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

Every organ is important for the human body to perform its functions normally. Kidneys too are vital and are responsible for removing the excess fluid and toxins from the body. If the kidney is not functioning properly, then the patient is advised to undergo dialysis treatment. In some cases, the patient is advised to undergo a transplant. However, in any case, the patient has to follow a healthy diet, for the treatment and the medicines to work positively.

Suitable diet during dialysis
Most of the patients are not aware of the diet prescribed for dialysis. Though it is always advised to consult a dietician before following any diet for the condition, it is also advisable to gain some knowledge about what the dietician might suggest, so that one is not clueless about the treatment. In a majority of the cases, food containing potassium, phosphorus, low-fat cholesterol, and sodium is included in the diet of these patients. However, these are prescribed in a limited amount and vary from patient to patient.

Sodium: The sodium level of the dialysis patients needs to be controlled; and this can be done by eating food items that have a low sodium content, not more than 2,000 mg. Hence, the quantity of snacks, pudding, and chips are to be reduced in the diet chart.
Potassium: The level of potassium also needs to be kept in check to avoid further deterioration of the kidney. Bread, certain vegetables, and grains contain a high amount of potassium. Moreover, various salt substitutes contain potassium chloride instead of sodium chloride. Large intake of these foods may affect the kidney permanently. Hence, these are majorly excluded from the diet. The patients are advised to include tomatoes and bananas in their diet, though not on a daily basis.
Phosphorus: The patient is advised to avoid foods with high phosphorus. This includes milk and dairy products and grains. However, while on dialysis, meat is important as it gives enough protein despite being high on phosphorus. But, an abundance of meat in the diet may affect adversely. Hence, this is advised, but kept in control.
Cholesterol: To keep cholesterol amount in check during dialysis, the patient needs to cut down on fruits and vegetables and specific fat diets, while eating a sufficient amount of fish.
Protein: High protein food is necessary for a patient with a kidney disease. Meat is an excellent source of protein. Along with that, poultry, fish, and eggs are important, as well. Hence, all this is included in the diet.
Fluids: Dialysis helps in removing the excessive waste fluids from the kidney. But, to keep the body hydrated, the patient is allowed liquid intake, but only up to a certain limit.
It is necessary to maintain a proper diet during dialysis, as it quickens the treatment as well as helps the patient recover quickly.

Undergoing Dialysis - What Should Be Your Diet?

What is Diabetic Nephropathy?

Diabetic nephropathy (Diabetic Kidney Disease) is defined as the progressive damage to the kidneys caused by diabetes. It is characterised by the scarring of the glomeruli in the kidneys due to prolonged diabetes mellitus.

What Causes Diabetic Nephropathy?

Diabetes is a condition characterized by high concentration of blood sugar. Although the cause of Diabetes Nephropathy is not yet well defined, it is likely that the high sugar levels in the blood damage the blood vessels present in the kidneys that help to filter waste products, thus resulting in decreased kidney function and ultimately, kidney failure.

Not everyone with diabetes suffers from diabetic nephropathy. Although, factors that can increase your chances of getting diabetic neuropathy are-

Smoking

Poor control of blood glucose

High blood pressure

History of kidney diseases

What are the symptoms of diabetic nephropathy?

In the early stages, there may be no symptoms at all, but as the disease progresses, you may notice swelling in the extremities like your feet. Thus it is recommended to get your blood albumin levels tested on a regular basis. If it is diagnosed in early stages, the damage can be reversed. Other symptoms that can indicate damage to the kidneys are-

Severe malaise

Headaches

Nausea

Lack of appetite

Frequent voiding

Itchiness of skin

General feeling of illness

Diagnostic tests that can confirm diabetic nephropathy are-

Routine urine test (urinalysis) - Kidney diseases are detected by the presence of a protein in the urine called albumin and this condition is called albuminuria. Other parameters that must be regularly monitored are-

Blood pressure

Cholesterol levels in your blood

How can you treat/ manage diabetic nephropathy?

If this type of nephropathy is diagnosed in the early stages, the damage to the kidneys can be reversible. The key to managing diabetic nephropathy are-

Diet: Reduce the dietary intake of salt, phosphorous and potassium in the advanced stages.

Glycemic Control: Monitor your blood glucose levels regularly

Management of Hypertension: It is important to manage your blood pressure as it can have a direct effect on the coronary blood vessels which in turn pump blood to the various blood vessels of the body

Renal Replacement Therapy: In chronically ill patients, renal replacement therapy is the best option. This can include haemodialysis (a procedure to flush out toxins from the blood, such as urea), peritoneal dialysis or ultimately renal transplantation.

Diabetic Nephropathy - Causes, Symptoms and Treatments

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!

Second hand smoke may cause bladder cancer. True or false? Take this quiz to know more. 

