Dr. Harika Tirungari

What is hemorrhoid?

Hemorrhoid (piles) is a condition where the veins in the lowest part of rectum and anus get swollen.

How to deal with it?

Following are the most effective measures to reduce the suffering from the piles:

1. Placing a towel soaked in cold water on the piles relieves the pain, irritation, and burning around the anus.
2. Protruded hemorrhoids can be pushed back into the rectum, using a lubricating jelly, while bathing.
3. A fiber supplement, which includes Metamucil, Citrucel, or Fiber Con, and a fiber-rich food, such as broccoli, beans, wheat, oat bran, whole-grain foods, and fresh fruits, should be included in the diet. Fibrous food softens the stool and makes it easier to pass, thereby reducing pressure on hemorrhoids.
4. Exercise will help by stimulating the bowel function and by improving constipation. Aerobic exercises, such as brisk walking, jogging, cycling, skipping for 20-30 minutes a day, at least for 5 days per week, should be included.
5. Do not strain. Straining for the stool leads to pressure on the hemorrhoids and causes worsening of the symptom.
6. Don’t wait for a convenient time. Immediately pass the stool when there is urging. This stool can back up, leading to increased pressure and will require straining to pass in future. Keep a fixed time for passing stool, such as after a meal, or after waking up, and sit on the toilet seat for a few minutes. This will help to establish a regular bowel habit.
7. Take a regular sitz bath. A sitz bath is a warm water bath for the buttocks and hips. It helps to reduce itching, irritation, and spasms of the sphincter muscle. A 20-minute sitz bath after each bowel movement, two or three times a day, will help reduce burning and itching after passing stool.
8. Topical medication, such as creams containing a local anesthetic agent, can be used to relieve the pain. They are applied before passing the stools. Anti-inflammatory home remedies, such as Witch hazel, aloe vera, and a warm bath with Epsom salt helps reduce symptoms of piles.
9. Using a toilet paper after a bowel movement can aggravate existing hemorrhoids, as wipes which have alcohol, perfume, or irritants cause more irritation and worsens symptom. Use wipes which are medicated, such as wipes with aloe vera or witch hazel.
10. Stool softeners or fiber supplements help reduce constipation, make the stool softer, and make it easier to have quick, painless bowel movements. Oral painkillers can be used to relieve the pain, such as aspirin and ibuprofen.
11. When an external hemorrhoid is very painful due to a blood clot, surgery is usually indicated in order to relieve the symptoms.

After any surgery, the most important thing that needs to be taken care of is the stitches/sutures. Serious cuts or incisions from surgical procedures may require stitches, or sutures, to hold tissues together while they heal.

As stitches are the most important thing that protects the internal organs to form infection and re-injury. They need to be observed carefully until they are dried and removed.

Care For Stitches/Sutures:
The doctor or nurse will give you instructions regarding how to take care of your stitches as your cut heals.

• They will teach you specific steps for cleaning and dressing the wound. 
• You are advised to keep the wound and bandages dry.
• The doctor will prescribe an antibiotic ointment to help prevent infection.
• The doctor will make you aware of signs that may indicate infection.

Following are the signs and symptoms that indicate infection for which you need to see your doctor immediately:

1. Increased body temperature - fever higher than 100 degrees farhanite is a sign of infection.
2. Red streaks on the skin near the wound or when edges of the wound leak blood or pus indicates infection.
3. If any of your stitches break open or skin around the wound becomes red, swollen, hot or painful you need to see your doctor and avoid doing anything at home.
4. Swimming may cause pain at the site of sutures due to excessive movement of the body causing the suture to tear open.
5. Lifting heavy weight may cause pressure on the skin which is sutured thereby leading to a tear or reopening of the wound leading to pain. If such a thing happens you need to see your doctor immediately.
6. Sutures may get infected if not cleaned properly or if hygiene level is not maintained leading to pain and infection. In such cases, you need to see your doctor and get it cleaned and re-sutured if required.
7. Keeping the suture area wet may also increase chances of infection leading to pain. To avoid this it is recommended to keep the sutured area clean and dry.
8. If kids play in the mud and if the sutured site is exposed to mud it can be infected and cause pain where they need to be taken to the surgeon and get it cleaned.
9. Suture pain may also occur because of rubbing or friction against clothes which may lead to redness and pain. In such a case you need to see your doctor.
10. Also, sometimes after the sutures are removed there can be an infection because of scratching which can introduce infection into the wound. It may become warm and painful and may discharge pus.

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

Weight loss surgery or bariatric surgery helps lose weight in those people who are about 100 pounds (male) and 80 pounds (female). It helps individual resolve obesity-related medical problems.

Types of Weight Loss Surgeries-

1. Gastric Band

A band is put around stomach tightly which divides the stomach into two sections, namely smaller upper and larger lower which is connected through a small tube by which emptying of the upper part becomes slow. Since less food is required to fill this pouch; there is no need to eat much. The band is connected to a device under the skin. It can be tightened after 4-6 weeks after surgery.

Merits: Simpler method. Recovery is faster leaving a small scar.

Demerits: Lesser weight loss than other surgeries. The band might slip out. Vomiting can occur after overeating food quickly.

2. Sleeve Gastrectomy

In this procedure, a larger portion of the stomach is cut off, and the remaining smaller part is attached to the intestine. Smaller the stomach, lesser is the production of appetite-regulating hormone ghrelin. As a result, less food is taken in.

Merits: It is a simple method. As it does not involve intestines, the process of absorption takes place smoothly, and the patient does not fall short of nutrients.

Demerits: It is an irreversible process. It can cause infection and leaking of sleeve might take place.

3. Duodenal Switch with Biliopancreatic Diversion

In this procedure, a larger part (70%) of the stomach is cut off leaving the duodenum. The surgeon cuts the middle part of intestine attaches it to the duodenum. It is called duodenal switch. The leftover part of the intestine is again attached to the last part of intestine allowing pancreatic juices and bile to flow into that part. This is biliopancreatic division. Food passes directly into the small intestine limiting absorption of nutrients and calories, ultimately resulting in weight loss.

Merits: It is a fast method to lose weight, and the patient can eat large amounts of food.

Demerits: Nutritional deficiencies are seen.

4. Gastric Ballooning

A small balloon filled with salt and water is placed in the stomach through a thin tube via throat.Merits: The patient feels full and will not be able to eat much.

Demerits: It is a temporary method, which can last only for 6 months.

5. Gastric Bypass

In this procedure, the surgeon divides the stomach into two parts, namely upper and lower. Here, the upper part of the stomach is directly connected to the last part of the intestine.

Merits: More than 50% weight loss take place, as much weight gets reduced, and conditions, such as diabetes and blood pressure come under control.

Demerits: As less of nutrients are absorbed, the patient might land up into anemia and nutritional deficiency. The patient might need to take supplements after surgery to maintain balance. In case you have a concern or query you can always consult an expert & get answers to your questions!