Category Archives: Health Care

Congenital Diaphragmatic Hernia (CDH)

The diaphragm separates the chest from the abdomen. It is a thin sheet of muscles or a muscular barrier between the chest and abdominal cavities. During the development of the fetus inside the womb, a hole is present in the diaphragm due to a gap formation during the development of the fetus. The stomach, bowel, and even liver move up into the chest cavity through this hole. This condition is known as a congenital diaphragmatic hernia (CDH). The space for the lungs reduces due to the presence of abdominal organs in the chest. This may lead to breathing problems and respiratory complications. The lungs of the growing baby grow in a restricted and compressed environment due to CDH. Therefore, a baby’s lungs do not develop normally until the birth of the baby.

What are the complications of pulmonary hypoplasia?

A congenital diaphragmatic hernia may lead to pulmonary hypoplasia – a type of underdeveloped lungs condition. In this condition, the baby may have abnormalities that impact the number of alveoli (air sacs) available; and pulmonary hypertension. The fetus may not suffer from low oxygen levels (hypoxemia) while growing in the womb as the placenta takes over all the functions of the lungs. However, immediately after birth, the baby depends on the lungs for oxygen. If the lungs are underdeveloped, then the baby requires artificial ventilation techniques. CDH can develop on right, left, or both sides of the diaphragm (chest). It occurs in around 1 in every 2500 live births.

How is CDH Detected?

A routine ultrasound during pregnancy may reveal excess abdominal contents in the fetal chest cavity. Experienced gynecologists recommend a detailed ultrasound and fetal chromosome testing and also measure the lung size of the fetus. The other tests include CT scan, MRI, and arterial blood gas test. Based on the findings of these tests, CDH is detected.

Gynecologists measure and compare the lung size of the fetus to the expected size at this stage of pregnancy. They also measure lung area to head circumference ratio (LHR) and then compare the observed and expected LHR. They also determine whether the liver has also moved into the chest. Based on these findings, they grade congenital diaphragmatic hernia as mild, moderate, or severe.

After Birth

A physical examination after birth may reveal the following abnormalities:

  • One side of the chest lacks breath sounds
  • Cyanosis – The skin of the baby turns blue
  • Breathing difficulty
  • Abnormal chest movements
  • Bowels sound in the chest
  • A half-empty feeling in the abdomen.

CDH Treatment

After delivery, gastroenterologists perform surgery on a baby with CDH to close the defect. Congenital diaphragmatic hernia treatment is an emergency situation. It typically requires surgery. Surgical gastroenterologists perform surgery within 48 to 72 hours after delivery.  The main objective of the surgery is to remove abdominal organs from the chest and place them back into the abdomen. The surgical gastroenterologist who specializes in performing hernia repair surgery repairs the diaphragm as well.

In emergency situations, surgery is performed earlier. Surgery may be delayed in some cases though. Prior to performing surgery doctors stabilize the baby and increase her oxygen levels.

Gastroesophageal Reflux Disease (GERD) / Acid Reflux

GERD Specialist in Hyderabad | Best Doctor for Acid Reflux in Hyderabad

When stomach content moves into the esophagus (flow backward), the condition is known as Gastroesophageal efflux disease (GERD). It is a common condition that most often becomes frequent and causes severe symptoms, inflammation, irritation, and injury to the esophagus. Chronic and untreated acid reflux may damage the esophagus, pharynx, or respiratory tract. There are several other names for this condition – such as Heartburn, acid regurgitation, acid reflux, and acid indigestion. If you have this condition, you must see a GERD specialist in Hyderabad – A gastroenterologist or a surgical gastroenterologist for GERD Surgery or Laparoscopic Nissen’s Fundoplication for GERD.

Signs and Symptoms of GERD

  • Heartburn is the most common symptom
  • Mild heartburn may occur twice a week (mild GERD)
  • Moderate to Severe GERD – symptoms may manifest more than twice a week
  • Severe GERD is associated with inflammation in the esophagus
  • A burning and painful sensation in the middle of the chest
  • Bad breath
  • Swallowing difficulty
  • Regurgitation of the stomach content
  • Chest pain
  • Irritated feeling in the esophagus and sore throat

GERD Diagnosis

A gastroenterologist begins the diagnosis of GERD with a comprehensive physical examination by taking into consideration the medical history and symptoms of the patient. If a person is presented with the typical symptoms of GERD – such as regurgitation and heartburn then the doctor diagnoses the cause as GERD without further referring any additional tests.

The gastroenterologist may recommend tests if the GERD specialist suspects esophageal damage due to atypical symptoms and severity of the reflux. If the symptoms do not respond to initial treatment, the surgical gastroenterologist may consider anti-reflux surgery.

The diagnostic tests for GERD include the following:

  • Reflux testing (wireless pH/pH impedance)
  • Upper endoscopy
  • Barium esophagram
  • Esophageal manometry [esophageal motility (movement) studies]

Complications Associated with GERD

  • Esophagitis
  • Esophageal ulcer
  • Esophageal Strictures
  • Barrett’s Esophagus
  • Esophageal cancer

Causes and Risk Factors of GERD

The lower esophageal sphincter ensures that the acid remains intact in the stomach. It is a ring of muscles that helps keep the top portion of the stomach closed, but the following factors cause the sphincter to relax:

  • Eating a heavy, greasy (oily), and large meal
  • Eating soon before going to bed
  • Lying flat soon after eating
  • Eating spicy or fried foods – onions, cabbage, citrus fruits
  • Consuming carbonated beverages and alcohol
  • Belching
  • Eating certain foods such as peppermint, chocolate, and high-fat foods.
  • Increased abdominal pressure due to obesity or overweight or during pregnancy in women
  • Inhaling second-hand smoke or smoking
  • Usage of certain medications such as painkillers, calcium channel blockers, antihistamines, asthma, and antidepressants.

