Acute Pancreatitis: Symptoms, Diagnosis & Treatment
What is Acute Pancreatitis? Acute pancreatitis, also called acute pancreatic necrosis, constitutes abrupt inflammation of the pancreas that may lead to death even after receiving due medical care on account of chance development of serious complications at a later stage. However, mild types of acute pancreatitis are mostly cured through conservative treatment procedures that include total elimination of oral feeding and aggressive intravenous fluid rehydration, while severe types often involve surgery to tackle infected pancreatic necrosis and related complications. What are the symptoms of acute pancreatitis? Some of the acute pancreatitis symptoms include: ■ Severe upper abdominal pain, often radiating to the back ■ Retching ■ Shivering ■ Faster heartbeat ■ Respiratory problem ■ Hemodynamic instability (shock) ■ Hiccup ■ Fever ■ Loss of appetite ■ Hemorrhagic discoloration of the flanks What causes acute pancreatitis? ■ Excessive Alcoholism ■ Untreated gallstones ■ Penetrating ulcers ■ Carcinoma of the head of the pancreas ■ Post – ERCP complications ■ Certain drugs such as diuretics, steroids, salicylates, sulfonamides ■ Infections such as Viral hepatitis, mumps, coxsackie B virus, cytomegalovirus, Mycoplasma pneumoniae ■ Radiation X-ray ■ Autoimmune pancreatitis. What are the types of acute pancreatitis? There are basically two types of acute pancreatitis, such as Mild and Severe. Mild pancreatitis involves inflammation and edema of the pancreas, while severe pancreatitis entails necrosis of the pancreas and injury to adjacent organs. However, the hallmark of an acute pancreatitis consists of the manifestation of the inflammatory response, such as the recruitment of neutrophils to the pancreas. Nevertheless, it leads to the secondary manifestations of pancreatitis: hypovolemia from capillary permeability, acute respiratory syndrome, disseminated intravascular coagulation, renal failure, cardiovascular failure, and gastrointestinal hemorrhage. How is acute pancreatitis diagnosed? Even though acute pancreatitis may be diagnosed clinically, CT evaluation becomes necessary to distinguish between mild acute pancreatitis and severe necrotic pancreatitis. However, also relevant are Blood Investigation that include Full Blood Count, Renal Function Test, liver function, serum calcium, serum amylase and lipase, arterial blood gas, and Trypsin-Selective test. Blood studies are also conducted to identify organ failure, while they provide prognostic data about the patient’s condition. Nevertheless, triple-phase abdominal Computed Tomography, along with abdominal ultrasound, is considered in many circles as the gold standard for evaluation of acute pancreatitis. However, imaging during the first 12 hours of complaint may not prove helpful as the inflammatory and necrotic process usually takes more than 48 hours to fully manifest. Incidentally, MRI or Magnetic Resonance Imaging has also been found to be a valuable tool for visualization of the pancreas, especially for pancreatic fluid collection and necrotized debris. MRI also proves effective for patients with an allergy to the CT’s contrast material and/or overall sensitivity to vascular complications, pseudoaneyrysms as also venous thrombosis. MRI, when associated with MRCP (Magnetic Resonance Cholangiopancreatography), provides additional information in terms of the etiology of acute pancreatitis, such as the existence of small biliary stones (choledocholithiasis or cholelithiasis) and duct anomalies. Meanwhile, clinical trials have established that MRCP is no less effective a diagnostic tool for acute pancreatitis with biliary etiology than Endoscopic Retrograde Cholangiopancreatography (ERCP), while being less invasive and so more in use. Along with some of the noninvasive methods of diagnosing acute (and/or chronic) pancreatitis, Endoscopic Ultrasound (EUS) is also currently viewed as one of the most sensitive methods for detecting pancreatic lesions while in close proximity to the transducer to the pancreas. What are the modes of Treatment for acute pancreatitis? The primary state of management of patients with acute pancreatitis comprises supportive care concerning the following issues: ■ Fluid replacement through aggressive hydration at the rate of 5 to 10 ml/kg/hour of isotonic crystalloid solution, unless cardiovascular, renal, or other related comorbid factors preclude such a process. However, fluid replacement needs to be reassessed at frequent intervals in the first six hours, as well as the next 24/48 hours on the basis of clinical assessment, hematocrit, and BUN values. ■ Pain Control – Severe abdominal pain control often involves the use of intravenous opiates, mostly in the form of a patient-controlled analgesic pump. While hydromorphone or fentanyl are commonly used in acute pain control, the latter is preferred by many on account of its better safety profile, particularly in renal impairment. ■ Providing rest to the pancreas – Rest to the pancreas will also relieve the pain and the disease condition if oral feeding is eliminated. Since the pancreas is designed to secrete enzymes when food goes into the stomach, nothing will happen if there is no food there. Studies reveal that more than 20% of acute pancreatitis patients report relapse of pain within 48 hours of oral feeding. However, giving intravenous fluids will prevent dehydration and related problems. ■ Nutritional support through post-pyloric enteral feeding (in which a feeding tube is endoscopically or radiographically introduced into the third portion of the duodenum). Since this form of feeding is more physiological, it prevents gut mucosal atrophy while being free from the side effects of TPN. The other benefits of post-pyloric feeding include an inverse relationship of pancreatic exocrine secretions and remoteness of nutrient delivery from the pylorus, as also lesser risk of aspiration. Postscript: Prevention is always better than cure – try to prevent acute pancreatitis by reducing your alcohol intake. However, for people who already have an attack, treatment, in general, will take the form of support for the body functions, allowing the pancreas to heal itself on its own.
