Medical Gastroenterology Procedure

Know Your Liver Numbers

Your liver plays a vital role in keeping your body healthy by processing nutrients, filtering toxins, and aiding digestion. Because the liver is essential to many bodily functions, it’s important to monitor its health, especially if you have risk factors like alcohol use, obesity, or a family history of liver disease. One of the most common ways to assess liver health is through liver function tests (LFTs), also known as liver blood tests.

These tests measure certain enzymes and proteins in your blood to see how well your liver is working. In this blog, we’ll explore what these tests are, what your liver numbers mean, and when you should pay attention to them.

What Are Liver Function Tests (LFTs)?

Liver function tests are a group of blood tests that give a snapshot of your liver’s health. These tests measure the levels of various enzymes and proteins that are produced or processed by the liver. The results help doctors assess how well your liver is functioning and can detect liver damage, inflammation, or diseases such as hepatitis or fatty liver.

Here are some key liver numbers to know:

1. Alanine Aminotransferase (ALT)

• Normal range: 7 to 56 units per liter (U/L)
• ALT is an enzyme found mainly in the liver. When liver cells are damaged, they release ALT into the bloodstream. High levels of ALT can indicate liver inflammation or injury, which may be caused by conditions like hepatitis, fatty liver disease, or excessive alcohol consumption.

2. Aspartate Aminotransferase (AST)

• Normal range: 10 to 40 units per liter (U/L)
• AST is another enzyme that, like ALT, is released into the bloodstream when the liver is damaged. While AST is found in the liver, it is also present in the heart and muscles. Elevated AST levels could indicate liver disease, but they may also be linked to muscle injuries or heart problems, so it’s important to consider AST levels alongside other liver tests.

3. Alkaline Phosphatase (ALP)

• Normal range: 44 to 147 units per liter (U/L)
• ALP is an enzyme found in the liver, bile ducts, and bones. High levels of ALP may indicate bile duct obstruction, liver inflammation, or bone diseases. In children and pregnant women, higher ALP levels are normal due to bone growth and changes in the body during pregnancy.

4. Gamma-Glutamyl Transferase (GGT)

• Normal range: 9 to 48 units per liter (U/L)
• GGT is another enzyme that helps transport amino acids in the body. High GGT levels can be a sign of liver disease, particularly related to alcohol use, bile duct issues, or fatty liver. Elevated GGT is often used to confirm whether elevated ALP levels are related to liver disease.

5. Bilirubin

• Normal range: 0.1 to 1.2 milligrams per deciliter (mg/dL)
• Bilirubin is a yellow pigment produced during the breakdown of red blood cells. The liver processes bilirubin so that it can be excreted in stool. Elevated bilirubin levels can cause jaundice, a yellowing of the skin and eyes, and may indicate liver disease, bile duct obstruction, or hemolysis (the breakdown of red blood cells).

6. Albumin and Total Protein

• Normal range for Albumin: 3.5 to 5.0 grams per deciliter (g/dL)
• Normal range for Total Protein: 6.3 to 7.9 grams per deciliter (g/dL)
• Albumin is a protein made by the liver, and it helps keep fluid in your bloodstream from leaking into other tissues. Total protein measures the overall amount of protein in your blood, including albumin and other proteins. Low levels of albumin and total protein can indicate liver damage, malnutrition, or kidney disease.

7. Prothrombin Time (PT)

• Normal range: 9.5 to 13.8 seconds
• PT measures how long it takes for your blood to clot. Since the liver produces proteins that are involved in clotting, a prolonged PT can be a sign of liver dysfunction or damage. Liver diseases like cirrhosis can result in slower clotting times.

What Do Your Liver Numbers Mean?

Understanding your liver numbers can help you and your doctor determine whether your liver is functioning properly or if there are signs of liver damage or disease. Here’s what different results might indicate:

• Normal liver numbers generally mean your liver is functioning well, and there’s no sign of damage or inflammation.
• Elevated ALT or AST levels usually suggest liver cell damage, which may be caused by hepatitis, fatty liver, or alcohol use.
• High ALP levels could point to a blockage in the bile ducts or bone disorders.
• Increased bilirubin levels may cause jaundice and indicate liver disease or bile duct problems.
• Low albumin or total protein levels can be a sign that your liver is not making enough proteins due to liver disease or malnutrition.
• Prolonged PT may signal a problem with your liver’s ability to produce clotting factors, suggesting liver damage or cirrhosis.

When Should You Be Concerned?

Mildly elevated liver enzyme levels are often not a cause for concern, and they may return to normal on their own. However, persistently high or very elevated levels of liver enzymes can be a sign of a more serious condition and may require further testing or treatment.

You should see a doctor if you experience any of the following symptoms:

• Yellowing of the skin or eyes (jaundice)
• Unexplained weight loss
• Fatigue or weakness
• Abdominal pain, especially in the upper right side
• Dark urine or pale stools
• Nausea or vomiting

How to Keep Your Liver Healthy

To maintain healthy liver numbers and support your liver’s health, consider the following lifestyle tips:

• Limit alcohol consumption: Excessive drinking can damage your liver cells over time, leading to conditions like fatty liver disease or cirrhosis.
• Maintain a healthy weight: Obesity increases the risk of fatty liver disease, which can lead to liver damage.
• Eat a balanced diet: A diet rich in fruits, vegetables, lean proteins, and whole grains can support liver health.
• Exercise regularly: Physical activity helps you maintain a healthy weight and reduces the risk of liver disease.
• Avoid risky behaviors: Sharing needles or engaging in unprotected sex can increase the risk of contracting hepatitis, which can harm the liver.

