An anorectal abscess is a painful swelling near the anus or in the buttock. The swelling contains pus. 60% anorectal abscesses are superficial and resulting from infection in small anal glands present in between internal and external anal sphincters (intersphincteric space). They are known as a perianal abscess. 30% of anorectal abscesses are deep-seated and results in systemic infection. They are call Ischiorectal abscess. Submucous abscess, pelvirectal abscess and pilonidal abscess developed from versatile cause are comparatively less common. Inadequate and improper management of anorectal abscess may potentially cause complication like fistula formation.


Fast facts on Anorectal abscess-

* Anorectal abscess should be drained at the earliest.
* Conservative medical management almost invariably invites complication like fistula formation.
* Surgical drainage of pus reduces the chance of fistula formation by 50%.


What causes Anorectal abscess?

* Blocked and infected anal glands (cryptoglandular infection).
* Untreated anal fissure that becomes infected.
* Sexually transmitted infections.
* Penetrating injury of the perianal or buttock region.
* Crohn s disease.
* Colon cancer.
* Tuberculosis.



What are the symptoms of Anorectal abscess?

Superficial abscess-

* Constant and throbbing pain that worsens on sitting down.
* Swelling, redness and tenderness of the skin around the anus.
* Discharge of pus.
* Pain is often associated with bowel movement.

Deep abscess-

* All or some of the symptoms of a superficial abscess.
* Fever with chill and rigor.
* General weakness.
* Sometimes fever is the only symptom of the deep abscess.

The anorectal abscess should preferably be explored under general or spinal anesthesia. Medical management often fails and subsequently fistula is formed.

Anorectal Abscess - Know In Detail About It!

It is an extremely embarrassing situation to have a bladder leakage. Social life could be altered, with reduced socialising for fear of losing control in the presence of others. Though not discussed frankly, it is an extremely common issue and about 25 million people in the United States suffer from this, with 75% of these being women.

Treatment depends on the type of incontinence, such as stress, urge, overflow, functional, or mixed. It starts with least invasive methods like lifestyle changes moving over to surgical approaches.

Ways to manage it

With trips to the toilet increasing considerably when you have urinary incontinence, simple measures can help manage leakage.

Bladder training: Train your bladder to control the urge for another 10 minutes. This happens by voluntarily contracting the muscles and holding up the urge to go to the toilet. Gradually, it will help increase the frequency of the visit to 4 to 6 hours.
Scheduled toilet trips: Whether or not there is an urge, visit the toilet every 4 to 6 hours.
Double emptying: Even after you have voided, force yourself to void one more time. The residual urine, which is almost always present in the bladder, also gets emptied.
Food/diet modifications: Stress incontinence is worsened by alcohol, spicy foods, acidic foods, and caffeine. Avoiding these can help reduce bladder leakage.
Kegel exercises: The simple repetition of contracting the pelvic floor muscles, holding it in place, and releasing it can do wonders for strengthening the pelvic floor. This can be done anywhere and any time of the day and is very effective for improving bladder control.
Catheters: These can be used if the incontinence is short-lived; the person would need to learn how to safely insert and remove it.
Absorbent pads and medical devices: The absorbent pads are helpful in preventing embarrassment during social situations. On the other hand, medical devices like pessary are inserted into the vagina to support the bladder neck and thereby prevent leakage from the bladder.
Drugs: Anticholinergics/antimuscarinics are useful to control a leaking bladder. Botox injections can help paralyse the overactive bladder muscles and provide a solution. Topical oestrogen may be used in small amounts to improve tone and reduce incontinence. Alpha blockers are also used in some people with good results. There are muscles that relax the bladder and increase the amount of urine it can contain.
Surgery: In the event that all these measures are not useful, surgical correction is possible. Sling procedure where an artificial mesh is used to support the urethra. Bladder neck suspension is where the bladder neck is given support to prevent leakage. If there is a pelvic organ prolapse, that is corrected to rectify the bladder leakage.

 Bladder Leakage - Solutions To Help You Manage It!

