Gastric bypass, one of the weight loss surgeries bring about many changes and alterations (physiological, metabolic, hormonal) in your body. The gastric bypass surgery rearranges the stomach into an upper pouch (the smaller part) and a relatively larger lower part. It is the small pouch that is connected to the small intestine, where the absorption of nutrients and minerals from the ingested food takes place. The surgery plays a significant role in limiting the intake of food. Thus, post-surgery, a person's body reacts differently than it used to before the surgery. Many, if not all, people experience difficulties in coping up with the changes.

Patients are often advised to refrain from alcohol consumption after the gastric bypass surgery. Surprisingly, and quite alarming, cases of alcohol abuse increases post the surgery. According to a survey by the American Society for Metabolic and Bariatric Surgery, few people, who had no prior history of alcohol abuse developed one after the weight loss surgery. What triggers the alcohol abuse in some patients is still a debatable issue.

Many patients experience an emotional breakdown, stress, anxiety, and depression after the surgery. People who needed no reason to binge on food are suddenly expected and made to consume a limited quantity of food. Unable to do what they loved doing the most, people look for an alternate solution. As expected, in most cases, alcohol becomes the much-needed solution. What started as a means of distraction gradually becomes an integral part of life. Hormonal changes associated with the surgery can also result in panic attacks, stress, and anxiety.

Incidences of alcohol abuse may also be high in patients who had a history of drinking (regular or occasional) and smoking before the gastric bypass. Under normal circumstances (before the weight loss surgery), there is a partial enzymatic breakdown of the consumed alcohol in the stomach before it passes into the small intestine. However, post-surgery, the small size of the stomach does not facilitate such enzymatic breakdowns. Thus, the alcohol passes into the intestine, where it gets rapidly absorbed. As a result, a person gets into an inebriated state at a faster rate.

It is because of this reason that doctors advise the patients to keep away from alcohol as much as possible after the surgery. To keep away from or reduce the instances of alcohol abuse after the gastric bypass surgery,

Look for healthier and low-calorie food options when you get an urge to eat.
Meditate, go for morning and evening walks. These physical activities act as great stress busters.
If you are feeling low or going through an emotionally low phase, share it with your loved ones. Do not suppress your emotions.
Consult your attending physician in case of any physical discomfort

Alcohol & Gastric Bypass - Can They Be Mixed?

Cancer is the abnormal, uncontrolled growth of cells in a particular body part. With continued growth, pieces of this tissue travel through the blood to different body parts and continue to grow in the new area. This is known as metastases. Breast cancer is one of the most common forms of cancer and affects about 1 in 8 women in the USA. Read on to know more details of breast cancer   breast anatomy, causes, symptoms, risk factors, detection, prevention, and of course treatment.

Anatomy: The main function of the breast is lactation through its milk-producing tissue that are connected to the nipple by narrow ducts. In addition, there is surrounding connective tissue, fibrous material, fat, nerves, blood vessels and lymphatic channels which complete the structure. This is essential to know as most breast cancers develop as small calcifications (hardened particles) in the ducts or as small lumps in the breast tissue which then continues to grow into cancer. The spread can happen through lymphatic or blood flow to other organs.

Warning signs/symptoms: The following are some symptoms that need to be watched out for if you have a predisposition to breast cancer.

    A lump in either of the breasts or armpits
    Change in size, shape, or contour of either breast
    Redness of your breast or nipple
    Discharge of clear or bloody fluid
    Thickening of breast tissue or skin that lasts through a period
    Altered look or feel of the skin on the breast or the nipple (dimpled, inflamed, scaly, or puckered)
    One area on the breast that looks very different from the other areas
    Hardened area under the breast skin

Either one or a combination of these should be an indication to get a detailed checkup done. Early diagnosis results in controlling the disease with minimal treatment and reduced complications.

Causes and risk factors: The exact cause for breast cancer is yet to be pinned down. However, risk factors are clearly identified, and women with risk factors need to watch out for warning signs.

    Family history: Of all the risk factors, the family history is the most important. Breast cancer runs in families, and if there is a first-degree relative with the breast cancer, the chances of developing it are almost double. Two genes BRCA1 and BRCA2 are the carriers of the disease, and this testing can be done in women to identify if they are at risk.
    Family history of other cancers: Even if there is no breast cancer, if there are other cancers that run in the family, watch out.
    Age: Women over 50 are at higher risk of developing breast cancer.
    Race: Caucasian and Jewish women are at higher risk of breast cancer than African-American women.
    Hormones: Greater exposure to the female hormone estrogen increases the chances of developing breast cancer. Women who use birth control pills for contraception and hormone replacement after menopause are at a higher risk of developing breast cancer.
    Gynecologic milestones: Women who have abnormal menstrual milestones need to watch out. These include those who attain menarche before 12 years of age, get pregnant after 30, attain menopause after 55, and have menstrual cycles shorter than 26 days or longer than 29 days.
    Obesity and alcohol abuse are also likely to increase a woman s chances of developing breast cancer.

