Articles on digestive system surgery

Gallstones -- Does Everybody Need Surgery?

Dr. Maruthesh Gowda, Bariatric Surgeon
What causes gallstones? It is difficult to tell what causes gallstones as there are so many associated risks. Its more in females (3:1 compared to men). Incidence increases with age. More in overweight/obese patients. Can be familial. Its also more in people who starve for long time or have drastic weight loss. Commonly associated with people who eat lot of oily food. As you can understand there is no specific reason.What is the incidence of gallstones in India?Incidence of gallstones varies in different parts of the world. In India there is huge variations in different parts of the country. North East and Bengal (10%) has highest incidence and south india has lowest (2-3%). In North east and Bengal gallstones can be detected at very early age compared to south India.Can medicines cure gallstones?Main question which worries the patients is what to do when diagnosed with them. It is more confusing as they get different answers from different doctors.If one tells them they can be resolved then should be very careful. If there was ever medicine to dissolve gallstones permanently then the person who discovered it would probably get Nobel Price and can be richest man as western counties spend billions on surgery and complications. In short, there is no medicine to dissolve them permanently.What complications does gallstones cause?Before answering the question whether one needs surgery or not we need to understand risks of gallstones and surgery.  They arePAIN (BILIARY COLIC): Normally comes after food especially fatty foods. Across upper abdomen and can radiate to back. Can last upto few hours. If any one experiences these symptoms repeatedly and is found to have gallstones then it is symptomatic gallstones. Patients are strongly advised to have surgery (Laparoscopic Cholecystectomy -- Key hole procedure to remove gall bladder with stones) before having any of other complications listed below.INFECTION -- CHOLECYSTITIS: This is infection of gall bladder usually happens when gallstone blocks the cystic duct (See Picture). This would need admission and prompt treatment with intravenous antibiotics atlas for 48 hours and surgery (Laparoscopic Cholecystectomy -- Key hole procedure to remove gall bladder with stones) on same admission.INFECTION  -- CHOLANGITIS: This happens when there is infection  with blocked bile duct caused by the stone in the bile duct. This is very serious condition as infection can spread to blood in very short term and cause serious organ damage (Renal failure/cardiac failure/liver failure). This is associated with high risks so patients would be in ICU. Patient will need ERCP ( Camera procedure to remove stone in bile duct). Once recovered from the infection will need surgery (Laparoscopic Cholecystectomy -- Key hole procedure to remove gall bladder with stones) on the same admission. JAUNDICE: This can happen when gallstone slipped from gallbladder to common bile duct causes obstruction to flow of bile (See picture). patient will need ERCP ( Camera procedure to remove stone in bile duct). Some times stone can pass on its own. This will be determined by serial blood tests. Once recovered from the infection will need surgery (Laparoscopic Cholecystectomy -- Key hole procedure to remove gall bladder with stones) on the same admission.PANCREATITIS: Most serious complication of gallstones with serious threat to life depending on the severity of pancreatitis. Most patient will need ERCP ( Camera procedure to remove stone in bile duct). Vary rarely stone can pass on its own. Once recovered from the pancreatitis will need surgery (Laparoscopic Cholecystectomy -- Key hole procedure to remove gall bladder with stones) on the same admission. What function does gallbladder have in our body?Function of Gall bladder: Its main function is to store bile and release it when needed (usually after food). Losing it will not interfere with digestion. After surgery main bile duct takes over the function of gall bladder. Contrary to belief there is restriction of food after surgery to remove gall bladder (Laparoscopic Complications)What are the complications of gallbladder surgery/Laparoscopic Cholecystectomy and what percentage have complications?Complications of Gall bladder surgery (Laparoscopic Cholecystectomy): These happen in 0.2% of cases. That is 1 in 500 cases of Laparoscopic Cholecystectomy world wide. Complications include bleeding, bowel injury and bile duct injury. The complication risks are higher in people who have had one of the above discussed complication from gall stones.Who needs gallbladder surgery/Laparoscopic Cholecystectomy?Now consider whether to have Laparoscopic Cholecystectomy -- Key hole procedure to remove gall bladder with stones). You can make educated decision.If the gallstones are symptomatic or you had any one of above complications then there is absolute indication for surgery on same admission or as soon as possible before you have other complications.If gallstones are incidental (This is the controversial part which patient needs to take decision)-- found on scan for some other reason and are not causing any complications then you have to decide whether to have surgery or not. The above article will help you to make that decision. If someone is diagnosed with gall stones then they have 2%-5% risk of above complications every year Vs 0.2% risk of complication from surgery to remove gallbladder. If have complication then you would need atleast 3-5 days admission, more time to recover and cost of treatment also increases with each complication.  It is ones decision whether to risk complications then face complicated surgery with higher risk of complications and prolonged recovery with added extra expenditure or have elective surgery where you can go home same or next day. If one does not live in select few cosmopolitan cities with access to all the healthcare facilities then it does not make sense to wait till the complication happens as it will be difficult to deal with them in small cities with limited resources and facilities. One's life is put to serious risk then.Do we need to avoid any food after surgery? Absolutely nil. One can start having food few hours after surgery and can eat all the food throughout the life without any restriction and malabsorption. 

