Author Archives: Dr Datta

Pancreatic cancer is a type of cancer that starts as an abnormal growth of cells in the pancreas. The pancreas is situated behind the lower part of the stomach. Enzymes and hormones that help digest food and help control blood sugar are made in the pancreas.

The most common type of pancreatic cancer is pancreatic ductal adenocarcinoma.

It is rarely found at an early stage when the chances of getting cured are higher. This is because the symptoms take time to manifest until then the cancer has spread to different organs.

Pancreatic cancer treatment in Hyderabad: The options for pancreatic cancer include – surgery, chemotherapy, and radiation therapy.

Symptoms 

Pancreatic cancer doesn’t cause any symptoms until the disease is advanced. Signs and symptoms of pancreatic cancer are as follows-

• Loss of weight
• Loss of appetite
• Itching
• Diabetes
• Swelling and pain in arms or legs
• The pain could be due to a blood clot
• Weakness
• Tiredness
• Jaundice

Causes

There is no particular cause that has been found for pancreatic cancer. Medical professionals and doctors have found some reasons that may raise the risk of this cancer. These reasons include- having a family history of pancreatic cancer or smoking.

Risk factors

Factors that may raise the risk of pancreatic cancer are as follows –

• Type 2 diabetes
• Smoking
• Pancreatitis (which is also known as chronic inflammation of the pancreas)
• A family history of DNA changes increases cancer risk. These include changes in the BRCA2 gene, familial atypical multiple mole melanoma (FAMMM) Syndrome, and Lynch syndrome.
• Family history of pancreatic cancer
• Obesity

Complications

As pancreatic cancer grows and spreads it causes complications like

Loss of weight – Various people with pancreatic cancer lose weight as this type of cancer uses more of the body’s energy.

Vomiting and nausea caused by treatment of this cancer or cancer pressing on the belly might make it difficult to eat.

This type of cancer blocks the liver’s bile duct which can cause jaundice. Yellowing of skin and the whites of the eyes are some of the signs. Jaundice can cause pale stools and dark-colored urine. It usually occurs without stomach pain.

If the bile duct is blocked, a metal or plastic tube called a stent is put inside. This stent helps to hold the bile duct open. All this is done using a procedure called endoscopic retrograde cholangiopancreatography which is also called ERCP.

During ERCP, a gastroenterologist puts a long tube with a small camera called an endoscope down the throat. This tube goes down through the stomach and into the upper part of the intestine (small intestine). The doctor also put a dye into the pancreatic ducts and bile ducts through a tiny tube that fits through the endoscope. The dye helps to show up the ducts on imaging tests.

Pain- an aggressively growing tumor might press on nerves present in your abdomen. Causing a severe pain. Treatments such as chemotherapy and radiation might help to slow the tumor’s growth and help reduce the pain.

If medicines aren’t helping. Doctors suggest a celiac plexus block. This procedure uses a needle to put alcohol in the nerves that control pain in the stomach. The alcohol infused in the nerves stops the nerves from sending pain signals to the brain.

Bowel blockage – pancreatic cancer can grow on the first part of the small intestine known as the duodenum. Which can block the flow of digested food from the stomach into the intestines.

When to see a surgical gastroenterologist who specializes in pancreatic cancer surgery?

Visit a surgical gastroenterologist if you have the symptoms that are bothering you.

Pancreatic Cancer Treatment in Hyderabad

The best and the only reliable option to cure pancreatic cancer is surgery.

It is possible to remove or resect all cancer when test results indicate potentially curative surgery. But, if the cancer has widespread, then palliative surgery is done to prevent complications and to get rid of symptoms.

Only 20% of pancreatic cancers remain confined to the pancreas when they are first diagnosed. In most cases, complete resection becomes difficult when the cancer spreads too far away.

