Category Archives: Health Care

BILE DUCT CANCER (Cholangiocarcinoma)

Bile is a fluid made by the liver. It helps in breaking down fats during digestion. Small tubes network called ducts connect the liver, gallbladder, and small intestine. Two small ducts emerging from the liver form left and right hepatic ducts. These ducts join outside the liver and form a common hepatic duct. The cystic duct connects the gallbladder to the common hepatic duct. Bile from the liver passes through these ducts and is stored in the gallbladder. During the process of digestion, the gallbladder releases bile that passes through the cystic duct to the common bile duct and then into the intestine.

What is bile duct cancer?

Bile duct cancer is a rare disease in which malignant (cancer) cells form in the bile ducts. Bile duct cancer is also called cholangiocarcinoma.

What are the types of bile duct cancer?

Intrahepatic bile duct cancer or intrahepatic cholangiocarcinomas: Cancer develops in the bile ducts within the liver. A low percentage of bile duct cancers are intrahepatic.

Extrahepatic bile duct cancer: This type of cancer develops outside the liver in the bile ducts. Cancer is of two types:  perihilar bile duct cancer and distal bile duct cancer.

Perihilar bile duct cancer: This type of cancer develops in the common hepatic duct region. It is also known as perihilar cholangiocarcinoma or Klatskin tumor.

Distal bile duct cancer or extrahepatic cholangiocarcinoma: This type of cancer develops in the region of the common bile duct.

What are the signs and symptoms of bile duct cancer?

The signs and symptoms of bile duct cancer include the following:

  • Fever
  • Itching
  • Weakness
  • Loss of appetite or weight loss
  • Upset stomach and vomiting
  • Pain in your belly or sides
  • Yellow skin or eyes (jaundice)
  • Dark urine
  • Light-colored stools

What are the risk factors for bile duct cancer?

The risk factors for bile duct cancer include:

  • Chronic ulcerative colitis
  • Blocking of bile ducts by inflammation and scarring due to primary sclerosing cholangitis – a progressive disease.
  • Infection with a Chinese liver fluke (parasite)
  • Cysts in the bile duct cause infection, inflammation, and swollen bile ducts. They block the flow of bile.

How is bile duct cancer diagnosed?

A surgical gastroenterologist will do a physical examination. The doctor will ask the patient about their general health, habits, lifestyle (smoking and drinking habits), and family history of liver disease and cancer. The doctor will also check for lymph nodes, masses, tenderness, and fluid buildup in the abdomen.

For an accurate diagnosis of cancer, a gastroenterologist may recommend the following tests:

  • blood tests
  • An ultrasound scan, endoscopy, and a CT or MRI scan

Percutaneous Transhepatic Cholangiography (PTC)

It is A specialized test in which a surgical gastroenterologist inserts a needle through the skin and into a bile duct. The doctor inserts a dye and then takes an X-ray.

Cholangioscopy

Peroral cholangioscopy is often performed during ERCP. This specialized procedure is used to detect cancers in the bile ducts and collect tissue samples (biopsy)

Biopsy – cell sample collected from the bile ducts during cholangioscopy procedure. The cells are analyzed for abnormal growth and cancer.

Magnetic resonance cholangiopancreatography (MRCP) – A MRI machine takes images of bile ducts.

What is the treatment for bile duct cancer?

Bile duct removal: A surgical gastroenterologist removes the affected part of the bile duct if cancer is present in it. Lymph nodes are also removed.

Whipple procedure: This is a surgical procedure to remove the gallbladder, the head of the pancreas, the bile duct, a part of the stomach, and the small intestine. To kill leftover cancer cells after removing cancer, doctors prescribe chemotherapy or radiation therapy.

Systemic chemotherapy is used to treat unresectable, metastatic, or recurrent bile duct cancer.

Radiation therapy is used to treat bile duct cancer – both external and internal types are used. Radiation therapy helps in relieving symptoms and improving the quality of life as palliative therapy.

Other Procedures

To relieve symptoms associated with a blocked bile duct and to improve quality of life, an experienced surgical gastroenterologist performs the following types of surgical procedures: endoscopic stent placement, biliary bypass, and percutaneous transhepatic biliary drainage.

Irritable Bowel Syndrome (IBS) Facts

Best doctor for IBD in Hyderabad Dr. Datta Ram U explains IBS in simple terms for a layman to understand it better for better management.

What is IBS Inflammatory Bowel Disease?

Irritable bowel disease is an inflammatory condition of the large intestine. People who have this condition suffer from abdominal pain, cramping, constipation, diarrhea, bloating, and gas. It is a chronic condition that needs to be managed on a long-term basis.