Conclusion

Liver function tests provide important information about the health of your liver. By understanding your liver numbers, you can take proactive steps to protect your liver and seek medical care when needed. Keeping an eye on your liver health is essential, especially if you have risk factors like alcohol use, obesity, or a family history of liver disease.

Taking care of your liver means taking care of your overall health. If your liver numbers are outside the normal range, talk to your doctor to understand the cause and take the necessary steps to keep your liver functioning well.

Chronic Pancreatitis

Chronic pancreatitis is a long-term inflammation of the pancreas that gradually impairs its ability to function properly. The pancreas, located behind the stomach, plays a vital role in digestion by producing enzymes that break down food and hormones like insulin that regulate blood sugar. In chronic pancreatitis, the damage to the pancreas becomes permanent, leading to digestive problems and possibly diabetes.

What Is Chronic Pancreatitis?

Chronic pancreatitis occurs when the pancreas is continuously inflamed, leading to irreversible damage. Unlike acute pancreatitis, which is a sudden, short-term inflammation, chronic pancreatitis progresses over time, often after multiple episodes of acute pancreatitis.

As the pancreas is damaged, it loses its ability to produce digestive enzymes and insulin efficiently. This can cause malnutrition, weight loss, and an increased risk of developing diabetes.

Causes of Chronic Pancreatitis

Several factors can contribute to chronic pancreatitis. The most common causes include:

• Heavy Alcohol Use: Long-term, excessive alcohol consumption is a leading cause of chronic pancreatitis. Alcohol damages the pancreatic tissue over time, leading to inflammation and scarring.
• Genetic Factors: Some people are more likely to develop chronic pancreatitis due to inherited genetic mutations. This condition is often called hereditary pancreatitis, and it tends to run in families.
• Autoimmune Conditions: In autoimmune pancreatitis, the immune system mistakenly attacks the pancreas, causing chronic inflammation.
• Blocked Pancreatic Ducts: Blockages in the ducts that drain digestive enzymes from the pancreas can lead to chronic inflammation. These blockages may be caused by gallstones or scarring from previous episodes of pancreatitis.
• Cystic Fibrosis: People with cystic fibrosis, a genetic disorder that affects the lungs and digestive system, are more likely to develop chronic pancreatitis.
• Unknown Causes: In some cases, the cause of chronic pancreatitis is unknown. This is referred to as idiopathic pancreatitis.

Symptoms of Chronic Pancreatitis

Chronic pancreatitis symptoms can vary depending on the stage of the disease and the extent of the pancreatic damage. Common symptoms include:

• Abdominal Pain: The most prominent symptom is persistent or recurring pain in the upper abdomen, which may radiate to the back. The pain is often severe and can last for hours or days.
• Unintended Weight Loss: Because the pancreas is not producing enough digestive enzymes, the body may struggle to absorb nutrients from food. This can lead to unexplained weight loss, even if you are eating a normal diet.
• Steatorrhea (Fatty Stools): When the pancreas is unable to properly digest fats, stools may appear greasy, pale, or foul-smelling. This is a sign of fat malabsorption.
• Nausea and Vomiting: Chronic pancreatitis can cause frequent episodes of nausea, vomiting, and bloating after eating.
• Diabetes: As the pancreas becomes damaged, it may not produce enough insulin, leading to diabetes. Symptoms of diabetes include increased thirst, frequent urination, and fatigue.
• Malnutrition: The lack of pancreatic enzymes can result in poor nutrient absorption, leading to deficiencies in essential vitamins and minerals. This can cause fatigue, weakness, and a reduced ability to fight infections.

How Is Chronic Pancreatitis Diagnosed?

To diagnose chronic pancreatitis, your doctor will start by reviewing your symptoms and medical history. They may also perform various tests, including:

• Blood Tests: Blood tests can measure levels of pancreatic enzymes and glucose to check for signs of pancreatic damage or diabetes.
• Imaging Tests: Imaging techniques such as ultrasound, CT scan, or MRI can reveal inflammation, scarring, or blockages in the pancreas.
• Stool Tests: A stool test can measure the amount of fat in your stool, which helps determine if your pancreas is producing enough digestive enzymes.
• Endoscopic Ultrasound: In this procedure, an ultrasound device attached to an endoscope is inserted into your digestive tract to get a clearer view of the pancreas.

