A Gastroenterologist is a physician with dedicated training and unique experience in the management of diseases of the gastrointestinal tract and liver. If you are planning to visit one, you most likely have a problem in one or many organs like esophagus, stomach, small intestine, colon and rectum, pancreas, gallbladder, bile ducts and liver. 

Visit your doctor to understand the severity of your condition and the course of treatment, as it is obvious that during this time you must be suffering from anxiety and you may not ask the questions arising in your mind. That is why you need to prepare in advance for your first visit with a gastroenterologist. Being an active partner in the doctor patient relationship is bound to have its benefits. Here are some handy tips:

1. Come mentally prepared: Don't let the anxiety get to you. If you need some extra help calming down, try yoga or meditation. You can simply go out on a walk alone to help you focus your thoughts. This is just like any other doctor visit. The good part is that you are taking the first step in easing your discomfort and starting treatment, so go with a positive mind.

2. Maintain a diary of symptoms: It is likely that you are experiencing discomfort from past few days or weeks before you finally realize the need to seek out a specialist. Try to remember as much as possible about the symptoms you experienced in a chronological order. Write down any over the counter medicines you've tried or anything unusual that you may have consumed in the past week. 

3. Take stock of your medical history: It is likely that your doctor may want to know about any historic conditions you've suffered that may or may not relate to your present condition. Many ask you to fill out forms during your first time patient registration which includes many minor details about your medical past. List down any allergies, especially food allergies you have. 

4. Take stock of your recent medical tests: Bring your latest blood tests and imaging tests (X-rays, ultrasounds, MRIs, and CT scans) with you for the doctor's visit. If you have a pre-existing condition like diabetes, thyroid or you suffer from other chronic conditions like increased uric acid, carry your most recent medical reports with you. 

5. Make a list of questions for the doctor: In most cases, the first visit is a crucial factor in determining whether you want to continue the course of treatment with a particular doctor. This comes out of your ability to trust the doctor, his knowledge and diagnosis and an overall comfort level that comes with how well he handles your questions. Start by making a list of questions you want to ask about your specific condition and course of treatment and see if you get satisfactory answers. 

6. Brace yourself: If you want to suggest a treatment option, make sure you read up all about it before you tell the doctor.

6 Tips For Your First Visit With A Gastroenterologist

Like most things in life, the uterus also has both good and bad sides to it. It is a symbol of womanhood and also carries the developing baby. The bad side is that it brings with it (and its appendages) many problems including dysfunctional uterine bleeding, endometriosis, fibroids, pelvic inflammatory disease, uterovaginal prolapse, adenomyosis, a pelvic pain of unknown origin, cancer of the uterine cavity and other obstetric complications.

Hysterectomy is one of the most commonly performed procedures and ensures complete relief from these symptoms. There are however, multiple procedures, which can be used to manage these conditions without having to resort to removal of the uterus. This can help in preventing complications from hysterectomy including prolonged recovery, infertility in women of childbearing age and loss of womanhood.

Read on to know some of the emerging conservative alternatives to hysterectomy:

Myomectomy: Where there are fibroids, which are in the smooth muscles of the uterus and show symptoms like pain and discomfort. In these, it is advisable to go for a myomectomy. This removes only the fibroid, leaving the uterus in place. It can be done in one of the 3 ways traditional surgical process through an incision; laparoscopically through minute incisions; and then through vagina. In all these, only the fibroid is removed and sent for biopsy to confirm it is benign. It is less invasive, requires less recovery time and helps retain the uterus.

Uterine endometrial ablation: In cases of dysfunctional uterine bleeding or menorrhagia with no fibroids, the lining of the uterus could require removal. In these women, thermal balloon ablation, cryoablation, and radiofrequency ablation can be used. A small amount of extreme heat or cold or radio frequency waves are used to remove the uterine lining, thereby managing symptoms.

Uterine artery embolization: In women with fibroids, the feeding arteries could be cauterised to ensure blood supply is stopped so that fibroid growth is stopped. With very promising success rates, this is gaining popularity as a conservative method.

Laparoscopy and endometriosis excision: In endometriosis, where the uterine tissue is growing in areas outside the uterus, it could be removed laparoscopically after identifying the area of growth on ultrasound and laparoscopy.

Vaginal pessary: In women with uterine prolapse, the uterus drops from its normal position, pushing against the vaginal walls. This can be due to vaginal childbirth, age, smoking and obesity. Vaginal pessary is where a removable device is placed into the vagina to prevent it from falling down. It is a temporary solution, but very useful in holding the uterus in place and relieve symptoms partially or completely.

In all these, medical management (painkillers and hormone replacement), stress and weight management, quitting smoking, reducing alcohol are also essential.

