10 Health Tips to Prevent Digestive Problems

As we age past the robust health of our youth, certain health problems start appearing on the horizon of our everyday attention. Digestive problems are one of them. Though not seemingly debilitating, digestion problems can definitely disrupt daily activities and make you think twice about taking an unplanned trip if you suffer from them.

So, what determines the health of this system that keeps us running? The food you eat and your daily lifestyle have a direct impact on the health of your digestive system. Over time, factors such as lack of activity, medications, and every day habits can take their toll and contribute to digestive issues. When there is something that disturbs your digestive system, you will most likely experience unpleasant symptoms. While some problems require a visit to your gastroenterologist, others may be related to your lifestyle and can be prevented.

Taking caution and steps to improve your digestive health can not only protect and improve your long-term digestive function, but have a positive impact on your overall health as well.

The following are some effective strategies and tips to help prevent digestive problems:

1. Track and avoid triggers that create digestive problems for you

Various things, that vary from person to person, can trigger digestive problems. You will have to identify what kinds of eating patterns, habits, and foods trigger digestive issues for you in particular. For some people, tricky foods can be dairy. For others, it can be gluten. Coffee, fizzy/ carbonated drinks, and dairy products are common causes for gas and diarrhoea.

Over the counter or prescription medication can also cause digestive upsets. Since such triggers can vary from person to person, it is best to track your diet and medication to identify your personal triggers. For instance, you can try an elimination diet to identify foods that irritate your digestive tract. You can also talk to your doctor to help identify any potential allergies and other food sensitivities. Inquire about any known side effects of any medication you are currently on to see if that is the culprit.

Certain activities such as travel and events such as menstrual hormones can affect your digestion also. If you suspect a connection, start taking note of foods and drinks, medication or supplements, and daily activities and events. You may start finding correlations between these tracked factors and digestive issues.

2. Make fibre a major portion of your diet

Fibre-rich food is highly beneficial to digestive function. Fibre adds bulk to your stool and keeps it moving smoothly through your digestive tract. A high-fibre diet is a key component in alleviating and preventing constipation. Increasing fibre intake prevents gas, bloating, and diarrhoea. A fibre-rich diet also helps maintain a healthy balance of gut bacteria that play a big role in the overall health of your digestive system. So, consuming a diet rich in vegetables, fruits, whole grains, and legumes can help improve your digestive health and prevent many digestive ailments such as heartburn, irritable bowel syndrome (IBS), haemorrhoids, diarrhoea, gas, nausea, and intestinal cramps.

3. Incorporate both soluble and insoluble fibre

You may have heard of soluble fibre with its growing popularity in food trends. It is a reputation, that is thankfully, well earned. Though dietary fibre is part of food that mostly passes through your system without being broken down too much, it plays an important role in our digestive function. In addition, fibres play an important role in maintaining healthy body weight.

Dietary fibre is of two kinds: soluble and insoluble fibre; both have unique benefits.

• Soluble fibre, mostly in the form of gums and plant pectin, dissolves in water into a gel-like substance in our digestive tract and aids in digestion by bulking up watery stools. Soluble fibre helps in regulating blood glucose levels and reduces the risk of diabetes. It also helps reduce cholesterol in the blood and is heart-friendly. Good sources of soluble fibre are nuts, seeds, legumes (kidney, black, and lima beans), fruits (avocado, apricots, pears), and vegetables (carrots, turnips, ladies fingers).
• Insoluble fibre, also called roughage, helps food pass through your digestive system with less strain and helps improve bowel regularity and health. It also helps regulate blood sugar levels and prevent diabetes. Good sources of insoluble fibre are whole grains, vegetables, and fruits.

4. Drink adequate water

Water is essential for good health and bowel function. It helps cleanse the digestive system and prevents constipation by softening stools. It aids the digestive function by helping break down food and improving the absorption of nutrients by your body. Drinking plenty of water will help you avoid dehydration and help you stay hydrated if you are suffering from diarrhoea.

Your aim should be to drink at least 8 glasses of water every day. However, you should avoid sugary and caffeinated drinks – they can make digestive problems worse. Also, to prevent ‘traveller’s diarrhoea,’ drink water from known sources when you’re on the road to avoid contaminated water. Stick to sipping on bottled or filtered water.

