Alzheimer

What is Alzheimer’s Disease

Alzheimer’s disease in a broader term is referred for progressive form of Dementia where the brain gradually loses its ability to remember, think and control the motion of behaviour.

In this condition, as the brain cells degenerate and die gradually, the brain stops responding to logical situations. Alzheimer’s symptoms start with forgetting recent conversations and events and the condition can gradually progress up to a situation where it becomes impossible to remember even daily work.

As of now, Alzheimer’s disease does not come with a definitive cure but with medications and lifestyle changes, the symptoms can be slowed down. If it remains untreated, Alzheimer’s disease can result into bed-bound state resulting in  malnutrition, infection or severe dehydration. These derived complications often become the cause of death of the patient.

Symptoms of Alzheimer’s Disease

Most of the symptoms revolve around different degrees of memory loss and problems originating from memory loss. Normal human brain keeps forgetting older things so that more recent occurring can take that place. But, with Alzheimer’s brain, the trend of forgetting is chronic and gradually increasing. If not treated, the symptoms can get worse with time.

• Forgetting everyday assignments and tasks
• Decrease in judgemental power
• Trouble in remembering daily-used stuff like the car or the microwave
• Trouble with speech and easy writing
• Mood swings and personality changes
• Difficulty with problem-solving
• Confusion with time and date
• Loss of Interest in personal hygiene.
• Disconnection from known community, friends and family
• Repetitions of same questions over and over again.
• Getting lost in familiar places and at times with in home itself

Stages of Alzheimer’s Disease

If not on treatment, Dementia increases with time and stages.

Stage 1: Negligible to no-symptoms; often diagnosed from hereditary probability

Stage 2: Mild forgetfulness appears with not much hindrance in daily life

Stage 3: Reduced concentration and weak older memory; mostly noticeable by people who regularly interact with the patient

Stage 4: At this stage, a person is officially declared as mild alzheimer’s

Stage 5: The symptoms increase and gradually move from moderate to severe level

Stage 6: At this advanced level, the affected person needs assistance in simple regular activities like putting on clothes or eating

Stage 7: This is the final of all dementia stages where the person loses his speech and facial expressions

Diagnosis and tests for Alzheimer’s Disease

Diagnosis

Instead of directly diagnosing Alzheimer’s disease, this problem is diagnosed with mental, physical and psychological symptoms. Diagnosing Alzheimer’s disease includes:

• Direct and indirect symptoms
• Past and present health condition
• Family history
• Current or past medications

Tests

Just like the diagnosis, there is no definitive test for Alzheimer’s disease as well. Therefore, Alzheimer’s disease tests include several mental, physical, imaging and neurological tests for an overall understanding of the patient’s mental and physical health.

To address what type of memory loss is it (long-term, short-term, existing and previously made memories, incapability of forming new memories, difficulty with understanding etc), few common questions are asked like:

• The time of the day
• Name of very important personalities (president, prime minister)
• Learning and remembering a list of words

Few indirect Alzheimer tests are:

• Computed tomography (CT) scan
• Magnetic resonance imaging (MRI)
• Positron emission tomography (PET) scan

Medication for Alzheimer’s Disease

Patients are prescribed multiple medications for healing the symptoms and delaying the process of the disease. Rivastigmine (Exelon) and Donepezil (Aricep) are 2 medicines prescribed mostly to treat early to moderate Alzheimer’s disease. These medicines keep up the acetylcholine level of our brain that helps in better communication among the brain cells.

Apart from these, medicines are given to treat the symptoms like:

• Restlessness
• Depression
• Agitation
• hallucinations
• Aggression

How to prevent Alzheimer’s Disease

Though there’s no foolproof cure of Alzheimer’s disease, the patients are advised to lead an overall healthy and preventive lifestyle that includes:

• Quitting smoking
• Following a plant-based diet
• Exercising regularly
• cognitive training exercises
• Antioxidant-rich diet
• Drinking green tea
• Maintaining a more active social life

Many people get confused between Alzheimer’s and Dementia. Dementia is a group of mental cognitive hindrance symptoms where Alzheimer’s disease is a type of it.

Content Reviewed By: Dr. Kunal Bahrani

Brain Cancer

What is Brain Cancer?

When brain cells grow in abnormality, it is called brain tumour. While a brain tumour is a broader term, it can be both: cancerous (malignant) and noncancerous (benign). The malignant brain tumours come with a bunch of symptoms like confusion, sleepiness, seizures, behavioural changes and loss of balance etc. The noncancerous brain tumours also have almost the same symptoms.

Types of Brain Cancer

Among all the brain cancer types, Glioblastoma is the most common one. This is an adult cancer developing a type of brain cells called the Glial cell.

Glioblastoma can be classified into primary Glioblastoma and secondary Glioblastoma.

Primary Brain Cancer

When a Malignant Glioblastoma first appears as ‘grade 4 Glioblastoma’, it is considered as primary stage cancer. Malignant brain tumours grow tremendously faster than benign tumours. This type of abnormal growth of cells keeps growing spoiling the normal growth of the rest of the brain. Whether cancer will return or not depends on the stage when it is diagnosed.

Secondary brain cancer

Secondary brain cancer is considered when the cancer has spread from one body part to another. For Glioblastoma, it develops from a lower grade brain tumour, Astrocytoma.

Glioblastoma Multiforme is an aggressive central nervous system tumour that affects the brain or the spine.

Metastatic Brain Cancer

Metastatic Brain Cancer is a type of cancer formed in different parts of the body and the cancerous cells travel to the brain through metastasis.

Causes of Brain Cancer

The most important fact about brain cancer is, there is no definitive cause of it discovered till now. There is no proven precaution for Brain Cancer so far as well. Exposure to radiation and genetic makeup are very few of the proven risk factors of brain cancer.

For 1 out of 20 cases, an inherited gene is responsible for brain cancer. Meningioma and Glioma are 2 types of brain tumours that mostly happen because of reactions from radiotherapy in the head at childhood. The chances increase manifold if the patient was 5 years or less when the radiation was given.

Is brain cancer curable?

Is there any cure for brain cancer? Does early detection help in curing brain cancer?

These questions come first when you hear the word Brain Cancer.

The answer to it is, it depends on individual cases.

Brain cancer is quite prone to spread from one part of the brain to another. Therefore, in spite of successful treatment at the first time, chances are always there for brain cancer to return.

Whether a tumour will return or not depends on factors like :

• The stage when diagnosed
• The location of the tumour
• How successful the surgery was
• Whether it’s molecular or genetic make-up

Brain Cancer Symptoms

Brain cancer symptoms largely vary from person to person and greatly depend on the age and other physical conditions. Brain cancer symptoms can clearly be classified into 2 categories: symptoms among children and symptoms among adult.

