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Overview

colitis: Treatment, Procedure, Cost and Side Effects

What is the treatment?

Colitis is defined as an inflammatory bowel disorder and is characterised by inflammation in the inner lining of the colon (large intestine) and rectum. The inflammation generally begins in the rectum and the lower part of the large intestine and gradually spreads upward to the entire colon. Colitis hardly affects the small intestine except for the lower part, which is known as the ileum. For a person suffering from colitis, with time as the cells on the surface of the lining of the large intestine die and slough off, ulcers develop resulting in pus, mucous and bleeding. The inflammation of the inner lining of the colon may cause diarrhoea and/or frequent urge for emptying of the colon.

The symptoms of a person having colitis may vary depending upon how severe the inflammations are and where the inflammation occurs. Some of the common symptoms of such a disorder include diarrhoea along with blood or pus, abdominal pain or cramping, loss of appetite, rectal pain, bleeding of rectum, anaemia due to excess bleeding, urgency to defecate, inability to defecate despite urgency, fever, weight loss, weakness and lack of growth in children. A few patients may also experience some indirect symptoms such as skin lesions, inflammation of eyes, osteoporosis, rashes, kidney stones, liver disorders and joint pain. A patient having such symptoms should immediately consult a doctor for proper diagnosis and treatment.

The diagnosis of patients suffering from colitis involves obtaining the medical history of the patient, physical examinations and a few laboratory tests. A few popular ways of diagnosis are laboratory examination of stool sample, abdominal computed tomography, abdominal X-rays and colonoscopy. Once the severity of the condition and the area of inflammation within the colon is accurately diagnosed, the treatment begins and it includes both medical as well as surgical treatments (if found necessary by the doctor).

How is the treatment done?

The first step for the treatment of the problem of colitis calls for proper diagnosis. Diagnosis of colitis involves laboratory examination of stool sample and imaging studies such as abdominal computed tomography, abdominal X-rays and colonoscopy. Once the severity of the condition and the region of inflammation within the colon are accurately diagnosed, the treatment begins. The problem of colitis is usually treated either by drug therapy or by surgery.

There are several categories of drugs that may prove effective in the treatment of colitis. The type of drug prescribed by the doctor mainly depends on the severity of the condition that a patient suffers from. Moreover, the response of patients to various drugs may also be different and hence it might take some time for the doctor to find out the appropriate medicine that would be effective for a particular patient. In addition to this, it is important for physicians to weigh out the benefits as well as the side effects of various medicines before prescribing them to their patient.

The drugs prescribed by the doctor for the treatment of colitis mainly include anti-inflammatory drugs, immune system suppressors, antibiotics, anti-diarrhoeal medications, pain relievers (except ibuprofen, naproxen sodium and diclofenac sodium as they tend to worsen the symptoms and increase the severity of the disease) and iron supplements. The common anti-inflammatory drugs used in the treatment of colitis include amino-salicylates and corticosteroids. The immune system suppressors used for treatment are azathioprine, mercaptopurine, cyclosporine, infliximab, adalimumab, golimumab and vedolizumab.

However, in severe cases of colitis, where medical treatment has no effect, the doctors may recommend for surgical treatment. The surgical treatment involves the removal of the entire colon and rectum (proctocolectomy) of the patient. This surgical method is followed by another process known as ileoanal anastomosis where the surgeon constructs a pouch from the end of the patient’s small intestine and attaches it to the anus. This pouch functions similar to rectum and collects the stool of the patient and helps in excreting them out normally.

Who is eligible for the treatment? (When is the treatment done?)

Any person irrespective of their age and having symptoms such as diarrhoea along with blood or pus, abdominal pain or cramping, loss of appetite, rectal pain, bleeding of rectum, anaemia due to excess bleeding, urgency to defecate, inability to defecate despite urgency, fever, weight loss, weakness due to inflammation of the inner lining of the large intestine or rectum is said to be suffering from colitis and is eligible for this treatment.

Who is not eligible for the treatment?

People who do not suffer from the symptoms of colitis are considered as not having this disease and are not eligible for such treatment. Moreover, if a patient suffers from serious side effects of a particular treatment of colitis, then the doctor may recommend switching to some other effective form of treatment of the disease.

Are there any side effects?