Hysterectomy - Know the Emerging Conservative Alternatives to it?

What is Laparoscopic Gallbladder Removal Surgery (Laparoscopic Cholecystectomy)?

Gallbladder removal is one of the most commonly performed surgical procedures. Gallbladder removal surgery is usually performed with minimally invasive techniques and the medical name for this procedure is Laparoscopic Cholecystectomy or Laparoscopic Gallbladder Removal.

The gallbladder is a pear-shaped organ that rests beneath the right side of the liver. Its main purpose is to collect and concentrate a digestive liquid (bile) produced by the liver. Bile is released from the gallbladder after eating, aiding digestion. Bile travels through narrow tubular channels (bile ducts) into the small intestine. Removal of the gallbladder is not associated with any impairment of digestion in most people.

What Causes Gallbladder Problems?

Gallbladder problems are usually caused by the presence of gallstones which are usually small and hard, consisting primarily of cholesterol and bile salts that form in the gallbladder or in the bile duct.

It is uncertain why some people form gallstones but risk factors include being female, prior pregnancy, age over 40 years and being overweight. Gallstones are also more common as you get older and some people may have a family history of gallstones. There is no known means to prevent gallstones.

These stones may block the flow of bile out of the gallbladder, causing it to swell and resulting in sharp abdominal pain, vomiting, indigestion and, occasionally, fever. If the gallstone blocks the common bile duct, jaundice (a yellowing of the skin) can occur.

Diagnosing 

Ultrasound is most commonly used to find gallstones.
In a few more complex cases, other X-ray test such as a CT scan or a gallbladder nuclear medicine scan may be used to evaluate gallbladder disease.
Gallstones do not go away on their own. Some can be temporarily managed by making dietary adjustments, such as reducing fat intake. This treatment has a low, short-term success rate. Symptoms will eventually continue unless the gallbladder is removed. Treatments to break up or dissolve gallstones are largely unsuccessful.

Surgical removal of the gallbladder is the time-honored and safest treatment of gallbladder disease.

What are the Advantages of Performing Laparoscopic Gallbladder Removal?

Rather than a five to seven inch incision, the operation requires only four small openings in the abdomen.
Patients usually have minimal post-operative pain.
Patients usually experience faster recovery than open gallbladder surgery patients.
Most patients go home the same day of the surgery and enjoy a quicker return to normal activities.
Are you a Candidate?

Although there are many advantages to laparoscopic gallbladder removal (cholecystectomy), the procedure may not be appropriate for some patients who have severe complicated gallbladder disease or previous upper abdominal surgery. A thorough medical evaluation by your personal physician, in consultation with a surgeon trained in laparoscopy, can determine if laparoscopic gallbladder removal (cholecystectomy) is an appropriate procedure for you.


Laparoscopic Cholecystectomy - Laparoscopic Gallbladder Removal Surgery!

Kidney transplant surgery is a surgical procedure where a healthy kidney is used to substitute a diseased one. The healthy kidney is obtained from either a deceased donor or a family member who has a good blood type match with the recipient. Usually, the recipient receives one kidney if the donor is alive and/or both the kidneys from a deceased donor.

Certain reasons for going for a kidney transplant surgery might include:
1. Kidney failure due to diabetes
2. Infections in the urinary tract
3. Autoimmune disorders such as lupus (an autoimmune disorder)
4. Polycystic kidney disorders
5. Obstructions in the kidney
6. Glomerulonephritis, where inflammation occurs in the kidney

Preparation for the surgery
Before the procedure, certain tests are carried out to determine your suitability for the procedure. The tests start with a psychological evaluation followed by blood tests and diagnostic tests to check for health problems. Once the tests are done, you will be placed on the waiting list for kidney recipients. Once the donor is available, you will be asked to get ready for the surgery.

Procedure: The procedure begins with you being administered general anesthesia. An incision is made in the lower part of the stomach, through which the donated kidney is inserted in the body. The next step involves attaching adjacent blood vessels to the kidney so that it has a proper supply of blood. Finally, the ureter of the kidney is linked with the bladder, facilitating normal disposal of bodily wastes. A plastic tube, known as a stent, is placed in the ureter to facilitate urine flow. This is later removed by a procedure called cystoscopy. Once the surgery is completed, the incision is closed by stitches.

Aftercare: After the procedure is completed, you will be given painkillers to ease the pain. Immunosuppressant medications will be prescribed to prevent your immune system from destroying the cells of the donated kidney. Usually, the duration of stay at the hospital post-surgery is about a week. 

