Rectal Bleeding

Rectal bleeding is a symptom of a problem in the gastro intestinal tract. Bleeding may come from any area or structure in the GI tract that allows blood to leak into the GI lumen and come out through the anus.

Gastrointestinal (GI) bleeding involves any bleeding in the GI tract from the mouth, oesophagus, stomach, small intestines, large intestines, to the anus.

However, any level of bleeding can lead to serious problems. Microscopic levels of bleeding can lead to anemia over time, and more massive amounts of bleeding can leads to medical emergency.

Causes for Rectal Bleeding

• Hemorrhoids:Hemorrhoids are swollen rectal veins in the anal and rectal area. They can cause burning, painful and bleeding.

• Anal fissure:This is a tear in the lining of the rectum caused by the passage of hard stools and bleeding per rectum.

• Diverticulosis:Diverticula are out-pouching that project from the bowel wall. It is caused by decreased fiber in the diet. When the diverticula becomes inflamed and infected it is called diverticulitis, which may cause rectal bleeding sometimes.

• Infection:Bacterial dysentery is commonly the source of infectious, bloody diarrhea.

• Inflammation:Inflammatory bowel disease (IBD) is a common cause of rectal bleeding in adults, typically younger than 50 years of age.

• Angiodysplasia:This is a vascular problem that involves enlarged veins and capillaries in the wall of the right colon. These areas become fragile and can cause bleed.

Bleeding Symptoms

• Bright red blood present in the stool
• Change in stool colour to black, red, or maroon
• Stool test positive for occult blood loss (blood may present, but you cannot see it)
• Rectal pain
• Confusion
• Dizziness, lightheadedness
• Fainting, palpitations or rapid heartbeat

Diagnostic tests

• Depending on the type and severity of bleeding
• Digital rectal examination:Initially examination for all rectal bleeding
• Blood tests:Complete blood counts and coagulation profile blood samples are taken to assess the extent of blood loss, the clotting ability of blood, and the possibility of infection.
• Flexible sigmoidoscopy:A flexible tube inserted into the rectum is used to evaluate the rectum and lower end of the colon.
• Colonoscopy:To study the entire large colon. It is used to locate areas of bleeding, masses, or irregularities.
• CT scan:May be used to diagnose diverticulitis or tumours in the bowel.
• Angiography:A contrast dye study is used to evaluate active areas of brisk bleeding.

Remedies and Precaution to avoid Rectal Bleeding

• Decrease straining with bowel movements.
• Increase fibre in the diet and adequate water
• Take a sitz bath. This is a warm water bath with water just deep enough to cover the hips and buttocks, and can help relieve some symptoms of itching, pain and discomfort of hemorrhoids.
• Avoid drinking alcohol.
• if the person's symptoms do not improve within one week of treatment, or he or she is older than 40 years of age, a doctor should be seen for further evaluation.
• The majority of people with significant rectal bleeding are elderly. Members of this population commonly have many other medical problems. All other causes of rectal bleeding should be evaluated and treated by a physician promptly.

 

Gastroesophageal reflux

Gastroesophageal reflux occurs when the esophageal sphincter does not close correctly, causing the contents of the stomach to leak back into the food pipe. When stomach acid enters the esophagus it causes inflammation and burning sensations which are known as acid reflux. When the condition becomes chronic and serious, it is called Gastroesophageal Reflux Disease GERD.

The Causes

GERD can occur in people of all ages and is usually the result of overeating, eating specific foods or lying down immediately after eating. It is most common among people who:

• Are overweight or obese which causes increased pressure on the abdomen.
• Are pregnant which also causes increased pressure on the abdomen.
• Are taking some types of medication, including medicines for asthma, calcium channel blockers, antihistamines, sedatives, and antidepressants.
• Are smokers or those who are exposed to second hand smoke.
• Consume alcoholic drinks.
• Do not get enough exercise.

In addition, certain foods and eating habits have been linked to the occurrence of acid reflux. These include:

• Greasy foods
• Spicy foods
• Chocolate
• Peppermint
• Coffee
• Carbonated drinks
• Acidic fruit juices
• Foods containing tomato products
• Foods that contain large amounts of salt
• Eating large meals
• Lying down soon after eating

Prevention

There are a number of actions and precautions that may be taken to reduce the chances of GERD occurring:

• Eating moderate amounts of food and especially not overeating.
• Not sleeping for 2 or 3 hours after eating.
• Stop smoking.
• Not wearing clothes that are tight or constrict the abdomen.
• Sleeping at a slight angle with the head elevated a little.

