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Liver Cancer: Causes, Symptoms, Diagnosis, Treatment & 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 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. In patients of chronic liver disease who develop liver cancer, transplant is preferred if fulfills the criteria for transplant and donor is available

  • 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 Best Oncosurgeon in Delhi 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 in Delhi 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 team work of Medical Oncologist and Oncosurgeon

Consult Dr Amit Jain Best Oncologist in Delhi for GI malignancy, Senior GI Surgeon at Max Hospital Patparganj Delhi & Vaishali Ghaziabad. For any query related to Esophagus, Stomach, Gallbladder, Liver, Pancreas and ColoRectal Malignancy call us at 7351088686

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

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

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

Gallstones or Cholelithiasis

Gallstones
Gallstones

Gallstones or cholelithiasis is most common diagnosis for acute right upper abdomen pain. It is the most common cause of Laparoscopic abdominal surgery

  • Gallbladder stone reason/ What Causes Gallstones

There are many theories about the formation of gallstone. But there is no preventive method. 80% of stones contain cholesterol while rest 20% have calcium and bilirubin salts. It is said that too much cholesterol secreted by liver which bile cannot dissolve causes formation of cholesterol stones. Pigment or bilirubin salt containing stones are formed if too much bilirubin is secreted. However there is no special gallbladder stone diet which can prevent there formation

  • Gallstones symptoms

Gallbladder pain or biliary colic is mild to moderate in intensity, localized to right upper abdomen and occur dut to stone at neck causing obstruction.Jaundice can occur if edema at GB neck causes external biliary obstruction.Fever develop if it becomes a pyocele

  • Complications

Distended gallbladder due to impacted stone at neck causes pain, also called as mucocele gallbladder.Gallbladder infection in mucocele is called as pyocele gallbladder.Repeated inflammation causes contracted gallbladder. When the stone moves through the cystic duct into CBD can cause jaundice, cholangitis, pancreatitis. Gallstone are risk factor for gallbladder cancer. however the incidence rate of cancer is very less

  • Gallstones Surgery

The standard treatment for gallstone is complete removal of gallbladder called as cholecystectomy. It is a day care surgery. Patient can be discharged from the hospital on same day of surgery, and from next day patient can do all day to day activities

  • Gallbladder removal side effects

There is no effect on digestion after gallbladder removal.It may be difficult to digest excess fat for initial 2-3 months. After this period patient can have normal diet
Dr Amit Jain is Best Laparoscopic Surgeon in Noida Delhi for Gallstone surgery. Call us at 7351088686 for your queries