Treatment Of Erectile Dysfunction
Treatment Of Male Sexual Problems
Treatment of H.I.V
Hydrocele Treatment (Surgical)
Urinary Incontinence (Ui) Treatment
Urology Minimally Invasive Surgery
Kidney Transplant Treatment
Gastric Bypass Surgery
Blood In Urine (Hematuria) Treatment
Reconstructive Surgery Procedures
Transurethral Resection Of The Prostate (Turp) Pro
Reconstructive Urology Surgery
Minimally Invasive Urology Surgery
Transurethral Incision Of The Prostate (Tuip) Proc
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In the past i consulted so many doctors, but nobody was able to help me with my gastric problem, but he has helped me immensely. I was shocked to experience the symptoms of gastric problem. He is very talented and seasoned doctor. It was an amazing experience as everyone in the Pace Hospitals is so nice. Govind Verma has so much knowledge that for everything my family takes his reference
Hi, I'm 21 years old student of engg having pain since few days in left lower abdomen. Can I know the reason.
I had three major surgery for fistula from 2010 to 2013. From 2014 onwards it heeling and now from the past two weeks it occurred once again what should I do now. I am using moxikind CV 625 mg tablet.
What are allowed foods for kidney failure patients they are suffering from this condition around one year.
I am Aslam aged 60. My prostate is enlarged in size and measures 4.1*4.4*3.9cm vol 36.9cc Impression: prostatomegaly bilateral large simple renal cortical cyst what should I do?
Gall bladder stones - during my health check up, gall bladder stones are detected size 12mm around. 1. Does it compulsory to remove gall bladder for stones or only stones are removed. 2. Also do let know any other way of removal of gallstones thru medicine etc. I mean without surgery. Please reply.
Sir I am suffering from fistula problem. I have done operation of this but the wound will not recover from this problem. please suggest me.
HOW CAN SURGERY BE SCAR LESS?
It is not possible to magically perform operations without access to the abdomen. Scar less or SILS (single incision laparoscopic surgery) is an advanced technique in laparoscopy where the procedure is performed through the umbilicus instead of the traditional 4 or more laparoscopic incisions. As the incision is through the umbilicus the scar is virtually invisible. Single-incision laparoscopic surgical procedures require an experienced surgeon who is highly skilled and experienced in laparoscopic surgery.
WHAT ARE THE ADVANTAGES OF SCAR LESS LAPAROSCOPIC SURGERY (SILS)?
In addition to improved cosmetic outcomes. Single incision laparoscopic surgery leaves the patient with the potential for less post-operative pain, quicker recovery time and reduced risk of wound site infections.
DOES IT NEED SPECIALIZED EQUIPMENT?
SILS surgery needs specialised ports and instruments so that we can achieve triangulation at the surgical site. The imaging system should be high resolution with a HD or 3D camera. The most important factor is a surgeon with the large experience in these procedures both by open as well as laparoscopic route so that it can be done safely.
CAN ALL SURGERIES BE PERFORMED LAPAROSCOPICALLY?
Though a wide range of surgeries have been attempted by SILS as of now it is performed on a regular basis for few standard laparoscopic procedures such as laparoscopic cholecystectomy, appendectomy and obesity surgery. Especially for surgeries like cholecystectomy with risk of bile duct injury it should performed by a surgical gastroenterologist with in-depth knowledge of the gallbladder and bile duct anatomy and physiology.
IS IT A SAFE OPERATION?
Patient selection is very important Not every patient who wants scarless surgery can be offered surgery. Generally patient uncomplicated appendicitis / cholecystitis can undergo scarless surgery. However if local factors are not conducive safe completion of the procedure is more important than cosmesis. Patients should be prepared for conversion to reduced port or multiport laparoscopic surgery if situation warrants.
IS IT AN EXPENSIVE OPERATION?
