Colorectal surgery: How to be sure you need it?

Colorectal surgery is performed to repair damages that occur in the organs of the anus, rectum, and colon. The damage that takes place in these organs can be the result of problems with lower GI like diverticulitis (a condition wherein pouches known as diverticula in the colon wall become inflamed), cancer and inflammatory bowel disease (a group of intestinal disorders that bring about inflammation of the GI).

Who needs this surgery?

In general, colorectal surgery is an essential treatment option for ulcerative colitis, colorectal cancer, Crohn's disease (an inflammatory bowel disease that gives rise to inflammation of the gastrointestinal tract) as well as certain diverticulitis cases. In such cases, the intestinal tract undergoes major reconstruction.

There are also other bowel problems that may require surgery but not of a serious nature and these are anal fissures, hemorrhoids, bowel incontinence and rectal prolapse. Most of the surgical procedures will aid in repairing tears, get rid of blockages, or make tighter sphincter muscles (muscles that surround openings in the body).

Colorectal surgery is also performed in cases of pelvic floor disorders like rectocele (a condition in which the rectum bulges towards the vagina) and perineal hernia (a hernia that involves the pelvic floor).

At the same time, injury, ischemia or compromised blood supply and obstruction may require the performance of bowel surgery as well. Scar tissue and masses can form within the rectum, clogging the organ and preventing the normal discharge of feces from the body.

Problems like ulcerative colitis (an inflammatory bowel disease that leads to the development of ulcers in the colon as well as inflammation of the area) and diverticulitis can give rise to perforations in the rectum. Surgery is suggested in instances when drugs fail to treat the problem of ulcerative colitis.

Likewise, in the case of recurrent instances of perforations or complications in diverticulitis, surgery may be required to remove the portion of the colon affected.



Colorectal Surgery: How To Be Sure You Really Need it

Renal Tubular Acidosis is a medical condition. When the kidney is unable to acidify urine, it leads to the accumulation of acid in the body. Usually, when blood is filtered by the kidney, it passes through the tubules of the nephrons (the functional unit of the kidney).

Before it flows into the bladder from the kidney, the urine undergoes an exchange of salts, acids and other solutes. Renal tubular acidosis results in the formation of excessive amounts of acid because the kidneys cannot drain them. This may happen because the kidneys cannot reabsorb the alkaline bicarbonate ions from the urine in the early segment of the nephron or because of inadequate production of acidic hydrogen ions in the latter half of the nephron.

Renal Tubular Acidosis is simply associated with abnormal urinary acidification. Other functions of the kidneys remain unimpaired.
There are several different types of renal tubular acidosis-

  Distal Renal Tubular Acidosis (RTA)
This is the most fundamental form of RTA. It is characterized when the hydrogen ions are not secreted into the lumen of the nephron by the alpha-intercalated cells of the medullary collective duct of the distal nephron. When this happens the pH of urine cannot be brought down below 5.3. Renal excretion is inhibited and hydrogen ions are not eliminated which leads to academia. At the same time, Potassium ions cannot be absorbed by the cell which leads to hypokalemia. The end result is protein retention and potassium excretion. Distal RTA can lead to the urinary stone formation, calcium deposits in the kidney, rickets and osteomalacia and Sjogren s syndrome.

  Proximal RTA
When proximal tubular cells reabsorb 85% of filtered bicarbonates and 60% of filtered sodium from the urine, then this again leads to academia. The distal intercalated cells, however, function normally and so the academia is not as severe as in case of Distal RTA. The alpha-intercalated cells can acidify urine to a pH of 5.3 or less because they produce hydrogen ions. Proximal RTA is also associated with Fanconi Syndrome which is characterized by aminoaciduria, uricosuria, glucosuria, and tubular proteinuria.

  Combined distal and proximal RTA
Inherited carbonic anhydrase II deficit leads to combined distal and proximal RTA. This is accompanied by osteopetrosis, cerebral calcification, and renal tubular acidosis. Cases of combined distal and proximal RTA are very rare.

How is RTA understood?
The following steps are applied to analyze Renal Tubular Acidosis-
  Determining the anion gap in acidosis. The normal Anion Gap is 8-12 (4-6 mEq/L)
  Separating the renal from the extrarenal causes of normal anion gap acidosis
  Classifying the types of RTA
  If it is distal RTA, further tests will be necessary to support the diagnosis

How is RTA diagnosed?
Three types of tests can reveal if a person is affected by Renal Tubular Acidosis-
  Urine test
  Acid load test
  Physical examination

Treatment of RTA-
Doctors prescribe either or both of the following two types of therapies-

  Alkali therapy- The pH level of urine is restored and electrolytes are balanced
  Vitamin D supplements- If RTA leads to bone deformities or rickets, your doctor will prescribe vitamin supplements to strengthen your bones.

