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Colorectal Polyp: Risk factors, Symptoms & Treatment

  • What are Colorectal Polyp

Colorectal polyp or colonic polyp are growth or mass that appear on the inner surface of the colon. Most of them are benign or harmless. Usually these does not cause any symptom. Colorectal polypTwo main types of polyps, One is non-neoplastic which is most common in which chances of conversion to cancer is negligible and other is neoplastic polyp which have a chance to convert to cancer
Non-neoplastic polyps are of three types: Hyperplastic polyps most common, inflammatory polyps and hamartomatous polyps
Neoplastic are of two types: Adenomas and serrated polyps.

Symptoms
Most colorectal polyp do not cause any symptom, but some people with large polyps may have such as change in bowel habits, Rectal bleeding, Pain, Iron deficiency anemia due to blood loss, mucus discharge

Risk Factors
Age: It is the most commmon risk factor. Chances of developing colonic polyp are more in older age
Inflammatory bowel disease such as ulcerative colitis and crohns disease
Family history and Genetic disorders such as Familial adenomatous polyposis (FAP), Peutz-Jeghers syndrome
Other rare cause: tobacco and alcohol use, obesity, type 2 diabetes

Diagnosis

Colonoscopy is the most common test for detection of colorectal polyp. It is an OPD base procedure in which gastroenterologist examine mucosa or the inner lining of the colon and rectum using a long, thin flexible tube with a camera and a light on the end. If polyp size is large they take a biopsy, otherwise small polyps can be removed at the same time
CT colonography also called as virtual colonoscopy can also be used to examine the colon indirectly but no biopsy or polypectomy can be done

Treatment
Polypectomy is advised for colorectal polyps as no test can predict which polyp will turn into cancer. most polyps can be removed during colonoscopy, rarely patients may require surgery for removal of large polyps

Prognosis
After polypectomy prognosis depends on the histopathology report. Polpectomy is sufficient for non-neoplastic and non-invasive cancer. Bowel resection may be required in invasive cancer. Follow up colonoscopy is required as patient may again develop polyps. Daily Aspirin or NSAIDs may reduce the risk of new polyps forming

Consult Dr Amit Jain Best Gastroenterologist in Noida for Colon Cancer

Esophageal Cancer: Risk Factors, Symptoms, Diagnosis & Treatment

Esophageal Cancer Risk Factors

Smoking, alcohol intake, obesity and GERD are common esophageal cancer risk factor. Smoking and alcohol cause squamous cell carcinoma. Obesity and acid reflux are risk factors for adenocarcinoma. Healthy life style can prevent esophagus carcinoma

  • Esophageal Cancer Symptoms

Esophageal CancerThe most common symptom is dysphagia. Initially it is for solid food and gradually to liquid also. Patient can have chest pain/regurgitation. Anorexia and weight loss are common. Advance carcinoma patients can have bony pain, abdomen distension due to ascites, respiratory distress due to pulmonary effusion

  • Esophageal Cancer Diagnosis

Upper GI Endoscopy is done by gastroenterologist and is the investigation of choice. It will show growth or stricture in the esophagus. Biopsy will confirm the diagnosis. Most common type of esophagus carcinoma is adenocarcinoma located in the lower third of esophagus. Squamous cell carcinoma is other type and mainly found in the upper and middle third of esophagus

  • Investigations

CECT Chest and upper abdomen is done.CECT will show the growth in the esophagus, its relation with surrounding structures, any associated lymph nodes, and metastases. It helps in planning of Esophagus Carcinoma  Treatment

  • Treatment

The recommended first line Esophagus Cancer Treatment is surgery if cancer is resectable. For locally advance tumor pre-operative chemotherapy is given.If patient respond to chemotherapy and tumor become resectable surgery is done. For metastatic disease endoscopic esophageal stent is placed for relief of dysphagia. If endoscopic stenting is not possible feeding jejunostomy is done surgically for nutrition

Consult Dr Amit Jain MS MCh (GI Surgery) Senior Consultant Max Hospital Patparganj Delhi and Vaishali Ghaziabad for Esophagus Surgery. Dr Amit is Best Oncosurgeon in Delhi Noida Ghaziabad India. He is Fellow in Advance Laparoscopy Upper GI Surgery.To know recent advance in management of esophagus cancer visit our facebook page Dr Amit Jain Laparoscopic Gastrointestinal and Bariatric Surgeon

Liver Cancer: Causes, Symptoms, Diagnosis & Prognosis

  • Liver Cancer Causes

In 80% of patients liver cancer develop under the background of chronic liver disease. Most common cause are alcohol intake, Hepatitis B & C infection. Fatty liver due to obesity, diabetes and Liver Cancerhyperlipidemia is emerging as the main cause of liver failure in future. There are certain inherited liver diseases such as hemochromatosis and wilsons disease which increase the risk. Exposure to aflatoxins, poisons produced by molds can also cause liver cancer