5. Consider a probiotic

Consider incorporating probiotics into your diet. Probiotics are a combination of live beneficial bacteria and yeasts that live naturally in your digestive tract. They are the ‘good’ bacteria that help your body function well and also fight the ‘bad’ bacteria.

They combat the ill effects of a poor diet, stress, and antibiotics. Probiotics can help break down lactose, strengthen your immune system, help treat IBS, and improve nutrient absorption. Fermented foods such as yogurt, kombucha (fermented tea) and kefir (fermented dairy drink) are good sources of probiotics.

6. Be active and exercise regularly

Regular physical activity has many bodily benefits which include maintaining a healthy weight, the most well-known use of exercise. But getting at least 150 minutes of muscle-strengthening and cardiovascular exercise every week will do more than get you on track of an overall healthy lifestyle. Exercise can, in fact, help maintain a healthy digestive function and aid bowel regularity by preventing issues such as constipation. Further, maintaining a healthy body weight can also aid your digestive system.

7. Limit foods high in fat

It is no secret that high-fat food or foods with high amounts of saturated fats are bad for you. They increase blood cholesterol, increase the risk of heart disease, diabetes, liver disease, hypertension, and have many debilitating effects on your body.

Unsurprisingly, fatty foods complicate normal digestive activity also. Fatty foods strain the digestive process and slow it down. That is why digesting fatty foods when you have an upset stomach is much harder. They also make you prone to constipation. However, it is important to get healthy or good fats, especially those high in omega-3 fatty acids, in your diet, and accompanying such food with high-fibre foods will help in easy digestion.

8. Manage stress

Stress can cause and aggravate gastrointestinal problems. In fact, research has found that digestive problems are one of the most common symptoms of anxiety and stress. Stress can cause a host of digestive issues such as loss of appetite, bloating, cramping, and inflammation.

Practicing stress-relieving activities such as exercise, yoga, meditation, and hobbies can reduce long-term or chronic stress and help alleviate many long-standing gastrointestinal problems such as constipation, indigestion, and diarrhoea.

9. Avoid or stop bad habits

Excessive alcohol and caffeine consumption and smoking interfere with digestion and can cause many common disorders of the digestive system. Smoking can contribute to acid reflux/ heartburn, stomach ulcers, liver disease and can increase the risk of gallstones. Alcohol consumption can cause bloating, diarrhoea, abdominal pain, and flatulence. Drinking large quantities of alcohol regularly affects your gut’s ability to absorb nutrients and proteins and reduces the secretion of digestive enzymes into your gastrointestinal tract.

10. Maintain a regular eating schedule

Eating your meals on a set schedule can help your digestive system stay healthy and aid in the regular flow of your digestive secretions. Look to have meals such as breakfast, lunch, snacks, and dinner around the same time every day. Eating several small meals throughout the day instead of a few large ones can also prevent digestive strain that large meals can cause.

Digestive problems can be an embarrassment as well as an impediment to daily activities. You are definitely not alone if you suffer from them regularly. Changing unhealthy habits and inculcating healthy diet and lifestyle changes can be powerful steps towards improving digestive health. If you are experiencing any symptoms related to digestion that warrant a visit to a specialist, or want to know more about the risks, treatments, and various procedures related to digestive conditions, consult the best gastroenterologists in Bangalore at the Department of Gastroenterology and Hepatology in Sagar Hospitals.

Varicose veins – Medical Treatments

Varicose veins do not require invasive interventions in most cases. Your doctor may prescribe you over-the-counter medication such as ibuprofen or paracetamol to alleviate painful symptoms of this condition. However, if you have persistent pain that does not have obvious physical signs or if you notice the discoloration in the area around the varicose vein, there may be deep vein involvement.

After the vascular surgeon diagnoses varicose veins, conservative options will be explored in the beginning. These options include home remedies, such as exercise, changes in diet, leg elevation, and avoiding standing or sitting for long durations, that improve blood circulation in your lower body. You may also be prescribed compression stockings or socks/ wraps of a certain grade, depending on the level of pressure required.

If your condition is still not improving, the next course of action may be to perform a procedure to correct the venous reflux.