Like most other treatments, medications used for treating colitis also have some side effects. It is important for a patient to know how to differentiate between the symptoms of colitis and the possible side effects that may arise from its medications. A doctor, who prescribes the medicines for a patient of colitis, must always weigh out the benefits as well as the possible adverse side effects of the medication. Some of the common side effects of the treatment of colitis include headache, nausea, vomiting, fever, rash, loss of appetite, decreased white blood cells, decreased sperm production in males, diarrhoea, abdominal pain and cramps, gas, hair loss, dizziness, kidney problems, weakness, pericarditis, pancreatitis, high blood pressure, weight gain, mood swings, acne, osteoporosis, cataracts, high blood sugar levels, insomnia, lymphoma and others. In case a patient suffers from some serious side effects then he/she must immediately consult a doctor for remedial measures.

What are the post-treatment guidelines?

The treatment of colitis involves a number of medications and proper diet (mainly fluids and excluding any type of spicy food). Even after the patient recovers from this problem, he/she needs to follow some guidelines given by the doctor in order to stay healthy. The post treatment guidelines to be followed by a patient include taking the medicines regularly on time, having a healthy diet, taking plenty of fluids to avoid dehydration and practising regular exercises to facilitate proper bowel movements. Even after recovery the patient needs to go for follow-up check-ups on a regular basis as instructed by their doctor. In case, a patient suffers from any side effects during the time of medication then he/she should consult a doctor for its remedy

How long does it take to recover?

The time taken for a patient of colitis to recover from this problem usually varies depending on the seriousness of the condition and the physiological response of the patient to the prescribed medications. Usually cases of mild colitis may take about 3 to 4 days to recover for children and about one week for adults. However, patients suffering from severe colitis may even take 3 to 4 weeks to recover from this condition.

What is the price of the treatment in India?

The price of the treatment of colitis in India varies depending upon the seriousness of the condition of the patient and the medication that his/her doctor prescribes. Usually mild colitis can be treated with medicines that can cost as low as Rs. 1300 (for full treatment). However, patients suffering from severe colitis may require costly medications and even surgical treatment (if necessary) and for such treatments the price range can be between Rs. 57,400 to Rs. 7,87,500 in India. This treatment is available in almost all leading hospitals in India.

Are the results of the treatment permanent?

It should be remembered that colitis, being an auto-immune disease characteristically has a relapsing-remitting course and this means that there are periods of flare-ups which are then followed by a period of remission. Presently there are no medical treatments for the complete cure of colitis. The medical treatments only tend to lessen the severity of the condition. However, conditions such as inflammation of the bowel, bloody diarrhoea and abdominal cramping can be stopped with surgical treatments.

What are the alternatives to the treatment?

Although medical and surgical treatments are considered as the best ways to control the conditions of colitis, there are a few alternative treatments as well. The alternative treatments for the conditions of colitis include taking of herbal and nutritional supplements, probiotics, fish oil (although excess consumption of fish oil can cause diarrhoea), Aloe Vera gel, acupuncture therapy and/or turmeric. In addition to this, the patient should avoid consumption of spicy food, dairy products, alcohol, beverages and fibres in their diet. Eating of small light nutrition-rich meals at regular intervals throughout the day, plenty of water and multivitamin supplement helps to recover from this condition.

Safety: Condition Effectiveness: Medium Timeliness: Medium Relative Risk: High Side Effects: Medium Time For Recovery: High Price Range:

Rs. 57,400 – Rs. 7,87,500

Popular Health Tips

Ulcerative Surgery - What Should you Know

MBBS, MS - General Surgery
General Surgeon, Pune
Ulcerative Surgery - What Should you Know

What Is Ulcerative Colitis?
Ulcerative colitis is a chronic, inflammatory condition of the colon and the rectum. It affects the mucosal lining of the large intestine (colon) and the rectum. The rectum is present just above the anus.
In this condition, patients have ulcers and abscesses in their colon and rectum.

Symptoms are seen periodically. The symptoms are severe pain in the abdomen, blood in stools and diarrhea. Anemia is seen due to decreased healthy red blood cells as a consequence of bleeding in stools.

When is surgery required?

