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Patient Review Highlights
Ram Yash Singh(retd Ips),advocate,patna High Court
I have occasion to know Dr Manoj Kumar since a decade and half.He is sincere and honest to his profession.As a gastroenterologist he is superb.He has wonderful clinical sense and diagnosing power.He even handles the complex cases very aptly.Apart from his specialised subject he is a very good physician.I have a high respect for him for being a perfect gentleman.
I normally refer patients who need specilised service for gastro -enterology to Dr Manoj kumar.Till date all the referred cases are well well managed and they are all happy with his consultation.
It was a fantastic experience with Dr manoj Kumar. He treat me very well.
Anal fissures are the small tears formed in the anal lining. They are also known as anal ulcers. An anal fissure causes a lot of pain and bleeding during your bowel movements. Usually a fissure heals automatically in a few days time. It can be treated with simple home remedies as well.
- You can suffer from an anal fissure if you pass hard and large stools.
- Also strained childbirth or suffering from violent spells of diarrhea might get you an anal fissure.
- Chronic constipation may also be cause of a fissure.
- Other rare causes may be anal cancer, HIV, tuberculosis or herpes.
Individuals of all age groups can suffer from anal fissures. It is not a very serious problem and heals on its own in a few weeks. Although it can heal itself, there are certain treatments which can help relieve the pain you get from an anal fissure.
An anal fissure has quite a lot of symptoms for you to understand what you are suffering from:
- There will be a very visible tear around the anal region. You will be able to spot the tear on the skin very easily.
- A small lump of skin may form next to the tear.
- When you will be undergoing your bowel movements, you will feel a very sharp pain in the anal region.
- You will find spots of blood on the stool passed.
- You will also feel a burning or an itching sensation in the anal region.
Although most fissures do not require treatment, there are a few remedies that will help cure them faster:
- Stool softeners: You get certain medicines at the chemist, which are known for their stool softening functions. These stool softeners help to soften the hard stools and initiates smooth bowel movements.
- Eat fibrous foods: Eat foods rich in fiber like fruits, whole grain cereals, raw vegetables, etc.
- Take warm baths: Take a bath in warm water as it relaxes your anal muscles, helps to relieve irritation in the region, and increases blood flow in the anorectal region.
- Use ointment: Apply nitroglycerin ointments and topical pain relievers to promote blood flow to the anal region and to relieve discomfort from the region respectively. If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.
The diagnosis as well as management of pancreatic cystic lesions is a general problem. Nearly 1% of the patients in the chief medical centers have been observed to have pancreatic cystic lesions on cross sectional imaging. It has also been observed that a quarter of all pancreas scanned in an autopsy series contain pancreatic cysts. Earlier, these cystic lesions were regarded benign but with increasing evidence made available from the cystic lesions, they are regarded as origin of pancreatic malignancies.
Information on Asymptomatic Neoplastic Pancreatic Cysts: The most vital medical tools that are used in the diagnosis and management of pancreatic cystic lesions include the endoscopic ultrasound and cross sectional imaging. These are used to distinguish non-mucinous cysts from mucinous cysts. The identification of pancreatic cysts creates a lot of anxiety for the clinicians as well as the patients related to the probable presence of a fatal tumor. The findings of a macro cystic lesion that enclose viscous fluid loaded in CEA are helpful in the analysis of a mucinous lesion.
The most common pancreatic cysts are the non-neoplastic inflammatory pseudo cysts, and they can be detected easily by imaging. The identification of pancreatic irregularity with probable association with malignant cells is a vital source of referral for the specialist. The set of guidelines that have been proposed for the management and diagnosis of patients with asymptomatic neoplastic pancreatic cysts are based specifically on the analysis of the quality of the data. It is also designed to address the most important and frequent clinical scenarios. The diagnostic suggestions are provided based on the clinical problem as well as the risk of malignancy.
Imperative Guidelines to Follow: To achieve accurate diagnosis of asymptomatic neoplastic pancreatic cysts is indeed a great challenge. It is all the more important to find the reproducible methods that can be used to stratify threat of cancer for the patients. The main guidelines include a two year screening interval of cysts that can be of any size as well as stopping observation after 5 years, in case there is no change. The new guidelines, for the most part, recommend surgery if more than one concerning feature is confirmed on the MRI by use of endoscopic ultrasound. The new guidelines even suggest discontinuation of inspection after the surgery if no dysplasia or invasive cancer is identified. The guidelines have mainly been developed by use of Grading of Recomendations Assessment, Development and Evaluation.
Dyspepsia is a disorder of the stomach that is characterized by pain in the upper part of the stomach. It is not a single disorder, but is a collection of symptoms such as nausea, burping and bloating. It results when the acid of the stomach comes in contact with the mucosa of the digestive tract. These acids cause a breakdown of the mucosa leading to inflammation and irritation, which leads to indigestion. It may also result from eating disorders or certain medications.
The symptoms of this disorder tend to occur mostly after consuming food and drink. In some cases, the symptoms tend to go away after eating or drinking. The symptoms of dyspepsia are:
- You may feel bloated on a regular basis
- You may experience discomfort in your stomach
- Loss of appetite
- You may experience constant burping
- You may feel nauseous
- Symptoms of heartburn
- You may also experience chest pain and breathing difficulties
- You may be affected by jaundice
The various causes of dyspepsia are:
- Irritable bowel syndrome, which hampers the movement of food through the intestines
- If you are unable to properly digest dairy products
- Gastroesophageal reflux disease that results in reflux of the acids of the stomach
- Any inflammation of the gall bladder
- Various medicines such as aspirin, steroids and antibiotics may lead to dyspepsia
- If you suffer from depression or anxiety then it may lead to dyspepsia
- Excess consumption of chocolate, coffee and alcohol
Dyspepsia may be controlled by modifying your lifestyle. Some of the changes that you may make are:
- Don't sleep immediately after eating, wait for at least two hours before you go to bed
- Avoid spicy foods as they tend to aggravate symptoms of dyspepsia
- Space out your meals, eat multiple smaller meals instead of few large ones
- Restrict smoking and alcohol consumption
- Lose weight as being overweight may lead to dyspepsia
- Avoid wearing tight clothes
- Exercise on a regular basis to keep your body healthy and maintain optimal weight levels
Cancer is one of the most fatal diseases in the world. Stomach cancer is also known as 'Gastric cancer'. Like other diseases, it is crucial that it gets identified in the early stages and gets treated before it reaches the incurable stage. Like other forms of cancer, the exact cause of stomach cancer is still not yet known. However, certain things make stomach cancer more likely to happen.
The possible causes of stomach cancer are given below:
Some of these causes apply to nearly all forms of cancer. However, some of them only apply to stomach cancer.
- Bad diet
- Stomach surgery for an ulcer
- Type-A blood
- Epstein-Barr virus infection
- Exposure to certain materials in certain industries
- Helicobacter pylori bacteria
Some of the symptoms of stomach cancer are:
Stomach cancer like all other forms of cancer has various stages and it is crucial that it is diagnosed in the early stages so that the progression of it is stymied. At first, the symptoms of stomach cancer include indigestion, loss of appetite, slight nausea, heartburn and the feeling of being bloated after a meal.
However, indigestion and heartburn, doesn't always mean that you have stomach cancer, but if these conditions persist, you should visit a doctor to rule out the possibility of stomach cancer.
The growth of the tumor in your stomach can lead to various serious symptoms too, such as:
- Stomach pain
- Blood in your stool
- Weakness or exhaustion
- Diarrhea and constipation
- Weight loss for no apparent reason
- Swelling in your stomach
- Trouble in swallowing
- Eyes and skin turn yellowish