Dr. Pranjal Deka

Rectal problems in women are quite common. It is experienced by many women in some form or the other such as rectal itching, pain or bleeding. Rectal problems are more common in women than in men. These conditions need to be attended to immediately as severe rectal problems may cause several health problems. There are many ways to deal with rectal problems in women.

Treating rectal itching: Rectal itching is a common rectal problem. These can be treated by

• Improve hygiene: You should clean the rectum area gently using cotton balls moistened with water. You should apply mild ointments to prevent irritation and soothe the skin.
• Unscented toilet paper or unscented lotions and creams: You should use white toilet paper that does not have any scent. Scented soaps, creams or lotions should be avoided as it may cause further irritation. You can also apply ointments containing 1% hydrocortisone.
• Control excessive sweating: Rectal problems may occur due to excess sweating. You should avoid sweating too much by wearing light clothes and using talcum powder for the absorption of moisture.

In case of excessive itching, you should follow the following tips:

• Do not scratch the area as scratching may lead to further itching. You can take an oral antihistamine during the night to get better sleep.
• You can take a warm sitz bath after every bowel movement, for at least three days, every day. The anus should be dried properly after the bath.
• Abstain from foods that stimulate rectal itching like tea, coffee, aerated drinks, alcohol, chocolate, spicy food, tomatoes and excess vitamin C, for a period of two weeks.
• You must maintain short fingernails to avoid injuries during scratching. To prevent unconscious scratching during sleep, wear cotton gloves.
• Stress should be managed as increased stress may lead to enhanced rectal itching. When you are anxious, do not scratch the rectal area.

Treating rectal bleeding: Rectal bleeding is another problem, which may be accompanied by other rectal problems. In case of rectal bleeding, avoid taking aspirin or any other non-steroidal, anti-inflammatory drug. These drugs may cause bleeding in the digestive tract. This will increase the blood amount in your stool. Bleeding hemorrhoids can worsen by the intake of these medicines. For soothing pain, opt for an acetaminophen. Constipation and diarrhoea may also lead to rectal bleeding. However, it is advised to consult a doctor before consuming any medicine.

Prevention
For prevention of rectal problems, you must have a good sense of hygiene. Keep the rectum region clean and avoid sitting in the toilet for a long time. You should have a fiber-rich diet including fresh fruits and vegetables. Avoid food items, which may cause rectal problems. General rectal problems are not very serious and can be treated using simple measures. Maintaining proper rectal hygiene is very important to avoid rectal problems. It is highly recommended to visit a doctor if the problem persists.

Peptic ulcer disease is a form of disease in which painful sores or ulcers are developed in the lining of the stomach or in the duodenum, which is the first part of the small intestine. Complications include severe blood loss and perforation of the stomach and intestines.

What can cause peptic ulcers?
Ulcers occur due to the imbalance of digestive fluids in the stomach or duodenum. Usually, ulcers are caused by the infection due to bacteria known as Helicobater pylori.
Here are the factors which may lead to peptic ulcer:

1. One can use painkillers, which are known as nonsteroidal, anti-inflammatory drugs, by the likes of aspirin, naproxen, ibuprofen and several others.
2. These kinds of ulcers may also occur due to excessive production of acid from gastrinomas.
3. Excessive alcohol consumption may also cause peptic ulcer.
4. Smoking cigarettes and chewing tobacco may cause such ulcers.
5. Sometimes serious illness may cause peptic ulcer as well.
6. Radiation treatment of the affected area may also lead to peptic ulcer.

What are its signs and symptoms?
There are several symptoms of peptic ulcer. They include the following:

1. People experience a sensation of burning or gnawing pain in the upper or middle part of the stomach, between meals and during night time.
2. Bloating is experienced.
3. A feeling or sensation of heartburn.
4. Nausea and vomiting are likely to be accompanied.
5. In severe cases of peptic ulcer, dark or black stool is produced because of bleeding.
6. The patient may vomit blood.
7. Weight loss and abdominal pain are indicated, especially in the upper to mid abdomen region.
8. Indigestion and change in appetite are also noticed.
9. There is pain in the chest.

How to treat them?
Peptic ulcers can be treated in various ways, which include medication, lifestyle changes or surgery.
1. Lifestyle changes: Elimination of substances which lead to peptic ulcer should be avoided. Smoking and drinking should be restricted. Certain NSAIDS may lead to ulcer, and they should be stopped.
2. Medication: Proton pump inhibitors help in reducing acid levels, which allow healing of the ulcer. Different types of PPI are esomeprazole, dexlansoprazole, omeprazole, pantoprazole and iansoprazole.

