Frequently Asked Questions (FAQs)
We help create a care plan that addresses your specific condition and we are here to answer all of your questions & acknowledge your concerns. Today the hospital is recognised as a world renowned institution, not only providing outstanding care and treatment, but improving the outcomes. Here are some of the general FAQs:
Gastroesophageal reflux disease (GERD)
Heartburn, Dysphagia (difficulty in swallowing), Odonophagia (painful swallowing), Belching
Cough, Wheezing, Sore throat, Globus sensation (foreign body sensation), Epigastric pain ,No cardiac chest pain, Headache, Bad breath
b) Esophageal manometry
c) 24 hrs. esophageal PH monitoring
2. Suturing of GE junction using either mucosal sutures with Endocinch device or full thickness suture placement (GERD-X)
3. ARMS (Anti reflux mucosectomy)
POEM (PER ORAL ENDOSCOPIC MYOTOMY)
Endoscopic Pneumatic Dilatation (PD): Under fluoroscopic vision a balloon is inflated at the lower oesophageal sphincter to disrupt the muscles. This treatment normally works well but requires repeat procedure within weeks, months and/or years
Heller’s Myotomy (HM): This is a surgical technique done under general anaesthesia in the operation theatre. In this technique lower esophageal sphincter (muscle) is incised from outside. As the sphincter is completely weakened, there is a high possibility of reflux later. So an anti-reflux procedure normally follows
POEM: Per oral endoscopic myotomy
Hospital stay and procedure cost is less
Procedure is relatively safe without intra and post procedure complication
The patient kept nil per-orally from mid night
Success rate is more compare to other modalities of treatment
Post procedure patient can have slight pain which can be managed with simple analgesics.
Reflux symptoms- Can be treated easily with acid-reducing medication.
Barium swallow. A series of X-rays are performed after barium is swallowed in order is to determine the rate of barium emptying into the stomach.
Endoscopy–it is required to exclude any other disorder of the oesophagus which might be contributing towards similar symptoms which might preclude treatment. It is also important to be sure that the oesophagus and stomach are clear of food and fluid just prior to considering POEM in order to reduce the risk of inhaling contents into the lungs.
Preoperative anaesthesia check up is required
Patient is admitted before the procedure
The patient kept nil per-orally from mid night
Consent is required before the procedure. Risk and benefit is explained
On the following day a chest X-Ray, CT scan or barium swallow will be performed to confirm that no small leaks have occurred
Chronic Liver Disease/Cirrhosis
Cirrhosis is when scar tissue replaces healthy liver tissue. This stops the liver from working normally. Cirrhosis is a long-term (chronic) liver disease.
a. Removing waste from the body, such as toxins and medicines
b. Making bile to help digest food
c. Storing sugar that the body uses for energy
d. Making new proteins
In cirrhosis, scar tissue slows the flow of blood through the liver. Over time, the liver can’t work the way it should. In severe cases, the liver gets so badly damaged that it stops working. This is called liver failure.
a. Hepatitis and other viruses: B and C
b. Long-term alcohol abuse
c. Nonalcoholic fatty liver disease (this happens from metabolic syndrome and is caused by conditions such as obesity, high cholesterol and triglycerides, and high blood pressure)
d. Other less common causes of cirrhosis may include: Autoimmune disorders, where the body’s infection-fighting system (immune system) attacks healthy tissue, Blocked or damaged tubes (bile ducts) that carry bile from the liver to the intestine, Use of certain medicines, Exposure to certain toxic chemicals, Repeated episodes of heart failure with blood buildup in the liver, Parasite infections, Some diseases passed from parent to child (inherited diseases) may also cause cirrhosis. These may include: Alpha1-antitrypsin deficiency, High blood galactose levels, Glycogen storage diseases, etc.
a. Fluid buildup in the belly (ascites)
b. Vomiting blood, often from bleeding in the blood vessels in the food pipe (esophagus)
d. Yellowing of the skin and eyes (jaundice)
e. Muscle loss
f. Loss of appetite & Low energy and weakness (fatigue)
g. Easy bruising
h. Spider-like veins in the skin
i. Weight loss
j. Confusion or encephalopathy as toxins build up in the blood
The symptoms of cirrhosis may look like other health problems.