  • The colon has ruptured
  • There is extensive bleeding
  • The treatment results in severe side effects affecting the patient's health
  • Drug therapy fails to provide results
  • When it progresses to colon cancer
  • Surgery for Ulcerative colitis

There are 2 types of surgeries:

  1. Colectomy: Surgery performed to remove the entire colon
  2. Proctocolectomy: Surgery is conducted to remove both the colon and rectum. It is considered as the standard treatment for ulcerative colitis.

Procedures for the surgery

  1. Ileostomy: The entire colon and rectum are removed and the surgeon creates an opening or stoma in the abdominal wall particularly below the waist. Stoma allows waste from the intestines to exit the body. The tip of the lower small intestine is brought through the stoma. An external bag, or pouch, is attached to the stoma. This is called a permanent ileostomy. Stools pass through this opening and collect in the pouch. The pouch must be worn at all times. Before an ileostomy, the surgeon will perform a proctocolectomy. They will perform the ileostomy in the hospital, and the patient receives a general anesthesia.
  2. Ileal Pouch Anal Anastomosis (IPAA): This is also called a J-pouch. This is a procedure that does not require a permanent stoma. The patient is still able to eliminate stool through the anus. A pouch is constructed at the end of the ileum and attached to the anus. This is called a J- pouch. As with the ileostomy, the patient will need a proctocolectomy before an IPAA. An IPAA is done in a hospital, and the patient will receive a general anesthesia.

Side-effects
Some people experience incontinence after the surgery. Medications may help control the function of the pouch.
Some women may become infertile after the procedure.

Recovery after Surgery
Both sets of the procedure will require a four-to-six-week recovery period.

  1. Keep your diet healthy: A healthy diet is essential because good nutrition can help the body heal faster and help avoid post-operation health issues. Absorption of nutrients can be an issue after these surgeries, so eating well will help in maintaining the proper level of nutrients.
  2. Keep yourself hydrated: Hydration is important for overall health, especially for the digestive health. Drinking six to eight glasses of water per day is recommended.
  3. Manage your stress: Anxiety or emotional stress can cause stomach issues, which can aggravate the complaint.

Ulcerative Colitis - How Surgery Can Help Manage It?

DNB (Surgical gastroenterology, MS( General Surgery), MBBS, Fellowship in Minimal Access Surgery, Diploma in Minimal Access Surgery, Fellow of International College of Robotic Surgeons
Surgical Gastroenterologist, Delhi
Ulcerative Colitis - How Surgery Can Help Manage It?

Ulcerative Colitis is one of the severe and chronic forms of Inflammatory Bowel Disease (IBD) that can throw life in a jeopardy. The condition that mainly affects the rectum and the large intestine can cause severe inflammation, ulceration, and abscess formation. The ulceration or the inflammation of the colon and the rectum left unattended for too long can give rise to deleterious consequences including damage and perforation of the colon, osteoporosis. Various studies also suggest that ulcerative colitis can increase the risk of a person suffering colon cancer.

Like most of the IBD, there is no definite cure for ulcerative colitis. The illness is a chronic condition and can flare up or recur at any point in time. Though medications may help to control the damage and the complications triggered by ulcerative colitis, a surgery may be essential in case of

  • Severe damage to the colon.
  • The nonsurgical treatments could do little to improve the conditions.
  • There is an increased risk of colon cancer.
  • Ulcerative colitis has resulted in Toxic megacolon (a life-threatening condition where the large intestinal muscles have dilated with some swelling).
  • There are extreme discomfort and bleeding.

Surgeries to deal with Ulcerative Colitis

  • In the case of Ulcerative Colitis, the nature of the surgery depends on the extent to which the colon or the rectum or both have been affected and damaged.
  • In the case of extensive damage with a high risk of colon cancer, the surgeon may perform Proctocolectomy or colectomy
  • Colectomy may involve
    • Removal of all of the colon- Total Colectomy
    • Removal of the diseased part of the colon- Partial Colectomy.
  • Following the excision, the surgeon may carry out necessary rearrangements to reconnect the remaining portion of the colon to the abdomen through an opening known as stroma (the procedure is known as colostomy).
  • In case of Total Colectomy, the small intestine will be connected to the abdomen by a process known as Ileostomy.
  • Proctocolectomy involves the removal of both the rectum and colon to avoid further aggravation.
  • Following the proctocolectomy, the surgeon may carry out Ileoanal Anastomosis (Ileal Pouch-Anal Anastomosis). In this procedure, a pouch is created using a small part of the small intestine. This pouch is then connected to the anus to help in the elimination of the wastes.

