Author Archives: Dr Datta Ram

A viral or bacterial infection causes gastroenteritis. It is the inflammation of the stomach and the intestines. When you have this condition, you will have vomiting and diarrhoea. Commonly, many people call it as a stomach flu. These symptoms are often due to gastroenteritis.

What are the symptoms of Gastroenteritis?

The signs and symptoms of gastroenteritis include the following:

• Stomach pain
• Watery diarrhea
• Vomiting
• Abdominal cramps
• Fever, nausea and headache
• Diarrhea may lead to dehydration

The signs of dehydration include the following:

• Dry mouth
• Excessive thirst
• Dry skin
• Light-headedness

Seek medical help immediately if you have the above symptoms with watery diarrhea and vomiting.

Note: Dehydration should be treated in emergency room. The following symptoms warrant seeking emergency medical care immediately to prevent potential complications due to severe dehydration:

• Dry mouth
• Lack of tears
• Extreme thirst
• Little or no urination
• Muscle weakness
• Trouble breathing or swallowing
• Lack of alertness
• Rapid heartbeat and breathing
• Dizziness or lightheadedness
• Sunkun eyes

Stomach Flu in children

Dehydration occurs quickly in children. Therefore, when your child has stomach flu with watery diarrhea and vomiting and abdominal cramps, look for the signs. The child’s skin becomes dry, urine output becomes less and mouth becomes dry and also feel thirsty. Don’t send your child to school until all symptoms disappear. Don’t give any medicines to your child – such drugs are not usually given to children younger than 5 years.

What causes gastroenteritis?

Rotavirus causes diarrhea in infants and children. Norovirus also causes serious foodborne disease and gastroenteritis.

Bacteria such as Salmonella, Campylobacter, and E. coli can also trigger stomach flu – but less commonly. These bacteria spread through live poultry, undercooked eggs and meat.

Contaminated food and drinking water spread another bacteria called shigella that causes gastroenteritis.

The less common cause of gastroenteritis is parasites such as giardia and cryptosporidium. You may get infected with them through contaminated drinking water.

When to call a doctor?

If you can’t walk, faint, confused or having trouble breathing due to severe dehydration, immediately call emergency department.

You should also see your doctor if you develop sudden and severe abdominal pain with vomiting and diarrhea.

ESOPHAGEAL CACNER – The sixth most common cause of deaths worldwide.

Esophagus is a long hollow tube that helps in moving the food. It runs from the throat to the stomach. A cancer that develops in the cells of the oesophagus is known as esophageal cancer.

The cancer develops usually in the cells that line the inside of the esophagus.

Risk factors for esophageal cancer

Tobacco use, excessive alcohol consumption; smoking, GERD, Barrett’s esophagus, bad dietary habits and obesity.

Learn more about GERD…

What are the symptoms of Esophageal Cancer?

The following are some of the signs and symptoms of esophageal cancer:

• Swallowing difficulty (Dysphagia)
• Sore throat
• Hoarseness or coughing
• Worsening heartburn or indigestion
• Pressure or burning sensation in the chest
• Chest pain
• Unexplained weight loss

What are the causes of Esophageal cancer?

There is no exact cause of esophageal cancer. A group of factors may play a role in the development of cancer. The cells in the lining of the oesophagus undergo mutations (changes in the gene sequence) in their DNA. When this happens, the cells grow and divide out of control and develop into esophageal cancer. Adenocarcinoma (cancer develops in the mucus-secreting cells of the esophagus) and squamous cell carcinoma are the common types of esophageal cancer. Choricarcinoma, melanoma, lymphoma, sarcoma and small cell carcinoma are some of the rare forms of esophageal cancer.

What are the complications?

In the advanced stages, esophageal cancer can cause pain (severe pain in the esophagus with swallowing difficulty). It can also lead to bleeding in the esophagus – which is mild to moderate in the beginning. The bleeding can become sudden and severe as well. Many people experience difficulty in swallowing food and liquid through the esophagus.

How is esophageal cancer diagnosed?

