Diverticulitis: What is it, the Treatment and Recovery?

Diverticula are the small, pouch-like protrusions occurring in the digestive tract, especially in the lower areas of the large intestine, i.e. the colon. These are common in people 40 years or above. This condition is called Diverticulosis, and when the diverticula get inflamed and infected, and then it is called Diverticulitis. It can cause severe nausea, abdominal pain and drastic change in bowel habits.

Causes of Diverticulosis and diverticulitis

The commonest cause of diverticulosis is long-standing constipation. As a result of increased pressure within the colon, diverticula arise from the weaker sections of the muscle layer of the colon. When one of these diverticula gets infected due to obstruction by fecal particles or loss of blood supply, its called diverticulitis and is associated with severe lower abdomen and fever.

Risk Factors

The risk factors include a diet low in fiber and high in red meat, obesity, lack of physical activity, increasing age, alcohol intake, smoking, genetics and residence in western countries

Complications

Diverticulitis has the potential to take a complicated course with abscess/ pus formation around the colon due to rupture of the diverticula. Abscess can be small or large depending on the extent of inflammation, with more severe inflammations leading to rupture of abscess within the abdominal cavity.

Diagnosis:

Diverticulitis is suspected when a typical elderly patient with longstanding constipation presents with acute lower abdomen predominantly on the left side, along with fever and vomiting. Some initial blood tests might indicate the presence of inflammation and a CT scan of the abdomen would confirm the diagnosis

Treatment:

This depends on whether it is Uncomplicated or Complicated Diverticulitis.

Uncomplicated diverticulitis can be treated as an outpatient with appropriate antibiotics, pain killers and laxatives to relieve constipation. Repeated diverticulitis requires a planned surgery to remove the affected portion of the intestine.

Complicated diverticulitis would require hospitalisation involving intravenous antibiotics and if necessary, insertion of a tube to drain excess pus. Sometimes a large amount of pus / significant inflammation

of colon might require emergency open or laparoscopic surgery to remove the pus or remove the affected part of the bowel. During surgery if the intestine is severely affected, the healthy portion of the colon is temporarily brought put and sutured to skin, this is called a colostomy.

Once the patient recovers completely the process is reversed and the bowels are reconnected at a later date.

Recovery and follow up:

Once patients recover from diverticulitis, they are prescribed long term bulk laxatives and diet rich in dietary fiber to avoid constipation. Periodic colonoscopic examinations might be required to assess the extent of diverticulosis.

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*Dr.Kamalesh MS, DNB(GIS), FMAS, FICS, FACS, *

*Senior Consultant in GI, HPB & Laparoscopic surgery*

*Aster Medcity, Cochin -682027+919895490173*

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Stomach Ulcers: What You Need To Know?

Stomach ulcers or gastric ulcers are the open sores that develop on the lining of the stomach when the lining of the stomach has become damaged. This is a type of peptic ulcer that affects both the stomach and small intestines.

A thick layer of mucus protects the digestive juices in the stomach. A decline in this mucus allows the digestive acids to eat away the tissues that line the stomach, causing ulcers. A stomach ulcer is common and can be cured easily. However, If left untreated, it can turn into a more severe condition.

Symptoms of stomach ulcers

Some stomach ulcers don't show any symptoms. If present, they can include:

• Abdominal pain just below the rib cage
• Indigestion 
• Nausea 
• Loss of appetite
• Vomiting 
• Weight loss
• Presence of blood in vomit or bowel motions
• Shock due to blood loss

What Causes Gastric Ulcers?

Gastric ulcer or stomach ulcer is usually caused when the layer protecting the stomach lining from stomach acid breaks down. This is mainly due to a bacterial infection called H. pylori. 

Other major causes of gastric ulcers are:

• Excessive usage of NSAIDs – non-steroidal anti-inflammatory drugs
• Excessive Smoking
• Hypercalcemia – excessive production of calcium
• Zollinger-Ellison syndrome – a condition when the body produces excessive acid.
• unrestrained consumption of alcohol

Treatment for a stomach ulcer

Lifestyle modifications can improve the symptoms of stomach ulcers. These include:

• Losing weight(If you are overweight).
• Quitting smoking
• Quitting alcohol
• Avoid foods such as coffee, chocolate, tomatoes, fatty foods, or spicy foods.

These modifications can reduce the severity of the disease, along with other treatment methods such as:

• Medication: Different drugs, including antibiotics, to destroy the H. pylori colony, and to speed the healing process. Along with these, tablets to reduce the acid content in the gastric juices are also suggested
• Breath tests: Breath tests help to make sure that the H. pylori infection has been treated successfully and to monitor the improvement.
• Changes to existing medication: Medications for other health conditions can have effects on the ulcer. These medications are slightly altered to improve the symptoms and effects of stomach ulcers. 

Most stomach ulcers will improve a few months after treatment. However, the chances of recurrence are high even after the treatment if the underlying causes are not properly addressed. If you suspect that you have stomach ulcers, talk to your doctor to discuss the appropriate treatment plan.

