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 gallbladder can be found under the liver and is a pear shaped organ. This four inch organ is responsible for storing bile, which is a combination of the various fluids as well as fat and cholesterol. These are essential for the body and its metabolism, as the bile helps in breaking down the food that enters the digestive system. With the help of the gallbladder, this bile divides the food into smaller parts within the intestine. This ensures that the energy released by the food is more easily absorbed into the bloodstream. There are a host of problems that can attack the gall bladder including stones, infection and more.

Let us find out the symptoms of a gallbladder attack and the various ways in which it may be successfully treated.

    Pain: One of the most common symptoms of a gallbladder attack includes pain. This can be felt in the section that lies in the middle and the upper right portion of the abdomen. The patient may initially experience mild pain that comes and goes intermittently. Eventually, if the pain is not treated, it can start to radiate on a constant basis and hold the patient in its grip.
    Nausea: Nausea and vomiting are also common symptoms of any gallbladder related problem. Chronic cases usually end up experiencing these symptoms. Nausea and vomiting in such conditions are a result of digestive problems like acid reflux which can be caused due to the gall bladder condition.
    Fever: If there is an infection in the gall bladder, then the patient may also experience fever and chills. This will require immediate treatment and the prescription of antibiotics. If it is not treated on time, the problem can become serious and dangerous.
    Loose Motions: Diarrhoea is a problem faced by many patients suffering from this condition along with jaundice and lighter coloured stools.

Treatment: Mostly, doctors will recommend surgical methods to deal with gall bladder attacks and conditions. A laparoscopic surgery may be conducted to remove the gallbladder. Also, medication will be prescribed to dissolve the gallstones that may have been caused by cholesterol. The patient will also have to undertake many lifestyle changes in order to successfully treat this condition over a period of time.

One will have to avoid greasy and oily food. Also, the fat intake of the patient will have to be reduced so that the cholesterol build up does not affect the gallbladder again. The patient will also have to add fibre to his or her daily diet, in the form of fruit and oats. This will help in improving the bowel movements as well.

The Symptoms and Treatment of Gallbladder Attack

Since the development of modern medicine, doctors and health care professionals have always tried to come up with minimally invasive procedures for both diagnostic purposes as well as surgery. Endoscopy was developed to see inside a human body without the need for large incisions or surgery.

What is Endoscopy?
Endoscopy is a type of procedure wherein the doctor inserts a long thin tube into the body through an opening such as the mouth, anus or the urethra. Sometimes small incisions may be made on your body to insert the tube as well. The tube which is inserted within the body is fitted with a camera which allows the doctor to see what is wrong within your body, a specific section or organ. Doctors can even take images or videos of your organs which help them to determine a due course of action in your treatment. Endoscopy may also be used as a part of a laparoscopic operation to correct problems within the body, especially in cases wherein tissues have to be removed.

Types of endoscopy and its uses-
Although endoscopy could be used in any part of the body, there are certain areas where they are used more commonly than the others. Some of the types or endoscopies are mentioned below:

Colonoscopy   Used to examine your colon wherein the scope is inserted through your anus
Laparoscopy   This is one of the most common forms of diagnosis as well as surgery wherein the tube may be inserted through a small area in your abdomen or the pelvic area. This is not only used for imaging or diagnosis but is used in surgery as well.
Arthroscopy   Here, an incision is made on the joints of your body to check for problems
Cystoscopy   In this type, the tube is inserted through the urethral opening to check for problems in the urinary tract or the bladder. Another variation of this would be ureteroscopy.
Enteroscopy   This is an endoscopic examination of the intestines wherein the tube is inserted via the anus or the mouth.
Hysteroscopy   Here, examination of the uterus and the female reproductive organ is carried out wherein the endoscope is inserted into the vagina.
Bronchoscopy   It entails an examination of the lungs wherein the scope may be inserted through the nose or mouth to check the lungs
Upper gastrointestinal endoscopy - This is used for the examination of the esophagus and the upper intestinal tract.
Risks and safety-
Endoscopy is a widely performed and very reliable procedure. In the hands of a skilled doctor, endoscopy will be able to determine the cause of the problem and also correct the issues if surgery is also performed along with it. However, like any procedure, it does carry certain risks although the chances are fairly low. Some of the risks are mentioned as follows  

