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

Colon polyps are growths that are typically found in the large intestine. Although the causes behind the occurrence of colon polyps are not known, this condition is usually seen to affect adults.
These colon polyps might turn into colon cancer over a period of time; the development of cancer can happen over a number of years.
Colon polyps are usually symptomless; hence it becomes difficult to diagnose the condition. They are commonly found as additional results of screening tests for colon cancers. Screening tests are conducted when there is a suspicion of a disease but it displays no significant symptoms. The symptoms can only be visible if the polyps are enlarged. Typical symptoms include:
Rectal bleeding.
Changes in bowel conditions such as diarrhoea and constipation.
Changes in urination patterns.
Change in appearance of stool.
As the presence of most polyps becomes evident only during colon cancer tests, it is recommended that regular tests for colon cancer be conducted for adults over the age of 50. Some of these tests include:
Colonoscopy: This is highly recommended for detecting colon polyps. A small tube used for viewing is inserted into the colon by the doctor.
Flexible Sigmoidoscopy: It is similar to colonoscopy with the only difference being that the tube is smaller.
Computed Tomographic Colonography (CTC): Also known as virtual colonoscopy, various computer systems and X-rays are used to create a detailed picture of the colon so that the doctor can search for polyps.
The size of the colon polyps helps to identify if the polyp is cancerous or not. Chances of the polyp being cancerous are high if the size of the polyp is higher than 1 cm or 0.4 inches. Hyperplastic polyps (smaller polyps) do not become cancerous and hence, do not need to undergo a colonoscopy. Another form of polyp is the sessile polyp which is usually a flat growth without a stalk and grows on the inner wall of the colon. Similar to other polyps, these polyps can be found and removed using a colonoscopy or a sigmoidoscopy.

Causes and Symptoms of Colonic Polyps

The word colic directly refers to the colon. Colic pain is a sharp abdominal pain followed by bouts of crying usually occurring in infants below the age of one year. The pain only last for a short period of time ranging from a few weeks to a couple of months. Very few number of babies will cry endlessly indicating towards an underlying condition.

It is mainly characterized by sharp crying for supposedly no apparent reason, irregular sleep patterns, and restlessness or owing to deviation from normal postures. The apparent causes of colic pain include indigestion and negative reaction of the sensitive gut to the breast or formula milk, although no concrete cause of the state has been discovered.

Doctors often suggest home remedies such as swaddling, pacifiers, holding and comforting the baby and more frequent feedings to reduce the condition. Since it is so common among infants and relatively less harmful, no proper medication is usually given. Physicians suggest mothers to reduce the content of caffeine, alcohol or spice in their diet. Sometimes a warm bath, burping the baby or going on more frequent walks is useful. Background music draws the attention of the baby and hence drives their focus, away from the abdominal pains.

Colic pains are mainly treated by care rather than medicine. The baby is made to feel comfortable and the distress is reduced just by being around the infant. The primary care giver plays an important role in consoling the child and helping them get through the sudden pain which further plays a significant role in personality development. Colic pains are extremely short lived and probably one of the first few challenges of parenthood. They are primarily dealt with care and feeding except in extreme cases where medicinal cures such as lactase drops and simethicone drops are used to treat the abdominal pain.

Colic Pain - How To Treat It

Chronic kidney disease is defined as kidney damage or a decreased kidney glomerular filtration rate of less than 60, for 3 months or more, irrespective of the cause. This results in a progressive decline in kidney function, resulting in accumulation of toxic waste products, excess water and salts, increased blood pressure, anemia and many other complex symptoms. Chronic renal failure is divided into Stages I - V, out of which the first three stages are asymptomatic, and usually discovered incidentally, while doing routine blood tests.

Symptoms of chronic kidney disease

Most people do not have severe symptoms until the disease gets worse. However, you may:

Have less energy
Have trouble thinking clearly
Have a poor appetite
Have trouble sleeping
Have dry, itchy skin
Have muscle cramping at night
Have swollen feet and ankles
Have puffiness around your eyes, especially in the morning
Need to urinate more often, especially at night
The management of chronic renal failure consists of treatment of the underlying cause if possible, aggressive treatment of high blood pressure and other symptoms, liquid and diet control, cessation of smoking, and finally, with end-stage disease, resorting to dialysis or a kidney transplant.

The Ayurvedic treatment of chronic renal failure is based on three principles:

Treating the damaged kidneys
Treating the body tissues (dhatus) which make up the kidneys and
Treating the known cause.
For patients with chronic renal failure intending to take Ayurvedic treatment (or for that matter, any alternative treatment), the following points should be kept in mind:

All patients should be under the regular supervision and treatment of a qualified and experienced Urologist

Ayurvedic medicines should be taken in the form of additional treatment, and should not replace other, regular treatment or dialysis.

The advantage of using Ayurvedic medicines in chronic renal failure is that in most patients, the kidney damage can be either partly or fully reversed, the frequency of dialysis can be reduced, and the increased risk of death from cardiovascular diseases can be significantly reduced. Thus, Ayurvedic medicines have the potential for an important therapeutic contribution in all the stages of this condition. We are treating Kidney patients with excellent results. We have developed specific Panchakarma treatment protocol and specific medicines for kidney patients. 2 to 3 weeks Panchakarma treatments specially Basti karma, Shirodhara, abhayangam with medicated oil and special Ayurvedic diet plan gives tremendous relief.