Treatment of Chronic Pancreatitis

Chronic pancreatitis is a serious condition, but with proper treatment and lifestyle adjustments, its symptoms can be managed. Treatment typically focuses on relieving pain, improving digestion, and preventing further damage to the pancreas. Here are the key components of chronic pancreatitis treatment:

• Lifestyle Changes:
  • Stop Alcohol Consumption: If alcohol is the cause of your pancreatitis, quitting drinking is essential to prevent further damage to the pancreas.
  • Stop Smoking: Smoking worsens the condition and increases the risk of complications.
  • Dietary Changes: Eating smaller, low-fat meals can ease the digestive load on the pancreas. A dietitian can help create a meal plan tailored to your needs.
• Medications:
  • Pain Relief: Over-the-counter pain medications may be used for mild pain, while stronger prescription medications may be required for severe pain.
  • Pancreatic Enzyme Supplements: Enzyme replacement therapy involves taking digestive enzymes with meals to help break down food and improve nutrient absorption.
  • Insulin: If diabetes develops due to chronic pancreatitis, insulin injections may be needed to control blood sugar levels.
• Surgery:
  • Pancreatic Drainage: If blockages in the pancreatic ducts are causing pain or inflammation, surgery may be performed to drain the ducts or remove the blockage.
  • Partial Pancreatectomy: In some cases, a portion of the damaged pancreas may be surgically removed to relieve pain and prevent further complications.
  • Endoscopic Procedures: For patients with blocked ducts or gallstones, an endoscopic procedure may be performed to remove the blockage and improve drainage from the pancreas.

Complications of Chronic Pancreatitis

Chronic pancreatitis can lead to several serious complications, including:

• Pancreatic Cancer: Long-term inflammation increases the risk of developing pancreatic cancer.
• Diabetes: Chronic pancreatitis can cause damage to insulin-producing cells, leading to diabetes.
• Pancreatic Pseudocysts: Fluid-filled sacs can develop in the pancreas, causing pain and infection.
• Malnutrition: Poor nutrient absorption can lead to severe malnutrition and vitamin deficiencies.

Conclusion

Chronic pancreatitis is a long-lasting condition that can severely impact your quality of life if not managed properly. Early diagnosis and treatment are crucial for slowing the progression of the disease and reducing the risk of complications. By following your doctor’s advice, making lifestyle changes, and using medication as prescribed, it’s possible to manage the symptoms and improve your overall health.

If you experience persistent abdominal pain, weight loss, or other symptoms of chronic pancreatitis, consult your doctor for evaluation and appropriate treatment. Your pancreas is vital to your digestive system and overall well-being, so taking steps to protect it is essential.

Colon Cancer

Colon cancer, also known as colorectal cancer, develops in the large intestine (colon), which is part of the digestive system. It typically starts as small, benign growths called polyps that can, over time, turn into cancer. Colon cancer is one of the most common types of cancer, but the good news is that with early detection and treatment, it is highly treatable.

What Is Colon Cancer?

Colon cancer occurs when cells in the lining of the colon grow uncontrollably, forming a tumor. If left untreated, these cancerous cells can spread to other parts of the body. Most colon cancers begin as non-cancerous polyps. Regular screening can detect these polyps early and prevent cancer from developing.

Causes of Colon Cancer

The exact cause of colon cancer isn’t fully understood, but several factors increase the risk of developing the disease:

• Age: Most cases of colon cancer occur in people over 50.
• Genetics and Family History: A family history of colon cancer increases your risk, especially if relatives were diagnosed at a young age.
• Lifestyle Factors: Poor diet (high in red or processed meats, low in fiber), lack of exercise, smoking, and excessive alcohol consumption are linked to a higher risk.
• Chronic Conditions: Conditions like inflammatory bowel disease (IBD), including Crohn's disease and ulcerative colitis, can increase the likelihood of colon cancer.
• Genetic Syndromes: Certain inherited conditions like Lynch syndrome and familial adenomatous polyposis (FAP) also elevate risk.

Symptoms of Colon Cancer

In the early stages, colon cancer may not cause any symptoms. However, as the disease progresses, you may experience:

• Changes in Bowel Habits: Persistent diarrhea, constipation, or changes in stool consistency that last for more than a few days.
• Blood in Stool: Bright red or dark, tarry stools may indicate bleeding in the colon.
• Abdominal Discomfort: Cramping, pain, or bloating that does not go away.
• Unexplained Weight Loss: Losing weight without trying can be a sign of many cancers, including colon cancer.
• Fatigue: Feeling unusually tired or weak can be caused by the cancer's impact on nutrient absorption or internal bleeding.
• Incomplete Bowel Movements: A feeling that the bowel doesn't empty completely after a movement.

If you notice any of these symptoms, especially for more than a few weeks, it’s important to consult a doctor.

Diagnosis of Colon Cancer

Diagnosing colon cancer involves several steps:

• Screening Tests:
  • Colonoscopy: A flexible tube with a camera is inserted into the rectum to view the entire colon. Any suspicious polyps can be removed and tested for cancer.
  • Stool Tests: Tests like the fecal occult blood test (FOBT) or fecal immunochemical test (FIT) check for hidden blood in the stool.
• Imaging Tests:
  • CT Scans: Used to get a detailed view of the colon and check if cancer has spread.
  • MRI and Ultrasound: These may be used to evaluate the extent of the cancer.
• Biopsy: If a polyp or suspicious area is found, a small tissue sample is taken for laboratory testing to confirm if it is cancerous.

Stages of Colon Cancer

Colon cancer is divided into stages based on how far the cancer has spread:

• Stage 0 (Carcinoma in Situ): Cancer is only in the innermost lining of the colon.
• Stage I: Cancer has spread into the muscle layer of the colon.
• Stage II: Cancer has spread through the outer layer of the colon but hasn’t reached nearby lymph nodes.
• Stage III: Cancer has spread to nearby lymph nodes but not to other parts of the body.
• Stage IV: Cancer has spread to distant organs, such as the liver or lungs.