Chronic Pancreatitis: Symptoms, Causes & Treatment
What is Chronic Pancreatitis? Chronic (long-term) Pancreatitis constitutes undeviating inflammation of the pancreas that impairs your system’s ability to digest food properly and regulate the blood sugar level in your body. Although acute, short-term pancreatitis often gets cured through conservative treatment, chronic pancreatitis seldom gets permanently cured. As a matter of fact, the damage caused due to a high degree of alcoholism and other causes over an extended period of time leaves so much ill effect on the organ that no line of ethical treatment can provide enduring relief. However, acute abdominal pain and secondary symptoms can be managed through medication and other means to some extent. What are the symptoms of chronic pancreatitis? Symptoms are usually absent in the initial stage, which, however, occur as outlined below as the ailment progresses. ■ Nausea and vomiting ■ Upper abdominal pain ■ Diarrhea ■ Pale, yellowish, sticky stool ■ Undue fatigue and too much thirst ■ Inexplicable weight loss However, as the disease progresses further, more alarming symptoms begin to appear that include: ■ Typical yellowish discoloration in the eyes and the skin, indicating the onset of Jaundice ■ Presence of pancreatic fluid in the abdomen ■ Internal bleeding ■ Intestinal blockage ■ Unrelenting abdominal pain What causes chronic pancreatitis? Although there could be numerous self-induced as well as inherited causes behind the onset of chronic pancreatitis in a person’s life, the commonest of all is alcohol abuse. Medical studies reveal that more than 70% of people affected by chronic pancreatitis have a long history of excessive alcohol consumption. However, some of the other causes that are also there are listed below: ■ Blockage of the pancreatic duct either by gallstones or pancreatic stones ■ Abdominal surgery ■ High calcium levels in blood (hypercalcemia), which may have been caused by an overactive parathyroid gland (hyperparathyroidism)/li> ■ High triglyceride level in blood (hypertriglyceridemia) ■ Chronic infection that remained untreated ■ Cystic fibrosis ■ Autoimmune disease ■ Excessive cigarette smoking ■ Family history of pancreatitis ■ Incredible, yet true – ERCP may lead to chronic pancreatitis. Wonder of all wonders – sometimes no cause is found at all! How is chronic pancreatitis diagnosed? Chronic Pancreatitis is not only difficult to treat but also difficult to diagnose. For instance, blood tests that normally reveal causes related to a lot of maladies prove to be of little value in diagnosing chronic pancreatitis, at least during the early stages of this deadly disease. However, blood tests do reveal the level of pancreatic enzymes in your blood. Nevertheless, some of the following tests are conducted to obtain more definite information, while imaging tests prove more helpful in diagnosing chronic pancreatitis. ■ X-rays ■ Ultrasound ■ CT scans ■ MRI scans To obtain conclusive evidence of the extent of damage caused to your pancreas, doctors (gastroenterologists) also go for an endoscopic ultrasound. During the procedure, the doctor inserts a long, flexible tube into your mouth, down through your stomach, and right up to the small intestine. The tube contains an ultrasonic probe that emits sound waves that create detailed images of your pancreas on a monitor attached to it. What are the modes of Treatment for chronic pancreatitis? To be honest about it, there isn’t much in the medical world to cure chronic pancreatitis, because the pancreas, like the liver, once damaged, cannot be recovered back to its original condition. However, medical help is available to manage the symptoms by way of medication, endoscopic therapies, and surgery. Medications that are often prescribed to manage the symptoms include: ■ Pain management medications to suppress agonizing abdominal pain ■ Supplementary digestive enzymes if your enzyme levels are found to be much too meager for digesting food properly ■ Insulin if you become diabetic ■ Steroids, if you happen to develop autoimmune pancreatitis Endoscopic treatment of chronic pancreatitis has currently drawn benefits from endoscopic procedures previously practiced for the main bile duct. While endotherapy is widely acclaimed as the most accepted alternative to surgery, cyst drainage procedure today presents the largest step forward in that non-surgical approach, regardless of whether direct (through stomach or duodenum) or indirect through the papilla in the duodenum. Pancreatic duct drainage, associated with stone clearance, is also feasible, while the procedure gives similar results to surgery with lower morbidity. Surgery, though not indicated for all, becomes inevitable for people who cannot endure excruciating abdominal pain that does not respond to pain-killing drugs. The only alternative then entails surgical removal of part of the organ. Postscript: People suffering from chronic pancreatitis should stay away from alcohol, even if hooch hasn’t been responsible for their dreaded illness, because it will exacerbate their sickness to a great extent. They should also refrain from smoking, as it would increase their risk of developing pancreatic cancer.
