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!

A diseased kidney is one that has lost its ability to carry out the filtration process in a proper manner. This process of filtration usually sends the waste and toxins out of the body in a routine manner. In such cases, a kidney disease manifests which requires a number of treatment measures. Dialysis is something that enters the treatment plan at a later stage as chronic early stage kidney disease can remain in the patient s body for many years. When the kidney function comes down to 15%, then most doctors recommend the start of dialysis which is basically a process that removes the excess waste and fluid from the blood. This can be a process that will leave the patient fatigued and in a mental state that is not exactly stable and positive at all times. It is common to see dialysis patients battling depression due to the chronic nature of the treatment as well as the low chances of recovery.

So, let us find out how dialysis patients can cope with depression.

    Professional Help: Depression is said to be like a common cold when it comes to mental diseases. The state of a person s body can very well affect the balance in his or her mind and lead to depression. Starting from pressing circumstances to hormonal changes as well as chronic ailments, depression can affect people due to a number of reasons. Dialysis patients who are undergoing depression must consult a professional specialist like a psychiatrist who will help the patient understand and cope with the situation with the use of therapy based counselling.
    Medication: The patient can also be given medication that will prevent the build up of unnecessary stress by blocking the production of those hormones that result in a negative state of mind. This medication must be prescribed after speaking the patient s nephrologist about what kind of medication will suit the patient specifically.
    Psychotherapy: Long term psychotherapy is also known as talk therapy that can help the psychiatrist or clinical psychologist in talking the patient through the problems. Besides giving the patient the scope and platform to air out the problems and reach solutions regarding normal day to day functioning despite the troubles, this kind of therapy also aims at equipping the patient with a better perspective and improved attitude.

While going through this kind of therapy and medication, it is important to keep a team of nephrologists and psychiatrists in the loop so that the patient may reach out at any time in order to avail help in the most trying situations. This will give a blanket of security to the patient as well.

3 Ways a Dialysis Patient can Cope with Depression

Causes of bladder control problems in women

Urinary incontinence is the term used to describe bladder control problems that affect several people. Many think it only occurs among older, menopausal women but it actually isn't uncommon amid young and active women.

Inability to control the bladder accompanied by pain can be symptomatic of various disorders ranging from a minor infection to cancer. Fortunately, bladder cancer is rare, and bladder pain is usually not serious.

The varied causes of urinary incontinence in women are as follows:

1) Urinary Tract Infection - This is the most common cause of urinary incontinence and it affects women more than men due to anatomical factors. It can also happen at any age.

2) Medicinal Side Effect: The inability to control one's bladder may be a result of the administration of certain medicinal substances such as alpha-blockers, antidepressants, sleeping pills and various narcotics.

3) Changes in the Reproductive System - Pregnancy and fluctuations in hormone levels can cause bladder irritation, which leads to urinary incontinence.

4) Impacted Stool - When stool gets tightly packed in the lower end of the digestive system and rectum, bladder control is affected. Chronic constipation and constraint strain on the lower intestines leads to the weakening of bladder muscles and hampers the bladder control.

5) Surgical Side Effects - Temporary loss of control of the bladder is often a result of prior surgery and radiation therapy in the pelvic region.

6) Nerve Damage and Neurological Disorders - Strokes and spinal cord injuries have a heavy impact on bladder control and amount to urinary incontinence. Diseases such as Alzheimer's disease, Parkinson's disease and multiple sclerosis also lead to the same.

7) Health Complications - Disorders such as diabetes and obesity directly affect the bladder and the ability to exercise control over it.

8) Disability and Impaired Mobility - For women who are physically impaired and suffer from problems of arthritis, urinary incontinence is a major problem as they are unable to reach the toilet easily.

9) Bladder Cancer - Even though it is extremely rare, bladder cancer affects a number of women every year and is treated through surgery and chemotherapy.



What Causes Bladder Control Problems in Women?

A bladder infection is a bacterial infection within the bladder. Some people call a bladder infection a urinary tract infection (UTI). This refers to a bacterial infection anywhere in the urinary tract, such as the bladder, kidneys, ureters, or the urethra. While most cases of bladder infection occur suddenly (acute), others may recur over the long term (chronic). Early treatment is key to preventing the spread of the infection.

What causes Bladder Infection?
Bacteria that enter through the urethra and travel into the bladder cause bladder infections. Normally, the body removes the bacteria by flushing them out during urination. Men have added protection with the prostate gland, which secretes protective hormones as a safeguard against bacteria. Still, sometimes bacteria can attach to the walls of the bladder and multiply quickly. This overwhelms the body s ability to destroy them, resulting in a bladder infection.
Bacteria that enter through the urethra and travel into the bladder cause bladder infections. Normally, the body removes the bacteria by flushing them out during urination. Men have added protection with the prostate gland, which secretes protective hormones as a safeguard against bacteria. Still, sometimes bacteria can attach to the walls of the bladder and multiply quickly.