Treatment of Colon Cancer

Treatment options for colon cancer depend on the stage of the disease, but common approaches include:

• Surgery:
  • Polypectomy: If cancer is detected early, during a colonoscopy, polyps may be removed before they become malignant.
  • Partial Colectomy: For more advanced cases, a portion of the colon containing cancer may be surgically removed. In some cases, the healthy parts of the colon are reconnected.
  • Colostomy: In rare cases, if reconnecting the colon is not possible, a colostomy is performed to create an opening in the abdominal wall to pass waste.
• Chemotherapy: Chemotherapy uses drugs to kill cancer cells or shrink tumors. It is often used after surgery to eliminate any remaining cancer cells or in advanced stages to slow the spread of the disease.
• Radiation Therapy: Radiation uses high-energy rays to target and kill cancer cells. It is more commonly used in rectal cancer but may also be used for colon cancer, especially in later stages.
• Targeted Therapy: This newer treatment targets specific molecules that cancer cells use to grow. Targeted therapies are often used when colon cancer has spread to other parts of the body.
• Immunotherapy: Immunotherapy helps the immune system recognize and attack cancer cells. It is typically used for advanced colon cancer that does not respond to other treatments.

Prevention of Colon Cancer

While there is no sure way to prevent colon cancer, certain lifestyle changes and regular screenings can significantly reduce your risk:

• Screening: Regular colonoscopies, especially after age 50, can detect polyps early and prevent them from turning into cancer.
• Healthy Diet: Eating a diet rich in fruits, vegetables, and whole grains and reducing red and processed meats can lower your risk.
• Exercise: Regular physical activity helps maintain a healthy weight, which can reduce your cancer risk.
• Avoid Smoking and Excess Alcohol: Both smoking and excessive alcohol use are linked to higher risks of many cancers, including colon cancer.

Conclusion

Colon cancer is a common and potentially life-threatening disease, but with early detection and treatment, the outlook is often positive. Regular screenings, a healthy lifestyle, and being aware of the symptoms are essential steps in reducing your risk. If you experience any unusual changes in your bowel habits or notice other symptoms, consult a doctor for evaluation. Early intervention can save lives.

By taking care of your digestive health and staying proactive, you can significantly reduce the risk of colon cancer and enjoy a healthy, balanced life.

Struggling with a Complex Hernia? Robotic-assisted surgery can help you get rid of it

Affecting over 15-20% of the Indian population, hernias are common, often painful, and occasionally life-threatening health conditions that require surgical intervention. Hernias come in various forms, with common types including inguinal, femoral, umbilical, incisional, and hiatal hernias. While surgical repair is the standard treatment for these conditions, it can be associated with potential complications such as postoperative pain, risk of surgical site infections, recurrence and longer recovery times. However, the introduction of new-age technologies like robotic-assisted surgery (RAS) has revolutionized the landscape of hernia treatment, and now doctors can address these issues more effectively with minimal complications, more precision, better repairs, and lesser pain.

Hernia repair in patients with adverse health conditions

These days, many doctors consider robotic-assisted surgery (RAS) to be a more effective approach for various hernias, particularly for individuals who have a weak abdominal wall and also in patients with comorbidities or underlying health conditions such as diabetes, are on anticoagulation (blood thinning medications), obesity or those who are cancer survivors( provided patient is fit to undergo general anesthesia). Patients with adverse health conditions often are at a higher risk of having secondary infections, bleeding and further complications when they undergo additional surgeries. However, using minimally invasive methods like robotic-assisted surgery has translated directly to a higher degree of patient care. The benefits of RAS are manifold, with its minimally invasive nature allowing for smaller incisions, less blood loss, reduced postoperative pain, better and safer adhesiolysis and diminished scarring. Moreover, RAS offers the potential for shorter hospital stays, enabling patients to return to their regular routines more swiftly. When compared to conventional methods, robotic-assisted surgery by using new-age technologies like the Da Vinci stands out for its precision, by providing surgeons with high-magnified vision, 3D visualization, and enhanced dexterity, all of which contribute to safer and more controlled procedures. These factors enable surgeons to navigate with unprecedented accuracy, making it particularly advantageous in addressing complex hernia cases. 

Recently, a 62-year-old female patient came to us with two hernias, one resulting from cancer surgery on the left side, and the other stemming from a previous C-section, resulting in an umbilical hernia. The patient reported excruciating pain and swelling, prompting medical intervention. We could effectively address this complex condition with the help of robotic technology, with minimal post-operative complications. This highlights the versatility and effectiveness of robotic-assisted surgery in managing complex hernia cases. 

The impact of hernia surgery on posture 

In womn, one of the most common hernias are post-partum hernias, which include umbilical hernias. This is because of the stretching of the abdominal wall and thinning of the muscles and what is called the divarication of recti (increase in inter-recti distance –recti being the six-pack muscles in the front of the abdominal wall). This can be both painful and uncomfortable and can have various repercussions on posture, back pain and overall ability to do a lot of activities which require core muscle strength. While treating these kinds of conditions, it is important to focus on the reconstruction of the abdominal wall as well.

