A kidney transplantation is a surgical procedure where a diseased kidney is replaced with a healthy one.

Once the surgery is over and you are recuperating, it is very important that you make certain alterations to your diet to facilitate faster recovery. You need to maintain your weight and exercise on a regular basis.

What Does a Balanced Diet Include?

After the surgery, eat meals or food items that are low in sodium. A properly balanced diet should include ample amounts of fresh fruits, lean meats, fresh vegetables, dairy products that are low in fat. Drink sufficient amount of water (2-3 litres) to keep yourself hydrated.

Why Do You Need to Supervise Your Diet?

Post a kidney transplantation surgery the patient will need to take anti-rejection drugs which are also known as immunosuppressive drugs. These medications lower the risk of the new kidney being rejected by the body. On the flip side, these drugs suppress the immune system making you vulnerable to infections. A healthy diet will ensure that you don t fall ill.

What Food Items Should You Avoid?

  Consuming undercooked or raw meat, poultry and seafood such as squid, crabs or prawns.
  Consuming dairy products that have been made from unpasteurized milk such as yoghurt and cheese.
  Undercooked or uncooked eggs or any food items that might contain such eggs
  Fruits such as pomegranates or grapefruits
  Unwashed salads, sprouts and vegetables.

Restrain Caution when Consuming Carbohydrates:

When you are taking drugs, it is difficult for the body to utilize all the extra carbohydrates that you consume. This can lead to high blood sugar levels. Carbohydrate-laden food items come from starches and sugars and provide fuel for the body.

In short right after a kidney transplantation surgery, you need to make sure that you are following a diet that is high in proteins but low in sugar. In order to avoid developing diabetes or any associated disease during this phase consult with your healthcare provider and chalk out a proper dietary plan.

Nutrition After Kidney Transplant!

Colorectal surgery is the broad term for surgical procedures performed on the colon, the rectum and the anus. There are various different surgical procedures which fall under colorectal surgery and these are used to treat a vast array of disorders, such as:
1. Anal cancer
2. Colorectal cancer
3. Severe complications related to constipation
4. Anal injuries
5. Inflammatory conditions of the gastrointestinal tract
6. Congenital defects

Procedures
The surgeries under colorectal surgery are performed after diagnostic tests such as proctoscopy, sigmoidoscopy and defecating proctography. The most common diagnostic test is colonoscopy. These help to identify the origin and nature of the problem and decide which surgical procedure is to be followed. The procedures under colorectal surgery are as follows:

Colectomy
This procedure involves removal of a section of the large intestine. This is known as partial colectomy. In extreme cases, such as advanced cancer or severe gastrointestinal infection, the entire colon is removed and this is called total colectomy. Sometimes, the rectum is also taken out along with the colon and this is called proctocolectomy.

Colonic polypectomy
An abnormal growth of tissues in the inner lining of an organ is known as a polyp. Colonic polypectomy is done to eliminate polyps from the colon and rectum before they become malignant. This can be done endoscopically. Surgery is required in case of large polyps.

Strictureplasty
Chronic or repeated bowel inflammation causes scar tissue to accumulate in the large intestine. This results in the narrowing of the colon. Stricturoplasty removes the scar tissue so that proper flow of digestive contents is resumed.

Colostomy or ileostomy
A damaged section of the colon is removed and the shortened intestine is then attached to another opening (stoma) in the anterior wall of the abdomen.

Hemorrhoidectomy
This surgical process is used for swollen hemorrhoids or blood vessels, which form in the anal canal. Hemorrhoidectomy is extremely effective in removing hemorrhoids, but the surgery also involves a number of complications.

Anoplasty
Anoplasty or imperforate anus correction is done to correct birth defects in the rectum and the anus. The structural flaw does not allow the stool to pass properly from the rectum and so it is repaired through surgery.

All About Colorectal Surgery

The kidneys make urine, which is a fluid through which wastes from the body including urea are eliminated from the body. There are two kidneys on the right and left side, which make urine, and pass it down to the bladder through tubes known as ureter. The bladder acts as a reservoir of the urine that is formed in the kidneys. It is stored temporarily there before being excreted out of the body through the urethra. The urinary bladder is a highly muscular organ and has a rich connective tissue. 

Interstitial cystitis (IC) or painful bladder syndrome (PBS) is a very common condition, which affects females more than males. While the exact etiology is not known, it could be age-related and also lifestyle related. People who are used to controlling the urge to pass urine are highly likely to develop this condition. The simple logic is that there is additional pressure on the bladder from the urine that is contained for longer period of time. As such, the muscular wall stretches and begins to feel stressed.

When this habit continues over a period of time, the bladder wall may become irritated or inflamed or even scarred in severe cases. There is no role of bacteria in this condition, and antibiotics are of no help in managing this condition (though the name cystitis usually indicates infection).