Diagnosis of esophageal cancer: It is based on the medical examination, reviewing symptoms, and medical history of the patient. In addition, a surgical gastroenterologist may also order certain blood and imaging tests including endoscopy, barium swallow X-ray; CT and PET scans, thoracoscopy and biopsy. These tests help in determining the extent of spread (metastasis) of esophageal cancer outside the esophagus.

Bottom line

Esophageal cancer is the sixth leading cancer in the world. In the early stages, it doesn’t cause any signs and symptoms. Advanced stages esophageal cancer can spread to other parts of the body (metastasis). Early detection of esophageal cancer helps in effective treatment.

Abdominal pain is a very common condition that everybody encounters at one time or another. It is usually an uncomfortable or disturbing sensations that one experiences in the abdominal region.

Abdominal pain can be sometimes not be the reason to worry because it occurs mostly as a common problem. If you see a specialist doctor, he or she can easily diagnose the cause and give treatment. Persistent, intermittent or episodic abdominal pain and sometimes chronic pain can be a sign of serious underlying health issue that needs prompt and immediate medical help.

Types of abdominal pain

Abdominal pain can be of different types depending on the intensity, severity and timing of pain and the manner in which it starts, progresses and how long it lasts.

Acute abdominal pain: It starts within a few hours and may persists for a few days and may be associated with other symptoms.

Chronic abdominal pain can be troublesome as it may last for a few weeks to months and may be intermittent.

Progressive abdominal pain can be severe, and may get worse over a period of time and is often associated with other symptoms.

Causes of Abdominal pain

Abdominal pain can be due to several reason whether it is mild, moderate or severe and the causes may differ in men and women. In general, irrespective of gender, abdominal pain can be mostly due to mild to severe infection, food poisoning, stomach virus, abdominal migraine or indigestion or constipation. For instance, a woman can have abdominal pain due to gynaecological issues such as uterine problems, uterine fibroids, polyps, ovarian cysts, endometriosis, menstrual issues, Pelvic inflammatory disease (PID), premenstrual syndrome, menstrual cramps or may be due to serious health issues such as ovarian or cervical cancer.

The other possible causes of abdominal pain may include gas, food allergies, ulcerative colitis or Crohn’s disease, urinary tract infection, abdominal muscle pull or strain, irritable bowel syndrome (IBS). You may get abdominal pain if you have ulcers or if you are lactose intolerant.

Are there any other causes of abdominal pain?

Yes, there are many other causes of abdominal pain. Inflammation of the gallbladder (Cholecystitis); inflammation of the pancreas (Pancreatitis); bowel obstruction or blockage; abdominal aortic aneurysm (swelling in the abdominal main artery); diverticulitis; appendicitis; gastroesophageal reflux disease (GERD); endometriosis; kidney stones; Gallstones; hernia; blocked blood vessel that causes low blood flow to the intestines; ovarian cysts or ovarian cancer in women and also ectopic pregnancy in women.

When should you consult your gastroenterologist for stomach pain?

You should consult your gastroenterologist as early as possible if you have fever and vomiting; if you feel very thirsty; have dark-coloured urine and you can’t have bowel movement.

You must seek immediate medical help or treatment as soon as possible or take medical care right away if you have severe abdominal pain associated with the following symptoms: swelling in the belly; constant vomiting; trouble breathing; black, bloody and tarry bowel movements; have yellow skin and have unexplained weight loss.

Can Colorectal Cancer be Prevented?

Colorectal cancer develops in the colon or rectum. It is also known as colon cancer or rectum cancer, but mostly grouped together and known as colorectal cancer owing to several common features both the colon and rectum cancers share. It usually develops as a polyp – an abnormal growth in the lining of the rectum or colon, which may or may not grow as cancer. All polyps may not grow as cancer. Only some types of polyps can grow into cancer after several years.

Types of Polyps

Inflammatory or hyperplastic polyps are common, but they are non-cancerous, but adenomas or adenomatous polyps can grow into cancer. Hence, they can be cancerous. Adenomas is a pre-cancerous condition. Majority of the colorectal cancers are adenocarcinomas. And the less common types of colorectal cancers include carcinoid tumours, gastrointestinal stromal tumours (GISTs), lymphomas, and sarcomas.