Timely diagnosis can prevent the effects of Renal tubular Acidosis from becoming compounded. With the right medication, a person can lead a healthy normal life.

What Should You Know About Renal Tubular Acidosis?

Urinary incontinence is a common problem that afflicts many adults around the world. Stress related urinary incontinence is a fairly common problem that afflicts many as well. This form of incontinence is usually caused by physical activity, which exerts pressure on the bladder and may cause the leakage of small amounts of urine.

Triggers and Symptoms for stress urinary incontinence
In terms of urinary problems, stress is used to describe physical problems in particular and not mental stress. So the triggers or risk factors of it could be any of the following:
1. Exercise
2. Jumping
3. Sneezing
4. Coughing
5. Exercises
6. Sexual activity

This form of urinary incontinence is very common in women who are older or have already been through menopause. It may also be common for women who have recently given birth or are pregnant. The urethra or the bladder may become prone to external stress and then involuntarily leak out some urine.

Causes
The causes can be quite varied from patient to patient but are primarily attributed to the weakening of the pelvic muscles, bladder or the sphincter. If any of these muscles open involuntarily due to physical stress, it leads to urine leaking out. Some of the causes which may lead to this are:
1. Pregnancy and childbirth: Pregnancy or childbirth related problems may cause damage to the urethra or sphincter during childbirth; leading to stress urinary incontinence.
2. Surgery of the prostate: Another common problem, especially with men, is with surgical interventions to correct prostate problems.
3. Menopause: Many older women often complain about stress incontinence after menopause due to the weakening of the muscles.
4. Pelvic surgery: Any surgery to the pelvic area or illnesses which may cause the muscles to become relaxed or act involuntarily due to external stress, may cause incontinence.
5. Weakening of the pelvic muscles: Certain illnesses may cause the pelvic muscles to become weak and thus cause the sphincter as well as the bladder to react involuntarily. UTIs or urinary tract infections have also been known to cause incontinence due to the same reason.
6. Obesity: Obesity has been known to put stress on many of the bodily systems and it may affect the bladder and the urinary sphincters as well.

Causes and Symptoms of Stress Urinary Incontinence

Often, early stages of kidney diseases do not come with specific signs and symptoms and most people will remain unaware of their condition. However, certain symptoms may be perceived that may indicate that a person is suffering from early stages of kidney failure. When you are diagnosed with kidney failure (also known as renal failure) in the initial stages, certain measures can be taken to retard the progression of the renal disease. This can also help reverse the condition and improve the quality of life of the patient. On the basis of a typical cause, the symptoms of kidney failure are grouped into specific categories that are given below. If you notice any of the specified renal failure symptoms, it is recommended to immediately fix up an appointment with your doctor and get your diagnostic tests done. 

Symptoms of Renal Failure from the accumulation of waste products in the body: 

Metallic taste in mouth 
Nausea and vomiting 
Facing difficulty in concentrating 
Loss of appetite 
Aversion towards meat (protein aversion) 
Itching or pruritus 
Symptoms of Renal Failure from the accumulation of fluid in the body: 

Dyspnoea or shortness of breath (this happens due to the accumulation of fluid in the lungs).
Swelling is seen in the feet, hands or face. 
Symptoms of Kidney Failure from damage to the kidneys: 

The amount of urine production changes, though it is not a reliable sign Haematuria or blood in the urine (usually in microscopic quantity). 
Frothiness or foam in the urine (usually happens when protein is present in the urine). 
Symptoms of Kidney Failure due to decreased blood production (anemia): 

Dyspnoea or shortness of breath. 
Fatigue Weakness. 
Confusion If you happen to feel cold all the time. 
The following diagnostic tests will be performed by your doctor in order to determine whether the symptoms are the manifestation of a kidney failure or not: 

Urine analysis - In this test, a sample of your urine is tested to find traces of blood, white blood cells or proteins which may indicate a problem in kidney function. 
Blood Tests - This includes tests for BUN and creatinine in the blood which are usually removed from the blood if the kidneys function properly. 
Actions must be taken when you show signs and symptoms of kidney failure: 

It is common that the symptoms of early renal failure are not always prominent, but if any of the above symptoms are witnessed, it is recommended to met a physician to determine whether they are caused by a kidney disease. You can pen-down the symptoms that you feel are related and bring it to the doctor when you fix up the next appointment. It is essential to know about your disease at the earliest as it will give you time and the ease of taking measures to retard the damage process and will decrease or delay the probability of undergoing dialysis or kidney transplant.

