Chronic Diarrhoea is a condition that results in watery or loose stools. While most diarrhoea subsides within a few days time, the chronic ones persist up to a couple of weeks. Some common symptoms that can help to identify chronic diarrhoea include bloating, nausea, fever, blood in the stool, abdominal cramps etc. Here is a brief look at the possible causes of chronic diarrhoea:

What are the possible causes of chronic diarrhoea?
Parasites and bacteria: Parasites and bacteria are often transmitted from contaminated food and water. Certain parasites such as the cryptosporidium and Giardia lamblia can lead to chronic diarrhoea. Some common bacteria include Escherichia coli, Campylobacter, Shigella, and Salmonella. In the more developed countries, diarrhoea is often referred to as the traveller s syndrome. Diarrhoea can also result from a course of antibiotics due to an infection from Clostridium difficile.

Viruses: Some of the common viruses that can lead to chronic diarrhoea include viral hepatitis, Norwalk virus, and cytomegalovirus. A certain virus known as the Rotavirus can lead to an acute childhood diarrhoea.
Medication: Certain medication is known to be the culprit when it comes to causing diarrhoea. Antibiotics, for instance, tend to equally destroy both the good and the bad bacteria thereby disturbing the bacterial balance of the intestine leading to chronic diarrhoea. Certain other drugs related to cancer, antacids containing magnesium etc can also lead to chronic diarrhoea.
Artificial Sweeteners: Certain artificial sweeteners are known to be causing chronic diarrhoea. Compounds such as Mannitol, Fructose etc found in certain sugar-free products or chewing gum can lead to chronic diarrhoea in otherwise healthy people. It is, therefore, advised not to consume too many artificial sweeteners in excess at one go.
Intolerance of lactose: Lactose is a type of sugar that is mostly found in dairy products. People who find it difficult digesting this compound often tend to suffer from diarrhoea when they consume dairy products. Our body produces an enzyme to digest lactose. However, this enzyme tends to rapidly feds away from the body with age. Lesser the amount of this enzyme, greater is the chance of lactose intolerance leading to an increased risk of chronic diarrhoea.
Surgery: There are surgeries that can begin the onset of chronic diarrhoea. Certain procedures such as the gallbladder removal surgery and abdominal surgery run a high risk of chronic diarrhoea.
Fructose: For people who find it hard to digest fructose can suffer from chronic diarrhoea. Fructose is a naturally occurring sweetener found in honey, fruits etc and is often added to beverages to enhance the taste.
Certain digestive disorders: Certain other situations such as celiac disease, microscopic colitis, Crohn s disease, ulcerative colitis irritable bowel syndrome etc can lead to chronic diarrhoea. 

Chronic Diarrhoea - What Causes It?

A peptic ulcer is usually found in the duodenum, or the first part of the small intestine. These ulcers can also be found in the delicate stomach lining near this region. These are usually painful sores that are caused due to too much acid production in the stomach, as well as excessive smoking and alcohol consumption. The symptoms generally include heartburn, bloating, nausea, vomiting, and even blood discharge in stool and vomiting. So how can you treat these ulcers? Here's a short list of ways to do so.

- Medication: The most common way of treating peptic ulcers is to ingest proton pump inhibitors which can be prescribed by a general physician. These medicines will effectively stop the production of acid and reflux in the gastroesophageal band, so as to prevent the growth and production of such ulcers. Antibiotics can also help, especially in severe cases where there is a risk of infection due to the presence of these ulcers.

- Upper Endoscopy and Surgery: For severe cases where there is bleeding in the peptic ulcers, an upper endoscopy may also be conducted. This quick procedure can give relief from the bleeding. Also, many specialists might recommend surgery so as to treat an ulcer that has punched a hole in the stomach's wall, in which case the persistent bleeding cannot be stemmed even with an upper endoscopy.

- Lifestyle Choices: The presence of a peptic ulcer usually points to tobacco and alcohol abuse. If you happen to be over 50 years of age and are busy drinking copious amounts of alcohol every day and even chain smoking, then you may be at risk. It is best to stop such abuse by giving up smoking and drinking so as to ensure that the peptic ulcer can be treated and does not become a fatality. Also, drinking plenty of water and eating a proper balanced diet along with exercise are some of the best ways of treating these ulcers.

- Side Effects: Peptic ulcers may also arise as a side effect of having pain killers too frequently. So it is important to stay away from medication that gives rise to this kind of reaction in the body.

Managing and treating peptic ulcers is a matter of getting the right tests done for diagnosis before discussing further medication or surgery based treatment for the ulcer so that it does not pose any grave danger to the patient's body.