What conditions can make a polyp more likely to develop into a colorectal cancer?

The following factors can make a polyp more likely to develop into a colorectal cancer:

• If the size of the polyp is larger than 1 cm
• If two or more than two polyps are present
• If abnormal cells are present within the polyp (dysplasia)

Are there any preventable causes of colorectal cancer?

There are several lifestyle-related risk factors linked to colorectal cancer, which are some of the strongest known risk factors for colorectal cancer.

• Being overweight or obese increases the risk in both men and women
• Being physically inactive can increase the risk
• Excessive consumption of red meat and processed meat increase the risk
• Heating meat at high temperature can increase the risk
• Smoking is linked to increase in the risk of colorectal cancer
• Heavy alcohol consumption

What are the risk factors of colorectal cancer that you cannot change?

Age: The risk of colorectal cancer increases as you age. It is common both in men and women after age 50.

Personal history of adenomatous polyps: If you have had adenomatous polyps, which were large with dysplasia, then your risk increases.

History of colorectal cancer: The chances of getting colorectal cancer after treatment are more likely as the cancer may develop in other parts of colon and rectum.

IBD (Inflammatory Bowel disease): If you have IBD (Crohn’s disease or ulcerative colitis), your risk may increase.

Family history of colorectal cancer or adenomatous polyps: 1 in 3 individuals witha strong family history of colorectal cancer may be at a risk of developing colorectal cancer.

Type 2 diabetes: Individuals with type 2 diabetes are at increased risk of colorectal cancer.

Genetic disorders: less than 5% of the people with colorectal cancer have genetic cause. The common inherited disorders linked with colorectal cancer include familial adenomatous polyposis (FAP); hereditary non-polyposis colorectal cancer (HNPCC) or lynch syndrome and other rare syndromes, such as – Peutz-Jeghers syndrome (PJS) and MYH-associated polyposis (MAP).

Treatment for Colorectal Cancer

Surgical resection is the common treatment for colorectal cancer. The other surgical options include laparoscopic surgery and radiofrequency ablation (radio-frequency waves are used to heat the tumour). Stereotactic Radiation therapy, brachytherapy and intraoperative radiation therapy – in which a single dose of radiation is given during surgery, are the radiation therapies for treating colorectal cancer. Sometimes, chemotherapy may be given along with radiation therapy prior to surgery and after surgery as well.  Chemotherapy along with targeted therapy is the first line treatment for advanced colorectal cancer.

Early detection is the key to prevention of colorectal cancer

In the polyp stage or during the early stage of cancer, the patient may not experience any symptoms. Even if the symptoms appear, they will most likely to vary depending on the size and location. Therefore, screening or colonoscopy is necessary to detect polyps early. Screening is recommended for individuals over age 50; and, for individuals with a family history, early and frequent screening is recommended. With early detection, surgery, radiation therapy and chemotherapy can be effective treatment to cure colorectal cancer. Even the rarest of rare type of colorectal cancer can be detected by genetic testing.

If you are worried about colorectal cancer, talk to your oncologist at the earliest.

Irritable Bowel Syndrome is a common condition of the digestive system mostly affects the large intestine. It interferes with the normal functions of the large intestine (colon). Though it does not cause any severe health problems, it can give you trouble for long. If you have this problem, your life may change. Taking part in daily activities, travel and going to social events can become troublesome for those who suffer from IBS. Which means, you may not be able to work properly, miss work, or may need to change your work setting. The symptoms of this disorder generally begin after 20 years – and may continue for long. IBS is common in women compared to men. Some people think that it may cause Crohn’s disease, ulcerative colitis and colon cancer, but IBS does not cause any of these conditions. Let us understand how this common abdominal problem can trouble you and what measures you should take to manage it comfortably.

What are the symptoms of irritable bowel syndrome (IBS)?