The Symptoms

The most common symptom of GERD is heartburn. Other signs of the condition include:

• Dry, persistent coughing .
• Wheezing
• Stop smoking.
• Asthma and Recurrent pneumonia
• Nausea
• Vomiting
• Throat problems, such as soreness, hoarseness, or laryngitis (voice box inflammation)
• Difficulty or pain when swallowing
• Chest or upper abdominal pain
• Dental erosion
• Bad breath

Complications
If not treated, GERD can become worse and turn into other medical conditions which include:

• Esophagitis: This is an inflammation of the esophagus.
• Esophageal stricture: In this condition, the esophagus becomes narrow, making it difficult to swallow.
• Barrett's esophagus: The cells lining the esophagus can change into cells similar to the lining of the intestine. This can develop into cancer.
• Respiratory problems: It is possible to breathe stomach acid into the lungs, which can cause a range of problems including chest congestion, hoarseness, asthma, laryngitis, and pneumonia.

Diagnosis

There are a number of tests, often used in combination, to confirm the presence of GERD. These include:

• Endoscopy
• Barium X-ray: Imaging the esophagus, stomach, and upper duodenum after swallowing a chalky liquid that helps provide contrast on images
• Esophageal manometry: Pressure measurement of the esophagus
• Impedance monitoring: Measuring rate of fluid movement along the esophagus
• pH monitoring: Acidity testing

Treatment

GERD is typically treated with medication. Proton pump inhibitors, which decrease the amount of acid produced in the stomach, are one of the main pharmaceutical treatment options available. Lifestyle modifications can also help in dealing with the condition. These include:

• Posture improvement such a sitting correctly
• Wearing loose, unconstricting clothing.
• Losing excess weight is overweight or obese.
• Avoiding wearing tight belts or doing physical activities that increase pressure on the abdomen.
• Stopping smoking.

If the condition does not respond to medication and lifestyle changes, then surgical intervention, known as fundoplication may be required.

Understanding PCOS

Dr. K Birundha, Gynaecologist, Kauvery Hospital, Hosur, shares valuable insights regarding PCOS, its symptoms, and the various management methods. 

What is PCOS?

Polycystic ovary syndrome is a disorder that occurs due to hormonal imbalance. People with PCOS develop numerous cysts in their ovaries and may also suffer irregular or skipped periods. They may also experience difficulty in getting pregnant. It has been related to obesity and insulin resistance.
PCOS and fertility 

Many women who come to the gynaecologist with infertility issues suffer from PCOS. The cysts in the ovaries can interfere with ovulation. Ovulation is the process in which your ovaries release an egg each month. If a healthy egg isn’t released, it is not available to be fertilized by a sperm, and therefore you can’t get pregnant.

PCOS diagnosis

Your doctor might recommend a physical examination, blood tests, and an ultra sound to check for PCOS.
How to prevent PCOS
PCOS can be prevented by making a few changes in your lifestyle like:-

• Weight loss
• Low-calorie diet
• A fitness program
• Medications to address the hormonal imbalance
• Infertility medication in case the couple is trying to get pregnant

PCOS is not to be taken lightly. It can occur to young people who are not married as well as to older people. If not addressed and treated, it could lead to other complications like high blood pressure, diabetes, gestational diabetes, and cholesterol. With a little help and a lifestyle change, PCOS can be treated effectively.

Importance of Exercising Right

Dr. S. Chockalingam, Orthopaedician, Kauvery Hospital Cantonment, shares useful tips on maintaining a healthy body and physique. 

Why should we exercise?

Our body needs exercise to be strong, healthy, and to look nice. Exercise helps tone our muscles, maintains balance, and keeps all our organs functioning properly. Exercise is essential for a human being at any point in life, but different activities are advised for different age groups. A person who is at optimum physical health can do high-intensity exercises. As we grow older, usually, due to age and, maybe, illness, the pace of exercising and the type of activities have to be changed to ensure that it is not taking a toll on the body.

Exercising as you age

A person who has been weight training and doing high endurance and high impact exercise most of their life may have to lessen the intensity of activity as they grow older. After a certain age, it would be wise to consult with a doctor to ensure that the exercises you are doing will not harm you. As we age, our muscles and bones become weaker, and so it is better to lessen weight training and concentrate more on low impact aerobic activity like walking, jogging, swimming, etc.

Pick an activity that keeps you fit but is not a strain on your body.