General precautionary measures to control Ulcerative Colitis
Making healthy lifestyle and dietary modifications can go a long way to control ulcerative colitis and the associated symptoms.

  • Spicy foods can worsen the incidence of ulcerative colitis. Enrich your diet with lots of fruits, vegetables (squash, avocados, fish (especially salmon and tuna), meat, dairy products, olive oil, walnuts, flaxseed oil, almonds.
  • Make sure the diet is a low-fiber diet.
  • Avoid alcoholic and caffeinated drinks and beverages, foods high in sulfur content, refined sugar.
  • Research suggests stress and lack of physical activities can aggravate the ulcerative colitis. Mediation and daily exercise can produce fruitful results.
  • Make sure your sleep is not compromised (6-8 hours daily).

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

3402 people found this helpful

Ulcerative Colitis Diet - Foods To Eat And Avoid!

MBBS, MD - General Medicine, DM - Gastroenterology, MNAMS
Gastroenterologist, Faridabad
Ulcerative Colitis Diet - Foods To Eat And Avoid!

Eating good and healthy food always contributes to the overall wellbeing of a person. Same holds true for the patients suffering from ulcerative colitis (UC). Ulcerative colitis patients need certain dietary modification to bring about a change in their condition. Though this condition isn’t directly caused by the food but the frequency of flare ups is influenced by the food taken. Below mentioned is the list of foods to eat and avoid.

Food to be Consumed
Usually, for ulcerative colitis, low fibre and low residue foods are considered the best since they are easy to digest. Here is a list of foods that can be included in the diet:

  1. Vitamin D: This vitamin boosts the immune system to fight the risks of ulcerative colitis flare ups. Since the sun is the best source of Vitamin D, it is important that a person gets as much exposure to the sun as possible.
  2. Probiotics: Maintain a balance between good and bad bacteria of the gut which in turn alleviates the symptoms of this condition.
  3. Omega-3 fatty acids: Omega-3 fatty acids have an anti-inflammatory effect, which can help alleviate intestinal inflammation caused by ulcerative colitis. Salmon is one of the best sources of Omega-3.
  4. Eggs: Eggs are typically easy to digest and offer a number of nutrients which makes them one of the best choices for the patients of UC.
  5. Plenty of fluid: People with this condition need to drink extra fluid, as diarrhoea can lead to dehydration.
  6. Supplements: Dietary supplements also help in balancing the nutritional needs of a patient.

And last but not the least there are many anti-inflammatory foods that help in reducing the ulcerative colitis flare-ups include turmeric, cloves, ginger and rosemary.

Foods to be Avoided
A patient should closely monitor what s/he is eating as the studies have revealed that the symptoms of ulcerative colitis are closely associated with diet. The following list will help you cut off the chances of UC flare ups.

  1. High Fibre Food: Are difficult to digest so should be cut off from the diet. It’s best to moderate the intake of fruits and vegetables with insoluble fibres.
  2. Oily and Fatty Foods: The greasy food can aggravate the symptoms of UC as well as can cause diarrhoea.
  3. Spicy foods: Spicy foods may disturb your bowel movements, so it is best to limit the intake of chillies, chilli powder, paprika, peppers etc.
  4. Dairy products: Patients of UC are mostly lactose intolerant. So, these patients should avoid dairy products.
  5. Seeds and nuts: Seeds and nuts are hard to digest, and it is best to avoid them if you are suffering from ulcerative colitis.

Ulcerative Colitis is just a disease which can be avoided by maintaining a proper diet and making few dietary modifications. One should eat smaller meals a few times per days instead of eating large ones.

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

3608 people found this helpful

Ways To Deal With Ulcerative Colitis!

MBBS, M.Ch - Surgical Gastroenterology/G.I. Surgery, Fellow of Advanced Laparascopic Surgery
Gastroenterologist, Bangalore
Ways To Deal With Ulcerative Colitis!