  • Liver Cancer Symptom

Most common symptoms are pain right upper abdomen along with anorexia & weight loss. Pain is constant, mild to moderate in intensity, Patients with chronic liver disease when develop liver tumor may have wosen there symptoms such as ascites, jaundice

  • Liver Cancer Diagnosis

USG abdomen is the first investigation done for any abdomen complaint. It will show a space occupying lesion in the liver, echotexture of liver, biliary tract dilatation, any associated abdominal lymphadenpathy, ascites. However triple phase CT abdomen is more specific for liver lesions. alfa-feto protein is tumor marker specific for liver tumor. FNAC is advised for liver lesions in which imaging study is inconclusive

  • Liver Cancer prognosis

It depends on many factors such as tumor size, no of primary lesions, loco-regional or distant spread, Underlying liver disease and general health status of the patient

  • Liver Cancer Survival Rate

Most important factor that decide survival rate is staging. Generally distant metastases cancer has worst prognosis with life span of 6 months with best available treatment, Locally advanced tumor patients survive up to 2 year with best treatment. For localized tumor in cirrhotic patients Liver transplant when done under strict criteria has got very good prognosis with 5 year survival rate of 75%

Consult Dr Amit Jain Oncologist at Max Hospital Patparganj Delhi & Vaishali Ghaziabad for Liver tumor treatment. call us at 7351088686 for your queries

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 for your queries on GI problems

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

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

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

Cancer: Causes, Symptoms, Stages, Treatment & Prevention

  • What is Cancer

A collection of related diseases is termed as cancer in which body cells start to divide without stopping and slowly spreads into whole body. It can develop almost anywhere in our body

  • Types of Cancer

Cancer

Carcinomas: Most common type and begins from the tissue that covers the surface of internal organs and glands. Examples include colorectal & pancreatic malignancy
Sarcomas: These begins from the tissues that support and connect the body. It can develop in nerves, muscles, fat
Leukemias: Blood cancer is leukemia in which healthy blood cells grow uncontrollably
Lymphomas: It starts from the lymphatic system

  • What Causes Cancer

Cells are building blocks of our body. Cells grow and divide to make new cells when old cells die or damaged. This process of division is controlled genetically and take place in a orderly process. In Cancer, control on cell division is lost and cells start to grow uncontrollably.

  • Symptoms

There are few symptoms which are common in all types such as anorexia and weight loss. Other symptoms are specific to which organ is involved such as dysphagia in esophageal malignancy

  • Prevention

Prevention is always better than cure.Vaccines are available for prevention of few cancers such as Hepatitis B Vaccine for prevention of liver tumor. Risk can be reduced if factors such as alcohol, smoking, tobacco chewing are eliminated

  • Stages 

It is a process to determine the extent of tumor spread. Stages 1 to 4 are usually given as the Roman numerals I, II, III and IV. The higher the number, more it has spread

  • Treatment

Treatment options are chemo-radiotherapy and surgery

  • Cancer Specialist

It is the team work of Medical Oncologist and Oncosurgeon

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 ligh 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/Stomach/Duodenum 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

Liver Cancer Treatment

Liver Cancer Treatment
Liver Cancer Treatment

Liver Cancer Treatment depends whether liver cancer develops under the background of normal or diseased liver. Chronic liver disease is risk factor for liver cancer. The main cause of chronic liver disease is alcohol intake, Hepatitis B & C infection, Fatty liver disease. These patients have a very high recurrence rate after liver resection and liver transplant is preferred in these patients if donor is available. Various local ablative procedures are available if patient is not fit for surgery or as palliative treatment for advance cancer

  • Liver Resection as Liver Cancer Treatment

Liver resection is first line of treatment if cancer occur in normal liver and after resection adequate amount of liver volume can be saved for normal liver function. It is said that about 30% of normal liver volume should be left after resection for adequate liver function

  • Liver Transplant as Liver Cancer Treatment

In patients of chronic liver disease who develop liver cancer, transplant is preferred if fulfills the criteria for transplant and donor is available. If there is long waiting list for donor meanwhile liver resection or local ablative procedure can be done
Milan criteria for liver transplant in liver cancer patients is associated with 70% 5 year survival rate. These criteria include a single tumor wth size 5 cm or less, maximum three tumors with size 3 cm or less and without evidence of vascular invasion. If tranplant is done beyond these criteria long term survival rate may not be good

  • Local Ablative Procedures as Liver Cancer Treatment

Ablation means tissue destruction without removing them. This technique is used in liver cancer when there are few small tumors and surgery is not a good option because of poor liver function/ poor health status of patient/ long waiting list for liver transplant. Various ablative procedures available are Radiofrequency ablation (RFA), Microwave ablation (MWA), Cryoablation (Cryotherapy), Ethanol (Alcohol) ablation

Consult Dr Amit Jain Best Oncosurgeon in Delhi Noida Ghaziabad NCR India for Liver Cancer. Call us at 7351088686 for your queries