Hiatal hernia can cause the opening of the diaphragm through which the upper part of the stomach moves up. When this happens the pressure in the esophageal sphincter lowers and acid reflux occurs.

GERD Treatment in Hyderabad

To manage and relieve symptoms of GERD, your doctor might encourage you to make certain lifestyle changes, like:

One should make changes in their lifestyle to manage and get rid of GERD symptoms. A GERD Specialist in Hyderabad may recommend and encourage us to make the following lifestyle changes:

  • Weight management (reducing weight if applicable)
  • Quitting smoking
  • Avoiding carbonated and acidic beverages
  • Avoiding heavy and big meals in the evening
  • Raising the head of the bed by around 8 to 10 inches
  • Elevating the head during sleep
  • maintaining a moderate weight, if applicable
  • waiting a few hours after eating to lie down

Treatment also includes prescription and other medicines such as antacids, H2 receptors blockers, and proton pump inhibitors.

Bottom Line

Acid reflux can become problematic as it interferes with daily living. A majority of people can get relief from acid reflux through home remedies, lifestyle changes, and medical treatment. In some cases, surgery is recommended when lifestyle changes, medicines, and home-based treatment have not stopped the symptoms. A surgical gastroenterologist or a GERD specialist in Hyderabad will recommend surgery if a person develops complications associated with GERD. Fundoplication is the recommended option.

Read more about “Laparoscopic Nissens fundoplication for GERD

Hiatal Hernia Symptoms, Complications and Treatment

Hiatal Hernia Symptoms, Complications and Treatment (Surgery)

Hiatal Hernia Treatment in Hyderabad | Hiatal Hernia Specialist in Hyderabad |Hiatal Hernia Surgery Cost in Hyderabad

Hiatal Hernia

Diaphragm separates your chest and abdomen. Your esophagus passes through a small opening through your diaphragm before it connects with the stomach. The small opening is known as hiatus. Sometimes, your stomach pushes up into your chest through hiatus. This condition is known as hiatal hernia. The stomach thus bulges and remain partly above the diaphragm.

“Protrusion of the stomach into the chest through the diaphragm (a large flat muscle that separates the abdomen and the chest. It is the main muscle for breathing).”

You may not know that you have this condition unless your doctor discovers it while examining you for another health issue. In general, small hiatal hernia doesn’t cause any symptoms or issues. However, you may develop heartburn and acid reflux due to a large hiatal hernia. It causes the acid and food from your stomach to flow back to esophagus. Some medications and home remedies or self-care measures can help relieve the symptoms. But, if you have a large hiatal hernia, you may require surgery to treat it.

Hiatal Hernia Symptoms

Small to moderate size hernias don’t cause any symptoms. But large hiatal hernia can cause the following symptoms:

  • Chest pain or abdominal pain
  • Feeling full immediately after eating
  • Pressure in the upper part of the abdomen
  • Heartburn
  • Regurgitation of liquid or food into the mouth
  • Acid Reflux (GERD)

Hiatal Hernia Causes

Though it is not known why hiatal hernia occurs, the following reasons can be attributed to the cause:

You may get hiatal hernia, if You:

  • Have unusually large hiatus (may be by birth)
  • Put excessive and persistent force or pressure on diaphragm and its surrounding muscles while vomiting or coughing.
  • You have undergone injury to the hiatus or subjected to trauma
  • Strain yourself during a bowel movement, exercising or lifting heavy objects
  • You have undergone a certain type of surgery

Hiatal Hernia Complications


In this condition, acidic stomach contents flow back into the esophagus. If you have GERD, you will experience severe burning chest pain and difficulty in swallowing.

GERD can cause severe esophageal ulcers and bleeding, narrowing of the esophagus and a pre-cancerous change in the esophagus called “BARRETTS ESOPHAGUS” which can later lead to esophageal cancer.

GERD affects the quality of life as the burning pain prevents you from eating the food of your choice. In most instances, you may be scared of eating the food you like the most due to precipitation of pain.

Volume Reflux

Some patients suffer regurgitation of food into the mouth.

Many aspirate it into the lungs especially at night and have cough and repeated respiratory infections.

Diagnosis of Hiatal Hernia

A typical history is often diagnostic and does not require any special tests
Upper GI endoscopy
24 hr ph Monitoring of the oesophagus
Esophageal manometry to assess esophageal motility

Hiatal Hernia Treatment in Hyderabad (Surgery) For further evaluation and treatment of hiatal hernia, do consult

Dr Datta Ram U
Senior Consultant Surgical Gastroenterologist
Sunshine Hospital, Gachibowli Hyderabad

Call: 9895437059
Email: [email protected]

Stomach Flu or Gastroenteritis

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 Cancer

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.