A hysterectomy is an operation to remove the uterus and, usually, the cervix. The ovaries and tubes may or may not be removed during this procedure, depending on the reasons for the surgery being performed. If the ovaries are removed, you will commence menopause. A hysterectomy is a major surgical procedure with physical and psychological consequences.

Why is a hysterectomy performed?

Common reasons include painful or heavy periods, pelvic pain, fibroids or as a part of therapy for cancer. You should have a clear understanding of your reason for this surgery.

How is this done?

The procedure is normally performed under a general anesthetic and takes approximately one hour. To commence your anesthetic a drip is inserted into your arm. Once you are asleep, you will have a urinary catheter inserted. The importance of the catheter is to reduce the size of your bladder, keeping it away from the operation site and reducing the risk of complications.

There are three ways to remove the uterus:

Vaginal hysterectomy - The removal of the uterus and the closing of the wound is performed through the vagina. There is no cut in the abdomen. 
Laparoscopic hysterectomy - About four small keyhole cuts are made in the abdomen to divide the attachments of uterus, ovaries, and tubes in the pelvis. The uterus is usually then removed through the vagina.
Abdominal hysterectomy - The uterus is removed through a cut in the lower abdomen. The cut is about 15 20 cm in length and runs across your abdomen, usually below the bikini line. Less commonly, it may be necessary to have a cut that runs from the belly button down to the pubic area.
What are the risks of undergoing this procedure?

Although the risks associated with hysterectomy are low, you should be aware that every surgical procedure has some risk. This may also depend upon the type of surgery you have. 
Severe bleeding from large blood vessels around the uterus or top of the vagina. This is not common. A blood transfusion may be required to replace blood loss. A vaginal pack may also be used to control the bleeding.
Infection in the operation site, pelvis or urinary tract.
Nearby organs such as the ureter (tube leading from kidney to bladder), bladder or bowel may be injured expected to happen to approximately one in every 140 women. Further surgery will be needed to repair the injuries.
The bowel may not work well after the operation; this is usually temporary. Treatment may include a drip to give fluids into the vein and no food or fluids by mouth.
Things to do before you come to the hospital

It is important for you to have all the tests ordered at your outpatient clinic appointment completed prior to coming to the hospital these include blood tests and an ECG and chest X-ray, if you are more than 50 years old

You may be required to have a bowel preparation, which will empty your bowel prior to the surgery.

You should stop eating and drinking at the following times on the day of your surgery unless otherwise notified

At midnight if your procedure is in the morning

At 6 am if your procedure is in the afternoon.

You will need to shower and dress in clean clothes prior to coming into hospital. It is important that you do not shave your operation site as this increases the risk of wound infection.

Please remove all body jewelry.

After your surgery

When you wake from the anesthetic, you will be ready to be transferred, in your bed, for recovery.

Having an anesthetic can make you feel sick and may cause vomiting. You will have a drip in your arm which is necessary to maintain fluid intake and provide pain relief. This will remain in until you can tolerate food and fluids and your pain control is changed to oral medication.

Your nurse will take frequent observations of your vital signs e.g. temperature, pulse, blood pressure.

You may have small amounts of water or ice to suck, then progress from fluids to a normal diet as tolerated.

If you have pain or nausea, please tell your nurse. Effective pain management is important.

You will have a urinary catheter in place. The catheter will normally be removed the day following your surgery.

Recovering at home

What to expect

You may have a blood-stained vaginal discharge which is similar to a light period. This will gradually reduce to nil over 4-6 weeks as your internal wounds heal

You may need to take some simple analgesia for pain/discomfort, especially on waking and settling at night

You may feel fatigued

You may require up to four to six weeks off work. You should have returned to normal activity by two to three months, depending on the type of surgery, although full recovery may take longer

After the operation, you will no longer have a period

For the majority of women, hysterectomy surgery does not have a negative effect on sexual function

What to avoid

For the first two to three weeks lift nothing greater than two kilograms. Increase gently as tolerated over six weeks.

