Following are some common Gall Bladder and Biliary Disorders. Read on to know in brief about them. 

1. Gall stones: Gall stones also known as cholelitiasis is a condition in which gall bladder contains stones or calculi. Usually, these stones are asymptomatic and do not cause any trouble to the patients. Few patients experience recurrent right upper abdominal pain. This condition is known as biliary colic and if it persists, the patiet is adviced gall bladder removal surgery. Sometimes the patient presents with severe right upper abdominal pain with fever and deranged Liver function tests. This condition is known as acute cholecystitis. The surgery is minimally invasive and is called Laproscopic cholecystectomy. If there are dense adhesions, the surgeon may plan to convert the surgery to open cholecystectomy. The patient is usually discharged by day 3 of surgery.

2. Common bile duct stone or choledocholithiasis: Occasionally stone from the gall bladder slips into the common bile duct (CBD stone).This causes obstruction of the bile duct causing Fever, abdominal pain and Jaundice. This is called Cholangitis and is a medical emergency. The patient requires urgent hospitalisation and decompression of the bile duct by inserting a plastic stent in the CBD with the help of ERCP. Severe untreated cholangitis can be life threatenig.CBD Stones which are detected because of dull aching abdominal pain, deranged liver function tests or by ultrasonography also need removal. The CBD stone is removed by an endoscopic modality called ERCP, which is minimally invasive and needs no surgery.

3. Bile duct cancer or cholangiocarcinoma: Cancer of bile duct usually occurs in the elderly patients who present with gradually progressive jaundice. Because of the obstruction to the flow of bile, produced in the liver, the patient develops jaundice. Gastroenterologists examine the patient and CT scan abdomen with MRCP is required to fully evaluate the stage and extent of the tumour. The treatment is multimodality and requires the expertise of Radiologists, Surgeons, Oncologists and gastroenterologists. The Gastroenterologists can help in decreasing Jaundice by inserting plastic or a metal stent (SEMS self-expanding metal stent ) in the common bile duct. These are very aggressive tumours and very few patients are fit for surgery. Survival is very low for these tumours.

4. Gall bladder cancer: Gall bladder cancers are very aggressive and lethal cancers. The patients present with obstructive Jaundice and Itching all over the body. Definitive treatment is surgery but very patients present in the early stage. Advanced stage cancers are treated with palliative intent by metal stenting (SEMS for cancer of gall bladder) to reduce jaundice.

Learn More About Gall Bladder And Biliary Disorders!

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

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 cancer of the bladder (an organ in the pelvic region that stores urine) is known as bladder cancer. This cancer begins in the cells that line the inner portion of the bladder. Though it usually affects the aged, bladder cancer can develop in people across other age groups as well. It is important to undergo frequent check-ups even after the condition has been cured, as there always remain chances of a relapse.
There are three types of bladder cancer:
1. Squamous cell carcinoma: Squamous cells appear in the bladder in response to any infection, which, with time, can become cancerous.
2. Transitional cell carcinoma: These cells are present in the lining of the bladder. They contract when the bladder is empty and expand when it is full. These cells are also found in the urethra, hence there are chances for the cancer to develop in the urethra as well.
3. Adenocarcinoma: Adenocarcinoma forms in the mucus secreting cells in the bladder.

The symptoms of bladder cancer are:
1. You may urinate frequently
2. Frequent backaches
3. You may experience pain during urination
4. Pain in the pelvic region
5. There may be presence of blood in the urine

There is no known cause of bladder cancer. However, certain factors such as smoking, infection and exposure to chemicals are known to trigger it. The risk factors of bladder cancer are:
1. Age: The risk of bladder cancer increases with age, it usually affects people who are above 40 years of age.
2. Smoking: Smoking releases toxins in the body that get stored in the urine. These can damage the inner lining of the bladder and lead to bladder cancer.
3. Gender: Men are more likely to develop bladder cancer as compared to women.
4. Chemical exposure: Exposure to certain chemicals such as arsenic increases your risk of bladder cancer.
5. Chronic inflammation of the bladder: If you suffer from chronic infection of the bladder, then the risk of squamous cell carcinoma increases significantly.

