Author Archives: Dr Datta

Barrett’s Esophagus GERD & Treatment

Barrett’s esophagus treatment in Hyderabad | Dr. Datta Ram U

Barrett’s esophagus is a condition characterized by the alteration of the cells that line the food tube (esophagus). While it is more prevalent among individuals suffering from gastroesophageal reflux disease (GERD), it can also develop in those without GERD. The management of this condition can range from regular monitoring of the esophageal lining using endoscopies to medical procedures aimed at eliminating damaged tissue. It is important to maintain a healthy esophagus by taking steps to manage heartburn or acid reflux.

What causes Barrett’s esophagus

It’s unclear why cells in the esophagus lining occasionally transform into cells resembling those in the intestine. Acid reflux or gastroesophageal reflux disease (GERD) may be linked to the development of Barrett’s esophagus, according to researchers. This condition increases the likelihood of developing an uncommon form of esophageal cancer.

The lower esophageal sphincter (LES) is a crucial valve situated between the esophagus and the stomach. Its failure over time can result in gastroesophageal reflux disease (GERD), which causes acid and chemical harm to the esophagus. Symptoms of GERD, such as heartburn or regurgitation, often accompany the disease. In some cases, GERD can trigger a change in the cells of the lower esophagus, leading to Barrett’s esophagus.

What are the signs and symptoms of Barrett’s esophagus?

Barrett’s esophagus is usually associated with chronic GERD. However, it’s interesting to note that around 50% of individuals who have Barrett’s esophagus don’t experience noticeable symptoms of acid reflux. Therefore, it’s advisable to talk to your gastroenterologist about your digestive health and the likelihood of having Barrett’s esophagus.

The signs and symptoms of Barrett’s esophagus may include:

  • Difficulty swallowing food
  • Chest pain (less common)
  • Frequent heartburn
  • Regurgitation of stomach contents

Are you at Risk of Barrett’s Esophagus?

You could be at risk of Barrett’s esophagus if you are obese, have GERD disease and have symptoms of heartburn for more than 10 years. The condition is common in males – especially in middle-aged males and those with a family history of Barrett’s esophagus.

How will you know you have Barrett’s esophagus?

Barrett’s esophagus does not show any symptoms by itself, and individuals may only become aware of its presence after seeking medical attention for gastroesophageal reflux disease (GERD) symptoms or upon being diagnosed with esophageal cancer. Due to the absence of noticeable symptoms, it is uncertain how prevalent Barrett’s esophagus is, but specialists approximate that it affects roughly 1% of the population.

Learn more about GERD (insert GERD link here)

Diagnosis of Barrett’s Esophagus

Barrett’s esophagus can only be diagnosed through a procedure known as upper endoscopy. Gastroenterologists insert a small tube with a light through the throat to the esophagus in order to inspect the esophageal lining for any changes. Although the appearance of the esophagus might indicate the possibility of Barrett’s esophagus, the only way to confirm it is by taking small tissue samples (biopsies) during the endoscopy. The pathologist will analyze the samples to confirm the diagnosis.

Barrett’s Esophagus Treatment in Hyderabad

If you have mild symptoms with no detection of abnormal growth, then your doctor will monitor your condition. You don’t need any treatment at this stage. However, your gastroenterologist may repeat upper endoscopy annually. To treat and manage GERD symptoms, your doctor will prescribe medicines to decrease stomach acid and protect your esophagus against damage. Your doctor will also suggest lifestyle changes – such as sleeping slightly inclined, having meals on time, avoiding having dinner late and so on.

To treat low-grade to high-grade dysplasia with GERD symptoms, your doctor may recommend ablation therapy and radiofrequency ablation, cryotherapy, endoscopic mucosal resection for the treatment of high-grade dysplasia. For the more severe cases, your surgical gastroenterologist will perform esophagectomy surgery to remove a part of the affected esophagus.

For the best Barrett’s esophagus treatment and GERD care in Hyderabad, meet Dr. Datta Ram U at KIMS Hospitals, Gachibowli, Hyderabad.