One of the most important muscle groups in the body, abdominal muscles are responsible for safeguarding and encompassing the abdominal organs and their functioning. The maintenance of these muscle groups also has an impact on our posture and general health. With advanced RAS technologies like the Da Vinci, we can separate all the layers of the abdominal wall and slide them back into their natural positions( Abdominal wall reconstruction), with enhanced precision. The re-establishment of the integrity of the abdominal core cylinder is of utmost importance to help a person recover back to his/her full mobility and for robustness of the hernia repair. 

Reduced post-operative pain

The biggest concern in patients undergoing even a simple hernia repair is post-operative pain management. Irrespective of the type of repair, a hernial defect closure comprising of stitches in the muscle is the main stay of the treatment – which causes post op muscle soreness and pain, especially on attempting to mobilize or even cough/ sneeze. This immediate post op pain can be very debilitating for the patients, restricting activities and deterring early return to work. With the Robotic platform, there is a huge advantage of significantly lower post op pain scores due to higher precision of the surgical procedure and better haemostasis (control of bleeding). 

In conclusion, Robotic surgical systems prove particularly advantageous for addressing different types of hernias, by offering enhanced access to the surgical area, thorough adhesion removal, and simplified placement of larger mesh implants and much more robust hernia repair and abdominal wall reconstruction. The benefits of robotic surgery not only enhance the overall experience but, also expedite the recovery process, allowing patients to return to their normal lives more swiftly.

Inflammatory Bowel Disease

Inflammatory Bowel Disease (IBD) is a term that refers to a group of chronic conditions affecting the gastrointestinal system. Crohn's disease and ulcerative colitis are the main subtypes in IBD. IBD primarily affects intestine, but can also involve joints, eyes, liver, skin, and pancrease.

What is Inflammatory Bowel Disease?

IBD involves inflammation of the gastrointestinal (GI) tract. The GI tract is a complex system responsible for breaking down and absorbing nutrients from the food we consume. When this system becomes inflamed, it can lead to a variety of uncomfortable and often debilitating symptoms.

Types of Inflammatory Bowel Disease

1. Crohn's Disease:

• Crohn's disease can affect any part of the GI tract, from the mouth to the anus.
• Inflammation of the GI tract can lead to ulcers, narrowing of the intestinal lumen, and rarely perforation of the intestine.
• Common symptoms include abdominal pain, diarrhea, blood or mucous in stool, fatigue, and weight loss.

2. Ulcerative Colitis:

• This condition specifically affects the large intestine.
• Inflammation can be limited to the rectum or can involve the entire large intestine.
• Symptoms may include bloody diarrhea, abdominal cramps, and urgency to empty stools.

Causes and Triggers

The exact cause of inflammatory bowel disease remains unknown, but it is believed to result from a combination of genetic, environmental, and immune system factors. Certain triggers can exacerbate symptoms or lead to flare-ups, including stress, diet, drugs, and infections.

Recognizing Symptoms

Identifying IBD symptoms early is crucial for timely diagnosis and management. Symptom severity may vary depending on the extent of small and large intestines involved. Common symptoms include:

• Persistent diarrhea
• Abdominal pain or cramping
• Mucous or blood in stool
• Unintended weight loss
• Fatigue

If you or someone you know experiences these symptoms regularly, it's essential to consult a healthcare professional for a proper evaluation.

Diagnosis

Diagnosing IBD typically involves a combination of medical history, physical examination, and various tests. These may include:

• Medical history
• Physical examination
• Various tests, including blood and stool tests, colonoscopy and gastroduodenoscopy, imaging studies (CT enterography or MRI enterography),

These examinations help doctors determine the extent and severity of inflammation.

Management and Treatment

Treatment of IBD depends on the severity and extent of the disease. In the present era, various treatment options are available and they can control inflammation, alleviate symptoms, and improve overall quality of life. Medications, including immunomodulators and biologics, are commonly prescribed based on the type and severity of the disease.

In some cases, surgery may be necessary, especially if complications such as bowel obstructions or perforations arise. Surgery can involve removing damaged portions of the intestine to provide relief.

Lifestyle Considerations

Adopting a healthy lifestyle can significantly contribute to managing IBD. This includes: 

• Maintaining a well-balanced diet
• Staying hydrated
• Regular exercise
• Managing stress levels

Additionally, avoiding tobacco products is crucial, as smoking has been linked to worsening symptoms and complications in individuals with Crohn's disease.

Conclusion

Inflammatory Bowel Disease is a chronic condition that requires lifelong management. Understanding the basics of IBD, recognizing symptoms, and seeking early medical intervention are crucial steps toward effectively managing the disease. While living with IBD may pose challenges, proper treatment, lifestyle adjustments, and a supportive healthcare team can empower individuals to lead fulfilling lives despite the complexities of their condition. If you think you might have IBD or are worried about your digestive health, talk to a healthcare professional at Sakra World Hospital for personalized guidance and care.

Esophageal Swallowing Disorders

Esophageal swallowing disorders refer to a group of conditions that affect the normal swallowing process and cause difficulty in swallowing (dysphagia). The esophagus is the tube that carries food and liquids from the mouth to the stomach.

The process that takes place in the esophagus involves muscular contractions, called peristalsis, that push food down to the stomach. The process starts when food or liquid is taken into the mouth and begins to be chewed and mixed with saliva. This mixture then travels down the esophagus, which is a muscular tube that connects the mouth to the stomach.