Chronic Renal Failure - Ways Ayurveda Can Treat It!

Our kidneys act as filters which constantly flushes out toxins and excess minerals with water in form of urine. Urine contains lots of minerals which may precipitate and form stones. Urine has lots of pro-precipitating agents and anti-precipitating agents. When their balance disturbs due to some disease, stones start forming. These stones may often lead to abdominal pain which is referred to as renal colic. 

What exactly is renal colic? 

Renal or ureteric colic is the term used for typical pain in one side of abdomen in flank region starting from back and radiating forward towards lower abdomen up to scrotum. This is usually associated with nausea, vomiting and urinary discomfort. There may be blood in urine. 

How kidney stones are related to renal colic? 

Kidney stones usually form inside kidney and lies there without causing any pain. But whenever they are dislodged and stuck at mouth of kidney (pelvis) or anywhere in ureter, they block the passage of urine of that kidney. This causes swelling in kidney termed as hydronephrosis. This swelling in kidney causes renal / ureteric colic. This colic is protective phenomenon and tries to push out the stones. Small stones do come out in urine by this natural process. This spontaneous expulsion of small stones is common and many local practitioners used to get credit of it feigning benefit of their medicine. However large stones need some form of intervention to come out. Otherwise, they do harm to kidneys in long term. 

Symptoms of kidney stones along with renal /ureteric colic - 

Most stones which are lying in calyces of kidney are asymptomatic 
Nausea & vomiting 
Frequent urinary tract infections 
Fever with chills 
Foul smelling urine 
Hesitency, frequency and burning in urination 
Blood in urine (urine with a reddish, pink or brownish hue) 
Passage of small stones in urine 
Treatment of renal colic 

Treatment of ureteric/renal stones involves control of symptoms and stone removal. 

Expectant Treatment or Medical Expulsion Therapy: Small stones of less than 4 mm size usually pass on its own and some medicines like alpha-blockers and steroid hasten up their expulsion. Medium size stone (4-6 mm), sometimes passes with aid of these medications. But stones larger than 6 mm usually require intervention. 
Lithotripsy: This method involves breaking of stones by shock waves into small dusty particles which pass through urine on its own. This is usually suitable for stones upto 1.5 cm and lying in kidneys. This is non-operative treatment which can be done on OPD or Daycare basis. 
Ureteroscopy (URS): This method involves entry of very thin semirigid scope through urethra into ureter. Stone is broken by LASER and removed. This involves single day admission and spinal anaesthesia. 
RIRS- Retrograde Intra Renal Surgery: In this method very thin flexible scope in maneuvered through urethra into the upper ureter and pelvi-calyceal system of kidney. Stones in kidney or upper ureter are broken by LASER and removed. This is also done under anaesthesia and requires a day admission. 
Mini- PCNL: This method is suitable for large renal stones. In this technique, a small hole is made into the kidney through back and tiny scope is entered into the kidney. Stones are broken by LASER and removed. This is done under anaesthesia and require two to three days admission.

Renal Colic - Ways it Can Be Treated?

Needless to say, your kidneys play an incredibly important role in filtering waste from your blood, and therefore maintain healthy functioning of the body. Blood pressure, production of red blood cells, and electrolyte balance, all of these are regulated by the proper functioning of the kidneys. Kidney failure causes too much build-up of waste nitrogen products,acids and/or excess fluid,which causes major cardio respiratory problem to the patient.
Symptoms-

Shortness of breath 
A reduced amount of urine
Swelling of your legs, ankles, and feet
Excessive drowsiness or fatigue  
Confusion
persistent nausea
Pain or pressure in your chest
Seizures
Coma 
Inability to properly remove potassium that runs in the bloodstream can lead to irregular heartbeat and ultimately, death that is sudden and unforeseen.

How can it be treated?
The causes of kidney failures are many and the key to treat them is to correct the underlying cause first. Chronic kidney disease, however, has no cure. Treatment generally comprises measures that aid in controlling symptoms and signs, reduce complications, and slow down the progression of this disease. Despite efforts to treat the cause, the condition might keep worsening and there is little to guarantee the fact that complications will not arise. This is precisely why it is of utmost importance to opt for examinations at regular intervals so that you may ascertain if your disease has remained stable or worsened.

End-stage of Kidney disease 
In the case that your kidneys are unable to keep up with fluid and waste clearance as is normally expected, then there s a good chance that you have developed a near-complete or complete case of kidney-failure, and are afflicted by end-stage kidney disease. If this is indeed the case, then you have two options to resort to:

Dialysis: This helps remove the extra waste products that the kidneys fail to do. In haemodialysis, fluid and waste filtering takes place with the aid of a machine that drives these excesses from the blood. In peritoneal dialysis, catheters are employed to rid the body of the accumulated waste products.
Transplant: Kidney transplants involve a surgical placement of a healthy kidney in your system from a compatible donor, either living or dead. Medications will be a necessity since the body has to be prevented from rejecting this new organ.
You may also opt for treating the condition with conservative measures in case you don t want to resort to the aforementioned procedures.

Kidney Failure - What Should You Know About it?

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