Anal Fissure - Painful Morning

Dr. Deepak Rathi, Ayurveda
Fissure-in-ano is one kind of ailment that is embarrassing to talk about, given the nature of the symptoms and manifestations. However, it is one of the most prevalent conditions in the world, with millions of people suffering the agony of bad painful fissures.Introduction:A fissure is a tear of the skin at the edge of the anus. It can cause pain, bleeding and/or itching.Causes :An anal fissure is usually caused by a hard and dry bowel movement, alongwith a tight anal musculature, which tears the anal lining. Other causes include diarrhoea and inflammation of the anorectal area.Trauma also can cause fissures. During childbirth, 11% of women develop anal fissures. Fissures can also be caused by digital insertion, foreign body insertion, or anal intercourse.A low-fibre diet may play a role in the development of fissures.Anal fissures affect people of all ages, particularly young and otherwise healthy people. They are equally common in men and women.Symptoms :1. An anal fissure causes a sharp, stinging, or burning pain during a bowel movement. The pain, which can be severe, may last for a few hours.2. Fissures may itch. 3. They often bleed lightly or occasionally cause a yellowish dischargeTypes:Fissures can be acute (new) or chronic (persistent). An acute fissure has an 80% chances of healing.When a fissure lasts over 6 weeks or is repetitive in nature, it is considered Chronic and has less than 50% chances of healing.Sometimes an anal fissure and a hemorrhoid develop at the same time.Diagnosis:Most health professionals can diagnose an anal fissure by listening to the symptoms and by looking at the anus. Usually, the health professional can see the fissure by gently separating the buttocks.A health professional may use a gloved finger (digital rectal examination) or a lighted instrument (anoscope) to examine the fissure. However, if the fissure is extremely painful, the health professional will usually wait until it has begun to heal before performing a rectal exam or using an anoscope (anoscopy) to rule out other problems. A topical anaesthetic may be used if an immediate examination is necessary.Treatment:Ayurvedic Medicines - If it’s a first or second episode of Fissure, at least 50 % of fissures heal by medicines without need for any kind of procedure or surgery. Application of special medicated cream, use of stool softeners, avoidance of constipation, and the use of sitz baths (soaking the anal area in plain warm water for 20 minutes, several times a day) help to relieve the symptoms and allow healing to occur.Kshar Sutra Therapy - For those Fissures that are giving problem again and again, Kshar Sutra Therapy is the best treatment option. It is safer than surgery and completely effective.Surgery

