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Rectum

Rectal prolapse in adults

March 25, 2023 by Dr. Harsh J Shah – Pancreas, Liver, Gastro & Cancer Surgeon Leave a Comment

Best Doctor for Rectal Prolapse in adults 1
English
ગુજરાતી
हिंदी
What is rectal prolapse?

Rectal prolapse in adults may be a rare condition that happens when some or all of the tissue that lines the rectum sticks out of the anus. (The rectum is the lower part of the large intestine.) Rectal prolapse is commonest in older women but can happen in men and women of all ages.

What causes rectal prolapse in adults?
  • Women who have had more than one baby by vaginal birth are more likely to get rectal prolapse. Other health conditions which will make rectal prolapse more likely include:

    • Long-term bowel problems such as:
    •  Constipation – this suggests your bowel movements are too hard or small, difficult to get out, and happen fewer than 3 times per week.
    •  Straining during bowel movements
    • Diarrhoea – this suggests your bowel movements are watery or runny and happen quite 3 times every day.
    • Problems within the pelvic area, including weak muscles or a history of pelvic surgery.
What are the symptoms of rectal prolapse in adults?

The main symptom is bright red tissue sticking out of the anus. The tissue might have mucus or blood on it. Rectal prolapse isn’t usually painful but may be uncomfortable. The tissue might stay outside the anus or move back inside the body.

Other symptoms include:

  • Trouble starting a bowel movement
  • Feeling such as you have not fully emptied your bowels
  • Leaking solid or liquid bowel movements (called “fecal incontinence”)
Is there a test for rectal prolapse?
  • Your Gastroenterologist can also tell if you have the problem by doing an exam. If the tissue has moved back inside your body, your Gastroenterologist might ask you to squat or sit on the toilet to check if the tissue comes back out of your body.

    You might need other tests. These tests can also show if you have a different problem. They include:

    • An MRI – This test creates pictures of the within the body.
    • Cystocolpoproctography – For this test, a Gastroenterologist fills your bladder, vagina, and rectum with a substance known as “assessment material” that indicates X-rays. The X-rays show how those parts of your body are functioning.
    • Defecography – This test also uses contrast material in the rectum and takes X-rays while you have a bowel movement.
    • Manometry – This test measures the pressure inside the rectum. It can show if the muscles that control bowel movements are working correctly.
How is rectal prolapse treated?

The treatment depends on how serious your symptoms are and if you have other health problems. Whatever treatment you have, your Gastroenterologist will likely tell you to:

  • Eat foods that have a lot of fiber. excellent choices are fruits, vegetables, prune juice, and cereal (table). you ought to eat between 25 to 30 grams of fiber per day.
  • Drink 4 to eight cups of water or other fluids per day.
  • Operation to correct the problem is usually required. It is done through laparoscopic technique.
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Filed Under: Rectum, Rectal Prolapse

મોટા આંતરડાનું બહાર આવી જવું

March 21, 2023 by Dr. Harsh J Shah – Pancreas, Liver, Gastro & Cancer Surgeon Leave a Comment

રેક્ટલ પ્રોલેપ્સ ના શ્રેષ્ઠ ડૉક્ટર
English
ગુજરાતી
हिंदी
મોટા આંતરડાનું બહાર આવી જવું એટલે શું ?
  • આ એક ભાગ્યેજ થતો રોગ છે. આ રોગ માં મોટા આંતરડાના અંતિમ ભાગ ની અંદર લાયનિંગ નો કેટલોક ભાગ ગુદા ની બહાર આવેલો દેખાય છે. આ પ્રકારની બીમારી મોટા ભાગે મોટી ઉંમરની સ્ત્રીઓમાં એટલે કે વૃદ્ધાઓમાં જોવા મળે છે. પરંતુ આ રોગ બધી ઊંમરના સ્ત્રી- પુરુષો ને થયી શકે છે.

શા કારણે મોટા આંતરડા ના છેવાડા નો ભાગ બહાર આવી જાય છે?

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મોટા આંતરડા ના બહાર આવી જવાના રોગ ના લક્ષણો કેવા હોય છે?

