Lybrate.com has a number of highly qualified Surgeons in India.
Book Clinic Appointment with Dr. Dinesh Shah
Submit a review for Dr. Dinesh ShahYour feedback matters!
Patient Review Highlights
I found the answers provided by the Dr. Dinesh Shah to be very helpful. Thank u sir for your valuable suggestion
Hernia surgery is performed for the correction of a hernia which refers to the bulging of internal organs or tissues through an abnormal opening. It is easy to detect hernia through any pain or discomfort while lifting heavy objects, cough and strain during urination or bowel movements or during prolonged standing or sitting. It can be found in both men and women. The Hernia can be congenital or can be developed over a period of time. If it doesn’t get better over time and also does not go away by itself, then surgery becomes the only option.
Types of Surgery
There are two types of surgery for hernia treatment. One is the conventional open method, which requires an incision in the skin directly over the hernia. The other one is the Laparoscopic hernia repair in which surgery is performed using a small telescope known as a laparoscope. In this type of surgery minimal invasions are made and the hernia is repaired with only small incisions adjacent to the hernia. Most hernia operations are performed on an outpatient basis, which means that you can go home the very same day.
Tips for early recovery
- Wear comfortable clothing with expandable waistbands.
- Keep yourself active by moving around as much as you can as it increases circulation, which further speeds up healing.
- Eat a diet rich in fibre, fresh fruits and vegetables.
- Drink lots of water and other fluids to avoid constipation.
- Do not lift any objects even if it is very light as it can bring back pain.
- Do not to pick up things from the floor as it will be difficult to bend.
- Hold a pillow against your stomach while sneezing or coughing to lessen the pain.
- Use stool softener for a few days before and after surgery to help you with your bowel movements.
- Avoid driving till the time you feel any pain and as long as you are taking narcotic pain medicines.
- Band-Aids which cover the incisions should be changed as and when needed.
- Refrain yourself from intercourse as it can be painful.
- Check with your doctor when to take a shower so as not to hurt your incisions, and make sure to gently dry your incisions and replace the Band-Aids after taking a shower.
- Do not consume any alcoholic drinks for at least 24 hours.
The tips mentioned above will definitely provide help to cope up with post surgery blues. However, in case of fever, excessive sweating, difficulty in urinating, bleeding or any prolonged pain consult your doctor immediately.
In case you have a concern or query you can always consult an expert & get answers to your questions!
How Smoking Impacts Your Organs
As you inhale cigarette smoke, about 7000 carcinogens stir the crevices of your body. In India, about 3,00,000 people die every year due to smoking-related issues.
Here's a list of 5 such organs, which are the most affected by cigarette smoke.
1. Your lungs - Your lungs are probably the first organs to bear the wrath of cigarette smoke. Majority of the lung cancer cases are due to smoking. Other diseases include bronchitis and emphysema. This smoke paralyzes the cilia lining the inner walls so much so that it overproduces mucous. When the mucous builds, respiration suffers. Asthma and cancer follow.
2. Your Skin - Your skin also gets affected up to a huge extent if you smoke. You could have deep circles under your eyes, wrinkles on your skin, and stretch marks, if you continue smoking over time. Also, there lies the risk of major health issues like skin warts, psoriasis, skin cancer, and wounds, which may take longer to heal.
3. Your Penis - Studies revealed that you can take longer for an erection and find it difficult to maintain it if you are a heavy smoker. Studies have also revealed that men who quit smoking had longer and firmer erections.
4. Your Liver - Smoking increases the chances of you suffering from liver cancer dramatically. According to studies, half of the liver cancer cases are due to smoking. Obesity can also take place if you're a heavy smoker.
5. Your Eyes - Smoking affects your eyes to the extent of making you blind. Partial vision loss, glaucoma, cataracts, dry eye syndrome, and diabetic retinopathy are some of the other diseases you are susceptible to if you smoke.
Despite the negative effects, quitting smoking can save you from all of these potential health hazards.