Living with ulcerative colitis can be very challenging. Patients of this disease will have to deal with pain in the abdomen and several digestion related issues in their daily lives. It is known to adversely impact the digestive tract. There can be extreme discomfort at the time of flare-ups. A patient can find life extremely difficult while dealing with symptoms like abdominal pain, fever, weight loss, and chronic diarrhea.

What is Ulcerative colitis (UC)?
It is a serious inflammatory disease. It is caused due to inflammatory bowel movements in the digestive tract. It can affect your daily life adversely. The worst part about this disease is that it relapses in the individual. It is characterized by flare-ups. You need to know fist what is an UC flare-up. Well, it is a term to refer to an exaggerated condition in the disease. It refers to a state when things turn worse. These flare-ups can be caused due to a number of factors. Some of these include:

  1. Side-effect of certain medicines
  2. Hormonal imbalance, especially during pregnancy
  3. Sudden withdrawal from medication
  4. Any infection or other medical condition

How to deal with the UC flare-ups?

  1. Doctors often prescribe corticosteroids to deal with the flare-ups. Some of the most common drugs are Prednisone and budesonide.
  2. Doctors prescribe the intake of steroids, 5-Aminosalicylates, antibiotics, and biologics.
  3. Lifestyle changes are helpful in treating this disease. You can work towards detoxification and de-stressing yourself to get rid of the flare-ups. Take up some exercises, meditation and Yoga for best results.
  4. You can also control chronic diarrhea by keeping a check on what you eat. You should avoid eating fibrous diet. Fibres are tough to digest for patients with UC. You must maintain proper hygiene as well to stay away from diarrhea.

Surgical Management of Ulcerative Colitis

Ulcerative colitis (UC) is an inflammatory disease of the colon and rectum limited to the mucosa, and may vary in severity from a mild intermittent disease to an acute fulminant and potentially fatal disease requiring urgent surgery. Management of ulcerative colitis depends on severity, extent, and duration of the disease, response and tolerance to medication, patient age and comorbidity as well as patient preference.

Surgery plays an important role in the management of UC both because of the premalignant nature of the disease, and because of the periodic failure of medical management. The underlying rationale for surgical treatment of the disease is that the disease is confined to the colon and rectum, and therefore proctocolectomy is curative. The goal of surgical therapy for ulcerative colitis is to remove the disease with as little alteration of normal physiological functions and lifestyle as possible.

Four surgical options exist for patients with ulcerative colitis and each has its own advantages and disadvantages.

The surgical choices are:

  1. Proctocolectomy and Brooke ileostomy.
  2. Abdominal colectomy and ilcorectal anastomosis.
  3. Proctocolectomy and Kock pouch.
  4. Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA).

The choice of operation requires consideration of the advantages and disadvantages of each option and must be tailored to an individual patient's needs and circumstances. Important factors to be considered in the choice of operation include the indication for surgery, age, associated medical conditions, body habitues, and quality of the anal sphincter. Extensive preoperative education is required which should include discussion with a specialized Gastroenterologist. 

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

5 people found this helpful

Colitis - 5 Common Types!

DM - Gastroenterology, MD - General Medicine, MBBS
Gastroenterologist, Hyderabad
Colitis - 5 Common Types!

Colitis is characterized by an inflammation of the large intestine (colon). It is generally caused due to reduced blood supply, autoimmune reactions (wherein the immune system erroneously starts attacking the body’s healthy tissues) and infections in the large intestine.

Symptoms of colitis
1. Presence of blood traces in the stool.
2. Acute colitis can itself be a symptom of hemorrhoids (inflamed and swollen veins in the anus or the rectum)
3. Tenesmus (constant urge to empty the bowels) is also quite common
4. Occurrence of abdominal pain in regular intervals, thus resulting in diarrhea
5. Constant abdominal pain
6. Fever and sudden chills throughout the day

Types of colitis
1. Inflammatory bowel disease: This condition is characterized by inflammation of the intestines or all the parts of one’s digestive tract
2. Microscopic colitis: This involves inflammation of the large intestine (colon), resulting in a cramping sensation that can be painful
3. Chemical colitis:  This condition is caused due to prolonged exposure to certain harsh chemicals which results in intestinal swelling and inflammation
4. Ischemic colitis: The most common form of colitis, this occurs mainly due to an insufficient blood supply to the large intestine
5. Infectious colitis: Caused due to certain bacterial or parasitic infections

Treatment for colitis
1. Medications such as acetaminophen and ibuprofen can be recommended to ease the pain
2. The drug ‘Loperamide’ can control the diarrhea. However, this should not be consumed if there is presence of blood in the stool
3. Colitis reduces your appetite. Thus, it is important to maintain a healthy diet in this regard. Avoid consuming dairy products or high fiber foods because they further inflame the large intestine.
4. Colectomy (surgically removing a part of the whole of the colon) is recommended in the most severe of cases. If you wish to discuss about any specific problem, you can consult a gastroenterologist.