Natural Short Term Strategies for a Bowel Movement

Dr. Anjana Gupta (P.T.), Physiotherapist
Are my stomach issues part of the human condition? Is constipation part of being a human? Did human 500 years ago get bloated all the time? Do other animals have these stomach issues?Seriously ponder these questions for a moment. Now think about them some more.Why have, we as a global society accepted these notions, the notion of having our stomach and digestion impaired, as being a part of the human condition.  We take medicines made in a lab some where, who's goal as a company, is to sale more of there products to people; getting them to believe that they need this medicine now for the rest of their lives. Most medicines are a band aid. A band aid when stitches is required.How come we have put our faith into these drug companies as a cure for our ailments. I will speak frankly now, it is due to laziness. We need to take our health into our hands by doing the appropriate research. Reading this article is a good first step, but there is much more reading that we can do. This article is intended to speedup the research process for you. Here is a list strategies that I have researched and experimented with myself personally after years of researching ways to correct my stomach woes.The world is changing with free trade, and globalization is taking over and our food products are produced all over the world. What has not changed is our diets. We still want to eat the same healthy foods that our moms and grandmas used to make for us. The only difference is that these same foods are not the same as our grandmas used to make. Sure they may look the same on the outside, but on the inside they are far from the same. The United States, in all its glory, has exemplified the quintessence of capitalism. The problem of capitalism is that past a certain point the cons start to outweigh the pros. In the food production industry, in the US, capitalism has reached that tipping point. Ever wonder why America is one of the most obese countries in the world? It's because their main stream food has not been healthy like grandma's, for a long time, right around 50 years. American food production practices are starting to spread, so our knowledge of harmful foods must keep up with this “expansion of philosophy,”in terms of main stream food production. So now that you know a little as to why your stomach could be irritated, lets talk about simple strategies to get it back on track.These strategies are for the short term. To get rid of your constipation, and get your digestion in order.   The Water Breakfast:It is literally exactly what it sounds like. Have nothing but water for breakfast. That seem easy until I say how much. You should consume your daily supply of water, all eight glasses of it, equalling at least 64 ounces. Sit down and for however long it takes you drink 64oz of water. If you drink hot water it will be even better. I sit and make a meal out of it by heating up a big pot of water, and creating my own concoction. I mix herbal teas, ginger, honey, lemon peals, cinnamon, and/or whatever else you want to put with it. It does not matter really what you put into it. I put the things I listed because they are known to aid digestion, put whatever is going to get you to drink it. Remember, not to much sugar or sweeteners.After the water breakfast, if you haven't produced a bowl movement, the next one should.Eat raw, with no fats:Eat a completely raw leafy green salad with raw vegetables after your water breakfast. I don't know what it is, but for whatever reason this works really well for me. A scientist would tell you it is because our stomach sends signals to the brain when an adequate amount of our nutrient levels are met.  Our brain then tells our digestive track that we have new and improved food, so out with the old.  If are nutrient levels are not reached then our brains tells our bodies to hold on to the food, as a natural surviving technique; that is why foods that are hard to digest, and have a low nutritional value are so hard to digest.  Go eat a McDonald's cheese burger in the US, and you will know what I am talking about.  Do not eat the salad until 2 to  3 hours after you consumed that water. We have good bacteria in our stomach that produces the necessary acid required to break down the food. If you try to stuff food on top of water, your food will not break down correctly, because the the bacteria will be to diluted. (Remember that for when you drink ice water with your dinner. Usually a small amount of Hot water with a meal is better for digestive purposes.) I am not suggesting that fats are bad for you. I believe the exact opposite actually. I believe healthy fats are really good and that is why sometime they can be exactly what we need to be healthy, just not when we are trying to fix our digestion and/or our irritable bowel syndrome. Make sense? Good. Next...Skip a meal:For whatever reason some people have began to form the opinion that skipping a meal is really bad for us; that eating unhealthy food is healthier than eating nothing at all. Nothing could be farther from the truth. As a species we were built for intermittent fasting, we actually can think at higher levels, if done properly.   Did you know that some US presidents do not eat at all the day they give the State of the Union address?   Imagine one hundred thousand years ago, people did not have grocery stores, so intermittent faster was just a way of life.  I just ordered off Zomato, and had them bring me a raw juice while writing this blog post, something tells me that wasn't around back then.  Delivery was not an option, so human ate what was literally in their immediate proximity.  Since we are a species that evolves to our environments to maximize our “level of fitness.” (Level of fitness, is a scientific term to describe the strong bodied) If the theory holds true, then humans would have evolved to have intermittent fasting serve us in some way. Whether that is to increase intelligence or strength, with the ultimate goal of increasing the chance of our off spring's survival. The point is is that skipping a meal is not going to kill you and may have some other benefits besides helping you fix your irritable bowl syndrome, and constipation.I believe that if you are going to skip a meal it is better to skip dinner, but it really depends on your personal schedule.  If your schedule is not an issue, then, it depends on what is inside your stomach currently as to whether you should skip a meal for lunch or for dinner. If you had high fats, breads, and legumes the night before then skip lunch to allow extra time for food to break down because those foods takes longer to digest.Don't eat different food types in the same meal:I know this could be hard for some people to consider, but that is whyI am only saying to keep an open mind, just for a few days about it. SO lets define what I mean when I say food types; they include proteins, fats, and carbohydrates. I mentioned earlier that our body has different types of healthy bacteria in the stomach. Well our stomachs are smarter than we give it credit it for, because it knows what food type we put into our stomach. If we put proteins, our stomachs starts producing the necessary chemicals to digest protein.  If we put in starches it knows we put in starches. Same goes with fats. The problem is, is that when we put in two at the same time there is a cancellation that takes places, so the food just sits in our stomachs, and gets past into our small intestines partially digested. Since our digestion is slowed we begin to form gas due to the fermentation process that takes place inside our stomachs.  When food sits in a heated area, like a stomach, it produces gases, and the dreaded and pain acetic acid is produced, which gives us indigestion, heart burn, and acid reflux. This is basic chemistry 101.  There who is so much more a person could write about proper dieting practices, but these are specifically the strategies that work best for me while trying to produce a bowl movement and relieve constipation. Relieving constipation is the first step in order to get back track, and heal our stomachs. So why is a physical therapist telling me about ways to heal my stomach. Its simple. The body is a complete system. If our stomachs are out of balance then our stomachs become inflamed. When our stomachs become inflamed  our immune systems are on high alert and working in over drive to heal that part of the body, then the immune system is not able to focus and fix another part of the body; the part of the body that we are coming in to the physical therapy clinic in the first place.  My job, as the physical therapists, is to make sure I perform proper physical therapy on your body, and your job is to make sure you heal your stomach and get your stomach's chemistry back to a state of homeostasis. Combined together our efforts will get the best physical therapy possible.

