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Colonoscopy: Indication, Preparation, Complications & Cost

  • What is Colonoscopy

A colonoscopy is lower gastrointestinal tract endoscopy in which inside that is mucosa of the large intestine (Colon & Rectum) is examined. It is used to evaluate GI symptoms such as rectal bleeding, chronic diarrhoea and altered bowel habits. During the procedure a flexible tube called as colonoscope which has a tiny video camera at the tip is inserted into the rectum and the doctor view the inside of the entire colon

  • Indications for Colonoscopy

colonoscopy

Colon Cancer Screening: For average risk patients for colon cancer, colonoscopy is done starting from age of 50 year and after 10 year thereafter for early detection of colon cancer
For Evaluation of intestinal symptoms and signs such as rectal bleeding, chronic diarrhoea, chronic constipation

  • Preparation for Colonoscopy

It is important to clean out or empty the colon as any residue may obscure the view of rectum and colon. Patient is asked to have clear liquid diet one day prior to procedure. Laxative in the form of solution in the evening a day before procedure to empty the large bowel

  • Complications

Perforation: Most serious complication which may be life threatening and in 80% of cases require immediate surgery for perforation repair.
Bleeding: Generally occur during therapeutic procedures such as polypectomy. It may be treated during the procedure itself by cauterization. Patient may require surgery if not controlled endoscopically

  • Day After Colonoscopy

Patient may feel bloating and abdomen fullness during first few hours after the procedure. Better not to drive himself after the procedure.It is expected a full recovery by the next day, if not so doctor should be consulted

  • Cost

Cost varies from one institute to other and also vary whether diagnostic or therapeutic procedure is done. It vary from RS 5000 to Rs 15,000

Consult Dr Amit jain best Gastroenterologist in Delhi for your queries on GI problems

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GERD (Gastroesophageal Reflux Disease)

  • What is GERD (Gastroesophageal reflux disease)

GERD

(GERD) Gastroesophageal reflux disease as the name indicates is the reflux of stomach contents back into the esophagus. Generally what happens, when we ingest food it passes through the esophagus, there is a valve at the lower end of esophagus which relax or opens and food enter into the stomach and after that valve gets closed. When this valve is not competent enough stomach contents reflux back

  • GERD Causes

  • Improper function of lower esophageal sphincter muscle as described above is the reason for gastroesophageal reflux
  • Symptoms of GERD

  • Heartburn (Burning sensation in chest, usually after eating, worsened at night)
    Regurgitation of food contents
    Difficulty swallowing
    Chronic cough/ New or worsening asthma
  • Risk Factors

  • Obesity
    Hiatus Hernia
    Delayed stomach emptying
    Pregnancy
    Smoking
    Alcohol/ Coffee
    Eating large meal
  • Complications
  • Esophagus ulcer is the first finding on endoscopy in simple reflux disease. Long standing reflux can cause Barretts esophagus which is a premaligant condition which predispose to esophagus cancer. Continuous reflux can cause benign esophageal stricture
  • Diagnosis
    Esophageal pH monitoring is the gold standard test to confirm the prsence of reflux
    Upper GI Endoscopy
    Esophageal Manometry
  • Treatment
    First step in acid reflux treatment is life-style modification
    Medical treatment include proton pump inhibitors which decrease the amount of acid produced by the stomach. these includes pantocid, rabeprazole. Another group of medicines which are beneficial include H2 blockers, Antacids, Prokinetics
    Surgical management: Surgery is indicated if above methods fail, and lower esophageal sphincter muscle is weak, associated hiatus hernia. In these cases Niissen fundoplication is done
  • GERD Diet
  • There is no special diet for GERD. Small frequent meal. Certain foods which trigger GERD symptoms should be avoided. These foods include coffee, alcohol, spicy foods, chocolate, peppermint
  • Prevention
  • Stop alcohol & Smoking
    Take small amount of meal at one time
    Donot lie immediately after eating
    Loose weight
    Stop eating 2 to 3 hours before sleeping
  • Consult Dr Amit Jain Best Gastroenterologist in Noida for reflux disease
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Liver Disease: Causes, Risk Factors, Symptoms, Prevention & Treatment

  • Liver Disease Causes

Infection: Various infections can cause liver disease, the most common types of liver infection are hepatitis viruses such as Hepatitis A, B, C & E

Liver Disease

Chronic Alcohol Abuse: Most common cause of liver cancer and indication for liver transplant
Fatty Liver: Common causes of fatty liver are obesity, hypertriglyceridemia, diabetes
Immune system abnormality: Examples include Autoimmune hepatitis, Primary sclerosing cholangitis, Primary biliary cirrhosis
Other Causes: Drugs and Toxins, Genetics