Surgical Treatment for Pancreatic Cancer

Whipple procedure (pancreaticoduodenectomy)

The most common and reliable procedure to remove pancreatic cancer is pancreaticoduodenectomy (Whipple procedure). In this procedure, an expert surgeon removes the head part of the pancreas or the body of the pancreas. Sometimes, a part of the small intestine, bile duct, lymph nodes, and gallbladder are removed.

Learn more about the “Whipple Procedure”

It can be done in both ways: open as well as laparoscopically.

Distal pancreatectomy

Pancreatic cancer confined to the body and tail of the pancreas is removed by a distal pancreatectomy procedure. Speen is also removed (splenectomy) during this procedure.

Total pancreatectomy

This operation removes the entire pancreas, the gallbladder and common bile duct, part of the stomach and small intestine, and the spleen.

Prevention 

Screening is done for people with a greater risk of pancreatic cancer. Screening uses tests to look for signs of pancreatic cancer that do not show any symptoms. Screening involves imaging tests such as ultrasound and MRI.

The main objective of screening is to find whether the pancreatic cancer is small or can be cured.

Another type of testing known as genetic testing is done to find DNA changes that run in families and increase the risk of pancreatic cancer.

Ways to lower the risk of pancreatic cancer

Stop smoking- If you smoke, then talk to a specialist about the ways and therapies to stop smoking. Some of the potential therapies might include nicotine replacement therapy and medicines.

Maintain a healthy weight. Exercise regularly. Choose a vegetable-rich diet with fruits and whole grains in smaller amounts.

Stop consuming alcohol

If you are looking for the best pancreatic cancer treatment in Hyderabad, then meet Dr. Datta Ram U.

Jaundice, characterized by the yellowing of the skin, eyes, and mucous membranes, is a common medical condition with various underlying causes. While it is often a symptom of an underlying health issue rather than a disease itself, understanding the causes of jaundice is essential for proper diagnosis and treatment. In this article, we will explore the primary causes of jaundice and discuss the associated symptoms and complications.

Jaundice Causes and Symptoms

Hepatitis

Hepatitis, inflammation of the liver, is one of the leading causes of jaundice. Viral hepatitis, including hepatitis A, B, C, D, and E viruses, can infect the liver and impair its function, leading to jaundice. Hepatitis viruses are typically transmitted through contaminated food or water (hepatitis A and E) or blood and bodily fluids (hepatitis B, C, and D). Other causes of hepatitis include alcohol abuse, autoimmune hepatitis, and drug-induced liver injury.

Liver Cirrhosis

Liver cirrhosis is a chronic liver disease characterized by the gradual replacement of healthy liver tissue with scar tissue, impairing liver function over time. Chronic alcohol abuse, viral hepatitis, nonalcoholic fatty liver disease (NAFLD), and autoimmune liver diseases are common causes of liver cirrhosis. As liver function declines, jaundice may develop as a result of impaired bilirubin processing and clearance.

Gallstones

Gallstones are hardened deposits that form in the gallbladder, a small organ located beneath the liver. When gallstones obstruct the bile ducts, which transport bile from the liver to the intestines, bile flow may become obstructed, leading to jaundice. Gallstone-related jaundice is often accompanied by symptoms such as abdominal pain, nausea, vomiting, and fever.

Bile Duct Obstruction

Obstruction of the bile ducts can occur due to various factors, including gallstones, tumors, inflammation, or scarring of the bile ducts. When bile flow is obstructed, bilirubin accumulates in the bloodstream, resulting in jaundice. Bile duct obstruction may be caused by conditions such as pancreatic cancer, bile duct cancer, primary sclerosing cholangitis, or choledocholithiasis (gallstones in the bile duct).

Hemolytic Anemia

Hemolytic anemia is a condition characterized by the premature destruction of red blood cells, leading to an increased production of bilirubin. When the liver is unable to process the excess bilirubin efficiently, jaundice may occur. Hemolytic anemia can be caused by various factors, including autoimmune disorders, genetic conditions, infections, medications, and toxins.