હા. તમારા ડૉક્ટર એક પરીક્ષા કરશે અને વિવિધ પરીક્ષણોનો કરાવશે જેના થી અતિસારના અન્ય કારણોને બાકાત કરશે, અને માઇક્રોસ્કોપિક કોલાઇટિસનું નિદાન કરશે. આમાં નિમ્નલિખિત હોઈ શકે છે:

  • રક્ત પરીક્ષણો
  • તમારી મળ ના નમૂના પર લેબ પરીક્ષણો
  • “કોલોનોસ્કોપી”(Colonoscopy) અથવા “ફ્લેક્સીબલ સિગ્મોઇડસ્કોપી” (flexible sigmoidoscopy) – આ એક પ્રક્રિયા થી ડૉક્ટર તમારા કોલોનની અંદરની તરફ જોઈ શકે છે. ડૉક્ટર તમારા ગુદામાં, અને તમારા ગુદામાર્ગ અને કોલોન માં એક પ્રકાશવાળા, કેમેરાવાળી પાતળી નળી દાખલ કરશે. આ પ્રક્રિયા દરમિયાન, ડૉક્ટર બાયોપ્સી (Biopsy) નામની એક પરીક્ષણ પણ કરશે. બાયોપ્સી માટે, તે અથવા તેણી તમારા કોલોનમાંથી પેશીના નાના નમૂના લેશે. પછી બીજા ડૉક્ટર માઇક્રોસ્કોપિક કોલાઇટિસની તપાસ માટે માઇક્રોસ્કોપ હેઠળના નમૂનાઓ જોશે. બાયોપ્સી જ એક માત્ર પરીક્ષણ છે જે તમને માઇક્રોસ્કોપિક કોલાઇટિસ છે કે નહીં તે ખાતરી થી દર્શાવી શકે છે.
આ રોગ માટે કોઈ પરીક્ષણો કરાવવાના હોય છે?

તમારી વ્યક્તિગત પરિસ્થિતિ પર સારવાર આધારિત છે. તેમાં સામાન્ય રીતે નીચેનામાંથી એક અથવા વધુ સારવારનો સમાવેશ થાય છે:

  • દવામાં પરિવર્તન – જો તમારા ડૉક્ટર ને લાગે છે કે તમારા લક્ષણો તમે લીધેલી દવાને કારણે થાય છે, તો તે અથવા તેણી ભલામણ કરશે કે તમે તે દવા લેવાનું બંધ કરો.
  • એન્ટી-ડાઇરર્હીયા (Anti-Diarrhea) દવાઓ, જેમ કે લોપેરામાઇડ – આ દવાઓ તમારી મળની થવાની થવાની સંખ્યા ઘટાડે છે.
  • બ્યુડેસોનાઈડ નામની એક સ્ટીરોઈડ દવા – આ દેવા, કેટલાક એથ્લેટ્સ ગેરકાયદેસર રીતે લેતા સ્ટીરોઇડ્સની જેવી નથી. આ દવા કોલોનમાં સોજો ઘટાડવામાં મદદ કરે છે.

જો આ ઉપચાર તમારા લક્ષણોને સરળ બનાવવા માટે પૂરતી મદદ ન કરે તો તમારા ડૉક્ટર ને જણાવો. બીજી દવાઓ અથવા સારવાર પણ છે જે મદદ કરી શકે છે.

કેટલાક લોકોને લાંબા ગાળા માટે સારવાર જરૂરી હોઈ શકે છે. કારણ કે કેટલીકવાર, સારવાર બંધ થયા પછી લક્ષણો પાછા મેહસૂસ કરવાના  ચાલુ થઇ જાય છે.

મોટા આંતરડાનું બહાર આવી જવાના રોગ ની સારવાર કેવીરીતે કરાય છે?
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Filed Under: Rectum, Rectal Prolapse

वयस्कों में रेक्टल प्रोलैप्स

March 21, 2023 by Dr. Harsh J Shah – Pancreas, Liver, Gastro & Cancer Surgeon Leave a Comment

वयस्कों में रेक्टल प्रोलैप्स के श्रेष्ठ डॉक्टर
English
ગુજરાતી
हिंदी
रेक्टल प्रोलैप्स की बीमारी में क्या होता है?

जब कुछ या सभी गुदा में होने वाली ऊतक या टिश्यू (पतली परत), गुदा से बाहर निकल आती हैं, तब उसे रेक्टल प्रोलैप्स कहते हैं। वयस्कों में अक्सर यह एक दुर्लभ स्थिति होती है। (मलाशय बड़ी आंत का निचला हिस्सा होता है।) वृद्ध महिलाओं में रेक्टल प्रोलैप्स सबसे आम है, लेकिन सभी उम्र के पुरुषों और महिलाओं में हो सकता है।