Kidney Failure - What Should You Know About it?

The prostate gland in a man begins to grow in size on reaching 25 years of age quite naturally, and this is known as benign prostatic hyperplasia abbreviated as BPH. Now the problem arises when the enlargement of the prostate is more than normal.

In men, the urine flows through the urethra from the bladder. An abnormally enlarged prostate blocks the flow of urine through the urethra. The cells of the prostate slowly multiply to cause it to enlarge. This puts pressure on the urethra thereby giving rise to a number of problems, most of which manifest as symptoms.

Common Symptoms of an Enlarged Prostate Gland
The condition of enlarged prostate gives rise to some noticeable symptoms which provide the signs that you need to visit a doctor to get it treated. A weak or slow urinary system is one of the most common symptoms of being affected with an enlarged prostate. This includes urinating more often, an increase in the urgency to urinate, difficulty in starting urination and a feeling of incomplete bladder emptying immediately after urinating. At times, it is seen that passing urine becomes very strenuous. All these above symptoms indicate that there is an enlargement of the prostate gland and medical help should be sought immediately to prevent the condition from worsening.

Steps to Manage an Enlarged Prostrate

Effective medication is usually the first step in the management of an enlarged prostate gland. Alpha blockers are the drugs that are most commonly used in this situation. These drugs do not reduce the size of the prostate, but they are great in relieving the symptoms to allow free and painless passage of urine. Another group of drugs known as 5-alpha reductase inhibitors can help in shrinking an enlarged prostate. The drugs work by the reducing the levels of the male hormone called dihydrotestosterone.
In some advanced stages of prostate enlargement, minimally invasive treatments are used for the effective management of the condition. Transurethral Microwave Thermotherapy or TUMT is used to treat mild blockages that reduce the frequency of urination, the urgency, and straining. However, it is not able to correct the bladder emptying issues. Transurethral Radio Frequency Needle Ablation or TUNA helps in the destruction of the prostate tissues resulting in an improvement in the flow of urine.
Prostatic stents are also sometimes used for the management of the condition of an enlarged prostate. In this treatment procedure, a small metal coil is inserted into the urethra for widening it and keeping it open. In most severe case of prostate enlargement, only surgical methods remain as the opted method of treatment. Laser surgeries are performed to destroy the tissues of the prostate for easing of the condition. Ultimately, an open prostate surgery is performed when the transurethral procedure cannot be used. In this surgery, the tissues of the prostate are removed by the surgeon in case of great enlargement.
The condition of an enlarged prostate gland requires medical attention and treatment for the most effective management, and it is best that a medical professional is consulted as soon as any of the symptoms surface.
Enlargement starts usually after 50 years. Surgery 'Transurethral resection of prostate (TURP)' either by monopolar or bipolar electrocautery. Enucleation of prostate by laser is also an option.

Enlarged Prostate - How Can It Be Managed?

Infection caused in the kidneys, bladder, urethra or the ureters is known as urinary tract infection. According to doctors, women are generally more at risk of suffering from this condition than men. Some of the causes which contribute to the development of this infection are:

1. Invasion of bacteria: like any other infection, one of the causes of urinary tract infection is the invasion of the bacteria escherichia coli in the bladder. This type of bacteria is most commonly found in the gastrointestinal tract and is most often held responsible for urinary tract infection.

2. Spreading of the bacteria from anus to urethra: the spread of the gastrointestinal bacteria from the anus to the urethra leads to the infection of the urethra thereby causing urinary tract infection. 

Some of the symptoms of urinary tract infection are

1. A nagging urge to urinate: one of the most predominant symptoms of urinary tract infection is a persistent, nagging urge to urinate. You would know your urinary tract is infected when you feel the urgency to urinate extremely frequently.

2. There is a burning sensation when you urinate: the symptoms of urinary infection are extremely visible and are felt intensely by the one suffering from it. If you feel a burning sensation while urinating, chances are extremely high that you are suffering from urinary tract infection.

3. Red colored urine: sometimes your urine may contain perceptible amount of blood in them. In most cases, presence of blood in urine is a definite sign of urinary tract infection.

4. Foul smelled urine: an internal infection in the urinary tract manifests itself in different ways. One of the chief symptoms of this infection is discharging foul smelling urine.

5. Pain in the pelvic area: women who suffer from urinary tract infection experience excruciating pain near the pelvic area, sometimes extending to the pubic bone.

Causes and Symptoms of Urinary Tract Infection

Don't wait any longer, manage your Urological Surgeon online with a Lybrate doctor today

Consult for Urological Surgeon - Online and Easy!

FilterClear All

COMMON SPECIALITIES

COMMON ISSUES