Brain cancer symptoms among children

• Persistent feelings of nausea and vomiting for more than 2 weeks
• Delayed or arrested puberty
• Abnormal eye movements
• Recurring headache on walking for more than 4 weeks
• Blurred vision or double vision
• Sudden behavioural changes
• Frequent seizures
• Head tilt and other abnormal head position
• Problem in coordination, walking and abnormal balance

Brain cancer symptoms among adult

• Throbbing or a dull headache
• Blurred vision, difficulty in reading and watching TV
• Seizures or fits
• Drowsiness and more sleep than usual
• Disruption of normal brain function

Side effects of Brain Cancer

Living with brain cancer can heavily disrupt regular lifestyle by affecting different parts of the brain. Some of the most daunting side effects of Brain Cancer are:

• Changes in mood and general character
• Memory difficulties and forgetting
• Difficulty in communicating and understanding languages
• Epilepsy
• Severe depression
• Long-term learning difficulty (cognitive disorder)

Treatment of Brain Cancer

Radiation therapy, chemotherapy and surgery are the 3 most prominent treatments of Brain Cancer.

The type of treatment is largely dependent on one’s age.

Brain Cancer treatment for children:

• Neurosurgery (possibility depends on individual patient)
• Radiotherapy (possibility depends on how much the child’s body can take)
• Chemotherapy (often incorporated with other treatments)
• Steroids (mainly given to treat the side effects)
• Proton Beam Therapy (targeted radiotherapy; not suitable for all types of tumour)

Brain Cancer treatment for adults

Apart from Neurosurgery, Radiotherapy and Chemotherapy, here are few more treatment procedures that are used only in adults:

• Stereotactic Radiotherapy (radiotherapy treatment with 3D image locator)
• Watching out (often very first stages are observed to understand the pattern)
• Temozolomide (chemotherapy drug for high-grade gliomas)
• Immunotherapy (using body’s own immune system to fight cancer)

Leukemia and Brain Cancer spreads very rapidly. Metastatic brain tumours are the types of cancers that start at one part of the body and reach the brain. The most common types of cancers which spread to the brain are:

• Colon Cancer
• Breast Cancer
• Lung Cancer
• Kidney Cancer
• Melanoma

Content Reviewed By: Dr.Kunal Bahrani

Arrhythmia

What is Arrhythmia?

Any irregularity in the heart rhythm; be it too fast, too slow or just unstable: all fall under Arrhythmia. Arrhythmia is one of the most common types of heart diseases. In fact, most of the people have experienced Heart Arrhythmia at some point of their lives. Heart Arrhythmia occurs when the heart’s normal electrical system is disrupted.

Cardiac Arrhythmia ranges vary widely in severity. Some of the Arrhythmia attacks are so mild that they don’t even have any consequences while some of them can be life-threatening.

Types of Arrhythmia

Arrhythmia or irregular heartbeat is often a symptom than a cause. Therefore, to start the treatment, the doctor must be sure what type of Arrhythmia the patient suffering is from:

Premature Heartbeats:

In ‘Extra Beats Symptom’, the heart produces extra beats  in the atria of the heart. This condition is called Premature Atrial Complexes (PACs). If the extra beats arise to the ventricles of the heart, the condition is called premature ventricular complexes (PVCs). Both PACs and PVCs are generally inconsequential.

Bradycardia:

When the heart rate is significantly slower than normal (fewer than 60 beats a minute), the condition is called Bradycardia. Bradycardia itself is not a problem unless it is not inviting other complications. Many people, especially the athletes often live normal lives with 40-50 beats heart rate.

• Sinus bradycardia: This type of Bradycardia is caused by the sinus node. For most of the Sinus bradycardias, the treatment is implantation of a pacemaker.
• Heart block: In more serious cases, the sinus nodes before reaching the ventricles generate electrical impulses. There, Cardiac Arrhythmia is a clear symptom of heart blockage. Right bundle branch block and Left bundle branch block are 2 common associated complications of heart blockage.

Tachycardia:

When the heart rate is too high than the normal range (more than 100 beats a minute), it is called Tachycardia. There are 2 types of Cardiac Tachycardia:

• Supraventricular tachycardia (SVT): This is a condition where the fast heartbeat either involves the atria or arises in the atria. The three most common Supraventricular Tachycardias are Atrial Flutter, atrial fibrillation and Wolff-Parkinson-White syndrome.
• Ventricular fibrillation (VF) and Ventricular tachycardia (VT): These 2 types of Tachycardia are most life-threatening Arrhythmias and they are responsible for cardiac arrest in most of the cases. Patients, detected with severe Arrhythmia are treated with an implantable defibrillator to prevent sudden cardiac arrest.

Arrhythmia Symptoms

In a significant number of cases; due to the asymptomatic nature of this abnormality, the patients do not even know that they are suffering from Heart Arrhythmia till the doctor confirms. Surprisingly, the severity of symptoms is always not directly proportional to the seriousness of the health condition.

Though Arrhythmias can be of different types and reasons, here are few most common palpable symptoms:

• Dizziness
• Cardiac arrest
• Skipping Heartbeats
• Sweating (Bradycardia)
• Palpitations
• Shortness of breath
• Fainting (Syncope) (Atrial fibrillation)
• Chest pain
• Confusion (Bradycardia)
• Trouble in concentrating (Bradycardia)
• Angina (chest pain) (Atrial fibrillation)

 

Treatments for Arrhythmia

Treatment for arrhythmia is generally not required till it aggravates into more serious complications.

The doctor first checks for any underlying cause of atrial flutter and Cardiac Arrhythmia. If any crucial underlying cause is found, that needs to be treated first. If no such condition is diagnosed, implanting a pacemaker is advisable.

The other treatments of Arrhythmia include:

• Vagal Maneuvers: Stimulation of the vagus nerve in ways like holding breathe and bearing down, immersing the face in ice-cold water etc.

• Cardioversion: Medication or electric shock is given to bring the heart rhythm back to normal

• Maze procedure: Artificial formation of blocks in the heart by surgical incisions for helping the heart to beat more efficiently

• ICD (Implantable Cardioverter-Defibrillator): Cardioverter-defibrillator is implanted near the left collarbone. This device detects the abnormality in the heart rhythm and stimulates the natural pumping of the heart.

• Cardiac Ablation: In this therapy, catheters are sent to the inner heart through blood vessels. This minimally invasive Ablation procedure destroys abnormal tissues responsible for Arrhythmia.

