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Digestive Disorders: Treatment, Procedure, Cost and Side Effects

What is the treatment?

The digestive process is complex and takes place in the digestive tract and involves a number of organs. It begins with the esophagus that helps to carry food to the stomach. A number of different organs like the pancreas and the gall bladder produce digestive juices that help to break down the food for digestion. Digestive problems can occur at any stage of the digestive process. Gas is formed as a natural corollary of the digestive process and is passed out through your mouth or through our anus. Some foods tend to produce more gas than others. This is why is important to avoid consuming certain types of food. Unnecessary build-up of gas in the stomach and intestines may cause you to feel bloated. Bloating may lead to serious complications in the future. That is why it should be treated by incorporating some changes in the lifestyle.You can take lactase supplements, alpha-galactosidase, simethicone and probiotics.

Heartburn is caused due to indigestion and can make you feel really uncomfortable. You can avoid fatty and oily foods and aerated drinks if you are suffering from this condition and take some medication. Peptic ulcers cause stomach pain and can cause internal bleeding and may also cause a hole to be formed in the stomach wall. Normally, 10-14 days of antibiotic treatment together with acid reduction therapy works to alleviate this condition. Gallstones are made of cholesterol and bile salts and may require treatment in some cases. Removal of gallbladder can be done through laparoscopy and also via mouth or vagina without any external incision. Other disorders include constipation, diarrhea, hemorrhoids and others.

However for acute digestive disorders, the key treatments are gastric electrical stimulation and islet auto-transplantation for chronic pancreatitis.

How is the treatment done?

Gastric electric stimulation or GES is performed in patients who suffer from gastroparesis due to diabetes or any other cause. This method uses a device implanted in the abdomen to send mini electrical impulses to the smooth muscles and nerves of the lower stomach. Gastroparesis is the condition where the nerves and muscles of the stomach are affected and this delays the emptying of food from the stomach to the small intestine. It can happen in people with diabetes or nervous disorder and sometimes, the cause is not detected.

A pocket-watch size device is inserted in the abdomen by means of a surgery that generally lasts for 2-3 hours. Sometimes surgeons choose to use minimally invasive methods rather than going for an open abdominal surgery. In the former case, a small incision is made and a viewing tube called a laparoscope is used to guide the entire procedure. A neuro-stimulator is implanted in the right side of the abdomen while two insulated wires are implanted in the muscle wall of the stomach. It is then routed under skin to the neuro-stimulator and connected. The wires transmit low-energy electrical impulses to the stomach once the device is activated. The doctor activates and programs the device externally using a hand-held programmer. The doctor can adjust the frequency and energy of the nerve impulses according to the requirement of the patient. Most people, however, do not feel the electric impulses.

Chronic pancreatitis requires auto-islet transplantation after a total pancreatectomy which is the removal of the entire pancreas. Chronic pancreatitis is a serious condition which causes inflammation of the pancreas that worsens over time and leads to permanent damage. It gradually impairs a patient’s ability to digest food and make pancreatic hormones. During islet autotransplant, the patient’s own cells are kept separate from the pancreas. They are put back when the patient starts receiving insulin.

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

GES or gastric electrical stimulation is done when a person is diagnosed with gastroparesis due to diabetes or some other unknown cause. It can also be done if someone is suffering from chronic nausea, vomiting or both.

This treatment can also be initiated if a person has not responded to medication or if/she is intolerant towards medication. It should also be kept in the mind only those people capable of undergoing surgery should be given gastric electrical stimulation.

Those people who suffer from chronic pancreatitis are eligible for islet autotransplantation. Furthermore, if you have to take medication to treat other forms of digestive disorders, it is always good to consult a doctor first.

Who is not eligible for the treatment?

Gastric electric stimulation can only be undertaken by those patients who have the ability to withstand a surgery. People without such physical tenacity are not eligible for this treatment.

Islet autotransplantation for the treatment of chronic pancreatitis involves pancreatectomy. This procedure can induce permanent diabetes due to its effect on insulin. Thus people with diabetes or people at risk of developing diabetes should refrain from undertaking this treatment.

Are there any side effects?

Heartburn patients are generally prescribed H2 blockers which reduces the amount of acid that a stomach intakes. However, there are a number of side-effects of consuming H2 blockers: they can cause constipation, diarrhea, headache or nausea and vomiting. Islet autotransplantation involves the complete removal of the pancreas. This exposes the patient to the risk of developing permanent diabetes. A patient will then have to take insulin shots or to use an insulin pump for the rest of their lives. Gastric electrical stimulation may cause pain at the implant site, infection, stomach wall perforation, lead obstruction of intestines, lead/device problems and lead penetration, irritation, inflammation, uncomfortable stimulation, tissue damage and others.

What are the post-treatment guidelines?

Gastric electric stimulation helps to reduce symptoms of chronic intractable vomiting and nausea related to gastroparesis. But it is not a complete cure in itself for gastroparesis. It helps to reduce symptoms but patients generally need to take medication and follow a special diet to control the symptoms even after undergoing this surgery. Islet autotransplantation may induce permanent diabetes in some people. Those people will have to take insulin shots or will have to use an insulin pump for the rest of their lives.

How long does it take to recover?

Most patients are discharged within 1-5 days of gastric electrical stimulation procedure. However, as this surgery is not an end in itself, a person will have to go to the doctor for regular check-ups. Other digestive disorders like gas, heartburn, constipation and diarrhea may be treated within a time span of a few hours to a few days with the help of proper medication and a proper diet. The islet autotransplantation procedure is complex and a person may require quite some time to recover.

What is the price of the treatment in India?

Common digestive disorders like heartburns, gas, constipation or diarrhea can be effectively treated with the help of some medicines which do not cost much. Medicines for indigestion and heart burn are available within a price range of Rs 50-100. However, islet transplantation for treating acute pancreatitis is expensive and may cost about 10,00,000 – 12,00,000 rupees. Gastric electric stimulation may cost around 6 lakh rupees in India.

Are the results of the treatment permanent?

Common gastric disorders like gas, constipation, diarrhea and heartburms are more often than not the result of lifestyle irregularities. Thus there is seldom a permanent solution to such problems. Gastric electric stimulation is not an end in itself and patients will require medication and routine check-ups to keep the symptoms of gastroparesis at bay. Islet transplantation procedure may cause to reduce chronic pancreatitis but it tends to have a lot of side-effects.

What are the alternatives to the treatment?

There is no such alternative to islet autotransplantation as these method is adopted only when all other options fail. Chronic gastric stimulation is used to treat gastroparesis. Alternative methods to treat gastroparesis may include changes in the diet of the patient and medications. Such medications like metoclopramide and erythromycin can be used to stimulate the stomach muscles. Other drugs that help to contain nausea and vomiting may include prochlor perazine and diphenhydramine.

Safety: Medium Effectiveness: High Timeliness: Medium Relative Risk: Medium Side Effects: Medium Time For Recovery: Medium Price Range: Rs 300000 - 550000

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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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