Kidney Transplant Surgery and What You Should Know About It

The incidence of pain and lumps in the breast is on the rise. Breast cancer has grown in incidence over the years. More women are getting diagnosed with it, and the age at which they are being diagnosed has reduced too. Therefore, preventative checks and screenings have gone up significantly. The number of women diagnosed with small lumps has gone up drastically. The good thing is that since these are diagnosed in the early stages, the treatment is simpler and the prognosis far better than women who get diagnosed much later in life.

In a majority of cases, once a lump is identified the most preferred treatment is removal. This is known as lumpectomy. However, before a final decision is made to remove the lump, there are certain tests that are run by the doctor to confirm the diagnosis and extent of spread.

A thorough breast exam to identify if this is an isolated lump or if there are more lumps in either breast. The exact shape and size of the lump also need to be identified so that treatment can be planned accordingly.
Imaging to see if the lymph nodes have been involved. In most cases, there could be spread to the lymph nodes in the armpits which also need to be removed if required. If the lump is too big or too many in number, then a mastectomy may be required instead of a lumpectomy. This requires removal of the entire breast tissue on one or both sides (rarely) along with involved lymph nodes.
Pre-surgery: Once the diagnosis is confirmed, then the doctor will plan treatment. Prior to the surgery,

Talk to your doctor about your other medical conditions and medications and allergies, if any
Gynecologic history is very important to be discussed in detail
Blood thinners have to be stopped prior to the surgery
Post-surgery care needs to be planned, including a caretaker for a few days and postop care
During surgery:

Lumpectomy or mastectomy is often done under general anaesthesia
This requires hospitalization and carries the risks associated with anaesthesia
The outlined breast tissue or complete breast and surrounding lymph nodes will be removed. The area will be closed using sutures and bandaged
Post-surgery:

The wound needs to heal, and so postop care is very important
For the first few days, painkillers and antibiotics are used to control pain and infection
As a follow-up, some women may require radiation therapy to contain the suspicious tissue that may be left behind after lumpectomy
If extensive breast tissue was removed, some women may prefer to have reconstructive surgery done
Remember that lumpectomy is not a definitive procedure, and there could be cases that require a repeat operation
Advantages:

Less invasive compared to a mastectomy
The appearance of the breast is minimally affected, and symmetry is maintained
Disadvantages:

May not ensure complete removal
May require additional radiation therapy
May require repeat surgery

Surgical Treatment For Pain And Lumps In Breasts Of Women!

Chronic kidney disease or CKD is the decreased function of the function of the kidney for a minimum of three months or more. In this the end stage renal disease usually refers to the end of the kidney function where the kidneys work for less than 15% of what they are supposed to. The kidneys play a vital role in the human body and if they do not function properly then a person can die. The functioning of many organs depends on the kidneys. However, the main function of the kidneys is to remove the products and regulate blood and water, control blood pressure, promote healthy and strong bones, and produce hormones.

Here are 5 facts about kidney disease you should know about:

1. Causes of the kidney disease: There are two main common causes of the end-stage kidney disease. These are preventable causes. These are diabetes and high blood pressure, but then kidney disease can be caused by other inherited diseases such as infection, trauma or polycystic kidney disease.

2. Serious Stages: The kidney disease has five stages and stage 5 is known as the end stage renal disease; this is the point where patients usually need dialysis or kidney transplant to lead a sane life. The stages of kidney disease are:

Stage 1   Slight kidney disease
Stage 2   Mild decrease in kidney function
Stage 3   Moderate decrease in kidney function
Stage 4   Severe decrease in kidney function
Stage 5   End stage renal disease

3. Detection of the disease: Kidney disease is usually difficult to detect because of the presence of very few symptoms. Age, gender along with the blood test is one way to determine information regarding kidney function. The people who are at a risk of getting kidney disease are:

    Over the age of 55 years
    People who suffer from hypertension and diabetes
    Ethnic groups such as Asians, Africans, Americans, Pacific Islanders and Hispanics

4. Signs and Symptoms: CKD is usually considered to be a silent disease and many people don t know that they are suffering from the disease. The signs and symptoms of the disease are:

    Fatigue and weakness
    Nausea, vomiting and loss of appetite
    Dizziness
    Numbness and headaches in hand and feet
    Frequent urination

5. Renal Replacement Treatment: This is the treatment for the end stage of the kidney disease. Dialysis involves the replacement of some part of the lost function of the kidneys and is usually continued throughout life. There are 2 types of dialysis:

    Hemodialysis: This cleans the blood via an artificial kidney which is hooked to the machine
    Peritoneal Dialysis: This removes the excess water and waste products and cleans the blood of the body by using the peritoneal cavity as a filter. 

5 Facts About Kidney Disease You Should Know

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