Dr. Ajay Kumar Gupta
General Surgeon, Faridabad
I am Dr. Ajay Kumar Gupta. I am into practicing of laproscopic and general surgery for the past 10 years from now. I have been witnessing many patients of chronic pain abdomen. It may lead to bowel habits leading to constipation and may lead to painful diffication and they lead to a disease called chronic anal fissure acute or chronic. There is a rampant increase in the weternisation of our society for the past 10 years from now. Because of westernization of toilet, increase use of digital mode of knowledge not having physical activities and the people are having sedentary lifestyle. What I could see from my OPD is that many patients having vague lifestyle from morning till night. The morning in the morning they wake up and they have a tea as a breakfast then have a light lunch and lunch they used to take burger samosa and some oily base. They openly have suffering of Chronic pain abdomen.
So we need to reconsider this modification of lifestyles need to be changed. You have to have four meals a day. In the morning they should have a light breakfast then have a should have lunch then munch as fruit and dinner at a proper in between 9 to 10 pms. Many other patients are having chronic constipation they lead to having a painful diffication. And that painful diffication lead to chronic anal fissure. And that is a disease which is having long morbidity and there is a surgical option for these patients but they have a chance of recurs 30 to 40% if they don’t change their lifestyle. Now from as of now what I could see many patients of the chronic anal fissure I have been treating on some dietary modification change in the lifestyle and they don’t need surgery.
So more important is if you to ask the patient to train themselves how to modify their lifestyle and they should avoid eating all the meals which lead to constipation improvement in their quality of life they will not have any painful diffication, they will not suffer any pain itching around the anus. So what I will request to all my patients is that they should have a modification of diet modification of lifestyle and then they should see if they assess themselves yes they are ok with it and they don’t have any problem so I think they don’t need surgery. Now if at all they do have problems after this so definitely surgical options we should consider and you have to prognosticate the patient that still they have 30 to 40% chance of recurs if they don’t change their lifestyle.
So prefeeding and topping up with the change in the lifestyle followed by a surgical intervention to benefit the patient if you don’t do this and directly go into the surgical intervention definitely they are going to have a recurs because they don’t know how to change their lifestyle how to make their bowel habits so that they don’t land up into constipation. And so my important submission is that nowadays owing to this all westernization of culture westernization of toilet I think very important is that each and every house be it a middle class lower middle class or upper middle class which makes definitely leads to incomplete evacuation of stool at every time so there needs to be addressed that Indian toilet has to be approved that there never patient have problem of the incomplete evacuation of his stool . So this is a small things which needs to be addressed at all fronts and in society it is going to play a chronic epidemic and rampant problem in the near course of time. So my submission is every time to think about your lifestyle think about your dieting habits. Don’t make it a chronical ailment of your part of your life.