Stages: Starting from stage 0, higher stages indicate advanced disease.

    Stage 0: The growth which has begun in the milk-producing tissue or the ducts has remained there (in situ) and not spread to any other area, including the rest of the breast.
    Stage I: The tissue slowly becomes invasive and has begun to affect the surrounding healthy tissue. It could have spread to the fatty breast tissue and some breast tissue may be found in the nearby lymph nodes.
    Stage II: The cancer at this stage grows considerably or spreads to other parts. There are chances that cancer may grow and also spread.
    Stage III: It may have spread to the bones or other organs but small amounts are present in up to 9 to 10 of the lymph nodes in the armpits and collar bones which makes it is difficult to fight.
    Stage IV: The cancer is widespread to far-flung areas like the liver, lungs, bones, and even the brain.

Screening: This is one of the most effective ways to identify the disease in its early stages. This will help in controlling cancer from spreading with minimal treatment.

    Self-examination: A thorough self-examination to look for changes in terms of shape, size, colour, contour, and firmness should be learned by all women. Watch for any discharge, sores, rashes, or swelling in the breasts, surrounding skin, and nipple. Examine them while standing and when lying down.
    In most women, annual screening mammograms are advised after the age of 40. However, in women who have a strong family history or genetic makeup, it is advisable to have screening mammograms starting at age 20 every 3 years and then annually from the age of 40.
    Women in high-risk categories should have screening mammograms every year and typically start at an earlier age.
    Ultrasound screening can also be given in addition to mammograms.
    Breast MRI is another way to screen for breast cancer if the risk is greater.

Breast Cancer Prevention: Now that there is so much awareness about causes and risk factors, there are definitely ways to prevent or delay the onset of the disease.

    Exercise and a healthy diet with reduced amount of alcohol are definitely effective in minimising the chances of developing cancer.
    Tamoxifen is used in women who are at high risk for breast cancer.
    Evista (raloxifene) which is used to treat osteoporosis after menopause. It is also widely used in preventing breast cancer.
    In high-risk women, breasts are surgically removed to prevent the development of cancer (preventive mastectomy).

Treatment: As with all cancers, treatment would depend on the stage at which it is identified and include a combination of chemotherapy, radiation, and surgery. As noted earlier, if you are at risk, look out for warning signs as early diagnosis is the key to maximum recovery.

Breast Cancer - Know More to Say 'No' More!

Gastroesophageal reflux disease or GERD is a chronic condition that can cause discomfort and a burning sensation in the chest. This is caused by stomach acids or bile that flows backward into the food pipe. If this happens more than twice a week, the patient may be diagnosed with GERD. Mild cases of GERD may be treated with lifestyle changes, antacids, diet changes and proton pump inhibitors. In more serious cases, surgery may also be needed. This aims at repairing or replacing the lower esophageal sphincter (LES). This valve is responsible for the backward movement of acids from the stomach to the food pipe.

Types of Surgery for GERD
Surgery is usually the last option for doctors treating GERD. This relieves symptoms of GERD and eliminates the need for long-term medication. There are many different types of surgical treatments. Some of the factors that determine the best type of surgery suited to a patient include the patient s age, weight, overall health etc.

Fundoplication: This surgery focuses on tightening the LES. Fundoplication may be performed as an open surgery or as a laparoscopic surgery. In both cases, the stomach is wrapped around the lower esophagus to reinforce and strengthen the LES. Fundoplication is the most common surgical procedure used to treat GERD and has a high success rate.
Stretta Procedure: This is an outpatient procedure that is performed using an endoscope. The doctor will pass a thin tube with an electrode at one end down the patient s esophagus. The electrode heats the tissue in the esophagus and makes tiny cuts. These cuts will then form scar tissue that strengthens the muscles surrounding the esophagus and blocks acid reflux. This is a fairly new procedure and hence the long-term results are still not clear.
Bard EndoCinch System: This procedure is not very common. It involves the use of an endoscope that is used to make stitches in the esophagus so as to create pleats in the LES. This helps strengthen the valve and prevent acid reflux.
Linx Surgery: This is a minimally invasive surgery where a special device called a linx is wrapped around the LES. A linx can be described as a small ring of magnetic titanium beads. This ring allows food to pass through but otherwise keeps the opening between the esophagus and stomach closed. Linx surgery is a relatively new procedure that has shown good results.
Recovering from Surgery for GERD
Recovering from surgery for GERD depends largely on the type of surgery undergone. Laparoscopic procedures have a short recovery time and are associated with less pain as compared to traditional open surgeries. Open surgery usually takes 2 weeks for full recovery while a patient may recover from laparoscopic surgery within a week.