Liver Cancer

Liver cancer, also known as hepatocellular carcinoma, can cause jaundice as it progresses and impairs liver function. Risk factors for liver cancer include chronic viral hepatitis, liver cirrhosis, alcohol abuse, obesity, and exposure to certain toxins and carcinogens. Jaundice associated with liver cancer may be accompanied by symptoms such as abdominal pain, weight loss, fatigue, and loss of appetite.

Gilbert’s Syndrome

Gilbert’s syndrome is a benign genetic condition characterized by mild jaundice that occurs intermittently, often in response to stress, fasting, or illness. In Gilbert’s syndrome, there is a deficiency of an enzyme called UDP-glucuronosyltransferase, which is involved in the conjugation and processing of bilirubin in the liver. While Gilbert’s syndrome does not typically cause serious health problems, it can result in mild jaundice and elevated bilirubin levels.

Symptoms of Jaundice

In addition to yellowing of the skin, eyes, and mucous membranes, jaundice may be accompanied by other symptoms, depending on the underlying cause. Common symptoms of jaundice include:

• Yellowing of the whites of the eyes (scleral icterus)
• Dark urine
• Pale stools
• Abdominal pain or discomfort
• Nausea and vomiting
• Fatigue and weakness
• Fever
• Unintentional weight loss

Complications of Jaundice

Untreated jaundice can lead to complications such as:

• Liver failure
• Bleeding disorders
• Encephalopathy (brain dysfunction)
• Increased risk of infections
• Malnutrition
• Kidney failure

Conclusion

Jaundice is a common medical condition that can result from various underlying causes, including liver disease, gallstones, bile duct obstruction, hemolytic anemia, and liver cancer. Recognizing the symptoms of jaundice and identifying its underlying cause, is essential for proper diagnosis and treatment. If you or someone you know experiences jaundice or related symptoms, seek medical attention promptly to determine the cause and receive appropriate care. Early diagnosis and treatment can help prevent complications and promote recovery.

Alcoholic liver disease (ALD) is a serious condition that arises due to excessive alcohol consumption over a prolonged period. At its core, ALD encompasses a range of liver disorders, including fatty liver, liver fibrosis, and cirrhosis. Let us try to understand the progression of ALD, shedding light on its causes, symptoms, and available treatment options.

Causes of Alcoholic Liver Disease

ALD primarily stems from the toxic effects of alcohol on the liver. When alcohol is consumed, it is metabolized in the liver, leading to the production of harmful by-products that can damage liver cells. Chronic alcohol abuse overwhelms the liver’s ability to metabolize alcohol efficiently, resulting in inflammation, oxidative stress, and ultimately, liver damage.

Additionally, individual susceptibility to ALD varies based on several factors, including:

Genetics: Certain genetic factors can predispose individuals to ALD, making them more vulnerable to liver damage even with moderate alcohol consumption.

Duration and Quantity of Alcohol Intake: The risk of developing ALD increases with prolonged and excessive alcohol consumption. Both the amount and duration of alcohol intake play crucial roles in determining the extent of liver damage.

Nutritional Factors: Poor nutrition, particularly deficiencies in essential vitamins and minerals, can exacerbate the harmful effects of alcohol on the liver, accelerating the progression of ALD.

Symptoms of Alcoholic Liver Disease

ALD often progresses silently, with symptoms becoming apparent only in later stages when significant liver damage has occurred. However, recognizing the signs of ALD is crucial for early intervention and management. Common symptoms of ALD include:

Fatigue: Persistent tiredness and weakness, even after adequate rest.

Abdominal Pain: Discomfort or pain in the upper right abdomen, indicative of liver inflammation or enlargement.

Jaundice: Yellowing of the skin and eyes due to impaired liver function and bilirubin accumulation.

Swelling: Edema, or fluid retention, particularly in the legs and abdomen, resulting from liver dysfunction.

Nausea and Vomiting: Persistent feelings of nausea and episodes of vomiting, often accompanied by loss of appetite.