  • Risk Factors: Following factors may increase your risk for Liver problem

  • Alcohol Abuse
    Diabetes
    Obesity
    Exposure to certain toxins or chemicals
    Unprotected sex
    Injecting drugs using shared needles
    Blood transfusion
  • Liver Disease Symptoms

  • Yellowish discoloration of skin and eyes (Jaundice)
    Nausea & Vomitting
    Chronic Fatigue
    Pruritus / Itching
    Abdomen pain and distension (Ascites)
    Swelling or edema in the ankle and leg
    Dark colored urine
    Pale stools
    Loss of appetite
    Blood in the vomitus (Hematemesis)
    Fresh blood in the stool (Hematochezia) or Black tarry stools (melena)
  • Liver Disease Treatment

Treatment varies from life-style modifications to drugs to surgery depending on the specific cause. Changes in life-style include stopping alcohol use, regular exercise, diabetes and weight control for fatty liver, Chronic liver damage is managed conservatively with drugs initially and Liver transplant for end stage liver problem

  • Liver Disease Prevention

Healthy life style with regular exercise and weight management is must for healthy liver. Diabetes control. It is predicted that Fatty liver will be the leading cause of liver failure  and liver cancer in future. Avoid alcohol intake and smoking. Hepatitis B vaccine is available. Unprotected sex, infected blood transfusion, sharing infected needles are risk for hepatitis infection and should be avoided

Dr Amit Jain MS MCh (GI Surgery) is Best GI Surgeon in Delhi for Liver Disease. Call us at 7351088686 for your queries. Visit our facebook page Dr Amit Jain Laparoscopic Gastrointestinal Cancer & Bariatric Surgeon to know more about Liver problems

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HeartBurn: Causes, Symptoms, Complications & Treatment

  • What is HeartBurn

Heartburn is a burning type chest pain usually lower chest caused by gastric reflux. It causes bitter or acidic taste in the mouth, depending on gastric reflux contents. It usually occurs after eating and wosens when lying down or bending over

Heartburn
Heartburn

Heartburns which are occasional are common and no cause for alarm. However frequent or interfering with routine activity require medical attention

  • Cause

It occur when lower esophageal sphincter is not tight enough to prevent reflux of gastric contents. Associated sliding hiatus hernia aggravates the problem

  • Risk Factors

Ceratin foods and drinks can aggravate heart burn. Obesity and pregnancy can also increase risk. Drinks and food which increase risk include: Alcohol, Coffee, Fried or fatty foods, chocolate, onions, spicy foods

  • Complications

Acid Reflux can cause esophagus sricture and esophageal cancer. It can be the cause of prolonged cough

  • Medical Management
  • First is life style modifications

Avoid smoking and alcohol
Reduce weight and regular exercise
Avoid lying down immediately after food intake
Small frequent meal

  • Medicines available for treatment of heartburn are proton pump inhibitors which include pantocid/rabeprazole. Should be taken on empty stomach

Heart Burn Surgery

Nissen fundoplication is the surgery for heartburn

Consult Dr Amit jain best Gastroenterologist in Noida Delhi NCR for acidity treatment

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Upper GI Endoscopy

Upper GI Endoscopy is a procedure which may be diagnostic or therapeutic done by gastroenterologist to see lining of upper GI tract. It is done with an endoscope- a flexible tube with a camera, under light sedation to relax the patient

Upper GI Endoscopy
Upper GI Endoscopy
  • Symptoms for which Upper GI endoscopy is done

  • Nausea & Vomitting
    Swallowing problem or dysphagia
    Heart burn/ acid reflux
    Hematemesis/ melena
    Unexplained weight loss

Hematemesis is blood in vomitus. Melena is passage of black tarry stool, generally indicate slow bleed in GI tract, most commonly Upper GI from stomach and duodenum

  • Diagnosis

  • Esophagus Cancer/ Stomach Cancer
    Corrosive Injury
    Esophagus/Stomach Ulcer
    Esophageal and Gastric varices
    Biopsy taken during procedure make the diagnosis of cancer

  • Therapeutic procedures

  • Dilatation of the esophagus and antral stricture
    Banding and glue injection for varices
    Foreign body removal
  • Preparation 

  • Fasting for 4 hrs
    Blood thinner drugs should be stopped
  • Complications
  • Bleeding
  • Perforation

It is not a painful procedure as nowadays it is done under mild sedation. Cost of procedure varies from one institute to other and also the indication for procedure. Simple diagnostic procedure cost varies from 1500 INR to 4000 INR 

Dr Amit Jain is best Gastroenterologist in Noida Delhi. Call us at 7351088686 for your queries. Visit our facebook page Dr Amit Jain Laparoscopic Gastrointestinal Cancer & Bariatric Surgeon to have regular updates on Gastrointestinal diseases

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Constipation: Causes, Investigations & Treatment