Liver Cirrhosis: Symptoms, Causes & Treatment
What is Cirrhosis Liver cirrhosis, or cirrhosis, denotes a disease condition where the liver fails to function due to extensive damage over a long period of time, involving loss of liver cells, as well as irreversible scarring of the liver. Even though at the initial stage, symptoms are negligible or nil, manifestations appear in rapid succession as the disease progresses. These include fluid buildup in the abdomen, spider-like blood vessels on the skin, swelling in lower legs, and many more that are being discussed in detail next, while the patient becomes weak, loses appetite, and develops yellowish skin (Jaundice). Likely to prove fatal if not treated early. What are the symptoms of Cirrhosis? Cirrhosis symptoms may be grouped under two heads: symptoms that have resulted from failure of the liver cells and those that have occurred due to portal hypertension (secondary). Manifestations caused by the failure of the liver cells: ■ Spider angiomata or spider nevi are vascular lesions comprising a central arteriole, surrounded by many smaller vessels, occurring due to an increase in estradiol. (The formation suggests the title). ■ Palmar erythema denotes the reddening of the palms at the thenar and hypothenar eminences, caused by increased estrogen. ■ Gynecomastia denotes an increase in the breast gland in males, caused by increased estradiol. However, this is neither related to increased breast fat nor can it be called cancerous. ■ Hypogonadism denotes a decrease in sex hormones, leading to loss of libido, impotence, and testicular atrophy, resulting from suppression of hypothalamic/pituitary functions. However, this is associated with cirrhosis on account of alcoholism and hemochromatosis. ■ Abnormal liver dimensions – Enlarged as well as shrunken. ■ Ascites denotes fluid accumulation in the peritoneal cavity, giving rise to flank dullness. ■ Fetor hepaticus, denoting musty breath odor, is caused by increased dimethyl sulfide. ■ Jaundice, denoting yellowish discoloration of the skin and eyes, is caused by increased bilirubin. Manifestations caused by portal hypertension Cirrhosis (liver cirrhosis) enhances resistance to blood flow and higher pressure in the portal venous system, which causes portal hypertension, the effects of which are listed below. ■ Splenomegaly denotes an enlarged spleen. 35% to 50% patients present this picture. ■ Esophageal varices result from collateral portal blood flow through vessels in the stomach and esophagus. However, when these blood vessels become enlarged (known as varices) they are prone to rupture. This often leads to copious bleeding, which can be fatal unless immediate medical aid is made available. ■ Caput medusa relates to dilated periumbilical collateral veins associated with portal hypertension. Blood from the portal veins may be moved through these veins, and eventually to the abdominal wall veins, manifesting a model that somehow resembles the head of MEDUSA, a Greek mythological monster. ■ Cruveilhier-Baumgarten Murmur denotes venous hum that can be heard in the epigastric region (through a stethoscope) caused by collateral connections forming between the portal system and the periumbilical veins (due to portal hypertension). What causes Liver Cirrhosis? Cirrhosis is mostly caused by excessive alcohol consumption, hepatitis B, hepatitis C, as also non-alcoholic fatty liver disorders. However, the latter is again associated with obesity, high blood pressure, high body fat, and diabetes. Some of the less common causes include autoimmune hepatitis, primary biliary cirrhosis, hemochromatosis, gallstones, and certain types of medications. Cirrhosis is also typified by the substitution of normal liver tissue with scar tissue. These result in loss of liver function. How is Liver Cirrhosis diagnosed? Even though the gold standard for diagnosis of cirrhosis is liver biopsy through a percutaneous, transjugular, laparoscopic, or fine-needle method, doctors currently insist on imaging as the best diagnostic approach. However, some of these approaches are outlined below. Ultrasound is customarily used in the evaluation of cirrhosis. It may show a small and nodular liver in advanced cirrhosis, along with increased echogenicity with irregularly appearing areas. Other findings suggestive of cirrhosis in imaging are an enlarged caudate lobe, widening of the liver fissures, and enlargement of the spleen. An enlarged spleen, which normally measures less than 11–12 cm in adults, is suggestive of cirrhosis with portal hypertension in the right clinical setting. Ultrasound may also screen for hepatocellular carcinoma, portal hypertension, and Budd-Chiari syndrome (by assessing flow in the hepatic vein). Other tests performed in particular circumstances include abdominal CT and liver/bile duct MRI (MRCP). Gastroscopy (endoscopic examination of the esophagus, stomach, and duodenum) is performed in patients with established cirrhosis to exclude the possibility of esophageal varices. If these are found, prophylactic local therapy may be applied (sclerotherapy or banding), and beta-blocker treatment may be commenced. What are the lines of treatment for Cirrhosis? Since no cure exists for biliary cirrhosis, treatment generally focuses on slowing down the progress of the disease, relieving symptoms as much as possible, and preventing further complications. However, researchers are continuing to explore new drugs for treating primary biliary cirrhosis. Immunosuppressant drugs, especially methotrexate (Trexall, Rheumatrex) and colchicine (Colcrys) have been extensively tried, but their efficacy is yet to be proved.