Gastrointestinal bleeding (GI) bleeding Causes & Treatment

GI bleeding causes & treatment | Dr. Datta Ram

GI bleeding indicates a problem with your digestive tract. It can be mild to severe, and sometimes, GI bleeding can become life-threatening. Knowing the cause and early diagnosis is the key to successful treatment of GI bleeding.

What are the symptoms of GI bleeding?

The signs and symptoms associated with GI bleeding can be mild to severe. They can also be either obvious or hidden. The symptoms may depend on the location and position of the area where bleeding starts.

The obvious bleeding signs include:

  • Red or dark brown vomiting (blood)
  • Tarry or black stool
  • Bleeding (anal or rectal bleeding in or with stool)

Gastrointestinal bleeding which is not obvious (Hidden or Occult) causes

  • Abdominal pain
  • Chest pain
  • Fainting
  • Breathing difficulty
  • Lightheadedness

GI Bleeding Causes

GI bleeding can occur in the upper GI tract or the lower GI tract due to several reasons.

Causes of Upper GI Bleeding

Tears in the lining of the esophagus – Also known as Mallory-Weiss tears. This type of bleeding is common in heavy drinkers.

Peptic Ulcers – These are sores on the lining of stomach and upper portion of small intestine.

Esophagitis – inflammation of the esophagus due to GERD (gastroesophageal reflux disease)

Esophageal Varices (enlarged veins in the esophagus)

Causes of Lower GI Bleeding

Proctitis – Rectal bleeding occurs due to the inflammation of the lining of rectum.

Anal Fissures – Tears in the lining of the anus

Hemorrhoids – veins swell, bulge and protrude from the anus or lower rectum and cause bleeding.

Colon Polyps – These are small growths on the lining of the colon. Though a majority of them are harmless, they may turn cancerous and cause bleeding if not removed.

Tumors – GI tract cancer can cause bleeding. Both benign (non-cancerous) and malignant (cancerous) tumors can weaking the lining of the digestive tract and cause bleeding.

Inflammatory Bowel Disease – Both Chron’s disease and ulcerative colitis can cause sores and inflammation in the lining of the colon and rectum and cause bleeding.

Diverticulitis or diverticulosis is a condition in which small bulging pouches form in the digestive tract. When they get infected and inflamed, they cause bleeding.

How is the cause of GI bleeding diagnosed?

Your gastroenterologist will take into account the signs and symptoms, make a note of medical history and then conducts a physical examination. The doctor might order a few blood tests. Stool tests and endoscopy.

Treatment

If GI bleeding stops on its own, it doesn’t require treatment. However, treatment mostly depends on the identified cause and the location of bleeding.  For instance, if polyps are the cause of rectal bleeding, they are removed during a colonoscopy procedure. If the GI bleeding is due to GERD, then treating GERD effectively can stop the bleeding. In a nutshell, once the source of GI bleeding is identified, your surgical gastroenterologist will suggest appropriate treatment.

When to seek emergency medical care?

If bleeding starts suddenly and progresses rapidly, it can lead to shock. The person who is in shock has the following signs and symptoms – rapid pulse, low blood pressure or drop in blood pressure; less frequent urination or urinating in small amounts and unconsciousness. If a person has these signs and symptoms of shock, someone should call and seek emergency medical care immediately. If you think you have the other signs and symptoms of GI bleeding, then you should seek an appointment with a surgical gastroenterologist.

Intestinal Obstruction – Causes, Symptoms & Treatment

Intestinal Obstruction Treatment

Intestinal obstruction and Ileus: Intestinal obstruction is a partial or complete blockage of the bowel.  If intestine is blocked, the contents of the intestine can not pass through it. The blockage can occur in the small or the large intestine. It can be partial or total blockage.

Large bowel obstruction

There is a blockage in the large intestine. It can be due to a scar tissue, a tumor or something else. It is a medical emergency condition wherein the risk of stool and gas build up and intestine rupturing is high.

Intestinal Obstruction Causes

Causes of obstruction of the bowel may be due to a mechanical cause, which means the blockage can be due to intestinal adhesions, twisting of the intestines, intussusception, tumors, stones, swallowed objects, and hernias.