The following symptoms are seen as a result of this constant irritation and inflammation.

One may suffer from pain and pressure in the bladder as it continues to collect more and more urine.
This pressure in the bladder also puts pressure on the surrounding tissues in the abdomen including the pelvis, urethra, abdominal organs, uterus, etc.
Women may experience pain in the vaginal tract including vulva and behind the vagina.
Men may experience pain in the area of the scrotum, testicles, prostate, and penis.
There is an increased urge to urinate, which may be as much as 9 to 10 times a day. As the condition progresses, there could be more visits, as many as 40 to 50 visits a day.
This tendency and urge to urinate increases during nighttime.
For women, this urge to urinate and other symptoms including pain are worse during menstruation.
There could be pain during intercourse for both men and women.
There could be pain even otherwise, which can range from a mild dull ache to a piercing pain.
At a structural level, this constant pressure leads to pinpoint bleeding (glomerulations) and sometimes even ulcers in the bladder wall.
There is no definitive treatment for IC or PBS. However, bladder distention and instillation are proven methods of increasing bladder capacity, which therefore helps in relieving symptoms.

Painful Bladder Syndrome - Know The Signs!

Urinary incontinence, commonly known as loss of bladder control can really cause embarrassment. The severity of this condition may range from once in a while leaky urine to the sudden and forceful urge to urinate, due to which you end up urinating before reaching the toilet.

Types of urinary incontinence-

Stress incontinence- when you feel the urge to urinate due to sneezing, coughing, laughing or while doing physical exercise
Urge incontinence- when you feel the urge to urinate, suddenly. This may occur during the day and even at night.
Functional incontinence- when you cannot reach the toilet on time because of a physical or mental impairment.
Mixed incontinence- when you involuntarily urinate due to more than one incontinence
Stress incontinence is the most common type in women. The activities which increase your risk, are:

You have had more than one pregnancy and vaginal delivery.
You have pelvic prolapse. This is when your bladder, urethra, or rectum slide into the vagina. Delivering a baby can cause nerve or tissue damage in the pelvic area. This can lead to pelvic prolapse months or years after delivery.
Female urinary stress incontinence is the involuntary release of urine during any physical activity that puts pressure on your bladder. This potentially embarrassing condition differs from general incontinence in that it happens when the body is under immediate physical stress. Activities that can put stress on your bladder include coughing, sneezing, laughing, lifting heavy objects, or bending over. This condition is particular to women, many of whom experience symptoms after muscles have been weakened due to a vaginal childbirth, following menopause, or during pregnancy.

Ensure that you consult a doctor-

If this condition hinders your day to day activities
If the urinary incontinence is the result of a serious underlying problem
Causes of urinary incontinence-

Urinary incontinence may be temporary or permanent. Causes for temporary incontinence are-

Alcohol
Caffeine and caffeinated drinks
Decaffeinated tea or coffee
Spicy and sugary foods
High intake of vitamin b or c
Urinary tract infection (uti)
Constipation
Causes for permanent incontinence are:

Pregnancy
Childbirth
Old age
Menopause
Hysterectomy
Prostate cancer
Enlarged prostate
Neurological disorders
Complications-

Chronic urinary incontinence can lead to certain complications like.

Skin problems- skin rashes and infections can develop around the vaginal area, because of the constant wetness one feels. It may also cause sores.
Urinary tract infections- urinary incontinence can also result in uti
Impact on personal and social life- urinary incontinence can lead to great embarrassment, thus affecting the social and personal life of an individual.
Treatment for female stress urinary incontinence-

There are several types of treatment available. Treatment options include lifestyle changes, medications, nonsurgical treatments, and surgeries.

Lifestyle changes: make regular trips to the restroom to reduce the chance of urine leakage. Drink fewer fluids and avoid activities such as jumping and running.
Medications: medications that reduce bladder contractions.
Nonsurgical treatments: kegel exercises strengthen your pelvic muscles. Done regularly, these exercises can strengthen your muscles, allowing you to control when urine is released from your body.
Surgery:

If other treatments fail, you will have to go for surgical treatment. Types of surgery include:

Injectable therapy, in which collagen is injected into your urethra to reduce incontinence
Tension-free vaginal tape (tvt) surgery, in which mesh is placed around the urethra to give it support
Vaginal sling surgery, in which a sling is placed around the urethra to support it
Anterior or para-vaginal vaginal repair surgery to repair a bladder that is bulging into the vaginal canal
Retropubic suspension surgery to move the bladder and urethra back into their normal positions
Some doctors even try electrical stimulation and medication. When the condition is highly advanced interventional therapies and surgery is recommended.

Some interventional therapies are-

1. Bulking material injections
2. Botulinum toxin type-a
3. Nerve stimulators.

All About Urinary Incontinence

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

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!

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