• Coronary Bypass Surgery: A healthy blood vessel from other parts of the body is transplanted in the coronary artery to bypass the original blocked and narrowed cardiac artery.

• Ventricular Aneurysm Surgery: If Cardiac Arrhythmia is caused by bulging in the blood vessels, the aneurysm or bulging is surgically removed in this procedure.

• Medications: Though medications don’t help in curing Arrhythmia directly, multiple medications can help in suppressing the symptoms.

 

Diagnosis of arrhythmia

The diagnosis of Arrhythmia often includes multiple rounds which include an interview with the patient, medical history checking, family history checking and multiple pathological tests. The clinical tests include:

• EKG (electrocardiogram)
• Holtermonitor
• Electrophysiologic testing
• Blood and urine tests
• Chest X-ray
• Heart catheterization
• Echocardiogram
• Tilt-table test

Risk factors for arrhythmia

Multiple risk factors influence and aggravate the condition of Arrhythmia. Few of the most significant risk factors are:

• Age
• Heart problem
• Illegal drugs
• Gene defect
• Obstructive sleep apnea
• Hypertension
• Obesity
• Hyperthyroidism and Hypothyroidism
• Diabetes
• Electrolyte imbalances
• Too much intake of caffeine
• Heavy alcohol consumption

Content Reviewed By: Dr Simmi Manocha

Brain Stroke

What is a Brain stroke?

When the normal blood flow to the brain is disrupted, one or multiple parts of the brain get damaged. This occurrence is called Brain Stroke.

Brain Stroke can happen to anybody at anytime. When such an occurrence, the blood flow to the brain is completely cut-off temporarily. Within a few minutes of complete disruption, the brain cells start dying.

Overcoming a Brain Stroke largely depends on immediate medical attention. After the attack, every moment is important for the survival rate. 80% of strokes can be prevented with immediate treatment.

Also, the repercussion of a stroke completely depends on the severity of the stroke and how many portions of the brain has been affected. Say, if only a few brain cells are affected, the person may experience some temporary inability to move in his or her limbs or speech problem.

Stroke symptoms

The symptoms of brain stroke largely depend on which part of the brain is affected by the stroke. Depending on the type of attack, the vital organs like the heart, liver or lung might lose their efficiency and indispensable body functions like breathing, blinking eye, swallowing and eye movements can be disrupted. Brain stroke could also create a problem with your speech and hearing ability.

Though the duration of the symptoms largely differs with the severity, here are few most obvious symptoms which ask for immediate medical attention:

The trouble with understanding and speech: The difficulty with understanding what the other person is saying, processing the logic and difficulty in understanding speech are the most common symptoms of brain stroke.

Trouble with walking: Unexplained dizziness while walking, stumbling upon trivial objects, loss of coordination and loss of balance are common signs of a stroke.

Paralysis in the arms, legs and face: Sudden paralysis in one side of the arms, legs and face is a clear sign of Brain Stroke paralysis. Ask the patient to raise his or her hands or both legs together and if one side feels numb; this is because of the nervous system that controls the action is damaged. The face paralysis is most vividly experienced while smiling.

Headache: A severe, unbearable headache accompanied by dizziness, vomiting and altered consciousness.

Blackened or blurred vision: Sudden blurred or double vision in one or both eyes may be a sign of Brain Stroke.

What causes a stroke

A Brain Stroke is caused by Ischemic Stroke or Hemorrhagic stroke where blood vessels get burst. If the disruption of blood flow is temporary, it is called Transient Ischemic Attack. This complication does not do any permanent damage.

There are mainly 2 types of Brain Stroke:

Ischemic stroke: Every 4 out of 5Brain Strokes are ischemic strokes. When the brain arteries are blocked or narrowed to a certain extent that the blood flow is almost impossible, the situation is called Ischemic Stroke.

Thrombotic stroke: When the blood supplying arteries have thrombus or blood clot, it’s called Thrombotic Stroke. The clot can be a result of fatty deposits in the arteries.

Embolic stroke: When a blood clot or other debris gets accumulated in blood vessels supplying brain, it is an Embolic Stroke. Embolic Stroke most commonly starts in the heart and blood clots move to the brain arteries.

Haemorrhagic stroke: When there is a leakage in the blood vessels of the patient’s brain due to multiple causes, the situation is called Haemorrhagic stroke. The conditions responsible for this complication are excessive hypertension, overtreatment with blood thinners and weak spots in the blood vessel walls.

Different types of Haemorrhagic strokes are:

Intracerebral Haemorrhage: This condition occurs when a blood vessel in the brain bursts and overflows into adjacent Parenchyma. Due to this, all the other cells of that area are highly damaged. All the other brain cells beyond that part gradually die due to inadequate blood flow. Vascular malformations, high blood pressure, trauma and blood-thinning medications are primarily responsible for this condition.

Subarachnoid Haemorrhage: When an artery around the surface of the brain bursts and leaks to the skull and the surface of the brain, the condition is called subarachnoid haemorrhage. The most significant symptom of this condition is a sudden and severe headache.

Factors which increases the chances of Brain Stroke

There are 2 types of Brain Stroke risk factors:

Lifestyle risk factors

• Extremely obese
• Heavy drinking
• Physical inactivity
• Illicit drug consumption

Medical risk factors

• Severe hypertension
• Diabetes
• Cigarette smoking
• Cardiovascular abnormalities (heart defects, heart infection, heart failure, abnormal heart rhythm)
• High Cholesterol level
• Obstructive sleep apnea
• Family history

Brain Stroke complications

A brain stroke can leave behind multiple temporary or permanent complications:

• Paralysis of limbs
• Difficulty in thinking, talking and reasoning
• Strange sensations and pain in multiple parts of the body
• Difficulty in swallowing and talking
• Difficulty in emotional connection
• Decreased self-care ability
• Changes in behaviour

Stroke Treatment and Prevention

The good news about strokes is that there is a lot of options now a days are available in form of Reperfusion therapies like I/V Thrombolysis –clot dissolving drug which can be successfully given within 4.5 hours of omit of stroke symptoms. Also, newer more effective stroke treatments are available in form of Mechanical Thrombectomy which can be opted with in 24 hrs of strokes onset.

Strokers are largely preventable with early recognition of signs and symptoms one may be able to avoid or decrease disability.

Consider taking steps such as:

• • Maintaining a healthy life style – Eating heart healthy foods and exercising regularly helps eliminate many of risk factors for stroke, such as high blood pressure and high cholesterol. Quitting smoking and moderating alcohol consumption can also reduce stroke.

 

• • Controlling Medical illnesses –Those with high blood pressure or cholesterol can reduce their risk of stroke by seeking treatment from their care providers. For diabetics, it’s especially important to control to control blood sugar levels to avoid damaging blood vessels in the brain and other organs.