Here are some ways to help you quit smoking.
1. Nicotine Replacement Therapy - There are a few nicotine replacement tools in the form of nicotine nasal sprays and nicotine inhaler, which you can use to quit smoking.
2. Chew on something - You should try to chew on some candy, or a gum, or anything crunchy and satisfying once you start getting restless for a cigarette or any other form of nicotine. That usually helps.
3. Relaxation techniques - If you are resisting tobacco strongly, it can be very stressful indeed. Take a break from whatever you are doing and go out for a walk, practice muscle relaxation, yoga or deep breathing to keep the craving out of the way.
4. Get involved in some physical work - Getting involved in some work will surely go a long way in reducing your craving. You can also try out physical exercises like squats, running, or jogging. Otherwise, you can also indulge in some needlework, or anything, which involves concentration or physical work.
In case you have a concern or query you can always consult an expert & get answers to your questions!
Roadside accidents are common and they lead to many health problems in which some may require amputation for removal of one of the limbs to save the life of a person.
Amputation is a life-saving procedure by which a part of the body that has suffered irreversible damage is surgically removed. Amputation is only carried out as a last resort when the infection/ decay spread to the other parts of the body.
Why is this procedure needed?
The most common cause of amputation is blockage of blood circulation. Without blood, the tissues do not get oxygen and begin to decay, and an amputation is carried out to stop the damage from spreading to other tissues. As stated above, an amputation is carried out only as a last resort. The surgeon checks the infected part for the following to make sure that an amputation is required:
- Checking for a pulse close to the region where the cut is to be performed
- Comparing skin temperatures with the affected limb
The surgeon tries to bypass arterial blood from the nearest artery to the affected region to rejuvenate the cells. Some reasons of amputation are:
- Severe injury (extreme burns/ vehicular accidents)
- Cancerous tumor in the bone or muscle
- Serious infection, which has stopped responding to antibiotics
- Thickening of nerve tissue called neuroma
Risks and complications of amputation
Risk of complication is lower in planned amputations than in emergency amputations. In the case of a planned amputation, the surgeon will shape individual muscles for future prosthetic limbs, smooth out rough bones and bone fragments and take care of all the loose ends of the procedure. In emergency amputations, however, the limb is amputated very fast and bleeding is stopped as soon as possible. The following complications may arise as a result of amputation procedures:
- Heart complications
- Venous blood clots
- Slow wound healing or infection of the wound
- Stump or "phantom limb" pain
- Psychological problems
In case you have a concern or query you can always consult an expert & get answers to your questions!
Any surgery that requires an incision will involve sutures or staples as the last step of the procedure. This helps close the incision and keep out infections. Taking care of your stitches can help limit scarring and discomfort and speed up the healing process.
Here are a few things to keep in mind.
- Keep it clean and dry: For the first few days, use a washed wet cloth to clean the incision site. After a few days, you may start washing the area with soap and water unless advised else wise by your doctor. Ensure that you dry the skin thoroughly after washing it. Avoid baths that involve soaking the area in water. Also, avoid swimming. Do not use any powders, lotions, creams, deodorants etc on the wound site.
- Look out for signs of infections: Avoid activities that may involve exposing your wound to dirty water, chemicals, dust etc. This increases your risk of infections. Also look out for signs f infections such as redness, swelling, pus or bleeding, fever or increased pain from the wound. In case you notice such signs, consult your doctor at the earliest.
- Do not scratch: As it heals, your skin is likely to turn itchy. However, refrain from scratching so as to reduce chances of infections. Do not try and pull away from the scab but let it fall off on its own. This will also help limit scarring.
- Limit contact: Avoid wearing tight clothes or anything that sticks to the skin while your wound is healing. Instead have plenty of loose, comfortable clothes easily accessible. Also, do not take part in close contact sports such as football etc until the stitches have healed completely.