People with IBS experience different types of symptoms including abdominal discomfort, pain, change in bowel habits or infrequent bowel movements: either go too often or less often and have thin, liquid, soft or hard stool. Some individuals may have constipation, bloating, crampy or severe abdominal pain or diarrhea. Some people pass mucus with stool and have irregular bowel movements. Many people feel better after a bowel movement. In some cases, stress can make the symptoms of IBS worst.

What are the Causes of IBS?

What causes IBS is still unknown, but there are some factors that could play a role including the following: stronger and weaker contractions of the muscles of intestine – longer and stronger contractions can cause diarrhea, bloating and gas and weaker contractions can make the food passage slow and lead to dry and hard stools. Another factor could be bacterial overgrowth and after a severe infection caused by bacteria or virus (gastroenteritis). In some people immunological response may cause inflammation in the intestine due to increased number of immune cells – which may cause pain and diarrhea. Poor coordination of signals between the nerves of the digestive system and brain can prompt changes in the normal digestive process and result in constipation, pain and diarrhea. According to some research studies, the colon becomes sensitive to some meals, medicines, food, emotions and stress in individuals who have IBS.

What is the function of Colon?

Colon absorbs nutrients, water and salt. Muscles, nerves and hormones control the movement of the colon. The motility of the colon helps in passing the contents through it. The contents of the colon move towards the rectum and strong contraction causes bowel movement. Relaxation and contraction of sphincters muscles and pelvic muscles in a coordinated manner helps in smooth bowel movement.

How Is IBS Diagnosed?

When you experience the symptoms of IBS, it is better to see your gastroenterologist. He will examine you and ask about your previous medical history and the symptoms you are experiencing. Diagnosis is based on physical examination, symptoms and medical history. However, your doctor may order a few other tests such as stool examination, blood tests and colonoscopy to rule out other health conditions.

Is IBS Linked to Other Diseases?

IBS is also known as spastic colon, mucus colitis or spastic bowel. IBS does neither cause any colon tissue damage nor colon cancer. And therefore, people with IBS are not at a risk of developing colon cancer. There is no connection between IBS and ulcerative colitis or Crohn’s disease.

What Is the Treatment for IBS?

The treatment for IBS is aimed at relieving symptoms as there is no specific cure for it. Gastroenterologists prescribe medicine to treat the symptoms and advice their patients to take medicines as instructed and also suggest changes in the diet and lifestyle of the patients. Most of the doctors advice patients to manage their diet and stress. Doctors also prescribe medicines for relieving abdominal pain, reducing constipation, bloating, diarrhea and muscle spasms. Some physicians recommend antispasmoic drugs or antidepressants to reduce diarrhea. Laxative or fiber supplements may also be prescribed. Some people tend to manage the symptoms of IBS with OTC medicines and laxatives, but they should consult their doctors. The treatment for IBS may differ from person to person as there is no specific medicine or a combination of medicines that work for everyone. Your physician will examine you, ask you about your symptoms, counsel you and support you in managing your symptoms.

Can IBS be Managed with Diet?

You can manage the symptoms of IBS with some lifestyle changes – especially the changes in your diet, eating habits and by managing stress. The best thin that you can do is making notes of all that you do routinely – especially the food you eat. By doing so you can observe which food is making the symptoms worst. If you notice some wheat products, milk and other dairy products are causing your symptoms then replace those products with better foods. You can prefer fiber rich cereals, whole breads, vegetables and fruits to reduce the symptoms of constipation. Avoid coffee, colas, and carbonated beverages. Eating smaller meals or smaller portions more often can help you relieve IBS symptoms.

Bottom Line

The signs and symptoms of IBS are severe only in a small number of people. Mild symptoms can be managed with diet, stress management and making other lifestyle changes. Symptoms that are more frequent and distressing can be managed by medication, diet and counselling.

Remember! Persistent severe abdominal pain, pressure, bleeding, fever, and weight loss are the symptoms indicative of other serious conditions like cancer. Therefore, if you notice any new symptoms including bleeding or blood in stools and weight loss, then never ignore such symptoms as people with IBS may have other health conditions. In such cases, physicians order further investigations to rule out life-threatening conditions like colon cancer as a part of diagnosis of exclusion.