 

• Learning the symptoms- “stroke is largely treatable but this matters”, the faster someone is treated, the more likely are to recover without permanent disability. Every second counts, so it’s important to quickly recognise signs/symptoms of stroke and should arrive at emergency room within 3 hours of their first symptoms to prevent disability or death.

Content Reviewed By: Dr. Kunal Bahrani

Breast Cancer

Introduction

Breast cancer is a disease in which cells in the breast multiply and grow abnormally. This can happen if the genes in a cell that control cell growth no longer function properly. As a result, the cell divides uncontrollably and may form a tumor.

You may be able to feel it as a lump under the skin, or you may not realize it’s there at all until it’s found on an imaging test, such as a mammogram (breast x-ray).

Breast tumors can be Benign (not cancerous) which means they can’t spread and are not life-threatening or Malignant tumors are cancerous. If not treated, the cancer can invade surrounding tissue and spread (metastasize) to other parts of the body.

Symptoms of breast cancer

Many breast cancers are discovered through routine screening tests such as mammograms, even when a woman has no other signs of disease. However, on your own, you may notice symptoms that could be point towards cancer. See your doctor right away if you have any of these conditions:

• a lump or thickness in or near the breast or under the arm
• unexplained swelling or shrinkage of the breast, particularly on one side only
• dimpling or puckering of the breast, any change in contour of the breast
• nipple discharge (fluid) other than breast milk that occurs without squeezing the nipple
• breast skin changes, such as redness, flaking, thickening, or pitting that looks like the skin of an orange
• a nipple that becomes sunken (inverted), red, thick, or scaly

 

Risk for getting breast cancer

Your risk for breast cancer rises as you get older. About 80 percent of breast cancers are found in women over age 50 — many of whom have no other known risk factors for the disease.

Although you’re two to three times more likely to get breast cancer if you have a strong family history of the disease, only 5 to 10 percent of breast cancers are inherited, meaning that they are linked to gene mutations passed down in families, such as the BRCA1 and BRCA2 gene mutations. Several other risk factors may slightly boost your chances of getting breast cancer.

Estrogen

Estrogen promotescell growth

Course leading to increase estrogen exposure and increase chances of developing cancer

• Early menarche (start of menses)
• Late menopause (stopping of menses)
• Alcohol
• Obesity
• Lace of exercise
• Stress etc.

 

Progesterone

Progesterone causes cell maturation and stabilizing. It is in growth phase that cell undergoes malignant transformation, i.e. cancer formation occurs

Whereas following induce healthy progesterone and decrease the chances of cancer occurrence:

• Timely pregnancy
• Proper and adequate lactation in breastfeeding

 

Screening for breast cancer

An annual clinical breast examination by a healthcare professional and self-breast examination starting at age 25 and an annual mammogram starting at age 40 for women of average risk without symptoms.

Ask your doctor if you need earlier or more frequent screening or additional tests if you are at above-average risk for breast cancer due to any of the following factors:

• a family history of breast cancer, particularly in close relatives such as your mother or sister, or in several family members
• atypical hyperplasia (a type of benign breast disease) or lobular carcinoma in situ (abnormal cells in the lobule)
• treatment with radiation (a therapy used for Hodgkin’s disease and some other medical conditions) before age 32
• BRCA1, BRCA2, or other  gene mutations and other risk factors

 

Diagnosis of breast cancer

Diagnosis of breast cancer involves triple assessment, that is

• Clinical breast examination
• Breast Imaging- Mammogram or Ultrasound or MRI breast
• Pathological diagnosis- Core needle biopsy

 

Types of breast cancer

There are mainly 2 types of breast cancer. Most cancers form in the milk ducts and are called ductal carcinoma. Others start in the breast’s milk-producing lobules or glands; these types are referred to as lobular carcinoma. Rarely, cancer can start in other parts of the breast’s tissue, a type known as sarcoma, or in the skin of the nipple, called Paget’s disease.

Molecular Profiles of breast cancer

Tumor samples are analyzed in a lab by pathologists who determine whether the tumors are sensitive to the hormones estrogen and progesterone, which can fuel breast cancer. Some genes and proteins they create are known to affect cancer cell growth like HER2neu.

According to these, breast cancer is classifies into molecular subtypes like

• Luminal A
• Luminal B
• HER 2 enriched
• Triple negative

This information is very crucial for your doctors; so that they can target treatment to your specific cancer and at the same time predict prognosis.

Lifestyle factors

Eating Unhealthy Food

Diet is thought to be at least partly responsible for about 30% to 40% of all cancers. No food or diet can prevent you from getting breast cancer. But some foods can make your body the healthiest it can be, boost your immune system.

Smoking

Smoking is linked to a higher risk of breast cancer in younger, premenopausal women. Research also has shown that there may be link between very heavy second-hand smoke exposure and breast cancer risk in postmenopausal women.

Drinking Alcohol

Research consistently shows that drinking alcoholic beverages increases a women’s risk of breast cancer, particularly hormone-receptor-positive breast cancer. Alcohol also may increase breast cancer risk by damaging damaging DNA in cells.

Stages of breast cancer

The stages of breast cancer are used to describe the extent of your cancer at the time of diagnosis. This is based on a physical exam and other diagnostic tests. This is known as clinical stage.

The final, or pathologic stage is determined after surgery when the size of the cancer is measured under a microscope and it is definitely known if there is cancer in the lymph nodes.

Knowing the stage helps guide your treatment plan. Breast cancer is typically staged with Roman numerals ranging from 0 (the earliest stage) to IV (the most advanced stage). Cancer stages are based on:

• T- the size of the tumor
• N- whether the cancer has spread (metastasized) to the lymph nodes, and if so, to how many of them
• M- whether the cancer has spread to other parts of the body, such as the lungs or liver

To make an informed choice, ask about the pros and cons of each option, potential side effects, and how effective the treatment is likely to be.

Depending on the type and stage, treatment options can be: 

• SURGERY to remove the cancer, such as lumpectomy (removal of the tumor and a small rim of tissue around it-‘margins’) or mastectomy (removal of the entire breast) along with removal of lymph nodes in armpit
• RADIATION THERAPY, using high-energy rays (such as x-rays) to destroy cancer cells 
• CHEMOTHERAPY with drugs that kill breast cancer
• HORMONE THERAPY medications that block estrogen and other hormones that fuel the growth of some breast cancers
• TARGETED THERAPY drugs that act like smart bombs by targeting specific molecules involved in breast cancer development, growth, and spread while sparing normal cells

Mostly breast cancer treatment usually involves a combination of these approaches.