Liver Function Test: Purpose & Procedure
Liver function tests (LFTs/LFs) conducted at LivGastro primarily consist of Blood Tests that provide vital information about the condition of a patient’s liver. Some of these tests comprise Prothrombin Time (PT/INR), aPTT, albumin, Bilirubin (both direct and indirect), and a few others. Liver transaminases (AST or SGOT and ALT/SGPT ) provide helpful biomarkers in terms of the types of liver injury a patient has suffered. Thanks to the high-tech medical equipment from the manufacturer, Hisky Med, for equipping this digestive hospital in the City of Joy with state-of-the-art medical instruments! Without them, it could not have offered accurate, convenient, and standard services to the locals approaching this diagnostic centre to diagnose chronic liver diseases. As luck would have it, call it ill luck, most liver disorders cause not so intense initial symptoms, while ninety percent of hepatic disease conditions have a poor prognosis. However, tests are essential to ascertain the extent of damage caused to the person’s liver and to determine the right course of treatment. While some tests are associated with functionality, such as albumen, there are others that relate to cellular integrity, such as transaminase, while some others are linked to the biliary tract (gamma-glutamyl transferase and alkaline phosphate). Some biochemical tests are also conducted for the evaluation and management of patients with hepatic dysfunction, especially in terms of ascertaining the extent of damage caused to the liver, as well as the line of treatment that would best suit such patients. Other tests commonly conducted at LivGastro include the following: ■ 5’ Nucleotidase (5’NTD), which is specific for cholestasis that refers to damage to the intra- or extrahepatic biliary system, is often used as a substitute for GGT in ascertaining if the elevated ALP is of biliary or extrabiliary origin. ■ Coagulation Test – The liver is responsible for the production of the vast majority of coagulation factors. In patients with liver disease, INR can be used as a marker of liver synthetic function, as it includes factor VII, which has the shortest half-life (2-6 hours) of all coagulation factors measured in INR. An elevated INR in patients with liver disease, however, does not necessarily mean the patient tends to bleed, as it only measures procoagulants and not anticoagulants. In liver disease, the synthesis of both is decreased, and some patients are even found to be hypercoagulable (increased tendency to clot) despite an elevated INR. In liver patients, coagulation is better determined by more modern tests such as thromboelastogram (TEG) or thromboelastrometry (ROTEM). ■ Serum glucose Test, also called ‘BG’ or ‘Glu,’ is conducted to measure the liver’s ability to produce glucose (gluconeogenesis). In fact, it is the terminal function to be lost in the setting of ‘fulminant liver failure’. ■ Lactate dehydrogenase Test – Lactate dehydrogenase or LDH is observed in most body tissues, including the liver. However, elevated LDH levels often indicate liver damage. However, LDH isotype-1 (or cardiac) is often used for estimating damage caused to cardiac tissues, even though troponin and creatine kinase tests are found to be better alternatives.
Fatty Liver Disease: Symptoms, Diagnosis & Treatment
Fatty Liver, as the name suggests, is the excessive build-up of fat in the liver of about 5-10% of the liver’s weight. Most of the time, it’s not a serious concern, but in some cases, it is something to fret about, as it leads to liver damage. It starts with inflammation, causing the tissues to damage. The medical term for this first stage is steatohepatitis. In the second stage, scar tissue begins to form, which in turn damages the liver. Doctors call it fibrosis. In the third and final stage, the healthy tissues get replaced by extensive scar tissue. This is when cirrhosis of the liver occurs. It is a final blow to the liver, whereby liver functioning starts slowing down. Sooner or later, the liver function gets blocked entirely. According to the Cleveland Clinic, this cirrhosis transpires into liver cancer or liver failure in patients. Do you now get why fatty liver disease is a thing to panic about? Forms of Fatty Liver Disease Fatty liver disease has two primary forms: Alcohol-induced – As hinted, it is caused by heavy drinking. Non-alcoholic – Alternatively called NAFLD or Non-Alcoholic Fatty Liver Disease, the cause is still unknown, but diabetes and obesity have been said to increase the risk of occurrence. Symptoms to Pay Attention The symptoms of fatty liver are often silent unless the disease progresses to liver cirrhosis. The signs to watch out for are: ■ Weight loss, appetite loss, and nausea ■ Extreme weakness, exhaustion, and mental confusion ■ Jaundice ■ Abdominal pain, especially in the upper right side of the abdomen ■ Edema or swollen legs and abdomen If you ever feel any of the symptoms above, be prompt and book an appointment with a hepatologist for diagnostic services. The next section covers the Liver function tests, or a diagnosis that a doctor may order. Diagnosis Fatty liver silently creeps in, and for a layperson, it is challenging to spot the same. However, a doctor can easily determine the condition by noticing the elevation in liver enzymes from blood tests done for other ailments. To map the liver injury, a doctor often orders the tests mentioned below: ■ A liver biopsy to check the stage the liver disease has reached ■ Ultrasound or a CT Scan to examine the liver condition ■ FibroScan to determine the fat content in the liver Treatment for Fatty Liver Disease Unfortunately, there is no medication for treating fatty liver disease. Doctors primarily advise altering lifestyles to improve health conditions. Therefore, the treatment mostly comprises the following: ■ Reducing weight ■ Intake of thiazolidinediones or vitamin E ■ Avoiding alcohol consumption ■ Intake of medications to control cholesterol, diabetes, and triglycerides How to Prevent Fatty Liver Disease? If you have not been hit by fatty liver disease, you can do the following to maintain your overall health: ■ Get yourself involved in regular exercise ■ Maintain a healthy weight ■ Take prescribed medications ■ Put a check on alcohol consumption Reverse Your Fatty Liver Disease! Yes, you read it right. It can be either through a weight loss program or by avoiding alcohol. A Mediterranean diet, where one needs to consume lots of vegetables, fruits, and good fats, can lead to steady weight loss. So, if you are living with the ailment, don’t worry! Just make sure it never progresses into liver cirrhosis, and even if it does, go for immediate treatment to prevent liver failure or cancer.