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Rectify peptic ulcer

Ulcers which occur in the inside of the stomach and the upper portion of the small intestine will be considered as peptic ulcer. Gastric ulcers occur inside the stomach and duodenal ulcers occur in the inside of the upper portion of the small intestine.

Symptoms
The most common symptom of ulcer would be severe stomach pain. Other signs would be as follows:

• Nausea
• Bloating
• Intolerant to fatty food
• Heartburn

Causes
Usually, peptic ulcers occur when acid in the digestive system eats away at the inner surface of the stomach or small intestine. And this can lead to severe pain as open sores form and it might even lead to bleeding. There is a mucous layer for the digestive tract which usually can protect against the acid. Ulcers are usually developed when the number of acid increases or when the amount of mucus decreases. Common causes could be as follows:

• Due to helicobacter pylori bacteria
• Using pain relievers on a daily basis
• Consuming too much of spicy food
• Certain medications

Medical care
The primary treatment for ulcers would be acid suppression and measures to heal the ulcers. Usually, doctors would prescribe certain medications for acid suppression and multiplication of the bacterium.This would include proton pump inhibitors, H2 blockers, and mucosal protective agents. These medications or antibiotics can help acid suppression or to heavily line the mucus, and this could reduce the formation of peptic ulcers. When these medications fail to treat ulcers, doctors would suggest surgery.

Usually, there are 4 types of surgical treatments for ulcers such as:

• Vagotomy - a surgical procedure that involves removing the part of vagus nerves. These nerves transfer messages from the stomach to the brain to stimulate acid secretion. If the vagus nerve is cut, then it will interpret the transmission of messages which could suppress the acid production.
• Antrectomy - a surgical option that involves removing the lower portion of the stomach that is antrum. Antrum produces hormones that will stimulate the stomach to produce digestive juices including pepsin and acid.
• Pyloroplasty - a surgery that will widen the opening of the lower stomach that is pylorus which will help the stomach to empty the contents into the small intestine that is duodenum.
• Laparoscopy - a surgical option that leads the passage to the inside of the abdomen or stomach and pelvis. Large cuts on the skin will not be required while performing laparoscopy. The pain is less and the recovery period is faster.
  

Ulcers could lead to further complications hence, it is recommended to treat before it gets worse or severe.

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Don’t Delay Your Hernia Treatment!

Are you feeling pain due to a bulge in your groin while bending or lifting any object or during coughing. Then you may be suffering from inguinal hernia. It occurs when the tissues of the intestines protrude through a weak spot in the muscles of the abdomen and results in a bulge.

Symptoms of Inguinal Hernia are as follows

• A visible bulge in the groin. 
• Aching sensation at the bulge.
• Discomfort and intense pain in the groin region.

Others signs:

• Vomiting and Nausea
• Inability to move the bowels

The condition in its initial stage is not very dangerous, it usually shows no signs of improvements with time and in future can cause complications that can even become a threat to the life of the patient. Thus it is recommended by doctors to not keep a hernia untreated and opt for a surgery to fix the condition, if you have symptoms. Book an appointment with Dr. Kamalesh by logging on to http://surgicalgastro.com/  to get expert advice. With unmatched experience, he can provide you with the best quality treatment and guide you towards a healthy life. 

Complications are as follows:

• Incarcerated Hernia: When the portions of the affected intestine get trapped within the hernia obstructing the bowel movements and can thus cause intense pain and vomiting.
• Strangulation: If the hernia is left untreated it can get incarcerated resulting in stopping of blood flow to the parts of the intestine. It can result in the damage of bowel tissues and may require immediate surgery.
• Increase in size: If left untreated the size of the hernia increases with time and thus creates huge complications. In such cases it becomes difficult to conduct a keyhole surgery or a minimally invasive surgery and an open surgery is done which further complicates the things.

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Best Laparoscopic colorectal surgery in town!

Colon and rectum are part of the digestive system which helps to carry out the process of digestion. The function of the colon is to absorb the water and excrete the waste products as stools, and  the rectum holds the stools before it is finally released. Colorectal disorders  affect some part of the colon and rectum. Colorectal surgery deals with surgically correctable disorders of the colon, rectum and anal canal.

 

How is laparoscopic surgery conducted?

Laparoscopic surgery is a minimally invasive surgery in which a camera attached to a narrow tube is inserted into the abdomen or chest. This camera ensures proper vision of the area that needs to be operated. During the procedure, small incisions(cuts) are made in the body through which other laparoscopic instruments are  inserted. The surgeon can look at the monitor and further conduct the operation. In the case of colorectal surgery, the affected part of the colon or rectum and blood vessels are removed. Being a minimally invasive technique, here the recovery period and the amount of pain is much less.

Traditionally open surgery was conducted to treat  colorectal disorders, but the use of laparoscopic surgery has made the whole procedure much easier and has reduced the complications.

 

Types of colorectal disorders treated

Some common colorectal disorders Colorectal cancer, Colonic Diverticulitis, Inflammatory Bowel Diseases include Crohn's disease and Ulcerative colitis and  Rectal prolapse.