 

Frequently Asked questions –

What is the female breast made of?

Also called the mammary glands, female breasts are mostly made of fatty tissue along with blood vessels, nerves, lymph nodes, bands of connective or fibrous tissue (ligaments) to hold everything together, and the milk system, including ducts and lobes. The amount of fat largely determines your breast size.

What are the different types of surgery for Breast Cancer?

The surgery for Breast cancer can be of either Mastectomy commonly called MRM where entire breast including nipple and areola and nodes from the armpit are removed or a Lumpectomy where only the cancer lump is removed.

However, patients who need mastectomy can go for now nipple preserving mastectomy where we save entire breast skin and nipple complex and the breast is made again using either fat or muscle from the body or an implant.

Similarly for a lumpectomy, concepts of plastic surgery are used so that breast shape and fullness are preserved to achieve best results.

Should I go for Breast Reconstruction?

The effect of losing a breast is different on every lady. So while one person may be comfortable with living without a breast for the rest of her life, there is no reason for everyone to do the same. We combine the removal and reconstruction surgery at the same time so that when you come out of surgery, the tumor is gone but the breast is similar to what it was before surgery. Reconstruction not only helps your appearance, but it also has psychological benefits and it helps increase the tolerance to radiotherapy

If you can choose to skip reconstruction, there are options of using external breast forms made of pad or silicone or can even make no attempt to change your appearance.

How is Reconstruction done?

There are many ways to restore the breast. We can use oncoplastic breast reconstruction  or fat from lower tummy or muscle from back or use silicone implant depending upon the suitability and patient’s wishes.

When’s the Best Time to Have Breast Reconstruction?

The timing is based on your desires, medical conditions, and cancer treatment. The best results are obtained if it is done along with the surgery to remove the breast. However reconstruction can also be done months or years after a mastectomy was done. If you’ve started any chemotherapy or radiation treatments, reconstruction is usually postponed until you complete those treatments. Your surgeon can help you decide the right timing for you.

Will I be at risk for lymphedema after surgery?

The risk of arm swelling depends on the surgery done and also upon whether chemotherapy and radiotherapy is needed after surgery. We have procedures like sentinel lymph node biopsy and axillary reverse mapping, etc that reduce the risk of development of arm swelling (Lymphedema)  after treatment.

How long will I stay in the hospital?

The stay will vary upon the procedure planned and it can be from 2 days to 5 days.

How long does it to recover from surgery?

Patient usually resumes routine activities like eating, ambulating 6 hours from surgery.

Cervical Cancer

What is Cervical Cancer

Cervical cancer affects the cells of the cervix. Cervix is the connector between the uterus and the vagina. It is situated at the lower part of the uterus.

For most of the Cervical Cancers, Human Papillomavirus (HPV), an infection spread by sexual contact is the primary cause. In general, a woman’s immunity system restrains the HPV from affecting or doing any harm to the body. For very few number of women, the infection does not die in the body and remains in the cervix for years. During these years, sometimes, HPV infection turns few cells at the top of the cervix to cancerous cells.

Periodical check-ups of the cervix and vaccination against HPV infection both work for preventing Cervical Cancer.

Cervical Cancer Symptoms

At an early stage, cervical cancer does not generally show any symptom. When the cancer reaches more-advanced stages, the probable signs of cervical cancer are:

• Vaginal bleeding in multiple occasions (after intercourse, between periods, after menopause)
• Heavy, watery vaginal discharge with a strong foul odour
• Sharp pelvic pain during intercourse
• Bleeding after a pelvic examination
• Kidney failure (because of bowel obstruction or urinary tract obstruction)
• Pain during urination

 

Cervix cancer causes

 In a normal human body, a set of cells grows and dies through their normal cycle. Cancerous cells grow in multitudes and do not die.

Apart from HPV infection, the other causes are still not very clear. Maximum of the women encounter with HPV infection in their lifetime but very less of them actually end up developing Cervical Cancer. Therefore, certain lifestyle choices and environmental factors might influence.

Uterine cancer, endometrial cancer and Cervical Cancer come with almost identical symptoms. Therefore, it is sometimes perplexing to diagnose correctly without a proper pathological test.

Types of Cervical Cancer

Squamous cell carcinoma

At the outer part of the cervix, there is a layer of thin, flat cells lining called Squamous cells. This lining projects into the vagina. Squamous cell carcinoma is the most common type of cervical Cancer affecting this part.

Adenocarcinoma

Adenocarcinoma cancer affects the cervical canal. The column-shaped glandular cells are directly affected.

Rarely, a cervix can be affected by both types of Cervical Cancers.

Risk factors of Cervical Cancer

Multiple sexual partners

The more number of sexual partners one has encountered with and the more number of partners each of them has encountered with increase the chance of Cervical Cancer.

Early sexual activity

Indulging into sexual activity before a certain age can increase the risk of cervical cancer.

Sexually Transmitted Infections

If a woman is infected with other Sexually Transmitted Infections like chlamydia, syphilis, gonorrhea and HIV/AIDS, it increases the chance of having HPV.

Weak immune system

If the patient’s immune system is genetically weak or it has been weakened by some separate health condition or infection, she is at a greater risk of developing HPV.

Smoking

Squamous cell cervical cancer has a direct connection with smoking habit.

Prevention of Cervical Cancer

Though there is no concrete preventive method of Cervical Cancer apart from vaccination, here are few of the most effective preventions of Cervical Cancer:

• Getting vaccination against HPV
• Keep doing a periodical pap test
• Building up the habit of safe and protected sex
• Reducing smoking and drinking

When to Seek Medical Care for Cervical Cancer

Multiple symptoms of Cervical cancer including bleeding and pain can actually happen for multiple reasons apart from Cervical Cancer. The severity can largely depend on the patient’s age, medical history and environmental condition.

If you are bleeding after menopause, this situation is never normal and requires immediate medical help. Excessive heavy bleeding during period and multiple bleeding between 2 cycles are also not normal and one should seek medical attention.

Vaginal bleeding after a vigorous sex is often normal if this happens occasionally. But, if the bleeding occurs regularly and often it is quite painful, the situation needs immediate medical help.

If any of the above-mentioned symptoms come with weakness, fatigue, light-headedness and actually fainting, the situation is most likely to be quite serious.

Cervical Cancer Examinations and Tests

When this is true for all the types of cancers; especially for Cervical Cancer, early detection is the key for the cure. Cancers that affect only the small surface of the cervix have quite a fold better chance to be successful than cancers that spread into the other parts of the body.

Pap smear test helps tremendously in early detection of cervical cancer. In this test, some cells of the cervix are collected and tested for any structural and growth abnormality.