If the patient built and local factors make it feasible to perform scarless laaproscpic surgery the cost is only marginally higher than standard laproscopic surgery because of the few additional specialized equipment used. It is definitely not much expensive compared to standard surgery.
WHAT CAN WE EXPECT AFTER SURGERY?
The surgery can be performed in about one hour with a typical hospital stay of less than 24 hours.
You will have mild pain and soreness at umbilicus with a 1.5 to 2 cm incision hidden in the umbilicus grove. Patients will probably be able to get back to normal activities within 3-4 days time, including driving, walking up stairs, light lifting and work.
In two weeks time the scar is contracts and disappear into the umbilical fold & becomes virtually invisible. You have undergone a magically scarless operation on your tummy!!
What is gastroesophageal reflux?
Gastroesophageal refers to the stomach and esophagus. Reflux means to flow back or return. Therefore, gastroesophageal reflux is the return of the stomach's contents back up into the esophagus.
In normal digestion, the lower esophageal sphincter (les) opens to allow food to pass into the stomach and closes to prevent food and acidic stomach juices from flowing back into the esophagus.
Gastroesophageal reflux occurs when the les is weak or relaxes inappropriately, allowing the stomach's contents to flow up into the esophagus.
The severity of gerd depends on les dysfunction as well as the type and amount of fluid brought up from the stomach and the neutralizing effect of saliva.
What is the role of hiatial hernia in gerd?
Some doctors believe a hiatal hernia may weaken the les and increase the risk for gastroesophageal reflux. Hiatal hernia occurs when the upper part of the stomach moves up into the chest through a small opening. Many people with a hiatal hernia will not have problems with heartburn or reflux. But having a hiatal hernia may allow stomach contents to reflux more easily into the esophagus.
Coughing, vomiting, straining, or sudden physical exertion can cause increased pressure in the abdomen resulting in hiatal hernia. Obesity and pregnancy also contribute to this condition. Many otherwise healthy people age 50 and over have a small hiatal hernia. Although considered a condition of middle age, hiatal hernias affect people of all ages.
Hiatal hernias usually do not require treatment. However, treatment may be necessary if the hernia is in danger of becoming strangulated (twisted in a way that cuts off blood supply, called a paraesophageal hernia) or is complicated by severe gerd or esophagitis (inflammation of the esophagus). The doctor may perform surgery to reduce the size of the hernia or to prevent strangulation.
What other factors contribute to gerd?
Dietary and lifestyle choices may contribute to gerd. Certain foods and beverages, including chocolate, peppermint, fried or fatty foods, coffee, or alcoholic beverages, may trigger reflux and heartburn. Studies show that cigarette smoking relaxes the les. Obesity and pregnancy can also play a role in gerd symptoms.
What are the symptoms of heartburn?
Heartburn, also called acid indigestion, is the most common symptom of gerd and usually feels like a burning chest pain beginning behind the breastbone and moving upward to the neck and throat. Many people say it feels like food is coming back into the mouth leaving an acid or bitter taste.
The burning, pressure, or pain of heartburn can last as long as 2 hours and is often worse after eating. Lying down or bending over can also result in heartburn. Many people obtain relief by standing upright or by taking an antacid that clears acid out of the esophagus.
Heartburn pain can be mistaken for the pain associated with heart disease or a heart attack, but there are differences. Exercise may aggravate pain resulting from heart disease, and rest may relieve the pain. Heartburn pain is less likely to be associated with physical activity.
How common is heartburn and gerd?
More than 60 million adults experience heartburn at least once a month, and more than 15 million adults suffer daily from heartburn. Many pregnant women experience daily heartburn. Recent studies show that gerd in infants and children is more common than previously recognized and may produce recurrent vomiting, coughing, and other respiratory problems.
What is the treatment for gerd?
We recommend lifestyle and dietary changes for most people needing treatment for gerd. Treatment aims at decreasing the amount of reflux or reducing damage to the lining of the esophagus from refluxed materials.