How are varicose veins treated?

Like tributaries/ smaller channels feeding the main waters of a river, shorter veins connect to a longer, larger, and deeper main vein called the saphenous vein. Most varicose veins connect to the saphenous vein directly or indirectly through tributaries/ branches. That is why complete treatment of varicose veins cannot happen until the reflux within the saphenous vein is not corrected; doing so would be like trimming the ends of tree branches when trying to fix the whole tree.

All veins with reflux, including the tributaries, the saphenous, and the affected varicose veins must be treated systematically in planned phases or at once during treatment sessions. The deeper and the largest veins need to be treated first.

Various medical procedures are conducted to treat varicose veins depending on the depth and severity of the condition.

Medical treatment procedures for varicose veins

• Endovenous thermal ablation (laser and radiofrequency therapy):

  For treating the saphenous (main trunk) vein a procedure called endovenous thermal ablation is recommended. This is also known as endovenous laser therapy (ELVT) when a laser is used and radiofrequency ablation (RFA) when a radiofrequency is employed. A small incision is made to insert a laser fibre (for ELVT) or a catheter (for RFA) into the vein. The laser or radiofrequency is then used to heat up the refluxing vein, causing it to collapse and seal. The heat energy does not affect or harm the surrounding area. This treatment usually requires multiple procedures.

  RFA is used to treat varicosity in the larger saphenous veins. ELVT is used to treat spider veins or smaller varicose veins.

• Sclerotherapy (injection therapy):

  To treat the tributaries and varicose veins sclerotherapy injections are recommended. Over time, sclerotherapy has become one of the most common procedures to treat varicose veins. These procedures are conducted, at times with ultrasound guidance, by injecting a solution into your veins. The solution irritates the walls of the vein, making them stick together. The vein collapses and turns into scar tissue, eventually fading away.

What is the outlook after the endovascular medical procedures treating varicose veins?

• These procedures are conducted under anaesthesia and are not painful.
• A compression sock will most probably be put on each leg.
• The treatment areas may be itchy or appear bruised for a few days after the treatment – this is normal. The veins themselves may appear darker or more pronounced after the treatment. However, this will pass over a few weeks.
• To avoid side-effects of the procedures, you are advised to wear the compression garments/ socks as instructed by your doctor. Most patients are advised to wear compression socks for 1-2 weeks. You are also advised to go on daily walks and undertake light exercise as advised by your doctor.
• In most cases, both the medical and cosmetic outcomes of the procedures for treating varicose veins have high success rates.

Advantages of endovascular surgery procedures for varicose veins

• Treatment is walk-in walk-out.
• You can return to work and most daily activities within 3 days.
• Most procedures do not leave scars and are painless.
• The chance of recurrence, though not zero, is minimal.
• The procedures are in daycare and can be performed in a clinic. They do not require you to be hospitalised.
• Procedures do not require you to be put under the influence of general anaesthesia.

Do varicose veins reappear after treatment?

Endovascular treatment for varicose veins is highly effective. However, varicose veins can return post-treatment.

There is a higher risk of varicose veins reappearing if:

• You have a sedentary lifestyle or if you are overweight.
• You become pregnant after a treatment procedure.

The results you want to see largely depend on the expertise of the endovascular surgeon treating you. Many medical advances have been made in endovascular surgery and simply stripping away varicose veins is not just the only treatment anymore. Though many cases of varicose veins get treated with conservative therapy options, some cases may require the intervention of medical procedures for long-lasting treatment. Endovascular surgeries provide this service safely with a high success rate. For more information about varicose veins, consult the best vascular surgeons in Bangalore at the Department of Vascular and Endovascular Surgery in Sagar Hospitals.

Varicose veins – Diagnosis, Prevention, and Home Remedies

Why you shouldn’t ignore varicose veins

Some cases of varicose veins may not cause any non-visual symptoms at all. However, varicose veins neglected can cause painful and serious complications. These include:

• Inflammation of the veins: The vein may feel hardened and warm to the touch. The area can also appear red and cause burning.
• Leg ulcer: The failure of valves in veins may manifest as wound-like ulcers.
• Swelling in legs: Untreated varicose veins may cause fatigue, pain, and swelling in the ankles and legs.
• Pigmentation and skin changes: Skin at the affected site may become dry, itch, and even contract. People with thin or sensitive skin may experience eczema or chronic discolouration near the varicose veins.
• Thrombosis: Malfunctioning veins, in extreme cases, can result in clotting of blood in the veins, accompanied by sharp, shooting pain in the leg.
• Sudden bleeding from an untreated vein.