When the Pap smear test is showing some abnormalities but the other physical examination results are normal, then generally doctors go with Colposcopy. The cervix is inspected with a microscope called colposcope. The cervix area is dyed with acetic acid for easy recognition of any abnormal cell growth.

The loop electrosurgical excision procedure is another method of diagnosis where tissue sample from the cervix is collected with an electrified loop of wire.

Content Reviewed By: Dr. Piyush kumar Agarwal

Dementia

What is Dementia?

Instead of categorising Dementia as a disease, it could be considered as a bunch of symptoms that affect the memory, speaking and socializing ability of a person. This situation gradually reaches a point where even the simple daily tasks seem difficult and somewhat impossible.

Alzheimer’s disease is the most common type of Dementia accounting for 40-60% of all the cases. After Alzheimer’s disease, vascular dementia, the post-stroke memory loss is the most common classification of Alzheimer’s disease. Apart from that, Vitamin deficiency, thyroid gland disorder and Lewy body Dementia are common causes of Alzheimer’s disease.

Symptoms of Dementia

The signs of dementia are not very concrete. Still, medical researchers have identified 5 most distinct symptoms. A patient is generally considered affected with Dementia if 2 or more symptoms are present in him or her. The symptoms are:

• Memory loss
• Inability to focus and to pay attention
• Difficulty in communication and language
• Poor visual perception
• Decreased ability of judgement and reasoning

In most of the cases, Dementia is a progressive condition. At the initial stages, the dementia symptoms are so subtle that only the close friends or family members can detect the concern.

Causes of Dementia

Damage of the human brain cells is the root cause of dementia. When brain cells are too damaged to connect with each other properly, human actions like talking, thinking, walking, taking decisions and thinking are affected.

Different brain sectors are allotted for different types of responses like analyzing, Judgement and movement. When a certain sector of the brain starts to under-work, then all the other actions also get hampered. In Alzheimer’s symptoms, hippocampus` is one of the first sectors of brain to be affected and shrunk. Hippocampus works for forming new memories.

Therefore memory loss is the worst result of Alzheimer’s disease :

• Most of the Dementia causes are permanent and only worsen with time. The memory loss can be aggravated with: Side effect of certain medication

• Depression
• Thyroid gland problem
• Excessive alcohol consumption
• Vitamin deficiencies

Diagnosis of dementia

Till now, no definitive test is invented to find out if someone has Dementia or not. Dementia is diagnosed by multiple pathological tests, laboratory test, a thorough physical examination, medical history and progressive changes in the behaviour.

Dementia treatment and care

As most of the Dementias do not have a cure, the situations are treated instead. Both drug and non-drug therapies are used to treat Dementia.

However, there are a few ways that might help the Dementia condition:

Keeping the mind active

Any work that trains the brain like solving puzzle, reading or playing word games can help your brain to remain more active.

Being more socially active

Interacting with people around you and investing time in physical exercise are 2 best ways to overcome social anxiety and brain lethargy. Neurologists suggest at least 150 minutes of weekly exercise for an active brain.

Consume more Vitamin D

Inadequate Vitamin D is a main reason for Alzheimer’s disease and many other forms of Dementia. Apart from food and supplements, the best source of Vitamin D is sunlight.

Quit smoking

This is proven in a multitude of studies that smoking, especially at the older age, negatively impacts the blood vessels and dementia. By quitting smoking, you can keep the brain nerves and vessels healthier.

Lowering the blood pressure

High blood pressure is directly associated with multiple Dementia types. Therefore, treating hypertension can help the brain functioning more efficiently.

Maintaining a healthy diet

Mediterranean diet is mandatory for most of the Dementias including vascular dementia. A complete Mediterranean diet consists of plant-based foods (fruits, vegetables, nuts, whole grains), healthy fats (olive oil and canola oil), herbs and spices, fish and poultry.

Complications in Dementia

Dementia is a complication that can affect multiple organs and their ability to function. If not treated properly, this condition can worsen to such an extent that a patient can even die. Here are a few most common complications of Dementia:

Malnutrition

Usually triggering from difficulty in chewing and swallowing, most of the Dementia patients almost abandon eating. Therefore, severe malnutrition and lack of nutrition are quite common among the Dementia patients.

Pneumonia

For swallowing problem, the food is not properly digested. Therefore, there’s a good chance of choking of the lungs with undigested food. This situation can lead to Pneumonia.

Incapability of self-care

As the dementia stage aggravates, even simple daily tasks become incredibly hard to be performed. Daily tasks like bathing, eating, brushing, combing hair and walking require someone else’s help.

Safety hazard

As day by day regular tasks like driving, crossing the road or switching off the gadgets become difficult; at the later stages of Dementia, these things create safety issues for the patient and the family.

Death

As the body cannot function properly, at the final stage of Dementia, the patient often dies from severe infection.

Content Reviewed By: Dr. Kunal Bahrani

Gall Bladder Surgery

What is Gall Bladder Stone Surgery

The Gall bladder is a pear-shaped small pouch situated just under the liver. It holds all the bile, the digestive-fluid produced by the liver. If the Gall bladder does not regulate the bile properly, it transforms into hard fragments. The stones can largely vary in size; from a rice grain to a golf ball.

Gall bladder stones do not go away naturally. Gall bladders are surgically removed and the procedure is called Cholecystectomy.

Types of Gallbladder Surgery

Generally, Gall bladder stones are removed in 2 ways:

Open surgery: Open Gall bladder surgery is done with 5 to 7-inch incision in the belly. If the patient has a bleeding complicacy, the open surgery is specifically required. If the patient has associated complications like excessive obesity and last trimester of pregnancy, then also an open surgery is the wisest way.

Laparoscopic cholecystectomy: Laparoscopic Cholecystectomy or Keyhole surgery is done with 4 small holes in the patient’s body. The operation is done after introducing long and thin telescope into the abdomen that comes with a lens and a tiny light lamp at the tip which is connected to the camera on the monitor outside. Surgery is done using long and thin instruments.. During the surgery, the surgeon monitors the positioning of the Gall bladder. Then, with other small surgical equipment, the gall bladder is seperated from all the adjacent structures and liver and is taken out along with gallstones. some times if the gallstone are big then they are broken down and taken out.

Who needs Gallbladder removal surgery

In many cases, though the Gall bladder does not function properly, it may not cause any problem to the daily life. Doctors generally don’t remove the stone until it becomes a continuous disruption to the daily life.

When the Gall bladder blocks the bile ducts, it is called“gall bladder attack”. Gall bladder attack produces a sharp, knife-like gall bladder pain in the belly that generally stays till operated.