 

The best doctor in town!

If you are searching for a renowned and experienced gastroenterology surgeon in Kerala on whom you can relay completely, Dr Kamalesh N. P is the ultimate surgeon for you. He has extensive experience in performing numerous laparoscopic surgeries.

Dr. Kamalesh is one of the best colorectal surgeons  in Kerala. He has performed  numerous laparoscopic colorectal surgeries, including many complex ones  such as those for very low rectal cancer, carcinoma anal canal and surgeries for Ulcerative colitis. So if you are facing any sort of colonic problem, stop wasting time! Visit his clinic as early as possible.

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Increase Awareness, Conquer Pancreatic Cancer

Pancreatic cancer is one of the most deadly cancers. Unfortunately, pancreatic cancer is very common  and an awareness if this condition is very much necessary to detect it at an earlier stage.

What is pancreatic cancer?

Pancreatic cancer starts in the ductal cells of the  pancreas and it can spread to nearby and distant organs at a very fast rate. It is one of the most aggressive of all cancers. Detecting it at the earliest is rarely possible. But those with a family history of pancreatic cancers or any other gastrointestinal cancers may be able to detect its presence (if Any) by conducting regular checkups. Pancreatic cancer is mostly seen in men rather than in women.

What are the different types of pancreatic cancers?

The pancreas secretes digestive enzymes and hormones such as  insulin, that controls blood sugar levels. The pancreatic cancer is classified according to the area it is affected. Here are the various kinds of pancreatic cancer.

Exocrine pancreatic cancer

Most of the cases of pancreatic cancer arise from the exocrine pancreas and is called pancreatic adenocarcinoma. Exocrine pancreas is that part of the pancreas which secretes digestive juices.

Endocrine pancreatic cancer

Endocrine pancreatic cancers are not that common. They arise from pancreatic cells that secrete hormones that are released into the blood stream directly. Cancers that  arise from these cells are called islet cell tumors.

What are the causes of pancreatic cancer?

The exact reason or cause behind pancreatic cancer is still not known but there are certain risk factors that can cause this.

• A family history of pancreatic cancers can increase the risk of development of cancer
• There is an increased risk of pancreatic cancer amongst cigarette smokers rather than the non-smokers and among alcoholics as well.
• Obese people have an increased risk of development of pancreatic cancer.

What are the symptoms of pancreatic cancers?

The symptoms and signs aren't usually noticed until the disease advances to a later stage.

• Jaundice – Yellowing of skin, eyes and urine is the most common symptom.
• Weight loss
• Loss of appetite 
• Upper abdomen pain that spreads to the back

Get yourself tested if you symptoms suspicious of pancreatic cancer. Don’t worry if you have been detected with pancreatic cancer. Dr. Kamalesh, laparoscopic gastro surgeon Kochi, has a vast experience in managing  pancreatic cancers and provides advanced laparoscopic pancreatic cancer surgery in Kerala at affordable cost.    

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Health Camp

It is great pride informing about a free medical camp by PVS Hospital, Kaloor, Kochi from 29th November 2017 to 23rd December 2017. The team of dedicated doctors in the area of surgical gastroenterology will devote their valuable time and knowledge for the benefit of the patients. 

Date 29th November 2017 to 23rd December 2017

Venue: PVS Memorial Hospital , Kaloor, Kochi, Kerala

Areas Covered

The camp will provide solutions to all type of gastrointestinal diseases. The camp treat all types of hernias and it will be bliss to those who are suffering from hernias. Obesity is considered to be one of the stumbling blocks in one’s personality and it causes some psychological impacts on the patients, withdrawing themselves from the society. The health camp managed to provide treatment to those who are victims of obesity. At the same time they provide screening for gastrointestinal cancers and this is a boon to those who are doubtful of gastrointestinal cancers. 

Liver cirrhosis and liver cancer will be diagnosed and treated in the camp. The camp will be beneficial in providing medical advices and suggestion to those who are suffering from gastrointestinal and related diseases. This will be a golden opportunity for gastro patients so that they can avail the diagnosis services for gastro intestinal cancers at affordable cost.

Benefits of the camp

The registration and consultation will be free of charge. 

There will be a reduction of 25 to 50% reduction in laboratory test, endoscopy, ultra sound scan and CT scan. This will definitely help the economically backward patients 

Dr. N. P Kamalesh focuses to provide the best surgical services in the country and renders best services to many and relieved them of their pain and suffering. The gastroenterology department is regarded as one of the best and top departments in India. They are dedicated to the management of disease of the digestive system. Dr N. P Kamalesh offers expert care in surgical gastroenterology. He is one of the leading gastroenterologists in India. The institute possesses modern state of the art equipment backed by a team of supporting staff. At present the institute has emerged as one of the pioneers in the medical sector. The institute is especially devoted in the care of gastrointestinal diseases along with other treatments 

For Registration, 

Please contact: 9656 104 786

Kaloor, Kochi 682017

0484 4182888 / 2348239

www.pvsmemorialhospital.com

gisurgerypvs@gmail.com

For More details,

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