Several antibiotics may also be used when a patient has helicobacter pylori infection. Several combinations of antibiotics may be used for the treatment. Bismuth may be used as well.
Upper endoscopy can be done as a part treatment of ulcer to cure bleeding ulcers. In case the ulcer creates a hole in the stomach’s wall, surgery is required. Peptic ulcer is a serious health condition and if not treated properly, it can cause several health hazards. There are several treatment options for peptic ulcer, and you should opt for the one that suits you the best.

The LES valve in the stomach is designed in such a way that as soon as food passes through it, it closes. If however, LES remains partially or fully open, acid produced by the stomach can move up to the esophagus resulting in a burning sensation called acid reflux or heartburn. This condition is commonly known as the hital hernia.

Some of the common symptoms of acid reflux:
1. Consumption of large meals at one go.
2. Lying down immediately after having a meal.
3. Obesity or being overweight.
4. Consumption of snacks just before bedtime .
5. Consumption of certain food items such as chocolate, garlic, onion and citrus-related food.
6. Consumption of caffeine related products such as coffee, liquor and cigarettes.
7. Certain medicines such as aspirin is also known to be a trigger for acid reflux.
8. Pregnant women or patients with blood pressure are known to be suffering from acid reflux.

Tips to deal with acid reflux
There is a wide range of treatment options available for acid reflux. If you are suffering from occasional heartburn, there are some wonderful home remedies that can be tried. However, if the acid reflux recurs more than once in a week, it is best to consult a doctor. Home remedies to deal with acid reflux:
1. Sleeping on the left side is known to reduce acid reflux.
2. Reducing weight greatly helps in tackling acid burn. Patients with obesity are more vulnerable to acid burn.
3. It is best to avoid food that triggers acid burn.
4. Chewing gum greatly helps in countering acid burn. It helps in producing saliva which soothe the esophagus.
5. Intake of One spoon of baking soda every day proves to be extremely effective. Baking soda contains sodium bicarbonate which has a pH of more than 7 and can effectively neutralize the acid from stomach.
6. Intake of aloe vera, apple, banana or ginger is known to have very positive effects on acid burn.
7. Intake of 1 table-spoon of mustard can give instant relief from acid burn. Mustard’s alkaline properties can make the acid neutral in the system.
8. Regular intake (one after every meal) of almond helps to fight acid burn

Medication:
1. If you are buying over the counter, Histamine 2 blockers is a great medicine that instantly gives relief from an acid burn. Typically Doctors suggest this medicine with a higher dosage. This medicine can be consumed half an hour before the consumption of a meal. However, It is best to consult a doctor before consuming any medication.
2. Doctors often suggest medicine from the PPI family. It effectively blocks acid production in the esophagus for a longer duration. Some common medicine from this group includes Lansoprazole, Pantoprazole and Rabeprazole. 

In case you have a concern or query you can always consult an expert & get answers to your questions!

Any kind of injury on the surface of the skin is immediately noticed by us, but when something happens to one of our internal organs, it can take a little longer to get to your notice for example, an obstruction in the bile duct. The bile duct is a tubular structure responsible for carrying bile from the liver and gall bladder through the pancreas to the small intestine. This bile helps the digestion process and the absorption of fat.

An obstruction in the bile duct can be triggered by a number of factors. Some of these are:

1. Gallstones
2. Inflammation of the bile ducts
3. Cysts
4. Traumatic accidents
5. Bile duct or pancreatic tumors
6. Hepatitis infections
7. Cirrhosis or severe liver damage
8. Abnormal narrowing of the bile duct

This can affect anyone, but the people who have a history of gall stones or tumors in the abdomen are at a higher risk of suffering from bile duct obstruction. Chronic pancreatitis, sudden weight loss or obesity can also increase this risk. The symptoms of biliary obstruction include light coloured stool, dark urine, pain in the upper right abdomen, nausea, vomiting and fever. Your doctor will also probably need an X-ray of the bile ducts, blood tests, a hepatobiliary iminodiacetic acid scan and ultrasonograph to confirm a diagnosis before they can start treating you for the same.

If not treated in time, bile duct blockages can lead to a dangerous buildup of bilirubin in the body and trigger a number of life threatening diseases. Treatment for biliary obstruction can be through medication or surgery with surgery being the more preferred mode of treatment. It is aimed at resolving the underlying cause of the obstruction and alleviating the blockage. Treatment for biliary obstruction can be two common forms of treatment include a cholecystectomy and ERCP. The former involves the removal of the gall bladder and is suited to obstructions caused by gallstones. The latter is a procedure to remove small stones from the bile duct or place a stent inside the duct.