Though this is a common health issue only a few people with IBD have severe signs and symptoms. The best way to manage this condition is by managing stress, anxiety, lifestyle, and diet. For more severe and nagging symptoms diet, medications, lifestyle, and counseling can help.

IBS doesn’t cause changes in bowel tissue or increase your risk of colorectal cancer.

What are the signs and Symptoms of IBD?

IBD Symptoms – symptoms may vary but may last longer. Common symptoms may include bloating, indigestion, cramping, inflammation, abdominal pain, passing mucus in stools, changes in bowel habits, changes in the frequency of bowel movements, and increased gas or mucus in stools.

Is there any precise cause of IBS?

IBS Causes – So far there is no known or specific cause associated with this condition. The following factors could play a role:

Early childhood stress: This may be the reason for IBS in some people. Those who were exposed to stressful events during their early childhood days tend to have IBD-associated symptoms during their adulthood and continue to have them for a long time.

Gastrointestinal infection: In some people, IBS can develop after severe diarrhea or gastroenteritis caused by a virus or bacterial disease. Bacterial overgrowth can also cause IBS symptoms. Disturbance in the balance of normal gut bacteria (microbial flora) of the gut can also cause IBS symptoms.

Nervous system abnormalities can cause discomfort in the abdominal muscles due to improper and poorly coordinated signals from the brain and intestines. This may result in pain, constipation, and diarrhea.

Stronger and longer intestinal muscle contractions can cause bloating, gas and diarrhea.

What triggers IBS?

Some people experience worse IBS symptoms when they eat or drink certain foods or beverages, carbonated drinks, milk, cabbage, beans, citrus fruits, dairy products, and wheat.

Stress: In some people, stress may trigger IBS symptoms or can make IBS symptoms worse, but doesn’t cause them.

What are the risk factors for IBS?

A strong family history – genes and environmental factors could play a role.

A history of stress, anxiety, depression, and emotional and sexual abuse can make the condition worse.

Sex – females are more prone to it compared to males and the condition is common in young females.

What are the complications associated with IBS?

Chronic diarrhea and constipation can cause Hemorrhoids. Those who have chronic IBS and associated moderate to severe symptoms regularly may have a poor quality of life. They also miss work more often compared to others. People with IBS are more prone to stress, anxiety, and depression and also people with stress and depression may have worse IBS symptoms.

When should you see a specialist doctor?

If you are searching for the best doctor for IBD in Hyderabad, you should not worry much unless you have the following signs and symptoms:

  • Persistent diarrheas – especially at night
  • Iron deficiency
  • Frequent abdominal cramps
  • Persistent abdominal pain
  • Nauseas & vomiting sensation
  • Rectal bleeding and other uncommon symptoms.

Ulcerative Colitis, Causes & Symptoms

Best doctor for ulcerative colitis in Hyderabad, Dr. Datta Ram U Explains

Inflammation in the rectum spreads to the colon. Symptoms are not regular – don’t persist for many. Symptoms may often come and go.  In addition to abdominal pain and cramps, the other symptoms may include pus or blood in stools, loss of iron, anemia, abdominal cramping, weight loss, and diarrhea.  Medicines may help in relieving pain and relaxing abdominal muscles and calming inflammation. However, for more stubborn and complicated cases, surgery remains the best option. If you are looking for the best doctor for ulcerative colitis in Hyderabad, this information is for you.

What is ulcerative colitis?

Ulcerative colitis (UC) is a type of inflammatory bowel disease (IBD). IBD comprises a group of diseases that affect the gastrointestinal (GI) tract.

Ulcerative colitis is the inflammation of the rectum and colon (the large intestine). It usually occurs in the lining of the colon. Tiny sores called ulcers form on the lining of the colon due to inflammation. The sores form in the rectum and spread upward. They affect the complete colon. Inflammation may lead to frequent emptying of the bowel and rapid movement of bowel contents, and urgency to defecate. When the cells in the lining of the colon die, ulcers form. Ulcers cause bleeding (rectal bleeding and pain) and discharge of pus and mucus.

What causes ulcerative colitis?

Many experts are not clear about the exact cause of ulcerative colitis, but they think that environmental factors, the microbiome, abnormal immunological reactions, and genes could play a role together. Even stress, food habits, and unhealthy lifestyle factors such as smoking, and eating spicy foods, can trigger symptoms, but they are not directly involved in the causation of ulcerative colitis. Ulcerative colitis runs in families. Therefore, strong family history is a risk factor.

What are the symptoms of ulcerative colitis?

The signs and symptoms associated with ulcerative colitis may include stomach pain, abdominal cramps, frequent and rapid movement of abdominal contents; an urge to empty bowels frequently; recurring diarrhea that may contain pus, mucus, and blood. The other symptoms may include loss of weight, loss of appetite, and extreme tiredness (fatigue). Due to ulcerative colitis, many people have a huge impact on their day-to-day lives.

