prevention of recurrent esophagitis or other complications. Lifestyle modifications include the following:

Losing weight (if overweight)
Eating small and frequent meals instead of large meals
Waiting 3 hours after a meal to lie down
Elevating the head end of the bed by 8 inches
Avoiding bending or stooping positions
Medications

H2 receptor antagonists (ranitidine, cimetidine)
Proton pump inhibitors (omeprazole, pantoprazole)
Prokinetic agents (aluminum hydroxide)
Antacids (magnesium hydroxide)
Surgery

Transthoracic and transabdominal fundoplication
Placement of a device to augment the lower esophageal sphincter

Gastroesophageal Reflux Disease - What Causes It?

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?

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