Capsule Endoscopy: What Gastroenterologists Want You to Know
You have probably had a colonoscopy recommended, or perhaps an upper endoscopy. What about the stretch of digestive tract in between – the small intestine – that stretches nearly six metres and sits largely out of reach of conventional scopes? That’s where capsule endoscopy comes in. If you have been dealing with persistent abdominal pain, unexplained bleeding, or recurring digestive discomfort and have not found answers yet, consulting the best gastroenterologist you can find might lead you straight to this procedure. It’s less intimidating than it sounds, and it often reveals what everything else misses. What is Capsule Endoscopy and How Does It Work? Capsule endoscopy is a diagnostic procedure in which you swallow a small capsule — roughly the size of a large vitamin tablet — containing a tiny camera, a light source, and a radio transmitter. Once swallowed, the capsule travels naturally through your digestive tract, from the oesophagus down to the small intestine, capturing around 10,000 photographs along the way. These images are transmitted wirelessly to a small receiver worn around your waist. The whole process takes about eight hours, after which the capsule passes out of your body through stool. Before the procedure, your doctor will administer laxatives to clear the digestive system of food debris. So the camera can capture clear images. There’s no sedation involved. You simply swallow the capsule and go about your day as usual while it does its work inside. What Conditions Can Capsule Endoscopy Detect? This is where capsule endoscopy earns its reputation. It’s particularly effective at identifying problems in the small intestine that standard endoscopy and colonoscopy cannot reach. Conditions it can help diagnose include: ■ Unexplained gastrointestinal bleeding — when upper endoscopy and colonoscopy have drawn a blank ■ Crohn’s disease — especially early-stage or small bowel involvement ■ Intestinal tumours — both benign and malignant growths ■ Angiodysplasias — abnormal blood vessels in the gut wall ■ Celiac disease — where damage to the small intestinal lining needs to be assessed ■ Colon polyps and inflammatory bowel disease (IBD) Symptoms that might prompt a referral to the best gastroenterologist for this test include abdominal cramping, blood in the stool, persistent diarrhoea, chronic fatigue linked to unexplained anaemia, or significant unintended weight loss. Who is Capsule Endoscopy For? Capsule endoscopy is recommended for a fairly specific group of patients — those for whom conventional diagnostic methods have been inconclusive or insufficient. ■ People who have been bleeding somewhere in the gut, and other tests have come up empty ■ Those with suspected or confirmed Crohn’s disease, where the small bowel needs a proper look ■ Anyone dealing with ongoing abdominal pain or weight loss that has not been explained yet ■ Patients keeping an eye on existing polyps or intestinal growths ■ Those with persistent diarrhoea or signs that the body isn’t absorbing nutrients the way it should — celiac disease being a common culprit One thing worth knowing: if you have a history of narrowing or blockages in the intestine, your doctor will want to discuss this before proceeding. There’s a small chance the capsule could get lodged, so your gastroenterologist will review your history and decide whether the procedure is right for you. How is Capsule Endoscopy Different from a Regular Endoscopy? The most obvious difference is comfort. There’s no scope insertion, no sedation, and no recovery time needed afterwards. You swallow a pill and carry on. That said, capsule endoscopy does have limitations worth understanding: The capsule cannot perform therapeutic interventions — it cannot take biopsies or remove polyps If the capsule moves too quickly, images may be blurred or incomplete If battery life runs out before the capsule completes its journey, areas may be missed Pinpointing the exact location of an abnormality can sometimes be difficult These are procedural realities, not reasons to avoid it. In many cases, capsule endoscopy remains the most practical and informative way to evaluate the small bowel — and that makes it invaluable. Book Your Capsule Endoscopy at LivGastro — Kolkata’s Trusted Gastroenterology Hospital At LivGastro, every capsule endoscopy is overseen by Dr. Vijay Kumar Rai — a gastroenterologist recognised by both the American College of Gastroenterology and the American Society of GI Endoscopy. That’s not just a line on a CV — it means the person overseeing your diagnosis is trained to international standards. We use equipment sourced from Germany, Japan, and America, and every test is carried out by qualified doctors, not left to junior staff. If you’ve been looking up “acidity doctor near me” or trying to find a gastroenterology hospital in Kolkata where you can actually trust who’s doing your tests, LivGastro is worth a visit. All diagnostic procedures at LivGastro are conducted by highly trained doctors under Dr. Rai’s supervision, and results are delivered promptly so your care can move forward without delay. We provide complete day care gastro and liver services — consultation, diagnostics, pharmacy, and nutrition — all under one roof. Reach us at +91 9147105221 or WhatsApp 9369120028 to book your appointment. We are available Monday to Saturday, 8 am to 10 pm.