Mechanical Blockage of Colon or Large Intestine

The blockage can be due to diverticulitis, volvulus and intussusception, colon cancer, ovarian cancer, adhesions from surgeries or pelvic infections; stool impaction, the narrowing of colon (stricture) due to inflammation or scarring.

Non-mechanical blockage (functional intestinal obstruction)

A temporary blockage is known as ileus (pseudo-obstruction). The causes include electrolyte imbalances, certain medicines, appendicitis or gastroenteritis and pelvic or abdominal surgery. The other causes may include diabetes mellitus, multiple sclerosis and other nerve and muscle disorders that cause nerve injuries.

Paralyzed ileus, also called pseudo-obstruction, is one of the major causes of intestinal inhibition in babies and children.

Signs and Symptoms of Bowel Obstruction

The signs and symptoms of bowel obstruction may include abdominal lump(distention), abdominal wholeness, gas, abdominal pain, severe bloating and cramping, constipation, diarrhea, nausea, vomiting, inability to pass gas or stool, decreased appetite and abdominal swelling.

Bowel Obstruction Diagnosis

A gastroenterologist examines you by pushing on your abdomen and then listening to the sounds using a stethoscope. The doctor may order other tests such as blood tests – liver and kidney function test, blood counts, levels of electrolytes, CT scan and colonoscopy. The diagnosis is made based on the results of the tests, scanning reports and symptoms.

Intestinal Obstruction Treatment

Partial intestinal obstruction due to adhesions or scarring may need medical support to clear up. However, large bowel obstructions can be treated by a variety of treatment options including medications, IV fluid replacement, nasogastric tube and barium enema. Surgical intervention becomes pertinent in large bowel obstructions due to adhesions, tumors or hernia. In some surgical cases, a segment of the dead intestine is removed during surgery to treat the obstruction.

Treatment involves placing a tube through the nose into the stomach or intestine. This relieves abdominal bloating(bloating) and vomiting. Intestinal torsion can be treated by fitting a tube into the rectum. If catheterization doesn’t relieve symptoms surgery may be needed to clear the blockage. Surgery may also be necessary if there are signs of bowel tissue death.

Prevention

Prevention – Prevention depends on the cause. Treating conditions that can cause blockage, similar as excrescences and hernias, can reduce the threat. Certain blocking causes cannot be prevented.

Bottom Line

Early diagnosis and treatment are crucial. Intestinal obstruction can become life-threatening and serious if ruptures. The condition leads to inflammation and infection of the abdominal cavity (peritonitis). Severe abdominal pain and fever develops. It is a life-threatening emergency condition that requires emergency surgery. For intestinal obstruction treatment, meet Dr. Datta Ram U.

Best doctor for fissure in Hyderabad

Best doctor for fissure in Hyderabad

Dr. Datta Ram explains everything about anal fissure that you always want to know.

ANAL FISSURES – Causes, Symptoms & Treatment

Anal Fissure: A small tear in the thin, moist tissue that lines the anus is known as anal fissure. It causes pain and bleeding with bowel movements. Anal fissures can occur in people of any age. In many cases, they get better with some home-based remedies such as warm-water bath sitz; increasing fiber intake; taking medications. Surgery may be recommended in some cases.

What are the causes of anal fissures?

Anal fissure causes include:

  • Constipation
  • Passing large and hard stools
  • Straining during bowel movements
  • Childbirth (women)
  • Long-lasting diarrhea
  • Anal intercourse

What are the symptoms of anal fissure?

Anal Fissure symptoms may include:

  • A crack or tear in the skin around the anus
  • A skin tag or small lump in the skin near the fissure
  • Bright red blood on stool or on toilet paper after a bowel movement
  • Pain during and after bowel movements

What are the risk factors for anal fissure?

 The factors that may increase the risk of anal fissure include:

  Age: Common in infants and middle-aged adults.

  Crohn’s disease: It can make the lining of anal canal susceptible to tearing.

  Childbirth: The risk of anal fissure increases after childbirth in women.

Constipation: Passing hard and bulky stools and straining during bowel movements can increase the risk of tearing anal skin.

Anal intercourse increases the risk of anal fissures.

 What happens if you don’t treat anal fissures?