Mental Confusion: Cognitive impairment, confusion, or difficulty concentrating, indicating advanced liver damage.

Diagnosis and Treatment Options

Diagnosing ALD typically involves a comprehensive evaluation of medical history, physical examination, and diagnostic tests, including blood tests, imaging studies, and liver biopsy.

Once diagnosed, the treatment approach for ALD focuses on:

Alcohol Cessation: The cornerstone of ALD management involves complete abstinence from alcohol to prevent further liver damage and promote liver regeneration.

Nutritional Support: Nutritional therapy, including supplementation with vitamins and minerals, is essential to address deficiencies and support liver function.

Medications: In certain cases, medications may be prescribed to manage complications of ALD, such as inflammation, infection, or fluid retention.

Liver Transplantation: In advanced cases of ALD where liver function is severely compromised, liver transplantation may be considered as a life-saving intervention.

Preventing Alcoholic Liver Disease

Prevention is key when it comes to ALD, and adopting healthy lifestyle choices can significantly reduce the risk of developing this debilitating condition. Strategies for preventing ALD include:

Moderate Alcohol Consumption: Limiting alcohol intake to within recommended guidelines can mitigate the risk of ALD and other alcohol-related liver disorders.

Balanced Nutrition: Maintaining a well-balanced diet rich in fruits, vegetables, whole grains, and lean proteins can support overall liver health and minimize the impact of alcohol on the liver.

Regular Exercise: Engaging in regular physical activity can help maintain a healthy weight and reduce the risk of liver damage associated with obesity and sedentary lifestyles.

Routine Health Screenings: Regular health check-ups and screenings can aid in the early detection and management of liver-related conditions, including ALD.

Bottom Line

In conclusion, alcoholic liver disease is a serious yet preventable condition that requires awareness, timely intervention, and lifestyle modifications. By understanding the causes, recognizing the symptoms, and adopting preventive measures, individuals can safeguard their liver health and reduce the burden of ALD on both individuals and healthcare systems.

The best Gallbladder surgeon in Hyderabad, Dr. Datta Ram U answers…

The gallbladder is a small pear-shaped organ situated beneath the liver. The primary function of the gall bladder is to store and concentrate bile secreted by the liver. The gall bladder has a tremendous water-absorbing capacity as it concentrates bile and digestive fluid and releases bile into the small intestine.

Do Gallbladder stones always cause problems?

No, though 15-20% of the population in India and elsewhere (some regions, the incidence is much higher) have Gallstones, the majority of them are asymptomatic. In them, the stones are detected incidentally. Some of them develop symptoms over time and some develop complications due to gallstones, which can be very serious. Silent/ asymptomatic gallstones do not cause any problems even if they are large. However, when they get inflamed or irritated, they can cause problems.

Is surgery the only treatment for gallbladder stones?

Unfortunately, Surgery is the only treatment for those who have symptoms due to gallstones and for those who develop complications. Unlike kidney stones, gallstones are different and the problem can be cured only by removing the gall bladder by surgery. 

Am I at risk of getting gallstones?

The following factors may increase your risk of gallstone formation: having a family history of gallstones, a low-fiber diet, a high-fat diet, a sedentary lifestyle, age 40 years or above, being female, eating a high-cholesterol diet, and having diabetes.

If I drink more water, can I be able to get rid of gallbladder stones?

No, you cannot get rid of your gallstones by drinking more water. It is always good and healthy to keep yourself hydrated.

Are there any alternative methods to get rid of gallbladder stones?

No, surgery is the only and the best treatment even today. The problems of gallstones can be serious and we urge patients not to try any unproven, unconventional treatment for gallstones as sometimes the complications of Gallstones can be serious and life-threatening. Medicines are useful if there is an infection and a doctor prescribes antibiotics and analgesics to temporarily relieve pain. In general, there is no proven and effective medical therapy for gallstones.  