People with the highest bladder cancer risk are those who?
  Smoke heavily
  Started smoking at a young age
  Have smoked for a long time
  All of the above - Right
Smoking cigarettes enhance the chances of an onset of the bladder cancer. As per studies over one-third of all bladder cancer cases have a link with smoking. Smokers are at increasing risk of getting bladder cancer, which may be up to 4 times that of someone who has never smoked. People who smoke may reduce their risk of getting cancer by passing urine more often. However, there is not enough evidence to support that this is true for everyone. The more you stay away from cigarettes, the better it is.

Which type of chemicals present in cigarette smoke may cause of bladder cancer?
  Formaldehyde
  Carcinogenic chemicals - Right
  Hydrogen cyanide
  All of the above
Cigarette smoke contains carcinogenic chemicals which are harmful to our body and known to cause cancer. When tobacco smoke is inhaled, these cancer-causing chemicals are absorbed into the blood stream. When the blood passes through your kidneys, these chemicals may often get deposited in the urine. As the urine waits in the bladder to be expelled, these harmful chemicals damage the cells lining the bladder, increasing your risk of bladder cancer. Experts believe that healthy eating habits may help in preventing bladder cancer.

Second hand smoke may cause bladder cancer.
  True - Right
  False
The health risks brought on by cigarette smoking are not restricted to smokers. Exposure to secondhand smoke or environmental tobacco smoke significantly increases the risk of cancer in nonsmokers, as well as also a few respiratory ailments in kids. Secondhand smoke is a combination of the smoke that is discharged from the end of a burning cigarette and the smoke emitted from the lungs of smokers. You may use medical masks when going outside, to protect yourself from second-hand smoke.

Aryl-amines present in tobacco decreases the risk of bladder cancer.
  True
  False - Right
As per medical research arylamines such as benzidine, 2-naphthylamine, and 4-aminobiphenyl which are present in tobacco smoke are associated with increasing the chances of getting bladder cancer. Aryl-amines use both an early and a late-stage activity, compatible with a two-mutation theory of bladder carcinogenesis. You may consult your doctor to educate yourself about these harmful effects.

Quitting smoking is a critical step in preventing bladder cancer.
  True - Right
  False
Quitting smoking has major and immediate health benefits for men and women of all ages. Quitting smoking not only decreases the risk of bladder cancer but also reduce the risk of getting a heart attack or chronic lung disease. As per research people who quit before reaching the age 50 reduce their chance of dying by half for the next fifteen years compared with those who continue to smoke. Smoking low-yield cigarettes, as compared to cigarettes with higher tar and nicotine, provides no clear benefit to health. The earlier a person quits, the greater the health benefit.


Bladder Cancer - How Smoking Can Cause It?

The kidneys filter the blood and eliminate the waste products through urine. The waste deposition is sometimes in the form of excessive calcium, uric acid and other undesirable contents. It causes the urine to get highly saturated. The solid depositions then turn into stone like formations, also termed as renal lithiasis or calculi. There are different kinds of kidney stones, which are differentiated based on its varied constituents. Kidney stones cause excruciating pain and uneasiness. Frequent urination and discomfort during urination, presence of blood in the urine, are some major signs of kidney stones.

Kidney stones can be prevented by maintaining a healthy lifestyle and a balanced diet with sufficient nutrients:

Calcium and oxalate-rich food should be consumed together. This leads to the binding of calcium and oxalate together in the stomach intestines, before they can be processed in the kidneys. This helps to control the formation of calcium and oxalate depositions in the kidneys.
Do not cut down on calcium. Since most of the kidney stones are found to be calcium depositions, many people tend to cut down on their calcium intake. It is important to continue with food that is rich in calcium such as milk. However, it is necessary to reduce intake of other calcium supplements. Decrease in calcium can lead to degeneration and deformation in bones and muscles.
Too much of red meat consumption and high fat dairy products can lead to the formation of stones in the kidneys. Animal protein is rich in purine that increases uric acid, saturating the urine and creating stones. It is important to balance your diet by including lots of green vegetables, whole grains, fibres, fruits and low-fat dairy products. Opt for non-animal protein such as lentils or legumes.
Cut down on sugary and aerated drinks. They contribute to the formation of depositions due to their high and unhealthy levels of fructose and preservatives.
Reduce or abstain from alcohol. Alcohol is known for its multiple disadvantages to the human body. It has also been found to increase the levels of uric acid in blood.
Keep your body hydrated. Drink adequate quantity of water throughout the day, preferably 3 litres or more depending on your physical activities. It prevents the solidification of the depositions and helps to eliminate wastes smoothly.
Increase the intake of anti-oxidants in the form of green tea, dark chocolates and fruits.
Lower the intake of salt. If you wish to discuss about any specific problem, you can consult a urologist.

Kidney Stones - 8 Diet Tips to Prevent It!

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