Diagnosing varicose veins

Your doctor will most likely conduct a physical examination of your legs and visible veins while you sit or stand and check if you are experiencing any pain.

In addition to this, your doctor may also conduct the following tests to check if your symptoms are being caused by other venous issues such as blockages and blood clots. These are:

• Ultrasound: This non-invasive test will reveal the flow of blood in your veins and check for markers of any complications.
• Venogram: A deeper assessment of your vein health can be performed by injecting a dye into your legs and then taking an X-ray to observe blood flow.

Prevention with lifestyle changes and treatment at home

Though there is no way to completely prevent the occurrence of varicose veins, there are some ways to reduce the risk of developing them or getting new ones. Improving blood circulation and the muscle tone in your legs can enhance the blood flow in your legs.

The measures and lifestyle habits that can be used to treat non-serious cases of varicose veins can also help you prevent them at home. These include:

1. Avoid sitting or standing for too long

Sitting or standing for long durations makes it harder for the blood to travel up your legs back towards the heart. This increases the pressure on the leg veins to pump/ push the blood harder against gravity towards your core. This can lead to blood pooling around your ankles and causing swelling in your legs.

This problem affects sedentary office-goers and workers who spend a lot of time on their feet alike. People who spend a lot of time working sitting down should take a break about every half hour to walk a bit, even if to the break room. Taking small breaks to walk will help improve blood circulation in your legs and reduce venous pressure.

If you are stuck at your workstation, you can perform small exercises sitting down, such as:

• Stretching your ankles
• Bending your knees and lifting them towards your core
• Paddling with your feet

On the other hand, if your job requires you to be standing for long times, take scheduled breaks and sit for a while to give your leg muscles some rest.

2. Adopt healthy lifestyle behaviours

Practicing healthy lifestyle choices can help prevent the occurrence of varicose veins or additional ones. These include:

• Maintain a healthy weight: Obesity or being overweight can aggravate the pressure inside the veins of your legs and put increased stress on your leg muscles. Losing weight can not only help prevent varicose veins from forming, but also reduce the risk of other lifestyle diseases such as diabetes and heart disease.
• Eat a healthy, low sodium diet: A balanced diet comprising of complex carbohydrates, fibre, proteins, and other necessary components can help you reduce your body weight. It is advisable to stay hydrated throughout the day and to avoid foods high in salt. Proper hydration will help maintain healthy blood circulation.

3. Exercise

Any leg exercise that strengthens your muscles and improves your veins’ ability to push blood to the heart will help prevent varicose veins from appearing. One of the easiest and most beneficial exercises you can do is walking.

Lower-body exercises help tone and stretch the deep muscles in your hamstrings and calves. These deep muscles can help your veins function properly and prevent pressure from building in them. These exercises include intensive activities such as running, cycling, and swimming. However, if you are facing age or injury-related issues, yoga can provide the same benefits without straining your joints and body too much. Sun salutations and most forward-bending poses will help you stretch and tone your legs.

4. Elevate your legs

To increase blood flow to your heart and reduce pressure in the veins of your legs, place your legs on a stool or a chair at an elevation at scheduled times or when possible during your day. Elevating your feet negates the impact of gravity and reduces swelling in your ankles. This is especially helpful if your work requires you to sit at a desk for long durations or of you to spend a lot of time standing.

Try elevating your legs at least thrice a day for 10-15 minutes.

5. Sleep on your left side if you are pregnant

One of the most common causes of varicose veins in women is pregnancy. It can be beneficial for pregnant people to sleep in positions that reduce the pressures of an expanding uterus on the veins to prevent them from becoming varicose. In case varicose veins have already formed, sleeping on the left side can help ease the symptoms of varicose veins during your pregnancy and reduce the pressure on the big vein in your pelvic region.