Coping with Peptic Ulcers

Role of relationship problems in depression and suicides - 
Almost everyday we read about people ending their lives by committing suicides from celebrities to common man to even children . Although this is not permitted in any religion and there is a legal debate on whether it should be legalized, the fact remains that people are driven towards this unfortunate step. Let's take a look at the common reasons for suicides to become so very common.

1) Lack of intimacy- We see that although we are surrounded by people most of people are having friends only on Facebook. Even among the people we interact everyday nobody wants to open up with anyone or allow you to open up with them.The fact that you are surrounded by people who don't share themselves with you intimately starts pulling your mind downwards. Work colleagues are bothered only about work, family is only bothered about the income you are generating, partners are obsessed with how much you can spend on them, friends are occupied with what benefits you can share with them. Therefore all in all, despite having all relationships, people feel left out and alone like as if their inner self has been left unwanted and uncared of. The monotony of mechanical life hastens the culmination of this abuse into drastic steps like suicide.

2) High demands- People are often left to fend with high demands from them from their social circle. Many people cannot attempt this and some who attempt are not able to make it. This leaves them with a feeling of failure which is often frowned and looked down upon whether it is a student or a professional. It is no surprise that today even below 10 years olds are successfully attempting suicides.

3) Inappropriate planning- Planning is a key necessity for successful results whether it is financial or relationships. but unfortunately many people are unable to obtain the correct know how which will enable to implement their plans successfully.

4) Inability to cope- Many people plan to do things but are unable to cope with the harsh realities that come with the plans. To some it may be unseen to some unbearable. So although they set out on doing something the journey is not what they had expected.

5) Lack of results- Sometimes although everything is planned well, executed well and completed well it does not fetch us the rewards that may seem appropriate to the level of efforts. This is something that is very difficult to deal for most people and is a result of many unfortunate casualties.

6) Lack of desire-It is very important to have something to look forward to in life. But unfortunately in an age where drinking water and using the toilet cost s money many people cannot think of having something to look forward to and hence this unfortunate step.

Therefore, you have to be very prudent in what we are doing today because we can never predict which way our lives may go and even importantly which way you may yourself go based purely on circumstances beyond our control dependent on the choices we make today or others make for us. Although suicide is not a sensible solution to any problem it does remain a common reality. If you are feeling suicidal please remember to seek help.

Please feel free to consult me privately for further assistance.

From Lybrate: If you found this tip useful, please thank the doctor by clicking on the heart icon below. Also, spread good health by sharing this tip with your loved ones over WhatsApp, Facebook and other media.

Health Tip - Role of Relationship Problems in Depression and Suicides

Anti-reflux surgery (Fundoplication) is a procedure for treating gastroesophageal reflux disease (GERD) incorporated in hiatus hernia operation. GERD occurs when stomach contents reflux and enter the lower end of the esophagus (LES) due to a relaxed or weakened sphincter or a hiatus hernia. GERD is very much treatable and can cause serious complications if left untreated. 

GERD symptoms
The main symptom of GERD is heartburn or indigestion, along with other symptoms, such as 

Acidic sour taste in the mouth
Burning pain in the throat
Difficulty in eating
Bloating and belching
Stomach pains
Regurgitating food
Nausea
Vomiting blood
Dark tarry stools
Laparoscopic Anti-Reflux Surgery
Laparoscopic surgery reinforces the lower oesophageal sphincter s ability to prevent gastroesophageal reflux from occurring. The surgery involves wrapping the top part of the stomach around the lower end of the esophagus and suturing it in place. Since the esophagus passes through the hiatus, suturing is done to narrow the hiatus as it helps in the prevention and treatment of concurrent hiatal hernia.

Laparoscopic Surgery Procedure
A laparoscope, a long, narrow telescope with a light source and a video camera at the end, is inserted through a tiny incision into the abdomen. Images from the camera are projected onto a large high definition monitor for the surgeon to view enlarged images as it helps the surgeon perform surgery with precision.

The patient is placed under general anesthesia
The surgeon makes a small incision in the upper abdomen and inserts the laparoscope into the abdomen.
The surgeon introduces carbon dioxide into the abdominal cavity near the belly button to expand the viewing area of the abdomen giving the surgeon a clear view and room to work.
Additional small incisions are made for a variety of surgical instruments to be used during the procedure.
After the identification of critical structure, the hole in the diaphragm, through which the esophagus passes, is then tightened with sutures.
The surgeon wraps the upper part of the stomach around the lower esophagus guided by the images on the laparoscope, then creates a valve which is precisely sutured in its place.
The laparoscope and other instruments are removed and the gas is released.
The tiny incisions are closed and covered with waterproof dressings to avoid any kind of infections.
The patient is usually discharged within 1-2 days of the surgery.
Post-surgery, hospitalization is required just for one day - no bed rest is required after that. The patient can quickly return to all normal activities and immediate relief from symptoms also happen. 