It will take about three weeks before you should drive a car. Only when you know you can act confidently with emergency breaking should you attempt driving the car.

Avoid sexual intercourse for six weeks to allow healing to take place.

Avoid inserting anything into the vagina for six weeks to allow time for healing to take place (e.g. use sanitary pads and not tampons).

It is important to avoid constipation and straining immediately after your surgery as this will assist healing and improve your comfort.

Contact your doctor if you develop any of the following complications:

Your wound becomes red or inflamed, painful.

You have heavy vaginal bleeding heavier than a normal period.

You have offensive vaginal discharge.

You develop a fever i.e. temperature of about 38  C, or you are feeling unwell.

You have pain that is not relieved by simple analgesia.

You are having difficulty passing urine or opening your bowels.

 In case you have a concern or query you can always consult an expert & get answers to your questions!

Surgery For Womb Removal - What You Need To Be Aware Of?

Heartburn or acid reflex is a burning sensation that is felt in the throat or chest region after the intake of certain foods. While many of us must have felt heartburn once in our lifetime, too many occurrences such as this could be a fair indication of esophageal cancer.

How an acidburn is related to esophagus?
Esophagus is the tube which carries food from the throat to the stomach. In the case of an acid reflux, the acid from the stomach jumps to the esophagus leading to a condition known as the Barrett s esophagus. This is a condition which replaces the tissue present in the esophagus with a similar kind of tissue found in the lining of the intestine. This being said, Barrett s esophagus doesn t necessarily lead to esophageal cancer.

Key symptoms of Esophageal Cancer
Difficulty swallowing is a key symptom of esophageal cancer. This condition is known as dysphasia. As the tumor grows bigger, it becomes more difficult to swallow food. Esophageal pain is also a common symptom reported by many patients. Loss in appetite and an unexplained weight loss are some of the other symptoms of this type of cancer. Although esophageal cancer does not show any visible signs in the early stage, some of the key indicators are chronic couch, indigestion and hoarseness of voice.

Key risk factors:
Some of the key risk factors for this type of cancer are as follows:

    Men tend to run a higher risk of getting this cancer than women.
    Esophageal cancer are often detected in people above the age of 55 or more
    Chronic tobacco users have higher chances of getting esophageal cancer
    Consumption of alcohol increases the risk of esophageal cancer
    Obesity increases the risk of acid flux thereby, leading to esophageal cancer
    Radiation treatment in the abdomen or chest area might also lead to esophageal cancer

How an esophageal cancer is detected?
Primarily there are 3 ways by which this cancer is detected. The first step for an oncologist to detect this cancer is to perform an endoscopy. If this fails, doctors often try a barium swallow on suspected patients and take an X-ray to understand the esophagus lining. If all this fails, doctors rely on a CT scan to detect this cancer.

How is esophageal cancer treated?
If a patient is lucky and the cancer gets detected in a very early stage, the tumor along with the infected cell can be surgically removed. Apart from surgery, some other alternatives are radiation and chemotherapy. A combination of radiation and chemotherapy or a surgery followed by radiation can also be suggested by the doctor. The treatment plan depends on the stage of detection.

Does Heartburn Lead to Esophageal Cancer?

Colon cancer is believed to be one of the common types of cancer affecting people. As the name suggests, here, the point of origin of the cancer is the colon or the large intestine. Though colon cancer can affect anyone, people with unhealthy lifestyle (sedentary) and habits (excess smoking and consumption of alcohol), obesity, certain medical conditions like diabetes, or exposed to radiations (radiation therapy) are at a greater risk of colon cancer. Colon cancer may also be hereditary.

Colon cancer usually proceeds through five stages, stage 0 (zero), stage I, II, III and IV.