Being Heart Smart

On 29th September, World Heart Day, Dr. Ramesh, Chief Medical Officer, Kauvery Hospital, Heart City, shares valuable insights regarding the importance of staying vigilant and reaching out to an expert at the slightest hint of cardiac problem. 

Understanding your heart

The heart is one of the most critical organs in our body and keeping it healthy is essential. Some conditions, such as high cholesterol, high blood pressure, and diabetes, as well as lifestyle factors, such as unhealthy diet, obesity, physical inactivity, and alcohol and tobacco use, can put your heart at risk. Sometimes, a tendency towards heart disease can run in families. Everyone needs to be heart smart, but it is even more critical for people who have a higher risk of heart disease to be smart and look after their hearts.

Heart smart tips

The chance of developing heart disease can be reduced by taking steps to prevent and control factors that put people at greater risk.

Some ways that you can minimize the risk of heart disease include:-

• Eating a healthy diet
• Maintaining a healthy weight
• Exercising regularly
• Limiting alcohol use
• Not smoking
• Keeping stress under control
• Maintaining optimum blood levels

People at higher risk of heart disease need to have regular health check-ups and consult with a cardiologist. In case of any discomfort, they should get to a hospital immediately.

Today, let us take an oath to protect ourselves against heart disease!

Do's and Don'ts of a Diabetic Diet | Kauvery

Ms. M. Mahalakshmi, Dietician, Kauvery Hospital, Trichy demonstrates a list of do's and don'ts diabetics should follow regarding their diet to keep their sugar levels at an optimum. There are many restrictions on the kind of food that a person with diabetes can and cannot eat.

Do's of a diabetic diet

A person with diabetes should exercise and maintain a healthy diet. Exercise should be done for at least 45 minutes. If it cannot be done at a stretch, it can be split into segments of 20/25 minutes, twice a day. It is not necessary to do vigorous exercise. A regular walk should do.

Don'ts of a diabetic diet

1. Avoid sweets, including honey and jaggery

2. Avoid or reduce salt

3. Avoid refined flour like maida, Maggi, noodles, etc. (Refined flours are higher in carbohydrates and thus contain more starch and sugar)

4. Avoid easily digestible foods like oats, porridge, juices, etc. (as they are digested faster, it cause glucose levels in the blood to rise)

5. Avoid aerated drinks like Coke, Fanta, etc.

6. Avoid processed instant powders like Boost, Horlicks, etc.

7. Avoid deep-fried food like bajji, vada, bonda, etc.

8. Avoid ghee, dalda (any oil that hardens when cold)

9. Avoid high sugar fruits like mango, pineapple, banana

10. Avoid tuber vegetables like potato, colocasia, yam, beetroot, etc.

Good eating habits include:-

• Stick to eating meat only once a week
• Eat meats like chicken, fish, and eggs
• Eat home-cooked food
• Eat plenty of vegetables and fruits
• Use different types of oil every month like sunflower oil, rice bran oil, groundnut oil, etc.

With a little care, you can successfully manage your diabetes.

Dengue Fever Awareness

While the world is dealing with a pandemic, mosquito season has come around again, bringing with it the risk of Dengue. To protect ourselves against Dengue, it is essential to understand the disease.

Dengue facts

• Dengue fever is a disease caused by a family of viruses transmitted by the Aedes mosquitoes.
• More than 67000 people a year across India are diagnosed with dengue fever every year.

Causes of Dengue fever

When a mosquito bites a person infected with a dengue virus, the virus enters the mosquito. Then, when the infected mosquito bites another person, the virus enters that person's bloodstream and causes an infection.

Symptoms

• Nausea
• Vomiting
• Rash
• Aches and pains
• Eye pain, typically behind the eyes
• Bone pain
• Fever

Symptoms of Dengue typically last 2–7 days. Most people will recover after about a week.

The Dengue mosquito

The mosquito that spreads Dengue, Aedes aegypti, can be recognized by white markings on its legs and a marking on its thorax's upper surface. Both males and females have antennae. The mosquito with the shorter antenna is the female mosquito, which is the one that spreads the dengue virus. These mosquitoes are most active during the day. They breed in stagnant water.

Preventative measure against Dengue

• Use insect repellent in your surroundings
• Wear long-sleeved shirts and long pants at home and outside
• Use mosquito meshing to prevent mosquitoes in your home
• Makes sure there are no stagnant water bodies around your house

With preventative action, you can get through the mosquito season without a problem.