Laparoscopic Surgery - How It Can Help With Anti-Reflux and Hernia?

Cancer can be very devastating, it can tear families apart. The cancer virus generally kills all the healthy cells in your body and starts to destroy your organs one by one. When a person is affected by breast cancer, their breasts have to be removed so that the cancer virus doesn t affect the rest of the body. In the society which we live in we are fed with the notion that breasts are an integral part of a woman s body and only voluptuous breasts make a woman look more attractive. Survivors who have won the fight against breast cancer have had to surgically remove their breasts for survival. 

They are left with an empty spot in their body as well as their lives. So, in such cases breast reconstructive surgery becomes extremely important. Breast reconstruction surgery implants a mound in place of the actual breast. So that it looks like an actual breast with the nipples and the areola.

How to get ready for a breast reconstruction surgery?
1. You should quit smoking if you are a regular smoker.
2. Avoid certain vitamins or supplements as prescribed by your doctor before the surgery.
3. Take someone with you to stay back during and after the procedure for moral support and to assist you with your stay in a hospital.

Possible complications:
1. Infection can occur after the surgery.
2. Hematoma or pooling of blood.
3. The implants can also break through the skin.
4. The implants can rupture and the silicon or saline can leak from the breast tissues.
5. Hard scar tissues can form around the implant.
6. It might not be enough for a woman who has had larger breasts.
7. Implants don t last life-long. It needs to be replaced after a point of time.
8. Radiation therapy might damage the implants.
9. It can leave a scar from the region where the extra tissue was taken for constructing the breast.

Methods of breast reconstruction surgery:
1. Tissue expander
2. Flap reconstruction
3. Abdominal flaps
4. Mold-assisted reconstruction
5. Direct to implant procedure

Breast Reconstruction - How You Can Prepare Yourself?

The quote 'Good day starts with coffee' suits a lot of people who love nothing more than a cup of coffee every morning. However, your morning tryst with a cup of coffee might not be a very healthy habit. Believe it or not, addiction to caffeine (in the form of coffee) is as harmful as addiction to any other drug. In fact, caffeine is a legal drug that slowly and gradually damages your gastrointestinal tract. Here are the negative effects of coffee on your digestive system:

Increases Acidity: Coffee is known to contain different kinds of oils, acids and caffeine. These compounds have an adverse impact on the digestive system. The stomach and intestinal linings get damaged due to the over-consumption of these compounds in the form of coffee. Moreover, as you take coffee, your stomach produces more hydrochloric acid for digestion. This causes acidity and hampers the HCL levels altogether. When we take coffee regularly for years in empty stomach, our body's capacity of producing proper amounts of HCL gets hampered. Often, HCL production gets reduced as well. This leads to indigestion of other food items and effects flatulence and produces unwanted gases due to the improper breaking of proteins and fats by the body.
Ulcers and Irritable Bowel Syndrome: Doctors believe that coffee acts as an irritant for patients of Irritable Bowel Syndrome (IBS), gastritis, Crohn's disease, colitis and ulcers. Coffee is responsible for the irritation of the lining of stomach and intestine. It is also noticed that certain enzymes present in the coffee beans are also harmful to the gastrointestinal tract.
Heartburn: Coffee is responsible for relaxing the esophageal sphincter muscle. The relaxation of this muscle hinders the process of digestion and causes acid-reflux, resulting in heartburn. It is known to have compounds that have diuretic, laxative and mineral blocking effects on the body.
Laxative Effects: Coffee stimulates the process of peristalsis or movement of food through the gastrointestinal tract. The peristalsis starts immediately after food is swallowed by the individual. The intake of coffee catalyzes peristalsis and consequently leads to emptying of the stomach even before the food is digested properly. The semi-digested food is sent to the intestine too early, causing injury to the intestine and hampering the absorption of nutrients.
Affects absorption of minerals: Caffeine reduces the ability of the stomach to absorb iron and also hinders the absorption of minerals like calcium, zinc and magnesium by the kidney. All these minerals help in digestion at different points and regulate the bowel movement.
Coffee is known to have benefits like reduction of constipation and sugar absorption. But, it also interferes with the smooth functioning of the digestive system. It has a tendency to increase stomach aches, disturb the fluid balance and the overall process of digestion.

Coffee and Your Digestion

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