Is There Surgery for Acid Reflux?

Dr. Maruthesh Gowda, Bariatric Surgeon
YES. While many people suffer from acid reflux not all of them have true acid reflux. It is true that there small group of patients who will truly benefit from acid reflux surgery. For this group of patients, surgery can be life saving.Are the symptoms that I am suffering are from acidity?Please look it up whether is it really acidity? Or is it IBS?Which group of patients will benefit from surgery?Surgery should be treatment of choice in people who suffer from acid/food coming upto oesophagus (food pipe)/throat. Symptoms are caused by acid/food coming into food pipe or upto throat. It is burning sensation between the ribs or back of the throat. In some, it can lead to recurrent throat infection or change of voice. If symptoms are severe then it might feel like heart attack at times. Some or all of this symptoms are made worse by bending down or lying position.Why does these symptoms happen?It happens if there is disruption in the defense mechanisms preventing the food/acid coming upto chest.1. Weak Lower Oesophageal Sphincter (LOS): LOS is a one way valve at the lower end of food pipe (Oesophagus). It is meant to allow food to go from oesophagus to stomach but not the other way around. When it is weak, it leads to acid reflux and burning of oesophagus (Oesophagitis). 2. Hiatus hernia: This is a condition when part of the stomach is in the chest through the weakness  of diaphragm muscle. This might give sensation of food being struck in the chest.Are there other factors that contribute to the acid reflux?Yes they areSmokingAlcoholTight dressBody posture – bending down/laying flatToo much of spicy & fatty/oily foodFood habitsCertain medicationsIs surgery first choice in all patients?  NoWhat are the steps before surgery?Life style changesDrug therapyWhen should one consider surgery?One should consider surgery in one of the following situationsMedicines are not giving complete cure and some symptoms are persisting inspite of taking medicines.Symptoms are suppressed when one is on medicines but return as soon as discontinuing medicines.One does not wish to take medicines for life long and risk serious nutritional deficiencies.How is Surgery performed and what are the benefits?Now a days surgery is performed as keyhole (Laparoscopic).  This means One is in the hospital only for 2/3 daysAble to return to work within week or so Scars are barely visible after few weeksMinimal post op pain needing only simple pain killer medicinesHow is surgery performed?It re creates the lost anatomical defense mechanism.  In general the stomach in the chest is returned to normal abdominal position and the valve which is weak is strengthened. Part of stomach (Fundus) is wrapped around the lower end of oesophagus to add extra strength to the valve.