  • What is Constipation

Most common complaint seen in day to day clinical practice is Constipation. Most frequently patient complain of difficult, infrequent or incomplete defecation. It is difficult to define it as there is wide range of normal bowel habit. More than 90% of population have at least three bowel movements per week.But frequency is not the only criteria as most patients who complain it have a normal frequency of defecation. Most commonly these patients complain of hard stools, excessive staining, a sense of incomplete evacuation and lower abdomen fullness

Constipation
Constipation

  • Causes

Usually due to less fluid intake, low fibre diet and decreased colonic transit time.
Recent onset may be due to colonic obstruction. Reason for same may be colorectal cancer, ischemic stricture, diverticular disease. Painful anal spasm which may be due to anal fissure or painful hemorrhoids
Most common cause of chronic constipation is irritable bowel syndrome with constipation predominant. Medical causes include hypothyroidism, hypercalcemia. There are some medications which on long term can cause constipation. Slow colonic transit time is common

  • Investigation

Colonoscopy is advised to rule out mechanical cause such as colonic stricture or malignancy especially in old age patients and with recent history associated with anorexia and weight

  • Constipation Treatments

Lifestyle: Regular time for defecation is important. Always respond to defecatory urge. Physical activity should be encouraged for those who have inactive lifestyle.The drugs which cause it should be avoided
Psychological Support: It can be result of emotional disturbance and can be aggravated by stress. Counselling is required for these patients
Fluid Intake: Less fluid intake causes salt and water absorption by the large intestine,it causes passage of small, hard stools. Thats why patient is encouraged to take plenty of fluids
Laxatives: Two types, Bulk laxatives and osmotic laxatives

Dr Amit jain is best Gastroenterologist in Delhi Noida Ghaziabad

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Gallbladder Polyps: Are These Indications for Gallbladder Removal

What are Gallbladder polyps

Gallbladder polyps are gallbladder wall elevations that project into the lumen. Commonly detected on ultrasound done for other symptoms. Incidence vary from 0.3 to 9%
As the incidence of polyp is more and chances of malignancy is rare, selective surgery is done for these patients and should be counselled accordingly

Symptoms of Gallbladder polyps

As the gallbladder polyp are attached to gallbladder wall and are non-mobile these do not cause any symptoms. Large polyps because of there size and twisting effect or when change into cancer may cause pain

Gallbladder Polyps
Gallbladder polyps

Diagnosis of Gallbladder polyps

Ultrasound abdomen is the most common investigation for diagnosis.It will detect the number and size of polyp. CECT abdomen is done when USG show suspicious of gallbladder cancer

Indication of Surgery

The only indication for surgery in gallbladder polyps is risk of cancer. It is said that risk of cancer is high in polyp size more than 10mm, single polyp and sessile polyp
For Polyp less than 6mm follow up ultrasound is done at 1, 3 and 5 year. For polyp 6-9 mm ultrasound is done at 6 months, 1,2,3,4 and 5 year; If during follow up increases by 2mm or more cholecystectomy is advised
For polyps 6-9mm if there are risk factors for gallbladder malignancy like age > 50 years, sessile polyp, indian ethinicity, PSC then also cholecystectomy is advised

Surgery for gallbladder polyp

Laparoscopic cholecystectomy is the standard surgical procedure for gallbladder polyp. Advantage of laparoscopy surgery being early recovery and discharge from the hospital. If investigations suggest cancer doubt in polyp then it should be treated like gallbladder cancer. Intra-op frozen section should be sent from suspicious area and should proceed accordingly

Consult Dr Amit Jain MS MCh (GI Surgery) for Gallbladder ployp management. Call us at 7351088686 for your queries.

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Laparoscopic Surgery: Indications In Gallbladder Disease

  • Laparoscopic Surgery for Gallstone

Laparoscopic Surgery
Laparoscopic Surgery for Gallstone

Gallstones is the most common surgical gallbladder disease. It is the most common indication for laparoscopic surgery for abdomen disease.USG abdomen is the best investigation for diagnosis of gallbladder stones. Most commonly patient present with biliary colic.The standard treatment for gallstones is laparoscopic cholecystectomy.Gallstones can cause various complications like jaundice, cholangitis, pancreatitis. There is no role for medicine in the management.Laparoscopic cholecystectomy is a day care surgery in which patient is operated early in the morning and can be discharged on same day by evening. From next day onwards patient can do all his day to day normal activities. There is no special diet after gallbladder  removal.Patient has to avoid excess fat in the diet for next 2-3 months post-surgery