There are many ways bile duct obstruction can be prevented which first and foremost includes following a healthy lifestyle. If you are overweight, exercise for at least half an hour a day to regulate your weight and reach a healthy BMI. Decrease your intake of sugar and saturated fats as both these can cause gall stones. Also, increase the amount of fibre in your diet. All the above mentioned tips will certainly help you in preventing bile duct obstruction. If you wish to discuss about any specific problem, you can consult a gastroenterologist.

The build-up of gases in the stomach can be uncomfortable and very embarrassing when it leads to flatulence. Flatulence can be defined as the release of intestinal gas from the anus. This may or may not be accompanied by sound and odour. Both men and women can be affected by flatulence at any age.

Some of the causes of flatulence include:
• Swallowing excessive amounts of air while eating
• Indigestion
• Lactose intolerance

Food that is difficult to digest often triggers the formation of gas such as hydrogen, carbon dioxide, methane and sulphur in the digestive system as a result of the microbial breakdown of this food. Sulphur is largely responsible for the odor that accompanies the release of these gases. Beans, chickpeas, cauliflower and cabbage are some such foods that can trigger flatulence.
Flatulence on its own is not a serious condition and usually resolves itself without medication. However if it triggers severe abdominal cramps, diarrhea, persistent constipation, blood in the stools, nausea and pain in the right side of the abdomen, medical care should be immediately sought.

If flatulence is a problem you suffer from often, take a look at your diet and modify your eating habits. Keep a food diary to determine what food triggers this condition and avoid it. If you are lactose intolerant switch your dairy products for soya substitutes and avoid dairy. Anti-gas compounds that are available over the counter can also provide relief. Chew your food slowly, thoroughly and ensure that your mouth is closed while chewing to prevent swallowing air. For this reason, also avoid chewing gums and fizzy drinks. If you must eat beans, soak them overnight before cooking.

Flatulence can be easily treated with home remedies. Following home remedies can be used
1. Ginger: Ginger aids the digestion process, eases bloating and reduces gas. It also helps stool pass smoothly and helps keep the intestines clear. This does not give stomach gases a chance to build up. Ginger can be consumed in the form of capsules or a tea made by steeping ginger in hot water for a few minutes.
2. Papaya: Along with being rich in antioxidants and flavonoids, papaya contains an enzyme known as papain that helps digest proteins and reduce gas. To benefit from papain, you could eat the papaya fruit or drink a tea made with papaya leaves. Papaya enzymes are also available as supplements. If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.

Heartburn or acid reflex is a burning sensation that is felt in the throat or chest region after the intake of certain foods. While many of us must have felt heartburn once in our lifetime, too many occurrences such as this could be a fair indication of esophageal cancer.

How an acidburn is related to esophagus?
Esophagus is the tube which carries food from the throat to the stomach. In the case of an acid reflux, the acid from the stomach jumps to the esophagus leading to a condition known as the Barrett’s esophagus. This is a condition which replaces the tissue present in the esophagus with a similar kind of tissue found in the lining of the intestine. This being said, Barrett’s esophagus doesn’t necessarily lead to esophageal cancer.

Key symptoms of Esophageal Cancer
Difficulty swallowing is a key symptom of esophageal cancer. This condition is known as dysphasia. As the tumor grows bigger, it becomes more difficult to swallow food. Esophageal pain is also a common symptom reported by many patients. Loss in appetite and an unexplained weight loss are some of the other symptoms of this type of cancer. Although esophageal cancer does not show any visible signs in the early stage, some of the key indicators are chronic couch, indigestion and hoarseness of voice.

Key risk factors:
Some of the key risk factors for this type of cancer are as follows:

1. Men tend to run a higher risk of getting this cancer than women.
2. Esophageal cancer are often detected in people above the age of 55 or more
3. Chronic tobacco users have higher chances of getting esophageal cancer
4. Consumption of alcohol increases the risk of esophageal cancer
5. Obesity increases the risk of acid flux thereby, leading to esophageal cancer
6. Radiation treatment in the abdomen or chest area might also lead to esophageal cancer

How an esophageal cancer is detected?
Primarily there are 3 ways by which this cancer is detected. The first step for an oncologist to detect this cancer is to perform an endoscopy. If this fails, doctors often try a barium swallow on suspected patients and take an X-ray to understand the esophagus lining. If all this fails, doctors rely on a CT scan to detect this cancer.

How is esophageal cancer treated?
If a patient is lucky and the cancer gets detected in a very early stage, the tumor along with the infected cell can be surgically removed. Apart from surgery, some other alternatives are radiation and chemotherapy. A combination of radiation and chemotherapy or a surgery followed by radiation can also be suggested by the doctor. The treatment plan depends on the stage of detection.