वयस्कों में रेक्टल प्रोलैप्स किन कारणों से होता है?
  • जिन महिलाओं को एक से अधिक बच्चे (सामान्य तरीक़े से मतलब की) योनि जन्म पद्धति से हुए हैं, उनमें रेक्टल प्रोलैप्स होने की संभावना अधिक होती है। रेक्टल प्रोलैप्स को और अधिक संभावित बनाने वाली अन्य स्वास्थ्य की स्थितियां  इस प्रकार हैं:

    • दीर्घकालिक आंत्र समस्याएं जैसे:
    • कब्ज – यदी आपका मल त्याग बहुत कठिन या कम मात्रा में होता है, तथा उसे बाहर निकलना मुश्किल है, और प्रति सप्ताह 3 बार से भी कम समय मल त्याग होता है, तो आपको क़ब्ज़ है
    •  मल त्याग के दौरान तनाव होना
    • अतिसार यनी के डायरिया (Diarrhoea) – इसका मतलब है कि आपका मल त्याग पानी से भरा हुआ या अधिक बह रहा है, और दिन में 3 बार से अधिक होता है।
    • पैल्विक (pelvic) यानी के श्रोणि क्षेत्र में समस्याएं, जिनमें कमजोर मांसपेशियां या पैल्विक सर्जरी का इतिहास रहा हो।
वयस्कों में रेक्टल प्रोलैप्स के लक्षण कैसे दिखते या मेह्सूस होते हैं?

मुख्य लक्षण होते हैं — उज्ज्वल लाल रंग के ऊतक जो गुदा से बाहर निकला हुआ होते हैं। ऊतक में बलगम या रक्त भी हो सकता है। आमतौर पर, रेक्टल प्रोलैप्स दर्दनाक नहीं होता है, किंतु बहुत असुविधाजनक हो सकता है। यह ऊतक गुदा के बाहर रह सकता है या शरीर के अंदर वापस भी जा सकता है।

अन्य लक्षणों इस प्राकार हो सकते हैं:

  • मल त्याग शुरू करने में परेशानी
  • ऐसा महसूस हो रहा हो कि आपने अपनी आंत को (संतोषजनक रूप से) पूरी तरह से खाली नहीं किया है
  • ठोस या तरल मल त्याग की रिसाव करना (जिसे “मल असंयम” कहा जाता है)
क्या रेक्टल प्रोलैप्स के लिए किसी विशेष परीक्षण यानी के टेस्ट की आवश्यकता है?
  • एक परीक्षण या टेस्ट (Test) करके, आपके डॉक्टर आसानी से बता सकते हैं, कि क्या आपको रेक्टल प्रोलैप्स की समस्या है। यदि ऊतक आपके शरीर के अंदर वापस चला गया है, तो आपके डॉक्टर आपको फिर से शौचालय पर बैठने को कह सकते हैं। इससे यह जांचने के लिए कि ऊतक फिर से आपके शरीर से बाहर आता है या नहीं।

    अन्यथा, आपको अन्य परीक्षणों की आवश्यकता हो सकती है। यदि आपको कोई अलग समस्या है, तो निम्न परीक्षण भी करवा सकते हैं। उनमे शामिल है:

    • एमआरआई (MRI) – यह परीक्षण शरीर के अंदर की तस्वीरें बनाता है।
    • सिस्टोकोलपोप्रोक्टोग्राफी (Cystocolpoproctography)- इस परीक्षण में, डॉक्टर आपके मूत्राशय, योनि, और मलाशय को “कंट्रास्ट मटीरियल” (contrast material) नामक पदार्थ से भर देंगे, जो एक्स-रे पर दिखाई देता है। उसके बाद, एक्स-रे से पता चलता है कि आपके शरीर के ये अंग कैसे काम कर रहे हैं।
    • डेफेकोग्राफी (Defecography)- यह परीक्षण मलाशय में “कंट्रास्ट मटीरियल” (contrast material) का उपयोग करता है, और जब आप मल त्याग करते हैं तो इस “कंट्रास्ट मटीरियल” के एक्स-रे लेते हैं।
    • मैनोमेट्री (Manometry) – यह परीक्षण मलाशय के अंदर के दबाव को मापता है। यह दिखा सकता है कि मल त्याग को नियंत्रित करने वाली मांसपेशियां सही तरीके से काम कर रही हैं या नहीं।
रेक्टल प्रोलैप्स का इलाज कैसे किया जा सकता है?