Perforation or other injuries to your organs such as scraping or bruising
Fever due to the introduction of foreign materials
Persisting pain in the specific area wherein endoscopy was performed
Swelling of the area wherein the tube was inserted
Infections after the procedure
Bleeding at the site of the incision or entry of the tube
However, these cases are rare and only occur in a very small section of the cases. Although there is minimal pain associated with the procedure, the benefits far outweigh the risks and inconveniences.

8 Types Of Endoscopies & For What They Are Used For!

Vaginal cysts are closed packets of fluid, air or pus which develop along the vaginal lining. Vaginal cysts are of many types, and they are usually caused by accumulation of fluids, childbirth-related injuries or non-malignant tumors in the vagina. Usually these cysts do not yield many symptoms, but may cause a little discomfort.

Treatment might not be needed in case of cysts which are tiny. However, larger cysts would definitely warrant medical attention.

Types of Cysts-

The commonly occurring cysts are:

Gartner s Duct Cysts: This duct forms around a woman s reproductive canal during pregnancy and it disappears post childbirth. If the duct remains even after the delivery, it may lead to fluid accumulation, thus resulting in a cyst.

Vaginal Inclusion Cysts: Any injury to the vaginal walls, especially during childbirth or surgery, can lead to vaginal inclusion cysts.

Bartholin s Cyst: Bartholin s gland is situated near the vaginal opening. A flap of skin covering this gland may lead to accumulation of fluid. This fluid accumulation usually leads to a cyst which is called a Bartholin s cyst.

Treatment-

Usually, cysts in the vagina do not require any treatment. Most of the cysts do not grow in size and thus do not cause major problems. A biopsy of the cyst may require in order to rule out chances of cancer. A common treatment for vaginal cysts would be to sit inside a bathtub filled with warm water so that the cyst is allowed to soak in the water. If there are symptoms of infection in the vagina, then antibiotics are required.

If the size of the cyst is large and filled with fluids, then a catheter needs to be inserted into it to drain out the cyst. Usually, the catheter is kept in place for a few weeks before it is removed. A surgical procedure called marsupialization is used in some cases, wherein an incision is made around the affected area and into the cyst in order to drain out its contents.

Surgery to remove the entire cyst may also be recommended to prevent its recurrence.

Vaginal Cysts - Types and Treatment

If the blood flow between left ventricle and aorta is obstructed, it is known as Aortic Stenosis.
Aortic stenosis can occur in newborn, infants, children and adolescents. It is more common among boys than in girls.
Mild cases of this disorder do not need treatment. However, if a child has a severe case of aortic stenosis, then it requires treatment.

Aortic stenosis: Causes-

Blockage in the valve, mainly in the form of bicuspid valve stenosis (Aortic valve stenosis)
Muscular/fibrinous obstruction beneath the aortic valve (Subaortic stenosis)
Narrowing above the aortic valve in aorta itself (Supravalvular aortic stenosis)
Aortic valves regulate blood flow to the body parts. When aortic valve opens, it allows blood to go forward then it closed down so that blood will not come back to left ventricle.
However, if there is a problem with the aortic valve, it cannot open entirely and that restricts the passage of blood. The heart has to work extra hard to ensure that the entire volume of blood flow through the faulty valve.

Sometimes babies are born with deformed aortic valve in the form of bicuspid aortic valve that is prone for obstruction as compared to normal trileaflet aortic valve.