Surgery For GERD - Types, Results and Recovery

The bladder is a hollow storage organ that collects urine from the kidneys and stores it until it can be passed out of the body through the urethra during the process of micturition or urination. It has a thin inner lining of cells called urothelial cells and a thick muscular wall, which exerts pressure to push the urine out of the body.

Causes of Bladder Tumors

In most cases, the bladder tumor develops on the inner layer due to a combination of some of the following factors.

1. Hereditary: A strong family history of cancer predisposes a person to cancer.
2. Gender: Men are 3 times more prone for bladder cancer than women.
3. Ethnicity: White people are more prone for bladder cancer black people.
4. Smoking: Smokers develop bladder cancer 2-6 times more frequently than non-smokers. cigarettes contain toxic, carcinogenic substances which reach the kidney and are stored in the bladder, leading to their damage.
5. Occupational hazards: Some workplaces have a higher likelihood of causing bladder cancers, especially dye and rubber industries. The effects can be damaging, and the person may develop cancers years after the exposure has happened.
6. Recurrent bladder infections: In some people, this can also lead to bladder cancer in the long run.

Types of Bladder Tumor

Depending on the extent of the cancerous spread, it can be of two types:

1. Non-muscle-invasive bladder tumors: The tumor spread is limited to the inner part of the bladder (urothelial cells)
2. Muscle-invasive bladder tumor: The tumor has spread to the thick muscular outer layer. This is more advanced and prognosis is poor compared to the noninvasive type.

The most common and diagnostic symptom of bladder cancer is the presence of blood in the urine, known as hematuria. This will be intermittent and happens whenever the tumor bleeding happens. Other symptoms include pain in the lower abdomen and frequent urination.

Diagnosis

From the most noninvasive to the most invasive diagnostic test, these include:

1. Urine microscopy to detect cancer cells in the urine
2. Cystoscopy A tube inserted into the urethra to look into the inner wall of the bladder is highly diagnostic
3. Ultrasound, CT Scan, and biopsy can also be further used to identify severity of the tumor.

Treatment

Once the tumor is diagnosed, treatment would depend on the severity of the tumor. For both invasive and noninvasive tumors, definitive therapy is surgery, known as transurethral resection of the bladder tumor (TURBT). The cancerous bladder tissue is removed through a cystoscope as done for diagnosis. The bladder is then flushed with chemotherapy agent to kill any residual cancer cells in the bladder. This is then followed by BCG vaccine, which is again done 1 to 4 weeks for several months to avoid recurrence. In some cases, radiotherapy may also be included.

Bladder Tumor and Its Common Causes

Homeopathy can very well dissolve gall stones of small and medium sizes, and relieve the gall bladder and body permanently from the pain, suffering and complications coming from gall stones. One of the benefits of homeopathic treatment for gall stones is that your gall bladder does not need removal, and being an important organ for producing digestive enzymes, it is better to keep it in your body. The other benefit is that you get a side effect-free treatment, which is completely efficient and practical, and costs really low compared to other modes of treatments and surgeries.

But before one goes for a homeopathic treatment, a complete evaluation of the patient s case history must be done so that the right medicine can be given as per the case, history, severity etc. Here is a quick look at the commonly used homeopathic medicines, which doctors, depending on your case history, may prescribe for your gall stone.

Homeopathic medicines used for treating gall stones

Calcarea carbonica: If you have a family history of kidney and gall stones, are anxious and slow, overweight with high deposits of triglycerides and cholesterol, then you would be given this medicine.
Chelidonium: If you get pain in any or both of the two patterns pain originating under your right shoulder blade and pain in the upper right abdomen, which spreads to the back, you will be prescribed this one.
Lycopodium: This medicine is usually recommended in case you have a family history of stones in kidney and gall bladder, along with other complications like, chronic digestive disorders, high cholesterol, gastric problems, constipation, peptic ulcers, gas and bloating. The patient may usually get biliary colic pains late in the afternoon. He or she may also get irritated easily, and hate contradicting opinions.
Natrum sulphuricum: The patient may have any or some of the problems like chronic diarrhea, gall stone pain, asthma, chronic obstructive pulmonary disease, depression, obesity and problem in joints. On top of that the patient may be too sensitive to changes in humidity and weather. In such a case, Natrum sulphuricum is given.
Nux vomica: If a patient suffers from nausea, colic pains, spasmodic pains, heartburn and acidity, gas and bloating, and takes too much of rich and oily food and drinks, then this medicine is used to treat gall stones for him or her.
As you can see, there is a remedy for all types of patients. Hence in case of small to medium sized gall stones, you can always retain the gall bladder, avoid surgeries, and keep patience with systematic homeopathic treatment from an expert doctor. You will get positive results soon.