- Change your dressing regularly: A dressing should be changed as soon as it gets wet or soaked with blood or other body fluids. Wear clean medical gloves while changing a dressing. When putting on a new dressing do not touch the inside of the dressing or apply any creams on the stitches unless advised so by your doctor. In the case of removable stitches, the doctor will usually remove the stitches after a few days. DO not attempt to pull the stitches out on your own.
- Avoid exposing the wound to sunlight: New skin that forms as the incision heals is very sensitive to sunlight and gets sunburnt very easily. Limiting your exposure to sunlight can help reduce the effects of scarring. In case you have a concern or query you can always consult an expert & get answers to your questions!
Colorectal surgery is a specialized branch of medicine used to treat patients suffering from colon, rectum, and anus ailments (damage, obstruction, injury, ischemia, inflammation, or any other medical condition). The colorectal surgery involves varied procedures that, at times, require the assistance of many specialized and experienced surgeons, consultants, and nurses (colorectal nurses).
Colorectal surgery help patients with:
- Crohn's disease: In this disease, there is weight loss, extreme fatigue, malnutrition, severe diarrhea, abdominal pain. Crohn's disease is mainly an inflammatory bowel disorder where the digestive tract (lining) gets inflamed.
- Ulcerative colitis: In ulcerative colitis, there is inflammation and ulcer formation in the rectum and the colon.
- Diverticulitis: In diverticulitis, there is inflammation of the diverticula or pouches (formed on the walls of the colon).
- Colorectal Cancer: Also known as bowel cancer and colon cancer.
Colorectal surgery is also helpful in case of:
- Anal fissures: In anal fissures, there is a tear in the anal canal (lining of the lower rectum). As a result, a person may experience extreme pain and discomfort in passing the stool.
- Bowel or fecal incontinence: In bowel incontinence, there is an uncontrolled bowel movement, resulting in a sudden (unexpected and uncontrolled) passing of stool.
- Hemorrhoids or Piles: It is a condition whereby the muscles and veins of the rectum and the anus (lower part) get swollen and inflamed. Piles are often accompanied by pain, bleeding, and itching. There is difficulty in sitting and in bowel movements.
- Rectal prolapse: In rectal prolapse, the entire rectal wall or the rectal mucosa protrudes out (loses its attachment).
Anal fistula and Anal abscess
Colorectal surgery can be of different types:
- Colostomy: It is a surgical procedure that links the colon to the abdominal surface through an opening called the stroma. This creates an alternative pathway for the removal of the feces. Colostomy comes in handy when the colon fails to function normally (due to a disease or an injury). A colostomy can be temporary or permanent:
- In a temporary colostomy, the damaged part of the colon is removed temporarily. Once the condition improves, the colon (part removed) can be reattached through a colostomy reversal surgery.
- In a permanent colostomy, the colon (damaged part) is removed permanently through surgery.
- Hemorrhoidectomy: As the name suggests, Hemorrhoidectomy is used to treat hemorrhoids or piles. In this procedure, the hemorrhoids are surgically removed through an incision (around the anus).
In PPH (Procedure for prolapse and hemorrhoids), the hemorrhoidal tissue is repositioned back into its original position (in the anus). Once repositioned, the surgeon trims the tissue causing pain and discomfort--
- Inflammatory Bowel Disease (IBD) Surgery: The surgery is an effective treatment for Crohn's Disease and Ulcerative Colitis. Here, the surgeon removes the colon to treat the condition.
- Rectopexy: Rectopexy is beneficial for patients with rectal prolapse.
- Internal Sphincterotomy: This is helpful in case of anal fissures. To reduce the pressure, the surgeon makes a small cut is made in the internal anal sphincter. In Internal Sphincterotomy, the patient is normally given a local anesthesia.
- Colectomy: To treat diseases that may affect the colon, a surgeon may remove the entire colon (Total Colectomy) or just a part of it (Partial Colectomy). Colectomy may further be:
- Proctocolectomy: Both colon and rectum are removed.
- Hemicolectomy: The left or right portion of the colon is removed. If you wish to discuss about any specific problem, you can consult a General Surgeon.