Bladder Cancer - 5 Things That Put You at Risk

A hysterectomy is a surgical procedure that is done to remove your uterus. Robotic hysterectomy is a more preferred procedure than open surgeries because:

They cause minimal discomfort.
They have better recovery options.
Loss of blood is minimized
The pain associated with the usual surgical procedures are less compared to other options.
This is one of the best procedures that have been designed after years of research in the field of robotics. It is true that they are safe, but it does not mean that there are immediate recovery options. The bottom line is that it is a procedure to remove the uterus and you have to give due importance to the recovery procedures that come along with such robotic surgeries. Let us have look at them.

Recovery
The recovery period depends on the type of surgery you had and also depends on a case to case basis. However, you might be asked to stay overnight in the hospital for observation. You would be constantly monitored during this period and any complications that might arise are given utmost care.

Pain medications and medicines to prevent infections that might arise due to the surgery are given during this period.
You may experience a light vaginal bleeding for a few days. However, this is normal and will gradually ease out. In case the ovaries are removed, the recovery period is extremely crucial. You will no longer have menstrual periods and your body would immediately start adapting to the menopause cycle.
During this transition, the hormonal changes start to occur and you might be experiencing mood swings and hot flashes. You may also experience periods of night sweats. However, all these factors are common occurrences and your body would gradually adapt to these changes. The exact recovery period can range from a week to about six weeks. During these times, you would be given the following advice:

Take plenty of rest and limit your activities.
Do not lift any weights or do any rigorous tasks during these periods.
Any sorts of sexual intercourse must be avoided till you heal completely. Talk to your doctor about this and get to know more about the recovery options.
Never miss a periodic check-up during these times.
Always take the prescribed medications on time.
There can be some sense of loss of your uterus during this period. For some women, this can mean that they would not be able to bear a child. These are some of the common stress factors that come into play during the recovery period. Watch out for them and get emotional support guidance from the counsellor, if the need arises.

Underwent A Robotic Hysterectomy? Here Are Some Recovery Tips!

Are you experiencing frequent and extended heartburn on a regular basis? This might indicate that you are having gastroesophageal reflux disease (GERD). It is a type of digestive disorder that affects your lower esophageal sphincters. The condition involves the return of the stomach s content back to your esophagus. Although heartburns are common, GERD involves chronic heartburns, which require an adequate treatment. 

Here the some important reasons why you should not ignore the symptoms of GERD:

Esophagitis: In case of GERD, the food, acid and digestive juices flow back from the stomach to the esophagus. This leads to irritation and swelling with time, which is called esophagitis. In case you have acid exposure in your esophagus for a few weeks, inflammation of the lining is indicated. This can be very painful and uncomfortable, making the esophagus more prone to scarring and further erosion.
Esophageal stricture: If esophagitis continues for a long time, scar tissues can lead to the narrowing of the esophagus. This is known as a stricture, which makes swallowing very difficult and painful. Large chunks of food may get stuck and you are more likely to choke while eating or drinking. You may tend to avoid food and water because of esophageal stricture, which may result in weight loss.
Throat and voice problems: Apart from heartburn, several other symptoms may also appear because of GERD. These are called cases of silent reflux where you may not experience heartburn. Instead, other issues are indicated which include voice hoarseness, voice changes, sore throat and chronic coughing.
Breathing problems: If stomach acid is inhaled after regurgitation, the symptoms of asthma and pneumonia may worsen because of GERD. Shortness of breath and breathing difficulties are likely, even without any lung problem.
Tooth decay: When the stomach acids and digestive juices go back to the esophagus and into the mouth, it leaves a sour taste. In case it occurs frequently, it wears away your tooth enamel and results in tooth decay. People experiencing acid reflux induced erosion may be unaware of the damage being caused until it reaches peak stages.
Esophageal ulcers: Stomach acid may result in the wearing away of the esophageal lining, resulting in ulcers and sores. These esophageal ulcers are different from stomach ulcers, which occur from bacteria. Patients with esophageal ulcers may vomit blood, and notice blood in stool. It is usually darker than its usual shade and may have the texture of coffee ground like particles.
It is important for you to visit a doctor immediately after experiencing the symptoms of GERD. This condition may cause severe distress if you let it advance, and hence, early diagnosis and treatment are very important.

GERD - Reasons Why You Should Not Ignore The Signs!

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