If Gall bladder is not operated instantly, it may lead to further complications like:

• Cholecystitis (inflammed gallbladder)
• Pancreatitis (inflammed pancreas)
• Cholangitis (inflammed bile ducts)

Gallbladder Diagnosis

Before surgically removing the gallbladder, the doctor will see how much and whether this surgery is going to affect the patient’s health.

The most significant tests are:

• Ultrasound
• Blood test
• MRI HIDA
• Endoscopic ultrasonography

The alternative of Gallbladder surgery

Making drastic changes to the diet can delay the attack to a few days or months. This dietary change cuts down all the fatty foods from the routine. But, this cannot be a permanent solution and the attack is bound to happen after a certain timeframe.

If the patient cannot anyway opt for a surgery, certain medications are prescribed for dissolving the stone inside the body. But, Gallbladder stone medications may actually take months or even years to dissolve the stones completely and not all types of stones can be dissolved by these medications. Also, dissolving the stone will not guarantee that it will never come back.

Gallbladder Surgery Risk Factors

Human liver  produces enough bile throughout the lifetime to run the digestive system normally. Gall bladder acts as an organ to store that bile and concentrate it till the time gall bladder pump it in the intestine when next food reaches there. Therefore, even if the Gallbladder is removed, the food would smoothly find its way to the small intestine and there is no significant change in digestion of food

Though Gall bladder operation is considered to be a safe surgical process, there are certain complications that may arise after or during the surgery:

• Bleeding
• Bile leakage
• Swelling
• Intestine, bowel or blood vessels damage
• Bile duct damage
• Heart problems
• Infection
• Deep vein thrombosis
• Pneumonia

Recovery from Gall Bladder Surgery

The recovery time largely depends on the patient’s other medical condition and the type of surgery he or she has gone for. If an open surgery is done, the patient might need to stay at the hospital for a few days after the surgery. It takes 6-8 weeks to get completely cured of an open surgery.

In the case of Laparoscopy, both the pain and the recovery time are much less. If there is no such other complication, the patient may go home on the same date of surgery. The complete recovery takes approximately 2 weeks.

Here are a few ways to avoid post-surgery complications:

• Moderate movement
• Drinking plenty of fluid
• Not lifting more than 6 pounds for 6 weeks
• Mainlining the hygiene of the operated area
• Changing the bandages as directed
• Avoiding wearing tight clothing

Content Reviewed By: Dr. Ved Prakash

Head and Neck Cancer

What is Head and Neck cancer?

Squamous cells are present in mucosal and moist surface inside the head and the neck. Head and Neck Cancer includes multiple types of organs such as mouth, sinuses, nose, throat, tongue, tonsils palate, parotid and thyroid gland. Rare, but salivary gland can also be affected with Head and Neck cancer. Also, as the Salivary glands have multiple types of cells, there are chances of growing multiple types of cancers as well. Head and Neck cancer is broadly divided into 6 categories depending on where they have begun.

 

Oral Cavity

Oral cavity cancer includes the oral parts such as the frontal two-third part of the tongue, the bony top of the mouth, the lips, the gum behind the wisdom teeth, the floor under the tongue and the cheeks and lip lining. Tongue cancer is the most common of all the categories here.

 

Paranasal sinuses and nasal cavity

This cancer starts with the small hollow spaces of the bone that surrounds the tip of the nose. The nasal cavity i.e. the hollow passage inside the nose can also form cancer.

 

Pharynx

Pharynx, behind the nose and mouth, is the membrane-lined cavity or hollow tube of 5 inches. It has 3 parts: the nasopharynx (the upper part), the Oropharynx (the middle part) and the Hypopharynx (the lower part). Any one of these three or all three parts can be affected with neck cancer.

 

Larynx

Laryngeal cancer is the growth of malignant cells in the tissues of the larynx. Excessive consumption of alcohol and tobacco products increases the risk factor of Laryngeal cancer. This type of cancer can damage the patient’s voice. If not early detected, this type of cancer has a tendency of spreading to the other parts of the head and the neck.

 

Salivary glands

All the major saliva glands that produce saliva can develop Salivary glands cancer.

 

Thyroid

The Thyroid can develop multiple types of cancers with good prognosis treatment.

 

Causes of Throat Cancer and Head Cancer

For Oral cancers, tobacco and smoking alcohol consumption are the top three factors held responsible. Researches show three-fourth of the Head and Neck cancer is caused by Tobacco and Alcohol.

 

Other risk factors are:

Betel quid or Paan is widely used as a mouth freshener in South-East Asia. The betel quid has a direct influence on cancer formation in the mouth.

 

Ancestry

Asian ancestry has a specific chance of developing Head and Neck Cancer.

 

Occupational exposure

Exposure to wood dust can be a symptom of nasopharyngeal cancer. Wood dust that contains asbestos and synthetic fibres may cause larynx cancer. People associated with the food industry, textile, metal, ceramic, construction and logging industry are especially exposed to larynx cancer. These conditions also increase the chances of nasal cavity and paranasal sinuses cancer.

 

Preserved or salted foods

Especially during childhood and early adulthood, certain salted and preserved foods increase the chance of nasopharyngeal cancer.

 

Radiation exposure

If radiation is given to someone’s head and neck for diagnosis of some another complication, it can have a future risk of Head Cancer specially Thyroid cancers.

 

Poor oral health

Missing teeth, weak gum and poor oral health may be indirect signs of oral gum cancer. Mouthwashes with high alcohol content can be a reason for mouth cancer but no study could prove it so far.

 

Epstein-Barr virus infection

The Epstein-Barr virus is a probable risk factor of nasopharyngeal cancer and salivary glands cancer. Human papilloma virus is a risk factor for Oropharyngeal cancers.

 

Head and neck cancer symptoms

For a significant amount of time, Head and Neck cancer is asymptomatic or the symptoms can arise at more advanced stages of cancer. Here are a few most common throat cancer symptoms and Head and neck cancer symptoms:

• A sore throat or swelling that does not heal
• Excessive foul mouth odour
• Double vision
• White or red patch inside the mouth
• Loss of teeth
• Persistent nasal congestion or nasal obstruction
• Difficulty in protesim of tongue
• Change in speech pattern
• Loss of mouth opening.
• Mass, bump or lump in the neck and head area (with or without pain)
• Change in voice (hoarseness)
• Difficulty in breathing
• Frequent nose bleeding or unexplained nasal discharge
• Jaw pain
• Weakness or numbness around the head and neck area
• Unexplained weight loss
• Difficulty in swelling, chewing, moving the tongue and jaw
• Blood from saliva or phlegm
• Ear pain or ear infection

Head and Neck Cancer Diagnosis

Head and Neck cancer diagnosis is done mainly for 2 reasons: to know the exact place of cancer and to know whether it has spread to other organs or not. If the Head and Neck cancer spreads from one organ to another, it is called metastasis.