6. Use compression

Applying upward pressure on the lower legs and ankles can help push blood towards your heart. Depending on the level of support and pressure that your legs need, your doctor may advise you to wear compression garments that range from everyday pantyhose (for women or as per personal preference) to specialty compression socks and stockings. These garments help improve the circulation of blood in your legs against gravity and reduce swelling. Compression socks and stockings that provide high pressure are usually available only if prescribed. These socks are meant to be worn throughout the day and in combination with a routine of elevating legs.

Varicose veins, though usually not harmful, should not be left untreated. Major internal complications can affect you if you ignore this problem. Though not entirely preventable, it is possible to reduce the risk of developing them without drug or surgical intervention by maintaining a healthy lifestyle and employing a few remedies and routines that can be practiced easily at home. If you are worried that your veins might be getting varicose or already have them, seek advice from your primary doctor. For more information about varicose veins, consult the best vascular surgeons in Bangalore at the Department of Vascular and Endovascular Surgery in Sagar Hospitals.

Varicose Veins – Risks, Causes, and Symptoms

Varicose veins are enlarged, swollen, or twisted veins that occur when veins get oversaturated with blood. Blue or dark purple in colour, these veins are seen almost always on the legs and feet. This is a common condition that affects almost 1 in 3 adults worldwide, and are for many a family trait. Women are more likely to develop varicose veins, with them being at twice as much risk to develop this condition.

These superficial twisted and swollen veins can be also be accompanied by patches of flooded capillaries called spider veins. Although they can seem unattractive, they are usually harmless. However, when inflamed, they can be painful and be tender to touch. In such cases, these veins can hinder the circulation of blood in the lower extremities, causing itchiness, swollen ankles, and aches in the affected leg.

Besides developing superficially, on rare occasions, interior leg veins can also become varicose. The deeper venous network of the legs is usually not visible. Such varicose veins can cause aches and inflammation throughout the limb and even blood clots.

What causes varicose veins?

Circulation of oxygen-rich blood throughout the body requires arteries and veins working together to pump blood from the heart and back to it. To push back blood to the heart, veins rely on the surrounding thick layers of elastic tissue and muscles. Cup-like valves in veins allow a one-way flow of blood to prevent backflow. For proper circulation, it is important the veins in the extremities function properly.

If these veins become varicose, one-way valves can get damaged or become faulty, allowing the blood to pool in the veins. This makes it hard for the supporting muscles to push the blood (especially in the legs) against gravity. As less blood flows from one valve to the next back to the heart, more of it continues to pool in the veins. This incremental pooling increases congestion and pressure in the veins, making them twist and bulge. Because of these tendencies, varicose veins tend to develop mostly in the veins farthest from the heart – in the legs, where the muscle support for the veins is much less than that for interior veins.

What are the risk factors?

Physical conditions that put excessive pressure on the abdominal area and legs can cause varicose veins. Potential factors that can cause varicose veins include:

• Pregnancy
• Menopause
• Obesity
• Sedentary lifestyle: Weak muscles offer poor support for pumping blood through the veins. A lifestyle that results in poor muscle tone and condition increases the risk of varicose veins.
• Tumours
• Standing for prolonged durations: People whose occupations require them to stand for long periods are at a greater risk of varicose veins.
• Chronic constipation
• Leg injury: Damaged valves from a prior injury can cause varicosity.
• Genetics: If there is a family history of varicosity, the risk of your suffering from varicose veins increases.
• Age: The risk of varicose veins also increases with age. Muscles weaken, daily activity reduces, arterial walls become stiffer and less elastic, and vein valves suffer more wear and tear with time. All these contribute to increasing the risk of varicosity.
• Venous insufficiency: This can occur when nutrients, blood, and waste is not exchanged between the skin and blood properly because of weak blood flow.
• Tobacco consumption
• Deep vein thrombosis (DVT): A blood clot forming in a deep vein can block blood flow and cause varicosity. This medical condition is called DVT. These clots usually develop in the lower leg and thigh.