A fistula is an abnormal, tube-like connection, a passage or hole that forms between two organs or an organ in your body and your skin. There are various types of fistulas that can develop in different parts of your body but the most common types are-
1. Obstetric Fistulas: This is the name given to a hole between the vagina and rectum or bladder. A vaginal fistula that opens into the urinary tract is called a vesicovaginal fistula and one that opens into the rectum is called a rectovaginal fistula.
A woman with obstructed labour or labour that is not attended by a doctor or a midwife, can suffer labor pain for up to six or seven days. And as the labour produces contractions that push the baby’s head against the mother’s pelvic, the soft tissues between the baby’s head and the pelvic bone are compressed and do not receive adequate blood flow between the mother’s bladder and vagina and/or between the rectum and vagina.
This means that a hole forms on the vaginal wall between the urinary tract and her rectum. The urine and faeces thus start to leak from the vaginal opening causing soiling and foul smell.
Apart from labour, hysterectomies that damage the vaginal wall can also cause such types of fistulas.
Enterovaginal – A woman may have gas and foul smelling fluids leaking out of her vagina due to an enterovaginal fistula which is a hole between the vagina and the digestive tract. It’s usually caused due to inflammatory bowel disease or IBD and ulcerative colitis.
2. Anal fistula
These are fistulas that form between the end of the bowel and skin near the anus.
An anal fistula usually develops due to a previous or current anal abscess. An anal abscess is an infected cavity filled with pus found near the anus due to an acute infection in the internal glands of the anus.
Common symptoms are:
- Pain in the anorectal area
- Rectal bleeding
- Urinary symptoms, such as trouble initiating urination or painful urination
- Inflammatory bowel disease – a chronic condition of the GI track which causes inflammation
- Diverticulitis – An infection in the large intestine
- Tuberculosis, HIV
- Surgery near the anus
Anal abscess and likewise anal fistula are treated by surgical drainage in which an incision is made in the skin near the anus to drain the infection causing an anal abscess. Hospitalization may be required for patients who have impaired immunity like diabetics.
Anal fistula though has no medical treatment and surgery is almost always necessary to cure it.
- If the fistula is straightforward which means one that involves minimal sphincter muscle, a fistulotomy may be performed. This involves cutting open the whole length of the fistula so it heals.
- Seton is another procedure in which a surgical thread called a seton is placed in the fistula and left there to help it heal. If you wish to discuss any specific problem, you can consult a general surgeon.
An anal fissure can affect people of all ages, and it’s often seen in infants and young children. Constipation is a common problem in this age group and it is a major cause of this problem.
An anal fissure usually isn’t a serious condition. In most cases, the tear heals on its own within four to six weeks. In cases where the fissure persists beyond eight weeks, it’s considered chronic, or long term.
- A visible tear in the skin around the anus
- A small lump of skin just next to the tear
- A sharp pain in the anal area during bowel movements
- Streaks of blood on stools or on wiping
- Burning or itching around the anus
- Straining during childbirth
- Straining during bowel movements as a result of constipation
- Chronic constipation
- Inflammatory bowel disease (IBD)
- Overly tight anal sphincter muscles
In rare cases, an anal fissure may develop due to:
- Anal cancer which occurs due mostly to ano-receptive sex without barrier protection
- HIV infection
Let’s take a closer look at these risk factors.
- Anal fissures are common in infants and young kids. Older adults also become prone to anal fissures as the blood flow to the anorectal region decreases.
- Women also become prone to these fissures due to straining during childbirth.
- The inflammation that occurs in the intestinal lining in people with IBD makes the tissue around the anus more prone to tearing, further causing fissures.
- People who frequently experience constipation are at an increased risk for fissures. Also, one can suffer from fissures due to straining and passing large, hard stools. In both these cases, one may experience tears in the anal lining.