Avoiding foods and beverages that can weaken the les is often recommended. These foods include chocolate, peppermint, fatty foods, coffee, and alcoholic beverages. Foods and beverages that can irritate a damaged esophageal lining, such as citrus fruits and juices, tomato products, and pepper, should also be avoided if they cause symptoms.
Decreasing the size of portions at mealtime may also help control symptoms. Eating meals at least 2 to 3 hours before bedtime may lessen reflux by allowing the acid in the stomach to decrease and the stomach to empty partially. In addition, being overweight often worsens symptoms. Many overweight people find relief when they lose weight.
Cigarette smoking weakens the les. Stopping smoking is important to reduce gerd symptoms.
Elevating the head of the bed on 6-inch blocks or sleeping on a specially designed wedge reduces heartburn by allowing gravity to minimize reflux of stomach contents into the esophagus. Do not use pillows to prop yourself up; that only increases pressure on the stomach.
Along with lifestyle and diet changes, doctor may recommend over-the-counter or prescription treatments.
Antacids can help neutralize acid in the esophagus and stomach and stop heartburn. Many people find that nonprescription antacids provide temporary or partial relief. An antacid combined with a foaming agent helps some people. These compounds are believed to form a foam barrier on top of the stomach that prevents acid reflux from occurring.
Long-term use of antacids, however, can result in side effects, including diarrhea, altered calciummetabolism (a change in the way the body breaks down and uses calcium), and buildup of magnesium in the body. Too much magnesium can be serious for patients with kidney disease. If antacids are needed for more than 2 weeks, a doctor should be consulted.
For chronic reflux and heartburn, the doctor may recommend medications to
Reduce acid in the stomach. These medicines include h2 blockers, which inhibit acid secretion in the stomach.
What if heartburn or gerd symptoms persist?
People with severe, chronic esophageal reflux or with symptoms not relieved by the treatments described above may need more complete diagnostic evaluation. Doctors use a variety of tests and procedures to examine a patient with chronic heartburn.
An upper gi series may be performed during the early phase of testing. This test is a special x-ray that shows the esophagus, stomach, and duodenum (the upper part of the small intestine). While an upper gi series provides limited information about possible reflux, it is used to help rule out other diagnoses, such as peptic ulcers.
Endoscopy is an important procedure for individuals with chronic gerd. By placing a small lighted tube with a tiny video camera on the end (endoscope) into the esophagus, the doctor may see inflammation or irritation of the tissue lining the esophagus (esophagitis). If the findings of the endoscopy are abnormal or questionable, biopsy (removing a small sample of tissue) from the lining of the esophagus may be helpful.
Esophageal manometric and impedance studies -- pressure measurements of the esophagus -- occasionally help identify low pressure in the les or abnormalities in esophageal muscle contraction.
For patients in whom diagnosis is difficult, doctors may measure the acid levels inside the esophagus through ph testing. Testing ph monitors the acidity level of the esophagus and symptoms during meals, activity, and sleep. Newer techniques of long-term ph monitoring are improving diagnostic capability in this area.
Does gerd require surgery?
A small number of people with gerd may need surgery because of severe reflux and poor response to medical treatment. However, surgery should not be considered until all other measures have been tried. Fundoplication is a surgical procedure that increases pressure in the lower esophagus. Endoscopic procedures that involve making the les function better or using electrodes to promote scarring of the les are newer options in treatment.
What are the complications of long-term gerd?
Sometimes gerd results in serious complications. Esophagitis can occur as a result of too much stomach acid in the esophagus. Esophagitis may cause esophageal bleeding or ulcers. In addition, a narrowing or stricture of the esophagus may occur from chronic scarring. Some people develop a condition known as barrett's esophagus. This condition can increase the risk of esophageal cancer.
Although gerd can limit daily activities and productivity, it is rarely life-threatening. With an understanding of the causes and proper treatment, most people will find relief.