Frequently Asked Questions
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Gastrointestinal (GI) cancer is a term used for cancer of the organs of the digestive system. The commonly occurring cancers of GI tract include esophageal, stomach, gall bladder, pancreas, colon and liver cancer.
Most of the cancers of GI tract have immense malignant potential except a few which include neuroendocrine tumors. Early detection of cancer before it has invaded locally or spread to distant organs can offer a chance of complete cure.
It is imperative not to neglect red flag signs in GI cancer which include loss of weight, blood in vomit or stools, black colour stools or vomit, difficulty in swallowing food and a falling hemoglobin.
With the advance of diagnostic and therapeutic GI endoscopy an early cancer of the luminal gastrointestinal tract can be removed through advanced techniques viz. endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD).
Individuals with family history of GI cancer should ideally undergo screening at least 10 years earlier from the age at which the family member got affected with cancer. Get the gastrointestinal cancer treatment in mumbai from Dr. Mehul Choksi.
What is IBS?
Irritable bowel syndrome (IBS) is a common disorder of the intestines with symptoms that include colicky pain, gassiness, bloating of abdomen and changes in bowel habits. An individual with IBS may have constipation (difficult or infrequent bowel movements) or diarrhea (frequent loose stools, often with an urgent need to move the bowels), and some experience both. IBS does not cause permanent harm to the intestines and does not lead to cancer. For many people, eating a proper diet and living a healthy lifestyle may lessen IBS symptoms.
Many people report that their symptoms occur following a meal. Eating causes contractions of the colon. Normally, this response may cause an urge to have a bowel movement within 30 to 60 minutes after a meal. In people with IBS, the urge may come sooner and may be associated with pain, cramps and diarrhea. Certain foods may trigger spasms in some people. Sometimes the spasm delays the passage of stool, leading to constipation. Certain food substances, like complex carbohydrates and caffeine, fatty foods, or alcoholic drinks, can cause loose stools in many people, but are more likely to affect those with IBS.
How is IBS diagnosed?
IBS is a diagnosis of exclusion. The doctor excludes organic and pathological diseases before labelling the symptoms due to IBS. This is done by taking a good history and clinical examination followed by blood tests, stool tests and diagnostic endoscopy.
Treatment of IBS
Diet: Eating a proper diet and avoidance of eating a large amount of food items at once helps avoid IBS symptoms. Changes in the diet can be made by avoiding the food item which leading to symptoms for example dairy products. Eating small portions more frequently helps.
Recent attention has been drawn to the FODMAP (FODMAP= fermentable oligo-, di- and mono-saccharides and polyols) concept; this relates to avoiding the ingestion of fermentable sugars, such as fructose or lactose, sorbitol, and fructans. These food items, if poorly absorbed, are broken down by bacteria to produce symptoms of gaseousness, bloating, abdominal discomfort and diarrhea, which are seen in IBS.
Pharmacological treatment: Constipation is treated by prescribing stool softners, polyethene glycol and fibers which increase intestinal fluid and help in easy passage of stool. Probiotics and antibiotics are used to treat bacterial overgrowth which can trigger IBS symptoms. Antidepressant drugs are used when abdominal pain is more severe, because they can help reduce visceral sensitivity and brain-gut dysfunction that contribute to the symptoms.
Psychological treatment: There are several psychological treatments that can help reduce the symptoms of IBS. These include cognitive-behavioral treatment, hypnosis, stress management, meditation and relaxation methods. These treatments seem to reduce abdominal discomfort and the psychological distress associated with IBS symptoms, improve coping skills, and help patients adapt to their symptoms. Get the Irritable bowel syndrome treatment in mumbai from Dr. Mehul Choksi.
Abdominal pain is pain that occurs between the chest and pelvic regions. Abdominal pain can be crampy, achy, dull, intermittent or sharp. It’s also called a stomachache.
What causes abdominal pain?
Abdominal pain is caused by irritation of the nerve endings in the gastrointestinal tract due an underlying inflammatory cause or the pain can be functional (without inflammation). The various causes of abdominal pain include:
Abdominal or chest wall pain:
- Shingles (herpes zoster infection)
- Costochondritis (inflammation of the rib cartilages)
- Injury (blunt trauma, muscle pulls)
- Nerve irritation (neuropathy)
- Hernias (protrusions of structures through the abdominal wall)
Inflammatory conditions of the abdomen:
- Ulcer disease (duodenal ulcer, gastric ulcer)
- Esophagitis (gastroesophageal reflux disease)
- Gastritis (irritation of the lining of the stomach)
- Pancreatitis (inflammation of the pancreas)
- Cholelithiasis (gall bladder stones)
- Cholecystitis (inflammation of the gall bladder)
- Choledocholithiasis (bile duct stones)
- Hepatitis (infection or inflammation of the liver)
- Colitis (infection or inflammation of the colon)
- Enteritis (infections of the small bowel, Crohn's disease) Diverticulitis (inflammation of pouches that form in the colon) Appendicitis
- Mesenteric vascular insufficiency (blocked arteries or veins)
- Renal or ureteric calculi (stones in the kidney or ureter)
Functional problems of the abdomen:
- Non-ulcer dyspepsia (discomfort after eating not due to ulcers)
- Functional abdominal pain (pain without clear cause)
- Irritable bowel syndrome (pain associated with bowel movements)
Get the abdominal pain treatment in mumbai from Dr. Mehul Choksi.
Non-alcoholic fatty liver disease (NAFLD) is a very common disorder and refers to a group of conditions where there is an accumulation of excess fat in the liver of people who drink little or no alcohol. The liver cells swell up due to deposition of fat and liver is enlarged is size and is bright on echotexture on an ultrasonography examination. Individuals with this condition are labeled as having a fatty liver. In a small percentage of people fat leads to oxidative damage to the liver called as non-alcoholic steatohepatitis (NASH). Long standing NASH leads to increased liver stiffness called fibrosis which when advanced causes permanent end stage liver disease called cirrhosis.
The majority of individuals with NAFLD have no symptoms and a normal examination. Fatty liver is most of the times incidentally detected when getting an ultrasound examination for some other cause or if the liver function tests (SGOT/SGPT) on a routine annual examination are abnormal.
Causes of NAFLD/NASH
NAFLD is part of the metabolic syndrome characterized by diabetes, or pre-diabetes (insulin resistance), being overweight or obese, elevated blood lipids such as cholesterol and triglycerides, as well as high blood pressure and hypothyroidism.
Diagnosis of NAFLD/NASH
As mentioned earlier, NAFLD/NASH is incidentally picked on routine ultrasound examinations or blood tests. The causes of fatty liver due to contributing metabolic conditions have to be investigated thoroughly. NASH has to be distinguished from other serious causes of liver enzyme derangements like alcoholic hepatitis, chronic hepatitis B and C and autoimmune hepatitis. Non-invasive methods like Fibroscan or invasive methods like liver biopsy are occasionally needed to determine the severity of liver stiffness.
Treatment of NAFLD/NASH
NAFLD is a lifestyle disease. Maintaining a healthy lifestyle with normal weight as per body mass index, controlling diabetes and cholesterol through diet and medication, controlling blood pressure and maintaining normal thyroid levels helps to reduce fatty liver. Aerobic exercise daily is of utmost importance.
Development of medications that could treat NAFD and NASH is an area of intense research. Recent trials in adult and children have shown that vitamin E (an anti-oxidant) could help improve NASH. Get the Fatty liver treatment in mumbai from Dr. Mehul Choksi.