- Frequent diarrhea can also tear the skin around the anus and so can ano-receptive sex without protection. This can lead to sexually transmitted diseases like genital herpes, HIV/AIDS and infection with HPV virus which causes anal cancer.
Treatment usually helps control anal fissures and the discomfort it causes. Your doctor will prescribe stool softeners and topical pain relievers to stem discomfort. However, if these do not make your anal fissure go away then surgery may be required. And in addition to this, your doctor will also need to look for other underlying causes that can cause anal fissures like for example anal cancer.
- An anal fissure can be diagnosed by simple physical exam. The doctor looks at the area around your anus and follows it up with a rectal exam to confirm the diagnosis.
- This can mean the use of an anoscope. In this, the doctor inserts an anoscope into your rectum to be able to see the anal tear.
- An anoscope is a thin tube and it allows doctors to inspect the anal canal. An anoscope is also used to diagnose other causes of anal or rectal pain such as hemorrhoids or piles. If you wish to discuss about any specific problem, you can consult a General Surgeon.
Did you know that polyp formation is one of the common ailments of the large intestine, affecting close to 5-10 per cent of the population? Although majority of the polyps are asymptomatic in nature and do not form into cancer, it is important that you stay alert.
What is the disease all about?
When an abnormal growth arises from the lining of the rectum or colon, a polyp formation develops in the area. Rectum constitutes the last 12 inches of the intestine. It can be flat or take the shape of a broccoli. The latter is known as a pedunculated polyp. This being said, there is a small percentage of polyps that can turn into cancer over a span of 8-10 years. It is estimated that 95% of rectal cancers generate from polyps. Certain factors such as the size and type of the polyp decide the malignant nature of polyps. It is also dependent on the pre-cancerous changes.
The different types of polyps
There are 3 types of polyps. The first type of polyp is known as a tabular adenoma. This form has a 5 percent probability of turning into cancer. The second form of polyp is referred to as Tubulo-villous adenoma. There is a 20 percent risk of this form of polyp turning into cancer. The third form is known as a Villous adenoma. In terms of polyp size, there is a 1 percent risk factor involved of getting cancer in the polyp size is greater than 1 cm. Polyps that are in the range of 1-2 cm, has a 10 percent chance of turning into cancer. For the ones that are greater than 2 cm, there is a 40 percent probability of cancer.
Not too many symptoms are associated with rectal polyps. However, there are certain symptoms which are evident signs of rectal polyps. Some of them include bloody stool, abdominal pain, rectal bleeding, mucous discharge, diarrhoea, constipation etc.
A word on the diagnosis
A digital rectal exam or sigmoidoscopy can identify rectal polyps. They can also be identified with x-ray, colonoscopy, barium enema etc. During the process of colonoscopy, doctors focus on the changes in the lining of the colon. Although there is no full proof method of detecting polyps, most doctors rely on a combination of the above-mentioned techniques to lock in on the diagnosis.
The right treatment
Many polyps can be removed immediately at the time of colonoscopy. This method can prevent cancer and help a person avoid unnecessary complications. If the polyp is too large, a surgical intervention might be required. If the location of the polyp is situated in the lower portion of the rectum, it can be eradicated by a process known as transanal excision. If the polyp is located higher above the rectum, it is generally removed by a process known as Trans Anal Minimally Invasive Surgery. If you wish to discuss about any specific problem, you can consult a General Surgeon.
Do you bleed or feel pain during bowel movements, or the skin around your anus feels sore or itches? Or maybe there's a lump in or around your anus, or you feel as if your bowels haven't emptied completely? Then you may be suffering from piles. Piles or hemorrhoids are essentially swollen veins and muscles in your anal canal or around your anus. And they may stay inside your anus or come outside depending on the severity of the affliction.
Often, piles can be successfully treated with high-fiber diet, proper hygiene, and topical medicines or ointments. But in situations where non-surgical methods don't achieve desired results, surgery becomes the only option. And this may be particularly necessary for those suffering from large painful or bleeding hemorrhoids. The different surgical options are given below:
Hemorrhoidectomy - In this procedure, the surgeon makes incisions around the anus to remove the piles formations. Local or general anesthesia is offered during the operation, and you can usually return home on the same day. After the procedure, the area might require stitches and commonly remains very tender and painful for quite some time.