As food and liquids move down the esophagus, the muscles in the wall of the esophagus contract and relax in a coordinated manner to push the food toward the stomach. This process of muscular contractions is called peristalsis. At the lower end of the esophagus, there is a ring-like muscle called the lower esophageal sphincter (LES) that opens and allows the food to enter the stomach. 

Collectively, these parts form a seamless system that transfers food from the mouth into the stomach while preventing backflow into the esophagus. This process may be affected by physical barriers or disorders that impair motor performance (esophageal motility disorders).

Types of Esophageal Disorders

There are different types of esophageal disorders which include:

• GERD

• Barrett’s Esophagus

• Esophageal Cancer

• Esophageal Spasms

• Achalasia

• Hiatal Hernias

According to studies, many people have complained of acid reflux and heartburn, and even difficulty swallowing. These issues with the mouth, throat, or esophagus are primarily caused by the following:

• Structural failure in physical systems
• Injury to the muscles or nerves controlling swallowing
• Physical impediment

Risk factors of Esophageal Swallowing Disorder

Several factors can maximize the risks of developing esophageal swallowing disorder. These include

• Consumption of alcohol
• Smoking 
• Gaining weight due to pregnancy or obesity.
• Radiation therapy to the chest or neck.
• Taking certain medications such as antibiotics, painkillers, and antidepressants.

Swallowing and esophageal diseases can have serious consequences if left untreated. Early diagnosis and treatment should be taken to get rid of this health issue.

Symptoms of Esophageal Swallowing Disorder

Depending on the esophageal disorder kind, various symptoms may occur. The symptoms are as follows:

• Sore throat or chronic cough
• Abdominal pain, back pain, or even chest pain
• Heartburn is a feeling of burning in the chest
• Wheezing or hoarseness
• An unexpected loss of weight
• Indigestion is a feeling of burning in the stomach
• Vomiting or regurgitation
• Feeling as if food is stuck in the throat or difficulty swallowing

Diagnosis of Esophageal Swallowing Disorder

The best doctor for gastroenterology in Bangalore will conduct a thorough physical examination, talk about the symptoms, and review the medical history in order to figure out whether an individual has a swallowing condition. Focusing on the following while one discusses the swallowing issues:

• If the person has any symptoms in the mouth, throat chest, or neck, where one is feeling the food being stuck
• If certain food triggers any symptoms or makes them worse
• When does the problem related to swallowing start
• Any other health concerns that one is experiencing 

Additionally, by examining the inside of the throat or mouth, the doctor may recommend other tests to know the exact cause of the swallowing issue. These are as follows: 

• Upper Endoscopy

• Esophageal Manometry

• Gastrointestinal X-rays

• Esophageal pH Test

In case you are experiencing any problem while swallowing and even notice any symptoms, you can visit the best gastroenterology hospital in Bangalore, Sakra World Hospital where their team is expert in treating health issues like esophageal disorders with the help of their gastroenterology specialists.

Stomach flu - Symptoms, Causes, and Treatment

Stomach flu, also known as gastroenteritis, is a common condition that causes inflammation and irritation of the digestive system, particularly the stomach, and intestines. This condition is characterized by symptoms such as nausea, vomiting, diarrhea, and abdominal pain. Stomach flu is usually caused by a viral infection, although it can also be caused by bacteria or parasites. The best stomach doctor in Bangalore recommends maintaining proper hygiene and washing hands regularly with soap and avoiding sharing food with people who are sick to avoid stomach flu. However, there are some home remedies available that can relieve symptoms of stomach flu. 

Symptoms of stomach flu

The symptoms of stomach flu typically appear within one to three days of exposure to the virus and may include:

• Stomach pain and stomach cramps
• Watery and non-bloody diarrhea
• Vomiting and nausea
• Fever
• Muscle aches
• Headaches

It's important to note that stomach flu is not the same as seasonal flu, which primarily affects the respiratory system. If you are experiencing symptoms of stomach flu, it's important to see a doctor for proper diagnosis and treatment. Most people recover from this stomach flu within a few days without any kind of complications. 

Causes of Stomach Flu

Stomach flu is usually caused by a viral infection. Some of the viruses are, 

• Rotavirus
• Norovirus
• Astrovirus
• Adenovirus

These viruses can be easily spread from person to person through contaminated food or water, or by touching a surface contaminated with the virus. Stomach flu can also be caused by bacteria or parasites, such as Salmonella or E. coli. In these cases, the infection is typically spread through contaminated food or water.

Treatment for Stomach Flu

The main goal of treatment for stomach flu is to manage symptoms and prevent dehydration. Here are some steps you can take to help relieve symptoms and speed up recovery:

• Drink plenty of fluids: This is essential to prevent dehydration, which can be a serious problem in severe cases of stomach flu. Try to drink at least eight glasses of water or clear fluids per day, and avoid caffeine, alcohol, and sugary drinks, which can make symptoms worse.
• Eat small, frequent meals: Start with bland, easily digestible foods, such as crackers, rice, or toast, and gradually introduce more solid foods as your symptoms improve.
• Avoid fatty or spicy foods: These foods can irritate your digestive system and make symptoms worse.
• Get plenty of rest: Stomach flu can be exhausting, so make sure you get plenty of rest and avoid strenuous activity until you feel better.