Gallbladder Stone - Can Homeopathy Treat it?

Problems of the large intestine are very common and patients should usually consult gastroenterologists for the proper diagnosis and treatment

1. Bleeding per rectum: Bleeding through the anal canal or rectum is usually the most common problem of the patients. It can be due to following reasons: 

A. Piles also known as Hemorrhoids: Hemorrhoids are dilated venous channels of the anal canal. They occur due to long term constipation or chronic cough or due to less fibre intake in the diet. Sigmoidoscopy or proctoscopy is required for diagnosis. Treatment options include medicines and high fibre intake, Injection therapy(Sclerotherapy) for stopping bleeding from piles and Stapler hemorrhoidectomy if the piles are large.

B.  Polyps: Polyps are soft tissue growths seen in the large intestine. They are usually silent but can present with bleeding or anaemia. Polyps usually grow slowly in size and large polyps can turn into cancer of large intestine also known as colorectal carcinoma. Colonoscopy is required for the diagnosis. The gastroenterologists can diagnose the presence of polyps by colonoscopy. Smaller polyps can be removed by polypectomy by gastroenterologists without the need for open surgery. However large polyps or those polyps with suspicion of cancer require surgery.

C. Large intestine Ulcer: They can occur due to early cancer, SRUS, Infections or drugs. They require colonoscopy for the diagnosis. The gastroenterologists usually take Biopsy from the ulcer to know the cause of the ulcer. The mere taking of biopsy does not mean cancer and biopsy samples are seen in the microscope for better diagnosis.

D. Ulcerative Colitis and Crohn s disease: Ulcerative colitis is one form of Inflammatory bowel disease (IBD). The other IBD is known as Crohn s disease. Whereas ulcerative colitis involves only large intestine, Crohn s disease can involve any part of the gastrointestinal tract including small intestine. Ulcerative colitis and Crohn s disease present with Loose stools(diarrhea), bleeding , abdominal pain, weight loss, Anemia and Perianal fissures and  fistula. The diagnosis of IBD is challenging and involves blood tests, CT Scan abdomen, Colonoscopy with biopsy and clinical history. Management includes Medicines which control the inflammation such as Pentasa, Rowasa, Mesacol etc. Severe disease requires additional drugs such as Azathioprine and Anti TNF sich as Infliximab and Adalimumab. Occasional cases require surgery such as those with tight stricture of the intestine, severe dilatation of Large intestine (also known as Toxic megacolon), excessive bleeding, the disease not responding to medical management, or presence of cancer with IBD.

E. Anal fissures: Cut in the anal skin (fissure) causes severe pain in the anal area during passing motions. It is usually due to constipation or straining. It is usually treated by Gastroenterologists initially by medicines and ointments. If the pain continues Surgery is required named as Lateral internal sphincterotomy (LIS).

2. Loose motions or Diarrhea: Excessive passing of liquid motions is known as diarrhea or commonly lose motions. It is usually due to Infections caused by contaminated food and water. It is usually self-limiting. Severe cases with dehydration require admission for IV fluids and antibiotics for the infection. Loose motions for more than 6 to 8 weeks is known as chronic diarrhea. It is evaluated by blood tests and colonoscopy. Usual causes include tuberculosis, celiac disease, ulcerative colitis, microscopic colitis, Malabsorption such as chronic pancreatitis and small bowel bacterial overgrowth.

3. Irritable bowel syndrome (IBS): IBS is very common and at least 20 to 30 percent of Indian patients suffer from it. Symptoms include altered bowel habits such as diarrhoea or constipation, abdominal pain which is usually relieved or increased by defecation. Weight loss or bleeding is not the feature of IBS. Few simple blood tests are required and good medicines are now available for IBS. Few cases may require colonoscopy to rule out alternative causes of the symptoms.

Understanding colonoscopy: Colonoscope is a flexible tube with a camera at its tip to see the inside of the large and small intestine. Bowel preparation is required at least 8 hours before the procedure so that the inside of the large intestine can be seen clearly without the interference of stools.colonoscopy is an OPD based procedure where the patients are discharged the same day. A colonoscopy helps in evaluation symptoms of the large intestine such as loose stools, bleeding and abdominal pain.

In Detail About Colorectal Disorders!

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