PPH or Procedure for Prolapse and Hemorrhoids - This method is minimally invasive and makes use of a stapler-like machine for repositioning the hemorrhoids and cutting off their blood supply. So eventually, the piles shrink and die without blood supply and your pain diminishes greatly. With this process, you can expect a faster recovery, less itching and bleeding, and minimal complications, if any.
Laser - An accurate and special laser beam is used in this method, to burn off the hemorrhoids.
Rubber Band Ligation - This procedure can be used for areas with fewer pain receptors. In this, a rubber band is tied around the base of hemorrhoid to stem the blood supply and destroy the affected tissue.
Sclerotherapy - This method involves the injection of a chemical solution around the blood vessel which supplies the hemorrhoid tissues, to shrink and kill them. Though non-invasive methods are preferred by many since they create less pain, hemorrhoidectomy may provide more long-lasting benefits. Here are some other aspects you need to consider regarding piles surgery:
Risks - Infection, bleeding, reaction to anesthesia, trouble with urination, fecal incontinence are some of the risks involved, though the surgery is usually quite safe.
Ways of treating pain - Pain, especially during and after a bowel movement, can be an issue for several days after the surgery. But it can be dealt with by taking prescribed pain medications, stool softeners, and soaking in a warm bath. Recovery can take up to 3 to 6 weeks after the procedure.
Avoiding recurrence - Following a high-fiber diet, maintaining good hygiene, taking lots of fluids, and avoiding straining or constipation can prevent piles from coming back. If you wish to discuss about any specific problem, you can consult a General Surgeon.
Colorectal surgery deals with the disorders of the rectum, anus and colon. Another name of colon is ‘large intestine’. These three body parts form the last stages of the digestive process. When the human waste passes through the colon, its salt and water are extracted before it exits the body as human excreta.
Common Colorectal disorders are:-
- Anorectal Abscess
- Anal fistula
- Anal fissure
- Rectal Prolapse
- Surgical Constipation
- Pilonidal Sinus
- Pruritus Ani
All these diseases are:
- Cause of significant patient discomfort & disability
- Major effect on overall quality of life
- Both men and women are equally affected
- Symptoms increase with age
Important Clinical Features of Anorectal Diseases are:
Bowel habits after colorectal surgery
Many patients report cases of diarrhoea, leakage of stool or gas, urgency to use the toilet and a feeling of insufficient evacuation of faeces. Relax; these conditions are not going to last forever. Your rectum and anus are adjusting to new conditions after this surgery. These organs may take six to twelve months to adjust to new bowel habits.
Is there a need to take a laxative or stool softener?
There is no need to take laxatives after a colorectal surgery. Drink lots of water to make your stool softer and easy to pass. If there is a water deficiency in your body, then it may lead to your faeces becoming hard. In that case, take milk of magnesium, colace etc.
Activities post surgery
You can continue with your normal schedule after this surgical procedure. Carry on running, jogging, exercising, climbing up the stairs etc. even after your surgery. Gastroenterologists recommend that patients should desist from lifting loads weighing more than 10 pounds so that there are no post surgery complications.
Diet after colorectal surgery
Avoid spicy and heavy to digest meals after your surgery. Once the intestines begin working normally, you can continue having your spicy food. Chew your food well to aid its digestion.
Returning to work after colorectal surgery
Most people are back to their work after taking a break of 2-5 days. If the surgery is pretty detailed, you may have to take a break of up to a month. Patients undergoing laparoscopic surgery may have to take a rest of 2- 4 weeks before they report back to work. Take it easy before slipping into your regular schedule. If working hurts after your surgery, don’t do it. If you wish to discuss about any specific problem, you can consult a General Surgeon.