The extent of inflammation and severity of symptoms may vary depending on the area of the colon and rectum involved.

What are the complications of Ulcerative Colitis?

The complications associated with unattended and chronic ulcerative colitis may include severe bleeding, formation of blood clots in the arteries and veins; swelling of the colon; inflammation of the joints, skin and eyes; bone loss osteoporosis; severe dehydration; and formation of holes in the colon – perforated colon. And also, an increased risk of colon cancer.

When to see a specialist doctor?

You should see a specialist doctor – such as a gastroenterologist or any other best doctor for ulcerative colitis in Hyderabad, if you experience persistent abdominal pain and cramps with changes in your bowel habits or if you have the following symptoms associated with chronic ulcerative colitis: blood and mucus in the stool, rectal bleeding, severe inflammation, ongoing diarrhea that doesn’t respond to OTC medicines and treatment; and diarrhea that wakes you up from the sleep and fever that lasts more than two to three days.

Bottom Line

Usually, ulcerative colitis is not very serious, but it may lead to life-threatening complications and can make you weak and prone to other serious health conditions such as perforated colon and colon cancer. Though the signs and symptoms are debilitating, treatment can greatly reduce them and bring long-term benefits.

To know about the various treatment and the best options for the management of ulcerative colitis, meet Dr. Datta Ram U.

Types of Abdominal Pain – When to See a doctor?

Stomach pain specialist Hyderabad | Dr. Datta Ram U

Many people experience abdominal pain as there are many potential causes. In general, abdominal pain due to indigestion, gas, bloating, and abdominal muscle sprains or spasms is not very serious. However, there are other potential conditions and causes that may require immediate medical attention. Location and pattern of abdominal pain give indications about the cause Let us try to understand the types of abdominal pain – acute, chronic, and progressive abdominal pain.

Acute abdominal Pain

Acute abdominal pain begins, continues, and gets resolved within a few hours or a few days. It may be associated with other symptoms that develop over hours to days. In most cases, the causes are due to minor conditions. Therefore, acute pain may resolve within a few days without any treatment. However, sometimes the causes of abdominal pain may be due to serious medical emergencies including the following: Pancreatitis, appendicitis, intestinal obstruction, blockage of blood flow to the intestines, abdominal aortic aneurysm, cystitis (bladder inflammation), cholecystitis, cholangitis (gallbladder inflammation), diverticulitis, duodenitis, intestinal obstruction, kidney stones, kidney infection and liver abscess.

Chronic Abdominal pain (Episodic or Intermittent)

This type of pain is episodic or intermittent and may persist for up to several months. It may be there all the time or recurring (come and go). Children often complain of abdominal pain. It is common among girls, affecting women more often than men. If abdominal pain persists for long people get evaluated by a doctor for typical disorders that cause pain. If the cause has not been identified by that time – only 10% of people have a specific physical disorder. In the remaining 90% of people, centrally mediated abdominal pain syndrome (functional abdominal pain) may present.

Conditions that may cause chronic abdominal pain include: irritable bowel syndrome (IBS – many factors including lifestyle personality, stress, genetic factors and underlying mental disorders (anxiety and depression) contribute to pain. In children, it may be due to lactose intolerance.

In adults, the common physical causes of chronic abdominal pain include Crohn’s disease (inflammatory bowel disease), giardiasis (parasitic infections), gallbladder disorders (cholecystitis), liver disorders (hepatitis), ulcerative colitis, celiac disease, gallstones, GERD, gastritis, hernia, functional dyspepsia and overuse of drugs and indigestion.

Progressive Abdominal Pain

If abdominal pain worsens over time, it is known as progressive abdominal pain. It is often associated with other serious symptoms. The causes may include hepatitis, gallbladder cancer, enlarged spleen, Crohn’s disease, cancer (stomach, liver, pancreatic, kidney, gallbladder), and lead poisoning.

Referred Pain

If you feel pain in an area that is away from the actual source of pain, it is known as referred pain. This type of pain is often confusing for many, but it helps experts to find the cause of the pain. For instance, some women experience pain in the back or shoulder blade, but the actual source of their pain is the gallbladder. In some cases, heart attack in women may cause abdominal pain. Twisting of a testis (testicular torsion) in men is one such disorder outside the abdomen that causes abdominal pain.

Bottom Line

Many of us think that abdominal pain is common and often a minor health issue. However, if the pain comes on suddenly and quickly becomes worse, it may indicate a severe and significant problem.