उपचार इस बात पर निर्भर करता है कि आपके लक्षण कितने गंभीर हैं, और यदि आपको अन्य स्वास्थ्य समस्याएं हैं। आप जो भी उपचार कर रहें हों, आपके डॉक्टर बताएँगे कि:

  • ऐसे खाद्य पदार्थ खाएं जिनमें बहुत अधिक फाइबर हो। अच्छे विकल्प फल, सब्जियां, प्रून जूस, और सिरिय्ल्स हैं। आपको प्रतिदिन 25 से 30 ग्राम फाइबर खाना चाहिए।
  • प्रतिदिन 4 से 8 कप पानी या अन्य तरल पदार्थों का सेवन करें।

अन्य उपचार में शामिल हैं:

  • जुलाब की दवाइयाँ – ये ऐसी दवाएं हैं जो मल त्याग को आसान बनाने में मदद करती हैं। कुछ गोलियां हैं जिन्हें आप निगलते हैं। अन्य गोलियां, मलाशय में डाली जाती हैं, जिन्हें “सपोसिटरी” (suppositories) कहते हैं।
  • एनिमाज़ (enemas) – इस उपचार में, डॉक्टर आपके मल को खाली करने में मदद करने के लिए आपके मलाशय में विशेष तरल पदार्थ डालते हैं।
  • बायोफीडबैक (biofeedback) के साथ पेल्विक फ्लोर (Pelvic floor) व्यायाम – इस व्यायाम से उन मांसपेशियों को मजबूत करते हैं जो मूत्र और मल त्याग के प्रवाह को नियंत्रित करती हैं। उन्हें “केगेल” (Kegel Exercises) व्यायाम (अभ्यास) भी कहा जाता है। बायोफीडबैक, सेंसर (Sensors) नामक उपकरणों का उपयोग करता है जो, मांसपेशियों की गतिविधियों को मापते हैं। वे आपको बता सकते हैं कि, क्या आप मांसपेशियों का सही तरीके से उपयोग कर रहे हैं या नहीं।
  • सर्जरी (surgery) – रेक्टल प्रोलैप्स को ठीक करने के लिए डॉक्टर विभिन्न प्रकार की सर्जरी का उपयोग भी कर सकते हैं। सर्जरी का प्रकार, आपकी उम्र और स्वास्थ्य पर निर्भर करता है। यह पेट के माध्यम से (केवल युवा, स्वस्थ लोगों के लिए) या गुदा के माध्यम से (बड़े लोगों या स्वास्थ्य समस्याओं वाले लोगों के लिए) किया जा सकता है।
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Filed Under: Rectum, Rectal Prolapse

Rectal stricture

March 7, 2023 by Dr. Harsh J Shah – Pancreas, Liver, Gastro & Cancer Surgeon Leave a Comment

22. Rectal stricture blog
English
हिंदी
ગુજરાતી
What is Rectal Stricture?
Rectal stricture is a condition where the rectal or anal opening is narrowed due to the presence of scar tissue from inflammation, a previous injury, or an aggressive cancer growth.
What are the symptoms of rectal stricture ?

Patient with rectal stricture complain of difficulty in passing stools, straining at stool & occasionally blood in stool. Sometimes the caliber & consistency of the stool changes. Some may develop bloating & inability to pass stools if the disease is advanced.

What are the Causes?

Following are some of the causes of rectal stricture:

  • Ulcerative colitis
  • Crohn’s disease
  • Radiation proctitis
  • Cancer
How is a Rectal stricture diagnosed ?

The diagnosis of a rectal stricture is based on history, physical examination, and, occasionally, imaging findings. The degree of a stenosis is best imaged with a water-soluble contrast enema. Computed tomography and magnetic resonance imaging, with or without rectal contrast enhancement, can be helpful in assessing other segments of the alimentary tract or the peritoneal cavity for conditions such as IBD and cancer.

How is a Rectal Stricture treated?
Rectal Stricture treatment is usually based on the cause and severity of the condition. The following covers the most common treatment methods, including non-operative management.
  • Dietary Adjustments: This is for mild anal stenosis and can include eating foods with more fiber, which can make stools larger.
  • Stool Softeners: For mild to moderate anal stenosis, this can help stretch a mild stricture.
  • Anal Dilation: This is a way to stretch the anal canal. It involves placing your index finger into the anus two times a day for about two months to help stretch the area. In severe situations, this can be done at a hospital.
  • Steroid Injection: When injections are made right into a scar it can potentially reduce recurrence of stricture.
  • Botox: Injections of Botox have been known to help stenosis caused by spasm.
  • Surgery: Two surgical options are sphincterotomy, which is used to repair fissures, or Sphincteroplasty, which is a flap procedure whereby healthy tissue is used replace a defective area after scar tissue has been removed.
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Filed Under: Rectum, Stricture