In stage 0, cancer remains in situ, (it remains confined within the innermost layer of the colon).
In stage I, cancer slowly starts spreading to the other layers (second and third) of the inner walls of the colon.
In stage II, cancer spreads further to the muscular walls of the colon (the lymph nodes, are, however, still not affected by this condition).
In stage III, cancer spreads outside the colon, affecting one or more lymph nodes.
Stage IV is more severe and metastatic. Here cancer has spread to and affected vital organs like the liver and the lungs.
Many of the symptoms do not appear at the initial stages. As a result, colon cancer mostly gets detected at a later (often metastatic) stage. Thus, a person should be alert. The initial symptoms, no matter how trivial, should be taken seriously. There is no harm in seeking medical help. It will only help you in the long run. 

The following symptoms are often the initial or first signs of something as big as colon cancer.

Unexplained poor appetite followed by sudden and rapid weight loss. Losing weight at an alarming rate without sweating it out needs thorough investigation. More than often, colon cancer interferes with the digestion process in a person. A person is not able to eat well. There is a feeling of being full (irrespective of how much you eat) all the time.
Constipation, gas or (and) diarrhea. Often overlooked and mistaken for common bowel disorder, these are some of the initial symptoms of colon cancer. The symptoms may be an outcome of polyps (abnormal tissue growths that can take place in any organs. These polyps are mostly benign in nature) or malignant tumors in the colon. Seek medical help if the conditions persist for more than a week. It is better to be safe than to be sorry.
A person feels exhausted, sleepy and weak all the time. The symptom may be an outcome of iron deficiency and anemia. Colon cancer can cause injury to the digestive tract. There may be bleeding followed by blood loss and hence the associated symptoms.
Mild to severe abdominal pain. The abdomen also appears tender than usual (in the case of metastatic tumor).
Stomach upset accompanied by pain, nausea, vomiting, cramps and at times, indigestion (an outcome of intestinal obstruction and inflammation).
There may be blood while passing stool.

Colon Cancer - What Signs You Must Watch Out For?

A breast lump is a restricted swelling, projection, lump or knot in the breast that doesn't feel like a breast tissue. There are diverse reasons why breast lumps occur.

Not all lumps are cancer. These can also be breast conditions that are not harmful and which can be easily curable.Knots that feel harder or are not the same as the rest of the breast need to be checked. This kind of irregularity might be an indication of breast cancer.

A self-examination should be your starting point. This is how you can detect a lump on your own:

Step 1: Begin by taking a look at your breast in the mirror. Keep your shoulders straight and your arms on your hips.

This is what you need to search for:

    Breasts that are their typical size, shape, and shading
    Breasts that are uniformly formed without distortion or swelling

In the event that you see any of the changes mentioned below, convey them to your doctor:

    Dimpling, puckering, or protruding of the skin
    A nipple that is not in its initial position
    Redness, rash or swelling

Step 2: Now, raise your arms and look for the changes mentioned above.

Step 3: While you're in front of the mirror, search for any indications of liquid or blood discharge from the nipples.

Step 4: Next, examine your breasts while resting.Use Your right hand to feel your left breast and use your left hand to feel your right breast. Cover the whole breast from your collarbone to the highest point of your mid-region, and from your armpit to your cleavage to search for any lumps.

Step 5:Examine your breasts while either standing or sitting. Many women find that the easiest approach to examine their breasts is when their skin is wet, so this step could be done while taking a bath as well.

Diagnosis:

    Mammogram: Mammography is a technique using X-rays to diagnose and locate tumours of the breasts.
    Breast ultrasound: Breast ultrasound utilises sound waves to create pictures of the breasts from the inside.
    Breast MRI:This involves using an effective and attractive field, and radio frequency pulses to create photos of the insides of the breasts.
    Ultrasound-guided biopsy: During this sort of biopsy, utilising ultrasound imaging to discover the bump, a radiologist will give you anesthesia and afterward insert a needle into the lump to evacuate some tissue for assessment under a magnifying lens. Stereotactic biopsy and an X-ray-guided biopsy may also be used.

Possible treatments:

    In case the knot turns out to be cancerous, surgery is typically performed.
    You may have a few discussions with different doctors for additional treatment, including radiation treatment and chemotherapy or hormone treatment.

What You Should Know About Breast Lump Detection

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