Prevention of Colorectal Cancer Through Early Detection
What Are The Major Risk Factors? Some of the key risk factors that cause colorectal cancer include family history (of the disease) as well as old age, while obesity, excessive alcohol use, indolence, and cigarette smoking are not ignored either. Alongside, people with a history of inflammatory bowel disease, such as ulcerative colitis and Crohn’s disease, reportedly run a higher risk of having colorectal cancer than those without such conditions. Screening tests for early diagnosis of colorectal cancer often prevent the spread of cancer. Quite a few screening tests have since been developed to help gastroenterologists such as Dr. V.K. Rai, M.D., and others detect colorectal cancer early, when the disease becomes more treatable. What’s more, some tests that detect or identify the adenomas are known to prevent the development of cancer through proper medical intervention. So, the screening procedure may also be considered as a form of cancer prevention method in most cases. What Tests Are Recommended For Diagnosing Colorectal Cancer? The following tests and/or investigative procedures are recommended for diagnosing colorectal cancer. High-sensitivity Fecal Occult Blood Test (FOBT) – Both polyps and colorectal cancers can bleed, while FOBT checks for tiny amounts of blood in feces (stool) that cannot be seen visually. (Blood in stool may also indicate the presence of conditions that are not cancerous, such as hemorrhoids. As of now, two types of FOBT are approved by the FDA for screening colorectal cancer: guaiac FOBT (gFOBT) and the fecal immunochemical (or immunohistochemical) test (FIT or iFOBT). With both types of FOBT, stool samples collected by the patient with the help of a kit are sent to the gastroenterologist. ■ Guaiac FOBT uses a chemical to detect heme, a component of the blood protein hemoglobin. Since the guaiac FOBT can also detect heme in some foods (for example, red meat), people have to avoid certain foods before having this test. ■ FIT uses antibodies to detect human hemoglobin protein specifically (4, 5). Dietary restrictions are usually not applicable in FIT. Studies, however, have revealed that guaiac FOBT, when performed every 1 to 2 years in people aged 50 to 80 years, can help reduce the number of deaths (due to colorectal cancer) by 15 to 33%. When FOBT is the only type of colorectal cancer screening test recommended, experts usually suggest yearly testing. Stool DNA test (FIT-DNA) is the only stool DNA test that has been approved by the FDA, while Cologuard® is a multitarget test that detects tiny amounts of blood in stool (with an immunochemical test similar to FIT) as well as nine DNA biomarkers in three genes that have been found in colorectal cancer and precancerous advanced adenomas. The DNA comes from cells in the lining of the colon and rectum that are shed and collected in stool as it passes through the large intestine and rectum. As with both types of FOBT, the stool sample for the FIT-DNA test is collected by the patient using a kit, and the sample is mailed to a laboratory for testing. A computer program analyzes the results of the two tests (blood and DNA biomarkers) and provides a finding of negative or positive. People who have a positive finding with this test are advised to have a colonoscopy. In one study comprising people who were at average risk of developing colon cancer but had no symptoms of colon problems, this test detected more cancers and adenomas than the FIT test (that is, it was more sensitive). However, the FIT-DNA test was also more likely to identify an abnormality when none was actually present (that is, it had more false-positive results). Sigmoidoscopy In this test, the rectum and sigmoid colon are examined using a sigmoidoscope, which is a flexible lighted tube with a lens for viewing and a tool for removing tissue. This instrument is inserted through the anus into the rectum and sigmoid colon as air (or carbon dioxide) is pumped into the colon to expand it so the gastroenterologist may be able to view the colon lining more effectively. During sigmoidoscopy, abnormal growths in the rectum and sigmoid colon can be removed for analysis (biopsied). The lower colon must be cleared of stool before sigmoidoscopy, but the preparation is less extensive than that required for colonoscopy. People are usually not sedated for this test. Studies, however, have shown that people who have regular screening with sigmoidoscopy after age 50 years have a 60 to 70% lower risk of death due to cancer of the rectum and lower colon than people who do not have screening. One randomized controlled clinical trial found that even just one sigmoidoscopy screening between the ages of 55 and 64 can substantially reduce colorectal cancer incidence as well as mortality. Experts generally recommend sigmoidoscopy every 5 years with or without gFOBT or FIT every 3 years for people at average risk who have had negative test results. Standard [Optical] Colonoscopy In this test, the rectum and entire colon are examined by using a colonoscope, which is a flexible lighted tube with a lens for viewing and a tool for removing tissue. Like the shorter sigmoidoscope, the colonoscope is inserted through the anus into the rectum and the colon, as air (or carbon dioxide) is pumped into the colon to expand it so the doctor can see the colon lining more clearly. During a colonoscopy, any abnormal growths in the colon and the rectum can be removed, including growths in the upper parts of the colon that are not reached by sigmoidoscopy. However, a thorough cleansing of the entire colon is necessary before this test. Most patients receive some form of sedation during the test. Studies reveal that colonoscopy reduces deaths from colorectal cancer by about 60 to 70%. Additional studies are currently being done to better evaluate how effective colonoscopy screening methods are. Experts recommend a colonoscopy every 10 years for people at average risk as long as their test results are negative. Virtual Colonoscopy This screening method, often called computed
8 Things You Should Know About Digestive Health