Is treatment necessary for all gallstones?

Yes, treatment is necessary for patients who have symptoms. Those who do not have any kind of symptoms or complications can wait and follow up with the surgeon and gastroenterologist and consider surgery when they develop the slightest symptoms. Surgery (Gallbladder removal, Cholecystectomy) is the best and only treatment for symptomatic patients. 

Is there any possibility of removing only gallstones and retaining the gallbladder through surgery?

No, it is not possible to remove the stones alone and retain the gall bladder.  Many patients ask me the same question when they consult me. The reason is, that the gallbladder does not have any vital function, and once the stones are formed the gallbladder function is lost. The gallbladder is the only site where the stones are formed and if we retain the gallbladder, stones and the related problems are going to come back. Furthermore, one should understand that technically it is not possible to remove the stones alone as it can cause bile leak and serious complications. Gall bladder removal is the simplest treatment and offers a cure for the problem.

Which is the best treatment for gallstones?

The best treatment for gallstones is the surgical removal of the gallbladder. This is the only and the simplest treatment.  Surgery cures the problem and the stones are not going to come back. You will get rid of the gallstone problem. Once symptomatic it is always advisable to get the surgery (Gallbladder removal) as soon as possible because once you develop symptoms, the symptoms are not only recurring, but the risk of developing complications also increases significantly.

Can medicines dissolve and remove gallstones?

No, medicines do not work for dissolving and treating gallstones. This is the biggest myth about gallstones and patients are often lured by the myth by unconventional therapists and fall into the trap of ineffective treatments. UDCA (Urso de oxy cholic acid) is a drug that helps in obstructive jaundice and may help from the stone size increasing. But this is not an effective therapy and I don’t advise this medicine for treatment because the drug is not only expensive, needs to be taken indefinitely (long-term therapy), and overall, it is ineffective in curing stones and preventing symptoms or complications. In my opinion, there is no effective medical therapy.

Are gallstones hereditary?

Yes, gallstone formation is hereditary as almost 30 to 35% of gallstone cases run in families.

What are the complications of gallstones?

Gallstones can cause serious complications.

• Infection of the gall bladder (calculus cholecystitis), pus formation (empyema), perforation, and gangrene (severe infection, the gall bladder can break and cause serious complications which can be life-threatening.
• Jaundice and cholangitis- Gallstones can spill into the bile duct and block the bile duct. When the bile duct gets blocked, the stone hinders the flow of bile and the patient will develop jaundice, i.e., yellowish discoloration of the eyes. There is also an upward spread of infection into the bloodstream and the patient develops a high-grade fever (Cholangitis, a serious condition). The patient can become sick and septic, requiring ICU care, IV antibiotics, and an intervention called ERCP (Endoscopic Retrograde Cholangiopancreatography) for bile duct stone removal and relief of bile duct obstruction.
• Mirrizzi syndrome- a gallstone stuck in the neck part of the gall bladder can cause compression of the bile duct and erode into the bile duct, this can block the bile duct and cause jaundice and cholangitis.
• Acute pancreatitis- gall stones can spill into the intestine through the bile duct and while passing through, they trigger Acute Pancreatitis which is a serious and life-threatening condition.  Gallstones are the leading cause of Acute pancreatitis. This can further get complicated by organ failure, necrosis (death of tissue) of the pancreas and the tissue around the pancreas, and the necrotic tissues can get infected (Infected Pancreatic necrosis) which is a serious condition. 

What are the signs and symptoms of a serious gallbladder complication?

Many people don’t have any clue about the complications of a troubling gallstone. If you develop intense or severe abdominal pain that doesn’t let you sit still or find a comfortable position. If you also have a high fever with chills and jaundice (yellowing of skin and whites of the eyes), then you must seek immediate medical care.

Learn about Gallbladder surgery cost

If you are searching for the best surgeon for gallbladder removal in Hyderabad, then meet Dr. Datta Ram U.