Bad Breath Could Be Bcoz of Acid Reflux

Dr. Swasti Jain, Dentist
You brush, floss, and pop breath mints like crazy, but nothing can kill your stubborn bad breath. Sound familiar? If you're frustrated by this stinky and embarrassing problem, maybe it's time to look beyond your mouth for some answers. Sometimes bad breath causes can be medical problems, like acid reflux.Cause of bad breath from the stomach is gastroesophageal reflux disease, or GERD. This condition is caused by acid coming back up the esophagus, causing burning sensation in the chest or throat.Acid reflux is the backward flow of stomach contents such as undigested food, regurgitated bile, and stomach acids into your esophagus. The primary cause of acid reflux in most people is a faulty or weak lower esophageal sphincterIt can also cause tooth erosion due to the acid in your stomach carrying into the mouth and weakening your teeth.WHAT TO DO ?Your physician may also suggest making lifestyle changes. Many people find that GERD symptoms get better when they avoid common triggers like fatty and spicy food, alcohol, and big meals, especially close to bedtime. In most people, the combination of lifestyle changes and the right medication can get and keep GERD under control.Drinking plenty of water and chewing gum (sugar-free) because it stimulates saliva production and clears acid from the mouth. Giving up cigarettes is especially important because smoking contributes to GERD symptoms and smoker's breath. Follow your doctor's advice, and you should be able to banish "bad breath reflux" for good.Eat foods that are rich in fiber to fight halitosis. Fiber helps the digestive movement (peristalsis) run smoothly so that reflux and obstruction are less likely to occur.Fibrous foods also keep you feeling full longer and may help you maintain your weight. GERD is linked to being overweight, so consult your doctor about losing weight to relieve acid reflux and heartburn.Some chewable antacids include breath-freshening ingredients and will relieve both symptoms at once

Changing Face of Colorectal (Bowel) Cancer in India

Dr. Maruthesh Gowda, Bariatric Surgeon
Colorectal cancer is cancer affecting the large intestine, and rectum. There has been rapid increase in colorectal cancer in India and this can be attributed to                                                                                               1. Increasing life expectancy        2.  Changing life style to western                                                                       Most cases occur above the age of 50. It is true that if detected early then colorectal cancer can be cured.      How does Colorectal cancer develop?Contrary to belief it take years to develop colorectal cancer. It develops from the inner lining of bowel (mucosa). Initially it forms a polyp which over the time turns into cancer. Tumor then starts to invade through different layers of bowel wall then into to lymph nodes near by.  If undetected, it can eventually spread to different parts of the body. Most of these cancer are on the left side. (see pic)Is there treatment for polyp? Yes. Most polyps do not contain cancer cells. Removal of polyp will be sufficient to prevent the cancer from developing.After removing the polyp, if cancer cells are found then it alone is sufficient if cancer cells are confined to polyp, however, if the cancer cells have spread to colon then further surgery is advised if necessary. What are risk factors for Colorectal cancer?Increases with ageWestern life style Genetic factor (First degree relative having colorectal cancer)Long term inflammatory bowel disease (Crohns, Ulcerative colitis)What reduces the chances of having colorectal cancer?Hormonal replacement therapy for womanVegetarian dietWhat are symptoms of colorectal cancer?Initially there might be no symptoms or very little symptoms and become more when the cancer grows in sizeChange in bowel habit either to constipation or passing too many  timesSensation of incomplete emptying after passing motionBlood mixed with the stoolPassing mucus with stoolSensation fullness after eating littleAbdominal distensionAbdominal painWeight lossWhat tests are needed before surgery?Colonoscopy and biopsy to prove it is cancer is a must unless its an emergencyCT scan to asses the spread inside the abdomen and chest MRI of pelvis if cancer is in rectumWhat are the treatment options?If it affects colon:  Surgery is done first. After excision the cancer is looked under microscope, if it has spread to lymph nodes then chemotherapy might be needed post op.If it affects rectum: In first two stages then surgery first. If 3rd/4th stage then chemo radiotherapy first is absolutely must. Chemo-radiotherapy is given first then operating reduces risk of recurrence from 85% to 5% (See Pic)If in Anal canal:  Chemo radiotherapy is main stay of treatment.How is Surgery done?If the patient is fit cancer surgery can be done safely with keyhole (Laparoscopic) with 3 or 4 small incisions. Usually the cut ends are joined using special stapler. In certain cases, colostomy can be done if the joining is thought to be risky. The options will be discussed with risk/benefits before surgery. Can the colorectal cancer be cured?Yes, if found in early stages. Even if it has spread to lymph nodes, then also it is curable. People with liver metastasis can also be cured at times.                                                                                                                                                           