Gastroenterology specialists in Kolkata are medical marvels, medical specialists trained to diagnose and treat conditions affecting the digestive system. This includes the stomach, small and large intestines (colon), rectum, liver, pancreas, gallbladder, and bile ducts. They provide care for a wide range of issues, including abdominal pain, acid reflux (GERD), ulcers, irritable bowel syndrome (IBS), Crohn’s disease, colitis, celiac disease, hepatitis B and C, pancreatitis, constipation, and chronic diarrhea. If you’re searching for a gastroenterologist near me in Kolkata, it’s important to choose someone with the right expertise to accurately diagnose and manage your condition with personalized care. These specialists play a crucial role in maintaining your digestive health. From performing colon cancer screenings to identifying early signs of gastrointestinal diseases, their work helps detect and manage problems before they become more serious. Gastroenterologists also offer practical guidance on diet and lifestyle changes to support a healthier gut. Visiting a GI doctor can feel intimidating, but it doesn’t have to be. Here are a few things your gastroenterologist wants you to know before your next appointment. 1. A Gastroenterologist Wishes to Help You Feel Better Gastrointestinal problems can change a lot of things, such as how much energy you have and how sure you are of yourself. Gastroenterologists are here to find out what’s causing your pain and come up with a treatment plan that not only helps but also makes your life better. Your comfort is always the priority. 2. No Symptom Is Too Small Digestive issues often present in subtle ways, and sometimes even serious conditions can start with mild symptoms. That’s why no concern is too small to discuss. A qualified gastroenterology specialist in Kolkata will take every symptom seriously because even minor digestive troubles can disrupt your routine, comfort, and overall well-being. 3. We’re Experts in All Things Digestive Gastroenterologists undergo years of specialized training to diagnose and treat everything from common stomach issues to complex conditions like Crohn’s disease or ulcerative colitis. Whether it’s a minor concern or a chronic disorder, you can trust that you are in capable, experienced hands. 4. Treatment Isn’t One-Size-Fits-All There’s often more than one way to manage a digestive issue. That’s why we tailor treatment plans to fit your lifestyle, preferences, and medical needs. Together, we’ll find an approach that’s not only effective but also practical for your daily life. 5. We’re Here to Support Your Health Goals The digestive system plays a vital role in how your body absorbs nutrients. A skilled gastroenterologist in Kolkata is well-equipped to guide you on diet and nutrition. We can create a personalized plan to help you live healthier, whether you are trying to manage a condition, boost vitamin levels, or adjust your weight. Nutritional advice is often a key part of our treatment approach. 6. We Understand Food Intolerances—and How to Manage Them If you suspect a food intolerance, like gluten or lactose, we can help identify the cause and guide you through the next steps. From ensuring proper nutrition to offering practical tips for Grocery shopping and meal planning, we will help you avoid symptoms and feel confident in your food choices. 7. Nothing You Say Will Surprise Us Gastroenterologists have years of experience handling a wide range of digestive issues—nothing is too awkward or embarrassing. Whether it’s rectal pain, bleeding, or changes in bowel habits, your honesty aids us in identifying the underlying issue and delivering optimal care. 8. Screenings Can Be Lifesaving Early identification of colon cancer can lead to much better outcomes. While there are several ways to screen for abnormalities, colonoscopy remains the most reliable method, allowing us to detect and often treat issues in a single procedure. Talk to your GI doctor about when to begin regular screenings. Prioritize Your Gut Health, Get Started Today We at LivGastro are dedicated to delivering world-class gastrointestinal care, combining expert clinical experience with the latest advancements in digestive health. Our team is actively involved in continuous research to make sure patients benefit from the most up-to-date and effective GI treatments available. Whether you’re managing a chronic condition or seeking answers to new symptoms, we’re here to help with compassionate, personalized care. If you’re searching for a trusted gastroenterologist in Kolkata near me, our specialists are here to support you. To schedule an appointment with our experienced gastroenterologist, contact the office closest to you or use our easy and convenient online request form. Your digestive health matters—and you can count on us for continuous support from start to finish.
Belching: Causes, Symptoms & Diagnosis
Belching involves expulsion of gas from the esophagus (and stomach) through the mouth (after a meal), resulting in the distinctive resonance known as Burp! Among certain ethnic groups, dinner receptions are not considered gratifying unless the guests belch loudly while leaving the table. Nevertheless, we all belch after consuming a hearty meal, which provides some comfort and satisfaction as the expelled gas brings relief to the distended stomach somewhat filled by swallowed air. However, too much or excessive belching can be a cause of concern needing medical attention by a gastroenterologist, such as Dr. V.K. Rai, since there are several medical conditions that may cause this wacky malady, calling for prompt diagnosis and treatment, if necessary. Medical Conditions Causing Excessive Burping Hiatal Hernia – A hiatal hernia that causes excessive burping occurs if and when the upper part of a person’s stomach pushes up through the diaphragm, reaching the chest region. Normally, the stomach remains below the diaphragm, but in people with a hiatal hernia, a part of the stomach pushes up through the diaphragm, while the opening it moves through is called a hiatus, and hence the name. However, when part of the stomach pushes up through the diaphragm, it remains at the same level as the lungs. But when the pressure drops in the chest cavity due to muscle movement (as a person breathes in), the same effect happens in this part of the stomach, pulling air in. On breathing out, the chest pressure changes, the lungs expel the air, but the bizarrely located stomach does not want to let go, thus making it uncomfortable for the person who feels the urge to belch for relief. Hiatal hernia may be diagnosed by a Gastroenterologist such as Dr. V.K. Rai, MD, in the following ways… ■ Barium X-ray – The gastroenterologist may have you drink a liquid with barium in it before taking an X-ray. This X-ray provides a clear silhouette of your upper digestive tract. The