  • Laparoscopic Surgery for Gallbladder Cancer

It is the surgical gallbladder disease which if detected early and treated carries a good prognosis. Most common symptom of gallbladder cancer is pain right upper abdomen along with anorexia and weight loss. Patient can have jaundice if gallbladder mass most likely at neck compress the biliary symptom.If there is doubt of gallbladder cancer on ultrasound CECT abdomen should be done. There is no role of FNAC if the gallbladder cancer is resectable. The standard surgery for gallbladder cancer is radical cholecystectomy in which gallbladder is removed along with liver wedge and standard lymphadenectomy is done. Earlier cancer surgery was not done laparoscopically in fear of port site metastases. Now we have sufficient data in literature which supports that even cancer surgery can be done laparoscopically with early benefits of minimally invasive approach and long term same survival rate compared to open surgery. Gallbladder cancer surgery is also being done laparoscopy in early stage cancers

Dr Amit Jain MS MCh (GI Surgery) is best gastrosurgeon in Ghaziabad India.Call us at 7351088686 for your queries.

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Symptoms of Gastrointestinal Cancer

  • Vomitting

It occur when there is obstruction in the gastrointestinal tract. Obstruction distal to the bile duct opening causes billious vomitting. Obstruction proximal to it causes non-billious vomitting.Primary stomach cancer or small bowel cancer casues vomitting due to intrinsic mass which compromise the lumen. Gallbladder mass can cause external compression over the duodenum and antro-pyloric region resulting in gastric outlet obstruction

Gastrointestinal
GI Cancer Symptoms

  • Dysphagia

Early and Common symptom of esophagus cancer. In patients with esophagus cancer patients have initial dysphagia to solid foods and gradually progress to liquid. This progressive dysphagia is indicative of any progressive mass lesion in the esophagus which is compomising the esophagus lumen and causing dysphagia

  • Jaundice

It occur when there is obstruction in the Common bile duct. Most common symptom of hepato-biliary gastrointestinal cancer symptom.This obstruction can be intrinsic due to bile duct cancer. It may be extrinsic due to external compression such as Gallbladder mass or pancreatic head mass causing external compression over the CBD. patient present with features of obstructive jaundice such as pale colored stool, dark urine and pruritus.

  • Melena

It is passage of black tarrish colored stool. Melena indicate slow bleed in the GI tract. This bleed can originate at any site along the GI tract. Cancer stomach and peri-ampullary cancer and right sided colon cancer have a tendency to bleed. Sometimes patient have occult bleed and present with feature of anemia such as weakness/tiredness

  • Hematochezia

It is the passage of fresh blood per rectum. symptom of lower gastrointestinal tract cancer that is colo-rectal cancer

  • Anorexia and Weight Loss

These are common symptoms of any malignancy in our body

Consult Dr Amit Jain Best Gastrointestinal Doctor for stomach, Liver, Pancreas, Gallbladder, Colo-Rectal Diseases. Call us at 7351088686 for your queries. Visit our facebook page Dr Amit Jain Laparoscopic Gastrointestinal Cancer & Bariatric Surgeon to know more stomach problems

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Gastroenterologist: Role in Gastro Intestinal Cancer Sypmtoms Management

  • Best Palliative Care by Gastroenterologist for Advance GI Cancer

Surgery is the treatment of choice in gastrointestinal cancers if the tumor is resectable and patient is fit for surgery. Gastroenterologist play important role if the tumor is advanced and metastatic. These patients require treatment for there symptoms. Best way of palliation of symptoms is minimally invasive approach

Gastroenterologist
Role of Gastroenterologist in GI Cancer

  • Palliation of Upper GI Cancers Symptoms by Gastroenterologist

Dysphagia is the most common symptom of esophageal cancer and the best way of palliation is endoscopic placement of esophagus stent across the site of obstruction.In similar way in patients of stomach cancer and duodenal cancer who have gastric outlet obstruction and have vomitting, stent can be placed across the obstruction site and vomitting can be relieved
Patients of esophagus and stomach cancer can present with hematemesis or melena. It indicate tumor site bleed. Many a times these bleeds can be controlled endoscopically

  • Palliation of Lower GI Cancer Symptoms by Gastroenterologist

Growth in the colon or rectum can cause bowel obstruction.Many a times these patients present in emergency with features of large bowel obstruction such as abdomen distension, vomitting, not passage of flatus and motion. When investigated further are found to have advanced colo-rectal cancer. In these patients endoscopically stent can be placed and obstruction can be relieved. A major surgery can be avoided in these patients

  • Palliation of Hepato-biliary Cancer symptoms by Gastroenterologist

Most common hepato-biliary cancer symptom which require palliation is jaundice. Jaundice is either due to primary cancer such as cholangiocarcinoma or it may be caused by external compression by nearby organ malignancy. Gallbladder neck mass, periampullary cancer, pancreatic cancer are common GI malignancy which can cause jaundice.Endoscopic internal biliary stenting is best palliation for these patients

Best Gastroenterologist in Noida Delhi Ghaziabad NCR India Dr Amit Jain

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