Other factors can increase the risk of bladder infections for both men and women. These include:

Advanced age
Insufficient fluid intake
Surgical procedure within the urinary tract
A urinary catheter
Urinary obstruction, which is a blockage in the bladder or urethra
Urinary tract abnormality, which is caused by birth defects or injuries
Urinary retention, which means difficulty emptying the bladder
Narrowed urethra
Bowel incontinence
Pregnancy
Diabetes
Symptoms for Bladder Infections

Cloudy or bloody urine
Urinating more often than usual
Foul-smelling urine
Pain or burning when urinating
A frequent sensation of having to urinate, which is called urgency
Cramping or pressure in the lower abdomen or lower back
Bladder infections can also cause back pain. This pain is associated with pain in the kidneys. Unlike muscular back pain, you might experience pain on both sides of your back or the middle of your back. Such symptoms mean the bladder infection has likely spread to the kidneys. A kidney infection can also cause a low fever.

Bladder Infections - Decoding one of the Most Common Gynae Problem in Women

The general perception that hereditary diseases cannot be prevented is changing. Polycystic kidney disease (PKD) is one such hereditary condition. The kidneys are the body's detox machine, which remove all impurities and flush it out of the system through urine. PKD is a condition where there are multiple, fluid-filled cysts which develop in the kidneys. These can vary in size and though noncancerous, can grow to a very large extent, producing severe symptoms including extremely high blood pressures and kidney failure.

In the recent past, however, there have been various theories that put forth how a modified and healthy lifestyle can prevent PKD. A child with a parent who suffers from PKD has 50% likelihood to develop the same. That cannot be prevented; however, changes can be made which can delay the onset and reduce the severity of symptoms of PKD, most notably high blood pressure and kidney failure which may require lifelong dialysis.

Symptoms and complications: The most common symptoms include high blood pressure, kidney pain (behind the back above the buttocks), infections of the kidneys or the bladder, bloody urine, kidney failure, headache, bloated abdomen due to the fluid-filled cysts, frequent urination, and kidney stones. There could be impact on pregnancy plans, with high blood pressure complicating the pregnancy. This needs extra care in management and is not life-threatening in most cases.

Prevention: The kidneys take the brunt of all the toxins that a body is subjected to. It is therefore, very important to reduce the exposure of body, especially kidneys to toxins. One of the best ways to keep the kidneys in good health is to control blood pressure. Some of the ways to do this include:

    Following a low-sodium diet with a good amount of hydration
    Reduce fat in the diet as much as possible
    Include a lot of berries, broccoli and apples
    Be diligent in taking your blood pressure medications as directed
    Ensure that your weight is within the prescribed limits for you
    Quit smoking and drinking
    At least 30 minutes of moderate physical activity should be included in your daily regimen

Read up on symptoms of PKD and keep an eye on them. If you are having a bloated feeling or pain in the kidneys or blood in the urine, consult a doctor. If you are planning on having a baby, genetic counseling may be useful to see if there is a risk of passing on the genes to the baby. Keep a positive outlook and have a frank discussion with family and friends on your overall condition. So, as much as PKD is a hereditary disease, there are ways to manage it and improve the quality of life.

Is Polycystic Kidney Disease Preventable?

When your kidney function falls below a certain point, it is referred to as a kidney failure or renal failure. Fortunately, you can still continue to lead a normal life with the right treatment for renal failure. Here are the three best treatments that you can choose depending on your condition and lifestyle:

1. Dialysis: Dialysis is the process that takes over the function of your kidneys to filter out the waste from your blood and maintain the proper balance of chemicals in the blood. You may use dialysis for many years or as a short-term treatment while waiting for a kidney transplant. Dialysis is not a cure for kidney disease, rather it helps you deal with renal failure. It is life-saving and without it, the kidneys will no longer function.

There are two types of dialysis treatments that you can choose from:

Hemodialysis   This type uses a machine to remove waste from the blood and sends it back to your body. It can be done at home or at a dialysis center.
Peritoneal Dialysis   This type uses the lining of your belly called the Peritoneum to do the work of your kidneys. A catheter and dialysis solution is used to carry out the function.
There are benefits and complications for each type of dialysis. The treatment decision will largely depend on the patient s illness and their past medical history. Discuss with your doctor to decide the best option for you.

2. Kidney Transplant: Kidney transplants can provide a better quality of life than dialysis and can be seen as a potential cure for kidney failure. A healthy kidney from a live donor or deceased donor is surgically placed in your body as a replacement to the failed kidneys. Although this may be a better option for you, it has certain shortcomings. There is an element of rejection and you may have to wait for a long time to get a donor. Extensive testing and anti-rejection medications are prescribed with this treatment.

3. Palliative Care: Rather than cure, it is the care that people with serious illness need. With so much to deal with, the patients have an array of tough questions and challenges to deal with. Patients need to take into account all medical options and care options based on their condition and severity of the renal failure.

Making the right treatment choice is difficult and that too when you are ill. It is normal to be fearful and worried about the risks involved. Get support from your family and doctor to help you make the right treatment choice. It may also be helpful to visit a dialysis or transplant center to talks to others who have been through these treatments.

3 Best Treatments for Renal Failure!

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