In severe cases, antiviral medications may be prescribed to help treat the underlying viral infection. Antibiotics may also be prescribed if bacteria are suspected as the cause of the infection. Some of the medicines recommended by doctors include, 

• Ibuprofen
• Antiemetics
• OTC antidiarrheals

Prevention of Stomach Flu

The best way to prevent stomach flu is to practice good hygiene, such as washing your hands frequently with soap and water, especially after using the bathroom. You should also avoid sharing utensils, food, or drinks with someone who has the flu and stay home if you are sick to avoid spreading the virus to others.

If you are experiencing any symptoms related to stomach flu, it is important to get a consultation with the eminent doctors at one of the best Gastric hospitals in Bangalore, Sakra World Hospitals where their team of experts guides you through some of the preventive measures and the necessary medications to avoid stomach flu in the future.

Chronic Pancreatitis - Causes, Symptoms, & Treatment

Chronic pancreatitis is considered an inflammation of the pancreas that does not improve over a period of time. The pancreas is an organ located behind the stomach in the upper abdomen and makes digestive enzymes, which are special proteins that help to digest food. The pancreas also makes hormones like Insulin and Glucagon that control the sugar level in the blood. 

Difference between Acute Pancreatitis and Chronic Pancreatitis

Pancreatitis is the medical term used to denote inflammation of the pancreas. When the inflammation is sudden severe abdominal pain, nausea, vomiting, and fever, pancreatitis is considered acute. On the other hand, chronic pancreatitis keeps on coming back and the inflammation is recurrent or persisting and does not heal for many years or months.

Chronic pancreatitis leads to permanent damage and scarring of the gland.  Cysts and calcium stones may develop and grow in the pancreas and this can block the ducts that carry digestive enzymes and juices to the intestine. Permanent damage to the pancreas leads to a decrease in hormones and digestive enzyme levels, which in turn makes it harder for one’s body to digest food as well as regulate blood sugar. This causes serious health issues which include diabetes, malnutrition, indigestion and loose stools, and many others. Chronic inflammation and ductal blockage and stones can also cause severe recurrent pain.  Thus, these cases of pancreatitis can be improved with proper treatment at the best hospital for pancreatitis in Bangalore.

What Causes Chronic Pancreatitis?

There are a variety of causes of chronic pancreatitis. The most common cause of chronic pancreatitis in western countries is long-term alcohol abuse and approximately 65% of cases are connected to the consumption of alcohol. 

The autoimmune disease primarily occurs during the time an individual’s body attacks healthy tissues and cells mistakenly.  Autoimmune pancreatitis is also a common cause of pancreatitis.

Tropical and subtropical countries like India have a significant number of chronic pancreatitis caused by abnormal pancreatic digestive enzymes as a result of mutations in the proteins which makes them unstable and causes inflammation of the pancreas. This is called idiopathic tropical calcific pancreatitis and this is the most common cause of pancreatitis in Southern India.

Some other causes are,

• A narrow pancreatic duct or opening of the duct that connects the pancreas to the small intestine.
• Cystic fibrosis is a hereditary disease that can cause mucus  to build up in the lungs and pancreatic ducts 
• A blockage of the pancreatic duct either by pancreatic stones or strictures 
• Genetics
• A high level of triglyceride fats in the blood is called hypertriglyceridemia.
• High blood levels of calcium and it is called hypercalcemia.
• Certain immune disorders
• Smoking

What are the Symptoms of Chronic Pancreatitis?

In the beginning, one may notice some symptoms. Transformations in the pancreas can become advanced before one begins to feel unwell. When the symptoms occur, these include,

• Diarrhoea
• Pain in the upper abdomen
• Nausea and vomiting
• Unexplained loss of weight
• Fatty stools which are pale, loose, and do not flush away easily
• Excessive fatigue and thirst

One might experience more severe symptoms as the disease progress, which include, 

• Jaundice is characterized by a yellowish discolouration in the skin and eyes
• Pancreatic fluids in the abdomen 
• Intestinal blockage
• Internal bleeding

Painful episodes last for a few hours or may last for days. Some people find that drinking and eating can make the pain worse and as the disease advances, the pain becomes constant. Patients with Chronic pancreatitis have an increased risk of developing cancer of the pancreas.

How can Chronic Pancreatitis be Diagnosed?

A pancreas specialist doctor in Bangalore will be able to diagnose only when the symptoms are present for a long time or the changes in the pancreas are irreversible. The healthcare provider is going to examine the belly of the patient and might ask for a few blood tests and other imaging tests.  These diagnostic tests include, 

• Blood tests like amylase and lipase 
• Abdominal ultrasound
• CT scan of the abdomen 
• ERCP
• Endoscopic ultrasound
• Magnetic resonance cholangiopancreatography

Treatment of Chronic Pancreatitis

Treatment for chronic pancreatitis focuses on minimizing pain and improving digestive function. The damage cannot be undone but with proper care, one can prevent the progression of chronic pancreatitis and improve pain, sugar control, and digestive functions. If a specific cause is found, corrective measures can be taken  These treatment procedures include, 

• Medications
• Surgery
• Endoscopy

If you are looking for treatment for chronic pancreatitis disease, Sakra World Hospital has the best pancreas specialist doctor in Bangalore who can guide you with their expert knowledge regarding the treatment plan for chronic pancreatitis.