image allows the gastroenterologist to see the location of your stomach. If it’s protruding through your diaphragm, you have a hiatal hernia. ■ Endoscopy – The gastroenterologist may slide a thin tube down your throat and pass it down to your esophagus and stomach. He/she will then be able to see if your stomach is pushing through your diaphragm. Any strangulation or obstruction will also be visible. GERD – Acid reflux or gastroesophageal reflux disease (GERD) can oftentimes cause excessive belching by promoting increased swallowing. Chronic belching may be related to inflammation of the stomach lining (gastritis) or to an infection with Helicobacter pylori, the bacterium responsible for some stomach ulcers. In these cases, the belching is accompanied by other symptoms, such as heartburn or abdominal pain. Diagnosing GERD involves three basic tests: (a) Upper Endoscopy, (b) Esophageal pH monitoring, and (c) Manometry, to be conducted by a gastroenterologist, such as Dr. V.K. Rai, MD for the following reasons. ■ Upper Endoscopy: An upper endoscopy can be used to determine the cause of heartburn and is often performed as an outpatient procedure. ■ Esophageal pH Test: The esophageal pH test is commonly used to help confirm the diagnosis of GERD or to identify the cause of various symptoms. ■ Esophageal Manometry: Esophageal manometry is an outpatient test that can identify problems with movement and pressure in the esophagus that may lead to problems like heartburn. Swallowing air – Bad or harmful habits cause excessive belching, too. These include overindulgence in drinking carbonated beverages, particularly when drinking with a ‘straw’. Also, people who eat and drink quickly, or when they are on the go. Chain smokers fall in this category in no uncertain way. Indigestion – Indigestion and heartburn can cause excessive belching, while the latter can stem from acid reflux, whether as a symptom of peptic ulcer, or a sign that last night’s spicy meal did not agree with your stomach lining. When acid moves back up the esophagus from the stomach, as in GERD, people often swallow frequently as a way to relieve some of the discomfort and then have to belch. Continuous swallowing causes more air to enter the system, which in turn causes more belching. Gastroparesis – A medical condition called gastroparesis can lead to excessive belching. Gastroparesis, sometimes referred to as delayed gastric emptying, is a condition in which food remains in the stomach longer than it should because the stomach’s muscles become weak or are damaged. Weak stomach muscles become unable to push food to the next stage of digestion. Undigested food that remains in the stomach can cause nausea, vomiting, and excessive burping, too. Postscript Belching is a normal human phenomenon associated with the ingestion of food and starts from the very primary stage, i.e., with newborn babies. However, when it gets beyond control or becomes unmanageably excessive, one needs medical intervention, especially by a senior Gastroenterologist like Dr. V.K. Rai.
Ultimate Guide to Colitis: Types, Causes, Symptoms & Treatment
Do you often complain of bloating and diarrhoea? Has discomfort and pain in your abdomen become commonplace? Chances are, you are suffering from colitis. It is the inflammation of your large intestine or colon, as many people recognise. However, determining whether it is colitis for real requires understanding its various types, symptoms, causes, and treatments. So, without further ado, let’s begin. Types of Colitis and Their Causes Colitis is of various types and is provoked due to many causes. While it’s easy to treat some, for instance, those occurring from a bacterial infection like food poisoning, others are serious and take a lot of time to go away. Beware of the severe cases! They may threaten your colon and affect your quality of life. Let us take a look at each of them and examine their causes. Pseudomembranous colitis (PC) PC is triggered when the C. difficile overgrows, and the ‘good’ bacteria fail to balance it. Consequently, C. diff takes over, releases toxins, and causes inflammation. Microscopic colitis It is mostly people aged 50 and above, smokers, and those who have suffered from an autoimmune disease who are diagnosed with microscopic colitis. The medical condition causes abdominal bloating, pain, and chronic watery diarrhoea. Ulcerative colitis (UC) It is the most common type of colitis, where patients have to put up with bleeding ulcers and inflammation. The disease occurs in the rectum but gradually spreads to the colon. UC happens when the bacteria in the digestive tract cause the immune system to overreact. Ischemic colitis (IC) It is usually blood clots that trigger IC. As the blood flow is cut off to the colon, blockage occurs. The condition recurs when fatty deposits build up in blood vessels. People having underlying conditions like diabetes, trauma or injury, blockage, colon cancer, and a history of dehydration and heart failure develop IC more often. Symptoms of Colitis It can be any of the following: Fever and chills Abdominal pain Diarrhoea Bloating in the abdomen Vomiting Unexpected weight loss Presence of blood in stool Diagnosis of Colitis When you visit a doctor, the physician may enquire about the frequency of symptoms and when they first occurred, followed by a thorough physical examination. The medical practitioner may also prescribe diagnostic tests, and a few to name would be – Ultrasound Stool samples Colonoscopy Abdominal imaging, such as CT scans or MRI Sigmoidoscopy Barium enema or an X-ray of the colon Treatment of Colitis The treatment of this medical condition depends a lot on the type and cause. It mostly includes: Diet – A wholesome diet low in fibre and easy to digest cures acute colitis. Avoiding certain foods that cause colitis flare-ups is also a great way to tackle the medical condition. Surgery – Surgery is prescribed to people diagnosed with IBD, necrotising enterocolitis, and ischemic colitis. However, it may or may not cure the conditions. It can only stop bleeding, remove a blockage, or repair a perforation. Medications – Medications like immune system suppressors, antibiotics, antidiarrheal drugs, pain killers, and antispasmodic drugs can help manage colitis symptoms. Postscript: Detection is critical for recovery from colitis. Early diagnosis can curb serious complications. Therefore, whenever you are not feeling well and believe it has something to do with your stomach, talk to a doctor.