The tests are done to diagnose are:
a. Blood tests. These will include liver function tests to see if the liver is working the way it should..
b. Liver biopsy. Small tissue samples are taken from the liver with a needle or during surgery. The samples are checked under a microscope to find out the type of liver disease.
c. CT scan. This is an imaging test that uses X-rays and a computer to make detailed images of the body. A CT scan is done for detection of liver cancer, portal vein block or other complications of cirrhosis.
e. Ultrasound. This test assesses for ascites, liver veins and any mass.
f. Upper endoscopy (EGD). A lighted flexible camera is placed through your mouth into your upper digestive tract to look for enlarged blood vessels that are at risk of bleeding because of your cirrhosis.
g. If there is fluid in the belly (ascites), the doctor may advise you a low-sodium diet, water pills (diuretics), and removal of the fluid with a needle if required (paracentesis).
a. Eating a healthy diet, low in sodium
b. Not using alcohol or illegal drugs
c. Managing any health problems that happen because of cirrhosis
d. If you have metabolic syndrome, it's important to lose weight and also manage any underlying conditions such as diabetes.
a. Portal hypertension. The portal vein carries blood from your intestines and spleen to your liver. Cirrhosis slows the normal flow of blood. That raises the pressure in the portal vein. This is called portal hypertension.
b. Enlarged blood vessels. Portal hypertension may cause abnormal blood vessels in the stomach (called portal gastropathy and vascular ectasia) or enlarged veins in the stomach and the food pipe or esophagus (called varices). These blood vessels are more likely to burst due to thin walls and higher pressure. If they burst, severe bleeding can happen. Seek medical attention right away.
c. Ascites: Fluid collecting inside belly. This can become infected.
d. Kidney disease or failure.
e. Easy bruising and severe bleeding. This happens when the liver stops making proteins that are needed for blood to clot.
f. Liver cancer. You will be screened with an imaging test (ultrasound, for instance) and sometimes blood tests every 6 months if you have cirrhosis.
Hemorrhoids can be either inside anus (internal) or under the skin around your anus (external).
They are very common in both men and women. About half of all people will have hemorrhoids by age 50.
• They often strain during bowel movements
• Are pregnant
• Have a family history of hemorrhoids
• Are older
• Have long-term or chronic constipation or diarrhea
• Bright red blood in stool, on toilet paper, or in toilet bowl
• Pain and irritation around anus
• Swelling or a hard lump around anus
• Physical exam. This is done to check anus and rectum and look for swollen blood vessels that are a sign of hemorrhoids.
• Digital rectal exam (DRE).
• Anoscopy. A hollow, lighted tube is put into anus. This is used to see internal hemorrhoids.
• Proctoscopy. A lighted tube is put into your anus. This gives a view of entire rectum.
• Sigmoidoscopy. This test checks the inside of part of large intestine. It helps to tell what is causing diarrhea, belly pain, constipation, abnormal growths, and bleeding. A short, flexible, lighted tube (sigmoidoscope) is put into intestine through the rectum. This tube blows air into your intestine to make it swell. This makes it easier to see inside. A tissue sample (biopsy) can be taken if needed.
• Colonoscopy. This test looks at the full length of large intestine. It can help check for any abnormal growths, tissue that is red or swollen, sores (ulcers), or bleeding. A long, flexible, lighted tube called a colonoscope is put into rectum up into the colon.
The main goal of treatment is to reduce your symptoms. This may be done by:
• Sitting in plain, warm water in a bathtub several times a day
• Using ice packs to reduce swelling
• Using hemorrhoid creams or medicines inserted into your rectum (suppositories)
Adding more fiber to your diet means eating more:
• Whole grains
In some cases, surgery is needed. There are several types of surgeries used to remove or reduce internal and external hemorrhoids. These include:
• Rubber band ligation. A rubber band is placed around the base of the hemorrhoid inside your rectum to cut off circulation to the hemorrhoid. The hemorrhoid shrinks and goes away in a few days.
• Sclerotherapy. A chemical solution is shot (injected) around the blood vessel to shrink the hemorrhoid.
• Electrical coagulation, also called infrared photo coagulation. A special device uses a beam of infrared light to burn hemorrhoid tissue.
• Hemorrhoidectomy and hemorrhoidopexy. These procedures permanently remove your hemorrhoids.
• Having a low blood count that makes you tired (anemia). This can happen because of bleeding from a long-term or chronic hemorrhoid.
• Blood flow being cut off from a hemorrhoid that is sticking out (prolapsed). This can happen when the blood supply to the hemorrhoid is cut off. This can be very painful and cause bleeding. You may need surgery.
• Eat a healthy diet, with plenty of fiber and liquids.
• Limit the amount of time while sitting on the toilet.
• Work with your healthcare provider to manage constipation and prevent straining.
• Maintain a healthy weight.