Rectal Surgery

March 7, 2023 by Dr. Harsh J Shah – Pancreas, Liver, Gastro & Cancer Surgeon Leave a Comment

rectal prolapse
English
हिंदी
ગુજરાતી
What is Rectal Surgery?
The word surgery means operation. Rectal Surgery means the operations performed over rectum. Surgery is usually the main treatment for rectal cancer. Radiation and chemotherapy are often given before or after surgery.
What are various types of rectal surgery for cancer ?
There are mainly two types of cancer operations for rectum. One is LAR(Low Anterior Resection) & the other is APR(Abdomino-perineal resection).
The type of operation used to remove the rectal cancer depends on the extent and location of the cancer. If the rectal cancer is located well above the anus, a low anterior resection (LAR) can be performed. This operation allows the patient to keep anal function and pass stools in a normal manner. If the rectal cancer is located close to the anus, sometimes the anus must be removed with the cancer in an operation called an abdominoperineal resection (APR). The patient must then use a colostomy bag.
What is a colostomy ?

A colostomy is an opening where the large intestine is attached to the abdominal wall. A replaceable bag that encloses the colostomy is worn by the patient to collect stool.

What are the Side Effects of rectal surgery?

Possible risks and side effects of surgery depend on several factors, including the extent of the operation and a person’s general health before surgery. Problems during or shortly after the operation can include bleeding from the surgery, infections at the surgery site, and blood clots in the legs. There is a minor but real risk of leakage from the bowel stitch line. Also there are chances of urinary retention. There may be ‘adhesion’ formation & distension of the belly.

What happens after surgery ?

When you wake up after surgery, you will have some pain and will need pain medicines for a few days. For the first couple of days, you may not be able to eat or you may be allowed limited liquids, as the rectum needs some time to recover. Most people are able to eat solid food again in a few days.

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Filed Under: Rectum, Surgery

Rectal prolapse in adults

March 7, 2023 by Dr. Harsh J Shah – Pancreas, Liver, Gastro & Cancer Surgeon Leave a Comment

rectal prolapse
English
हिंदी
ગુજરાતી
What is rectal prolapse?
Rectal prolapse in adults may be a rare condition that happens when some or all of the tissue that lines the rectum sticks out of the anus. (The rectum is the lower part of the large intestine.) Rectal prolapse is commonest in older women but can happen in men and women of all ages.
What causes rectal prolapse in adults?

Women who have had more than one baby by vaginal birth are more likely to get rectal prolapse. Other health conditions which will make rectal prolapse more likely include:

  • Long-term bowel problems such as:
  •  Constipation – this suggests your bowel movements are too hard or small, difficult to get out, and happen fewer than 3 times per week.
  •  Straining during bowel movements
  • Diarrhoea – this suggests your bowel movements are watery or runny and happen quite 3 times every day.
  • Problems within the pelvic area, including weak muscles or a history of pelvic surgery.
What are the symptoms of rectal prolapse in adults?

The main symptom is bright red tissue sticking out of the anus. The tissue might have mucus or blood on it. Rectal prolapse isn’t usually painful but may be uncomfortable. The tissue might stay outside the anus or move back inside the body.

Other symptoms include:

  • Trouble starting a bowel movement
  • Feeling such as you have not fully emptied your bowels
  • Leaking solid or liquid bowel movements (called “fecal incontinence”)
Is there a test for rectal prolapse?

Your Gastroenterologist can also tell if you have the problem by doing an exam. If the tissue has moved back inside your body, your Gastroenterologist might ask you to squat or sit on the toilet to check if the tissue comes back out of your body.

You might need other tests. These tests can also show if you have a different problem. They include:

  • An MRI – This test creates pictures of the within the body.
  • Cystocolpoproctography – For this test, a Gastroenterologist fills your bladder, vagina, and rectum with a substance known as “assessment material” that indicates X-rays. The X-rays show how those parts of your body are functioning.
  • Defecography – This test also uses contrast material in the rectum and takes X-rays while you have a bowel movement.
  • Manometry – This test measures the pressure inside the rectum. It can show if the muscles that control bowel movements are working correctly.
How is rectal prolapse treated?

The treatment depends on how serious your symptoms are and if you have other health problems. Whatever treatment you have, your Gastroenterologist will likely tell you to:

  • Eat foods that have a lot of fiber. excellent choices are fruits, vegetables, prune juice, and cereal (table). you ought to eat between 25 to 30 grams of fiber per day.
  • Drink 4 to eight cups of water or other fluids per day.
  • Operation to correct the problem is usually required. It is done through laparoscopic technique.
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Filed Under: Rectum, Cancer

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