During Monsoon, Ayurveda Can Cure Your Stomach Upset

Dr. Satish Sawale, Ayurveda
Indigestion is very common in cloudy and humid climate of monsoon often give rise to issues likeHeartburn, Bloating, Diarrhea, Constipation and gas. If the issue not attended on time, it can lead to even torturing issues like GERD or gastroesophageal reflux and irritable bowel syndrome. Ayurveda shares a concept known as Ama, which can be termed Non-toxic metabolites and toxins created by faulty metabolism / indigestion. There are many ways to treat to indigestion in an ayurvedic way. Let us look at some tips for the same: Langhanam, swedanam, Hot water and  use of Dried Ginger i.e. Sunthi, cumin seeds, Ajwayan carom seeds some salts and  salty pickles is so common in Indian culture and being used since ancient times i.e. tradition.Aloe vera: An ounce of aloe vera a day will keep indigestion away. Break off, a leaf and scoop some gel into a smoothie for smooth digestion.Turmeric: Haldi or Turmeric helps in reducing bloating and is one of the most commonly used spices found in ayurveda. This spice is a staple in indian cooking as well, where pretty much all dishes are seasoned with cooked turmeric.Maintaining Biological clock and Traditional Healer fasting : For better digestion, one must take meals at the same time everyday. Also, do not sit down for the next meal before the previous meal has been digested properly, its seen over eating causes much more issues after certain age say 40+ so once in a week light food or skipping food or usually on full moon or on No moon there is fast that adds value.Choosing healthy food: one must avoid unhealthy food that are excessively fried, fatty, sweet or cold so as to aid the digestive fires in doing their job effectively.Triphala with Saindhav(Rock salt): This combination of three fruits (Avala,Behada and Hirada)with saidhav ensures that your digestive system remains in good working condition during monsoonWater: one must have clean filtered potable adequate of water a day(Excess water must be avoided), in order to flush the toxins out, keeping in mind Monsoon causes much more water born diseases so use of Crystal Allum, Nivali/ Nirmali/clearing nut Beej(seeds) to clean and to deodorize Ayurveda offers Mustha/chandan/ushir/Taruni/Jai/jui/chanpak and Bakul flowers.Rest and bed Room: sleep (1 of major pillar of health and fitness tripod like Diet and Celibacy) is a major factor that cures stress and creates a balance of sorts in one's routine, thus aiding proper digestion. Room must be clean as excess  humidity can cause Allergic skin and Respiratory issues in Kids and elderly population so fumigate space with sunthi / Gugulu / Tulasi / Jatamasi / Haldi / Ajawayan / peels of Garlis or Dehumidifier can be used.Exercise: Those who eager to stabilise at Health and Fitness and yeah Finances too must engage in  some form of movement and exercise (Actively) is imperative to keep the digestive system in prime working condition. Walk and yoga, especially are ideal to boost one's digestive health.Meditation: This is one of the best ways to give digestion a positive push with a good dose of mindfulness and awareness for better balance in the body.Massage: a good oil massage on a regular basis keeps the blood flow in order and ensures that all the organs function well.In ayurveda, the point is to heal and prevent, which is why the methods tend to get to the root of the problem.Basti Therapy and Rasayan Therapy: For details communicate with  Ayurveda college Hospital Or your Ayurveda dr in your city