In some cases, abdominal pain is the only sign that demands the need for surgery – and therefore, must be attended by a stomach pain specialist in Hyderabad to prevent complications. In older people, even if the condition is serious, abdominal pain may develop gradually. Newborns, infants, and small children who develop abdominal pain are unable to communicate the reason for their pain. The causes of abdominal pain in children are different than those in adults

When to see a doctor

People with warning signs such as loss of appetite, jaundice, nausea, vomiting, and swelling with gradually worsening pain should see a doctor right away. People with steady and worsening pain should see a doctor within a few days. People without warning signs should see a doctor at some point.

If you are searching for a stomach pain specialist in Hyderabad for abdominal pain, then, see

Dr. Datta Ram U

Follow These 10 Tips to Prevent GERD

How to Prevent GERD | Dr. Datta Ram U Surgical Gastroenterologist

Acid reflux is a condition wherein acid from the stomach flows back into the esophagus. Your lower esophageal sphincter controls the backflow of acid into the tubular esophagus that connects your throat and stomach. If you develop acid reflux, the most prominent sign or symptom you feel is heartburn or a burning sensation in the chest. You will also have other symptoms such as an acid taste in the mouth. Acid reflux is also known as gastroesophageal efflux (GERD). If this condition becomes chronic you will also have frequent heartburn, chest pain, and difficulty coughing, and swallowing.

Learn more about Acid Reflux

Lose weight

If you are Obese, you will be at risk of getting GERD problems. Extra weight, flesh, and fat in your abdominal region put pressure on your abdomen leading to GERD symptoms. If you are obese and have a GERD problem, then lose weight. Next, if you have normal body weight then don’t gain weight.

Check the medicines you are using

There are many medicines that interfere with your digestive process or relax your lower esophageal sphincter or irritate your esophagus. Such medicines increase the risk of GERD.  For instance, iron tablets, certain antibiotics, painkillers and sedatives, anti-allergic medicines, asthma medicines, calcium channel blockers, some non-steroidal anti-inflammatory drugs (NSAIDs), potassium and magnesium supplements, and many other medications can increase the risk of GERD. If you use these medications or any other such medications, then talk to your doctor about the best alternative drugs. Remember – to talk to your physician prior to stopping any prescribed medications.

Elevate Your Bed

Gastric acid remains in the stomach if you elevate your head by around six to eight inches. Gravitational force helps in keeping the gastric acid down in the stomach. Some people may prefer taking extra support or a pillow to raise their head, but this will not help. However, wedge-shaped support will help. To get a significant outcome, it is better to elevate your entire upper body.

Don’t lie down after eating

If you lie down immediately after having meals you are not letting the food and acid in the stomach to settle down. You will become prone to developing GERD if you lie down immediately after taking food. This is because acid easily passes through the LES into the esophagus. In general, gravity helps in keeping acid reflux under check.

Don’t Take Large meals at Once

If you take large meals at once, you are putting pressure on the lower esophageal sphincter by filling the stomach completely. This may lead to acid reflux and GERD.

How to Prevent GERD

Avoid the following foods if you are at risk of GERD

Spicy foods, mints, chocolates, acidic fruits such as pineapple, citrus fruits; fatty foods, carbonated beverages, coffee, caffeinated beverages onions, baked foods, oily foods, greasy foods, fast foods, donuts, burgers, pizzas, and other canned and stored foods can increase the risk of GERD.

Wear loose-fitting clothes

This is simple to understand. If you wear tight-fitting apparel or clothes, they constrict your abdominal muscles increasing your risk further. For instance, tight jeans or belts, and skin-tight clothes can increase your risk.

Quit smoking

Smoking can increase your risk of getting a GERD manifold as the nicotine present in cigarette smoke has the ability to relax the lower esophageal sphincter. It also reduces saliva’s ability to clear acid from the esophagus.

Avoid Alcohol

Alcohol is also not a good drink if you are prone to GERD because it also relaxes esophageal sphincter muscles and causes them to spasm.

Other Tips on How to Prevent GERD

There are many reasons behind the GERD issue. Stress could be one of them or it is capable of augmenting the symptoms. To reduce stress, the best bet would be to indulge in Yoga, meditation, hypnosis, NLP (neuro linguistic programming), tai chi, and taking rest.

Chew gum after meals: You’ll make more saliva, which helps neutralize heartburn-causing acid.

Bottom Line

If after trying the above tips, you are still experiencing GERD, see your gastroenterologist. There are medications to get relief from GERD symptoms. If lifestyle changes and medications do not provide any relief from the nagging symptoms of GERD, then you have to see a specialist doctor – a surgical gastroenterologist – who specializes in certain specific surgical procedures – such as Nissen’s Fundoplication that offer a permanent solution to your problem of GERD.