Aortic Stenosis: Symptoms-

Symptoms due to aortic stenos is depends on age of the child and its severity.
If occurs in newborn babies, it is generally severe in intensity and babies are generally in shock like state due to low cardiac output.
Infants are generally tired easily during feeding.
Children show signs of easy fatigue, chest pain, loss of consciousness and in late stages with shortness of breath.
Diagnosis of Aortic Stenosis-

Pre-natal testing like a fetal echocardiogram can reveal aortic stenosis if moderate to severe in intensity. That is why as soon as the baby is born, treatment is initiated.
Even if the child was not born with a problematic valve, this condition can arise a few years later.
For diagnosing this disease pediatric echocardiogram by pediatric cardiologist needs to be done from the chest of the child
Treatment of Aortic Stenosis-

If aortic stenosis is mild to moderate in intensity then we need to do follow-up of the child at regular intervals.
However, in severe aortic stenosis, treatment needs to be done
In valvular aortic stenosis, treatment of choice is by doing ballooning of aortic valve (Balloon aortic valvuloplasty, BAV) in any age group.

Balloon Aortic Valvuloplasty - This is not open-heart surgery. It is done in cardiac cath lab under fluoroscopic guidance by using vessels in thigh. We cross the valve with wire and catheters and we inflate a balloon across the stenosed aortic valve.

Open heart surgery: In subvalvular and supravalvular aortic stenosis, treatment is by open heart surgery.

Valve Replacement - An artificial valve or a donor valve is surgically attached at aortic valve location when valve is not amenable for ballooning. It is generally done in adolescent or adult patients.
Parents need to be alert and attentive to any physical discomfort that their child is suffering because that could be a symptom of aortic stenosis. The right treatment at the right time is necessary whenever required.

Aortic Stenosis - All You Must Know About It!


Cancer is the most dangerous disease noticeable throughout the world. The most common type of cancer that affects men is prostate cancer. Prostate is a small exocrine gland situated directly below the bladder and in front of the rectum. This is gland is approximately in size of a walnut and plays an important role in production of a milky fluid during orgasm of sex in which the semen travels. During the climax stage of the prostate gland is forced to push the fluid and remove the semen out of the reproductive structures.

Prostate gland is a slow progressive disease which makes many males left unidentified even the presence of prostate cancer even until they die. 6 out of 100 male over the age of 60 are getting prostate cancer. Though prostate cancer can be cured at a better rate when compared to other type of cancer it is always best to stay protected. Prevention is always better than cure. Here are few tips to keep your prostate healthy.

Signs and symptoms of prostate cancer-
During the early stages of prostate cancer there are usually no symptoms. Most men at this stage find out they have prostate cancer after a routine check up or blood test. When symptoms do exist, they are usually one or more of the following:

The patient urinates more often
The patient gets up at night more often to urinate
He may find it hard to start urinating
He may find it hard to keep urinating once he has started
There may be blood in the urine
Urination might be painful
Ejaculation may be painful (less common)
Achieving or maintaining an erection may be difficult (less common).

If the prostate cancer is advanced the following symptoms are also possible:

Bone pain, often in the spine (vertebrae), pelvis, or ribs
The proximal part of the femur can be painful
Leg weakness 
Urinary incontinence 
Fecal incontinence 

Ways to have a healthy prostate  
Diet and weight   the most important factor is the diet to maintain a healthy weight. Avoid fatty food items and take fats from vegetables than from animals. Avoid dairy products and increase the intake of fresh fruits and vegetables.
Exercise   have a regular practise of doing exercise at least for 30mins a day. This really helps you to keep your body fit.
Be precautious   if you have a family history of prostate cancer or if you feel you are at high risk of getting prostate cancer talk with your doctor about it and take preventive drugs as per the doctor s advice.
Red foods   research shows that men who consume red foods like watermelon, tomato and other red fruits are at lower risk of getting prostate cancer as they contain a powerful antioxidant called lycopene
Caffeine   three to four cups of coffee per day reduces your risk of getting prostate cancer.
Stop smoking   if you are at high risk of getting prostate cancer it is best advised to quit smoking and alcohol. 


Prostate Cancer -  Signs and Symptoms

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