Jivha Nirlekhan...Tongue Scrapingby Ayurveda

Dr. Shailesh Phalle, Ayurveda
Ayurveda tells us the tongue is the first organ of digestion and the mirror to all the organs of the body. The tongue is an important tool of Ayurvedic diagnosis. The appearance of the tongue reveals the health condition of the entire body. When you look on your tongue, it’s an opportunity for self-awareness. If you see a thick coating of different color, it means you are accumulating toxins from the last several days, months or years.  Tongue scraping is an ancient ritual of personal hygiene and self-care for the removal of toxins i.e. bacteria, viruses, food debris and fungi from the surface of the Tongue Scraping? Our tongue is important not only for the sense of taste. It also performs the function of filtering toxins from our food intake. The toxins in the food are filtered and they remain in our tongue and should be removed daily.While we sleep, our digestive system remains awake and is busy removing toxins from our body. By this process, toxins are excreted and deposited onto the surface of our tongue. If we fail to regularly scrape them away, they get reabsorbed into the body and lead to problems in the respiratory and digestive systems.When to do Tongue Scraping?This Ayurvedic ritual should be done on a regular basis in the morning upon rising, while the stomach is still empty.How to do Tongue Scraping?According to Ayurveda, tongue scrapers which are U shaped and made of gold, silver, copper, tin or brass are effective. The tongue scraper should not be sharp.With a relaxed tongue, using your U shaped tongue scraper, gently reach to the back of the tongue and scrape the tongue from back to front. Repeat this 5-10 times, rinsing the scraper after each pass.Other Health BenefitsTreatment of bad breath, halitosis, low appetite, anorexia or poor appetiteImproves dental and gum healthBeauty, peaceful and calm mindActivates saliva production and helps Agni (digestive fire)Boosts immunity and ojas (vigour or life energy).                                                                                                  