3553 people found this helpful

Popular Questions & Answers

I have ulcerative colitis. Please sir I want to know my diet plan and about medicine. Now my weight 73.5 and I want to grow up my weight.

MD - Gastroenterology
Gastroenterologist, Delhi
If your disease is controlled, you can take normal diet. Take turmeric with milk and water. If disease is not controlled, increase your medicine after consulting a gastroenterologist. contact us for further treatment and life long follow up.
4 people found this helpful

What is ulceration of intestine. Is apc a successful procedure? Are solitary rectal ulcer syndrome and ulcerative colitis the same?

MBBS
Gastroenterologist, Gurgaon
Hello sir, An ulcer in the upper (small) intestine is a raw place or sore in the lining of the part of the intestine that connects to your stomach, yes apc is a successful procedure. No, ulcer syndrome and ulcerative colitis is not same.
1 person found this helpful

I have suffered ulcerative colitis. please suggest some medicine I got depressed due to this. My mother also have same. I go 2 toilet 2wice a day. Toilet hard sometime soft and sticky Too much gas. Wt 68 but feel weakness in legs and hand.

MD - Psychiatry
Psychiatrist, Chennai
Ulceartive colitis has strong correlation to mind and requires medications from psychiatrist apart from gastro, it will lead to wonderful recovery and fewer relapses. Consult any psychiatrist. All the best.
2 people found this helpful

I am suffering from Ulcerative Colitis for more than 2 years. I have tried Mesacol tablets Mesacol Enaema. It worked ok in the beginning then their effect wasn't much. So I switched to Ayurvedic Medicines since I heard it can be cured with that and its almost 1 month, can't see any significant difference. My life has become a living hell. Im passing motions like almost 6 times a day now from 3 earlier. I'm running out of options. Please help me. Please.

MBBS, MD-General Medicine, DM-Gastroenterology, Advanced endoscopy fellowship
Gastroenterologist, Visakhapatnam
Dear Mr. lybrate-user I am sorry to hear that you are suffering from ulcerative colitis please let me stress upon the following things to make you better and understand about this disease and outcomes 1. The disease gets worse with stress, anxiety and psychological depression. So first relax yourself 2. You need to visit only a qualified medical gastroenterologist and please followup him up regularly and be compliant to those medicines 3. Changing docotors in attempt to loom for a better treatment will put varying and differing opinions in your mind. This would add to more stress confusion and anxiety. So please stick on to a single gastroenterologist. Do enough research before choosing your gastroenterologist. 4. It is a life long disease and you need to deal with it. So please make up your mind and be strong good luck and get well soon.
2 people found this helpful

I have been diagnosed with Ulcerative colitis 6 years back. Since last one and half years I am facing problem of frequent mucus and blood in stool. Also I have lost my weight by 12 kg in one year. My doctors says it will be like this only and there is no remedies except continuing the same medicines (mesacol 1.2 gm 4 Tab per day). Pl suggest if it can be cured to normal stage at least.

MS - General Surgery, FMAS.Laparoscopy
General Surgeon, Gandhinagar
Respected lybrate-user hi lifestyle modifications along with YOGA are major role playing factors along with medicines keep your moral at top to get cured without losing hopes dear life gives us daily challenges and the one who faces it cheerfully is the winner at the end dear thanks regards.
1 person found this helpful

Table of Content

What is the treatment?
How is the treatment done?
Who is eligible for the treatment? (When is the treatment done?)
Who is not eligible for the treatment?
Are there any side effects?
What are the post-treatment guidelines?
How long does it take to recover?
What is the price of the treatment in India?
Are the results of the treatment permanent?
What are the alternatives to the treatment?
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