Chronic anal fissure fails to heal up to several weeks – may be up to six to eight weeks. It needs comprehensive treatment.

Untreated fissure and fissure that extends into the ring of muscles that keeps anus closed may become problematic. Once a fissure enters into the internal anal sphincter, it becomes difficult for it to heal. When this happens, you may need medicines to ease the discomfort. And to reduce the pain or remove the fissure, you will need surgery.

Treatment

The treatment for anal fissure depends on the severity of the condition and associated symptoms. The non-surgical approaches may include external application of nitroglycerin if other conservative approaches fail to give any relief. In addition, doctors may also prescribe topical anesthetic creams to relieve pain.

Surgery: If conservative treatment approaches fail to give any results, your surgical gastroenterologist may recommend surgery. The doctor will perform lateral internal sphincterotomy (LIS). If the symptoms are severe, then this procedure may help relieve pain, reduce spasm and promote healing.

Anal Fistula Symptoms and Treatment

Fistula treatment in Hyderabad by Dr. Datta Ram U

Anal Fistula – The glands lining the anus from inside makes mucus. When these glands get clogged, they become infected leading to an abscess.

Fistula is a small tunnel or channel that develops in the anal region. It is often a result of an infection that causes a collection of pus (abscess) in the nearby anal tissue. A small channel is left behind when the pus drains away. Anal fistula causes very unpleasant and disgusting symptoms including skin irritation, pain, bleeding, and oozing of pus. These symptoms do not get better on their own. In most cases, surgery is recommended to treat anal fistula.

Anal Fistula Symptoms

The signs and symptoms associated with anal fistula include:

  • Bowel incontinence – difficulty in controlling bowel movements
  • Passing blood and pus during bowel movements
  • Inflammation, redness, and swelling around the anus
  • Fever – if an abscess develops
  • Chills and a feeling of fatigue
  • Smelly discharge from near the anus
  • Skin irritation around the anus
  • Persistent, nagging, and throbbing pain that may become worse with cough, movement, sitting, or moving around.

What causes an anal fistula?

Anal fistula causes: Anal abscess is the main reason behind the development of anal fistula. Most of the time, an anal fistula may result when the abscess doesn’t heal properly.

An anal fistula may also develop less commonly as a consequence of a long-term skin condition (hidradenitis suppurative) that causes scarring and abscesses near the anus. The other less common causes of the anal fistula may include diverticulitis, Crohn’s disease, HIV infection, trauma, radiation treatment, tuberculosis, cancer, and also as a result of complications of surgery near the anus.

Diagnosis of Anal Fistula

Your gastro surgeon examines the area around your anus and looks for an opening in the skin. Next, the doctor will see the opening of the fistula track and try to determine how deep it is. In a majority of cases, pus drains out of the external opening. In some cases, a fistula may not be visible on your skin surface. Therefore, to diagnose a fistula, your surgical gastroenterologist may perform additional tests such as an anoscopy or colonoscopy. Your gastro surgeon may also order an ultrasound or MRI of the anal region to get a better picture of the fistula tract.

Anal fistula Treatment in Hyderabad

The gold standard treatment for anal fistula is surgery. It is almost always recommended by well-experienced and expert colorectal surgeons and surgical gastroenterologists specializing in colorectal surgery. An expert colorectal surgeon’s goal is to perform surgery tactically and diligently to get rid of the fistula while protecting the anal sphincter muscles. If these muscles get damaged bowel incontinence may result.

Best fistula treatment in Hyderabad

The aim of the surgery for an anal fistula is to ensure that the anal sphincter muscle is safe during the procedure. The most common procedure is fistulotomy which involves cutting and opening the fistula along its whole length so that it heals as a flat scar. It is the most effective procedure for most fistulas.

The other procedures for the treatment of fistula include Seton technique, advancement flap procedure (the fistula is covered with a flap, or piece of tissue, taken from the rectum, like a trap door), LIFT procedure, LASER surgery for fistula, Endoscopic ablation and the insertion of a bioprosthetic plug.

Meet Dr. Datta Ram U for the best treatment of anal fistula. You can discuss all of your treatment options with Dr. Datta Ram U.