Cholera: Causes, Symptoms, and Treatment

Overview

Recently fifteen cases of cholera have been reported in India in Bengaluru city. There is already a panic across the world over the global outbreak of the novel coronavirus and now water-borne diseases have been reported in Bangalore. 
Cholera cases have been reported from the South, East, and West divisions of Bangalore and water supply to these areas have been stopped until the source of infection is found.

What is Cholera?
Cholera is a bacterial disease which spreads through contaminated water and food. It is an extremely severe disease that can cause acute watery diarrhoea with severe dehydration.

What Causes Cholera?
It is caused by the bacterium Vibrio cholera. It produces a toxin in the small intestine that causes the body to secrete enormous amounts of water, leading to diarrhoea and a rapid loss of fluids.
The bacteria can be found in surface or well water, seafood, raw fruits and vegetables, municipal water supplies, ice made from municipal water grains, etc.

What are the Symptoms of Cholera?
Most people infected with Vibrio cholera do not show any symptoms, although the bacteria are present in their faeces for 1-10 days after infection, they can still infect others through contaminated water.
It takes 12 hours to 5 days for a person to develop symptoms after consuming contaminated food or water. Cholera affects both children and adults and can cause death within hours if not treated. 
 

Symptoms of cholera infection include:

• Diarrhoea

• Nausea and vomiting

• Dehydration

• Low blood pressure

• Muscle cramps

What are the risks associated with cholera?
Everyone is vulnerable to cholera except the infants who get immunity from nursing mothers who have previously had cholera. Still, there are certain risk factors that can cause cholera such as:

• Poor sanitary conditions

• Reduced stomach acid

• Household exposure

• Type O blood

• Raw or undercooked seafood

How is cholera diagnosed?
A stool sample test is the only way to confirm a diagnosis of cholera. In areas with no laboratory testing, the Crystal ® VC dipstick rapid test is done to confirm the cholera diagnosis. This test helps to decrease the death rates at the start of the cholera outbreaks.

How is cholera treated?
Immediate treatment is necessary for cholera as it can cause death within hours. There is a vaccine for cholera but WHO have specific guidelines for who should be given the vaccine.
 

Other methods of treatment are:

• Rehydration: Oral rehydration salts (ORS) is used to replace the lost fluids and electrolytes. It is available in powdered form and can be made with boiled or bottled water.

• Intravenous fluids: People who are severely dehydrated require intravenous fluids to get better.

• Antibiotics: Severely dehydrated patients need antibiotics to reduce the duration of diarrhoea and shorten the amount and duration of V. cholerae excretion in their stool.

• Zinc supplements: Zinc reduces the duration of diarrhoea and shortens the duration of cholera in children.

How can you Prevent Cholera?
There are a few things you can do to protect yourself and your family from cholera.
Use boiled water, chemically disinfected water or bottled water only for the following purposes:

• Drinking

• Preparing food

• Making your teeth

• Washing your face and hands

• Washing fruits and vegetables

• Washing dishes and utensils

• Brushing your teeth

To prevent cholera consume food from hygienic outlets only. Eat well-cooked food and use water only from a clean source. You can disinfect the water by boiling it for 1 minute to 3 minutes at a higher temperature.

Things you should avoid:

• Raw food

• Unpeeled fruits and vegetables

• Raw or undercooked meat or shellfish

• Fruits kept exposed for a prolonged period under unhygienic conditions

Be aware of the sources of the food and the consequences of consuming solid food and drink prepared under poor hygienic conditions.
Note: If you develop severe diarrhoea and vomiting then seek medical help immediately. Cholera is highly treatable if treated within a few hours of developing symptoms.

 

Water and Foodborne Diseases during Festivals

During festivals, it is a common trend to enjoy street food. One can indulge in festive delicacies, but you should also be cautious about health. As, there are many food and water-borne diseases which spread through unhygienic practices. They affect the gastrointestinal tract (GIT) and liver. GIT disorders are predominantly bacterial and liver diseases are commonly due to viruses.

Symptoms of GIT infections:

• Loose stools – could be watery or blood mixed
• Vomiting
• Abdominal cramps
• Dehydration: dryness of mouth and skin, dark urine, decreased urine output

Mild symptoms are common, which may stop spontaneously. However, severe symptoms are observed in Children and Old people.

Liver Diseases:

• Viruses causing jaundice are called Hepatitis viruses. They are named as Hepatitis A, B, C, D, E viruses. Amongst these Hepatitis A and E are transmitted through contamination of food and water with human excreta. Hepatitis A is more common in children, Hepatitis E in adults.Most of the epidemics are caused by Hepatitis E
• Jaundice may take several weeks to subside. Complete recovery is seen in most patients
• People with underlying long standing liver disease are more prone to worse outcomes
• Danger signs are (rare): Altered behaviour, bleeding from various sites and swelling of abdomen (due to collection of fluid in side abdomen).  These indicate worsening liver function and need immediate medical attention
• Common misconception during jaundice–Many a times, patients with jaundice are advised a restricted diet (Avoid oil, Non-Vegetarian food, Turmeric etc.) by family and relatives. No such restriction is needed and good nutrition during jaundice is extremely important
• Tips to keep in mind during Jaundice:
  • Avoid taking water/ food from source which you feel is unhygienic
  • Take warm/ hot food
  • Consult nearby doctor if any of the above-mentioned symptoms appear