Hemorrhoids - the Bleeding Devil in Your Body

Dr. Deepak Rathi, Ayurveda
Hemorrhoids (Piles)  are one of the most common condition to affect humans, having been mentioned many centuries ago. The first descriptions of problems associated with hemorrhoids are found in the Bible, and the occupation of proctology apparently was established then as well.If you have hemorrhoids, you are not alone. They are a common problem. In fact, hemorrhoidal tissues are a natural part of the body. Most of the time you do not notice them as they help during bowel movements. But if these tissues become swollen or inflamed, they can cause uncomfortable symptoms.The good news is that hemorrhoids can be treated.What are Hemorrhoids (Piles)Hemorrhoids - commonly known as piles - are swollen blood vessels (veins) which develop inside and/or outside the anus. They are felt as lumps around and inside the anus . The lumps are formed by increased pressure on blood vessels in the area, causing them to enlarge and swell. If they become infected, they can cause bleeding, pain and discomfort and require medical attention.Causes of Hemorrhoids (Piles)The exact cause of piles is not known. One theory is that it is due to weakness of the tissues that connects the anal cushions to the muscle layers underneath. Due to this weakness, the anal cushions slide out of their normal place and down the back passage.You have an increased risk of getting piles if you: Have Constipation – this is the most common cause which leads to straining during defecation. Straining leads to pressure on blood vessels causing them to swell, elongate and slide down the anal opening. Eat a low-fibre diet- Lack of dietary fibre can cause hard stools, constipation and straining. Spend too much time in the toilet and holding the urge when you have to go. Have long-lasting (chronic) diarrhoea.Are pregnant - due to the effect of hormones on the blood vessels, plus the increasing weight of the baby within your abdomen. Are Overweight.Lift heavy weights. Have a family history of piles. Have cancer or growths in your pelvis or bowel, which may put pressure on your abdomen. Old age- Ageing reduces the efficiency of the circulation.Types of Hemorrhoids (Piles)There are two types of hemorrhoids: Internal hemorrhoids - these occur inside the anus - Usually painless External hemorrhoids - these appear outside the anus - may become painfulHemorrhoids are also classified by the Degree of prolapse (dropping outside the anus), their size and if they are infected : GRADE I - hemorrhoids bleeds but do not prolapse (do not come outside the anus while passing stools) GRADE II - hemorrhoids prolapse on straining and then reduce by itself (go back inside the anus by itself) GRADE III - hemorrhoids prolapse on straining and do not reduce by itself and may require manual reduction (have to push it back inside the anus by using your fingers) GRADE IV - prolapsed hemorrhoids are trapped outside the anus and may become strangulated, infected and painful.Symptoms of HemorrhoidsBright red blood spots in the toilet or on the toilet paper. Heavy bleeding during defecation (During Passing Stools) Itching and discomfort around the anus. Feeling of a lump or mass near the anus which may be painful or painless. Discharge around the anus and soiling of clothes. Pain while passing stools and after passing stools. Feeling of incomplete evacuation of your bowels.The most frequent complaint in true Hemorrhoid is Painless bleeding, which usually appears early in the course of the disease. See your doctor if you have blood in your stool. Hemorrhoids could be the problem, but bloody stool could also be a symptom of something far more serious, like colon cancer. ComplicationsIf Hemorrhoids are ignored and no treatment is given to cure them, they can lead to- Iron Deficiency Anaemia (from heavy bleeding) Weakness Prolapse of whole hemorrhoidal tissue outside the anus.How a diagnosis is madeIn most cases, diagnosis is easily made by a thorough history taking and on physical examination by your doctor. In advanced cases some tests may be required like Anoscopy (Proctoscopy) , Sigmoidoscopy and Colonoscopy.It is never a good idea to diagnose the condition yourself. Always consult an Expert.Treatment Options Multifold approach is essential for correct treatment of existing condition and to prevent the recurrence. This includes: Lifestyle Modifications Oral medication: as prescribed by your doctor. These can be used to temporarily treat small bleeding piles. Analgesics: For temporary relief, if pain is present. Laxatives: to keep the bowel clear. Oral medicines: to regularise digestive system and to enhance healing. Topical treatment (Creams and Ointments): as prescribed by your doctor (Avoid prolonged use) Herbal Medicines (Ayurvedic Medicines): Ayurvedic Medicines are very effective treating hemorrhoids. Very effective control in bleeding and pain can be achieved through medicines. Cold pack applied to anal area Hot sitz bath in tub for 20-30 minutes twice daily. Kshar Sutra Therapy: This is the best treatment available for hemorrhoids, anal fistula, anal fissure and pilonidal sinus. By this technique, Kshar Sutra is placed right at the root of hemorrhoidal tissue and the whole hemorrhoid is ligated with Kshar Sutra. Blood supply to the existing hemorrhoid is cut off and hemorrhoid will shed off after some days. Kshar Sutra that is placed at the root of hemorrhoid will help to prevent the recurrence of the disease. Surgery : Many kind of surgical techniques are present Sclerotherapy (Injection Therapy): Sclerotherapy is a popular form of hemorrhoid treatment whereby a chemical agent is injected into the hemorrhoid to cause it to shrink and go away. Rubber Band Ligation- A rubber band is placed on the haemorrhoid so as to cut off the blood supply and shedding off the hemorrhoid Infra Red Coagulation- Infra red rays are used to kill hemorrhoids Cryosurgery – Very low temperature is used to shrink the hemorrhoids Surgical Excision – Hemorrhoids are cut off using a knife. Stapler surgery – Used in rectal prolapse And Many more.....Keep in mind that your treatment differ depending on your symptoms and the location of your hemorrhoid.