 

Few most authentic diagnoses of Lymphoma and other Head and Neck cancers are:

• Biopsy
• Panoramic Radiograph
• Endoscopy
• Imaging test
• Ultrasound
• Molecular testing of the tumour
• Computed tomography scan
• Blood and urine tests
• Bone scan
• X-ray
• Magnetic resonance imaging
• PET or PET-CT scan
• Barium swallow

 

Apart from these tests, the overall diagnosis of the person depends on these factors:

• The type of cancer
• Patient’s signs and symptoms
• Patient’s medical condition and age
• The results of earlier medical tests

Head and Neck cancer is a type of cancer which is often curable if detected early. The treatment might include radiation therapy, surgery, chemotherapy or multiple treatments combined from the list.

 

Treatment

Primary treatment of an Oral cavity, salivary gland and thyroid cancer is surgery. Other cancers are amenable to radial or combined chemotherapy & Radiation.

Content Reviewed By: Dr. Piyush kumar Agarwal

Hernia

What is Hernia?

Fascia tissue is a band of connective tissues located beneath the skin. These connecting, stabilizing and enclosing tissues are broken through by fatty tissues or a part of any organ. This occurrence is called Hernia. In Hernia, sometimes the organs push through the muscle openings as well. One of the most common types of Hernia is when intestine breaks through the weakened abdominal wall.

A Hernia can appear in the abdomen, belly button, upper thigh and groin areas. Hernia, if kept untreated, neither goes away naturally nor poses any life-threat.

Types of Hernia

There are multiple types of Hernia from which these 5 are the most common ones:

• Inguinal (inner groin) The bladder or the intestine peeps through the groin inguinal canalor, the abdominal wall. Almost all the groin hernias are inguinal. Men have a tendency to lose strength in this region with aging. An Inguinal hernia is the result of this weakness.
• Femoral (outer groin) Femoral Hernia, one of the most uncommon Hernias is painful lumps in the upper-inner groin and thigh. The pain decreases with lying down and increases with straining or coughing.
• Incisional (result of an incision) In a case where any abdominal surgery was done previously and the same didn’t heal properly, the intestine hits and comes out through the abdominal wall. Three types of people are most prone to an incisional hernia: older people, excessive overweight people and people who have lived completely sedentary life after an abdominal operation.
• Hiatal (upper stomach area) Hiatal Hernia is the pushing of the lungs to the diaphragm muscle.This is a treatable condition. It can last as short as a year to as long as a lifetime.
• Umbilical (belly button) Before a person is born, the umbilical cord passes through the abdominal muscle. With Umbilical hernia, a portion of the patient’s intestine sticks out through it.

 

Hernia Symptoms

Irrespective of the type of Hernia, primarily a lump or bulging is seen in the affected area. Only for the Inguinal Hernia, the lump is seen on sides of the pubic bone; specifically where the groin and thigh meet.

A Hernia is well palpable and can be felt more while changing postures and walking. If the Hernia has developed with babies and infant, the bulging is visible the most when it’s crying. Babies are most prone to Umbilical Hernia.

Apart from these, other types of Hernia (Inguinal) symptoms are:

• Constant or periodical discomfort or pain in the affected area. In most of the cases, the lower abdomen is the affected area.
• Increase in the pain and the discomfort while changing positing, coughing and lifting some object.
• Heaviness and pressure in the abdominal area
• General weakness
• A gurgling, burning or aching sensation around the spot

Apart from these, symptoms of a hiatal hernia include:

• Chest pain
• Difficulty swallowing
• Acid reflux (when stomach acid moves to the esophagus)

In most of the cases, the early phases of Hernia are asymptomatic and patients don’t feel the problem till their daily activity is disrupted.

Causes of Hernia

Muscle strain and muscle weakness are jointly responsible for Hernia. Depending on what is responsible for this complication, a hernia can grow rapidly or over a long period of time.

Muscle weakness, the main cause of Hernia is caused by:

• A congenital defect, failure of the abdominal wall near the womb
• Chronic Coughing
• Age
• Damage from any surgery or injury

Other reasons for muscle weakness are:

• Pregnancy as it puts pressure in the abdomen
• Constipation as it creates a strain on the bowel movement
• Persistent coughing or sneezing
• Heavyweight lifting
• Sudden gain of  weight
• Fluid accumulation in the abdomen
• Surgery in that area

Who are at risk of Hernia?

A Hernia is pretty common in India. The risk factors of Hernia are:

• A family history
• A  chronic cough
• Being overweight
• Smoking that welcomes chronic coughing
• Chronic constipation

Cystic fibrosis is a life-threatening disease that damages the digestive system and the lungs.  This disease has a direct connection with Hernia. Cystic Fibrosis interrupts the normal efficiency of lungs which leads to chronic coughing.

Diagnosis of Hernia

For an Incisional hernia, multiple physical examinations are done. The physician often makes the diagnosis by feeling the bulging within the patient’s body.

Endoscopy and barium X-ray are 2 tests done for Hiatal Hernia.

With barium X-ray, multiple photographs are captured with the affected digestive tract. Prior to the examination, the patient is given a liquid solution of barium. This liquid helps to show the digestive track more prominently in the X-ray.

With Endoscopy, a small camera is inserted at your esophagus and stomach with a tube through the throat.

With both the tests, the internal situations of the organs and their functions are vividly shown.

For Umbilical Hernia, the diagnosis is generally done with an ultrasound.

Hernia Treatment

Whether and what type of treatment you need depends on the stage and the background of the Hernia. A hernia can be treatedbroadly by three types of treatments:

• Lifestyle changes
• Medications
• Surgery

Changes in lifestyle include:

• Avoiding heavy meals
• Do muscle strengthening exercises
• Avoiding foods that cause heartburn or acid reflux
• Avoiding tomato-based foods
• Giving up smoking

Treatment with medications include:

• Medicines that reduce stomach acid
• Proton pump inhibitors
• H-2 receptor blockers

Treatment with surgery includes:

• If the Hernia is rapidly growing, the best treatment is to get it operated. In most of the cases, the hole in the abdominal wall is repaired.
• Hernia surgery can be done in 2 ways: open surgery and laparoscopic surgery. For open surgery, the patient may need up to 6 weeks to walk around normally.
• Every type of Hernia is not fit for laparoscopic surgery. If the part of the intestine moves down into the scrotum, then open surgery is the only alternative left.

Content Reviewed By: Dr. Ved Prakash