Pregnancy and Varicose veins

Pregnant people are at a greater risk of developing varicose veins due to various factors, making them more likely to develop varicose veins than at any other point in their lives. These include:

• Additional pressure is put on the circulatory system with pregnancy. Pregnant people have a lot more blood in their bodies, and this added burden of pumping more blood from the lower limbs adds to the risk of varicosity.
• Changes in hormone levels can also cause the relaxation of the walls of blood vessels.
• As the pregnancy progresses, the pressure on the pelvic region increases with the growing womb. While varicose veins resulting from advanced pregnancy usually dissipate after the pregnancy, this is not always the case. Sometimes, even though varicosity improves, visible markers of the condition remain.

What are the symptoms of varicose veins?

• A sensation of heaviness in the legs, especially after physical exertion or during sleep.
• Swelling in ankles
• Longer bleeding than usual in the area (caused by an injury)
• Pain or ache in legs
• Spider veins or telangiectasia
• Hardening or tapering of the skin above the ankles with inflammation of fat under the skin.
• Cramping in legs upon standing suddenly
• Redness, dryness, and itching in the affected area. This condition is called venous eczema.
• Shiny discolouration of the skin near the varicose veins
• Scar-like irregular, whitish patches near the ankles.
• Restless leg syndrome: A nearly uncontrollable urge to move the legs due to the feeling of some discomfort, usually in the evenings.

Are they dangerous?

Varicose veins can appear quite sickly – swollen, twisted, or bulging with a dark purple or blue colour. Though these veins on the legs may be unpleasant to look at, they are seldom painful by themselves.

However, they can sometimes be dangerous if left untreated:

• Untreated varicosity can lead to the formation of blood clots in the interior or deep veins (deep vein thrombosis).
• Varicose veins can also burst, causing a medical emergency.
• Varicosity in the testicular veins can lead to infertility in men.

When should I consult my doctor about varicose veins?

If you are concerned about varicose veins, how they look, or if they are uncomfortable, a consultation with your healthcare provider will be helpful.

You should seek a professional consultation if you see that the veins or your skin are:

• Swollen and painful
• Inflamed, red, and warm to touch
• Bleeding
• Discoloured

For more information about varicose veins, consult the best vascular surgeons in Bangalore at the Department of Vascular and Endovascular Surgery in Sagar Hospitals.

What are the Common Urinary Problems in the Elderly?

As much as many diseases are connected to our lifestyles, there are others that come with age, as our bodies change. A few of them are bladder-related problems. As you get older, your bladder changes. The bladder tissue, for instance, can toughen and become less elastic. This loss of elasticity can mean a lowered capacity to hold as much urine in your bladder as earlier and, consequently, more trips to the bathroom. On the other hand, a weak pelvic floor and bladder walls may make it harder for the bladder to be emptied fully and cause urine to leak.

Common bladder problems

• Urinary tract infection (UTI):
• UTIs are very common infections that can occur in your body. More than 50% of women suffer from a UTI at least once in their lifetime and this infection can occur anywhere in your urinary system. The chances of a UTI increase the longer urine stays in the bladder. This occurs more with age as bladder muscles weaken, making it harder for the bladder to be emptied completely.
• The various kinds of UTIs include:
• - Bladder infection: Bacterial infection in the bladder is the most common kind of UTI. It is most commonly caused by E.Coli, a bacteria found in the gastrointestinal tract. A bladder infection can cause a patient a sudden urge to urinate.
• - Urethra infection: A less common infection, urethra infections occur when bacteria from the gastrointestinal tract enter the urethra. This kind of UTI is more common in women, as their vagina is closer to their anus.
• - Kidney infection:
• - Bladder infections can spread to the kidneys, causing serious problems. Kidney infections that occur frequently or are not eradicated in time can impair kidney function permanently.

• Lower intestinal tract symptoms (LUTS):
• LUTS broadly represent a group of symptoms caused by issues with the urethra, bladder, or pelvic floor muscles.
• Various kinds of LUTS include:
• - Overactive bladder:With age, it becomes harder for older people to store urine in the bladder because of weaker bladder muscles. This can cause frequent urination or even urinary incontinence.
• - Prostate Enlargement:The prostate is situated near the neck of the bladder. When it gets enlarged it can cause problems with coordination between the urethra and bladder muscles, causing problems with urination.
• - Problems with water balance:With ageing, the kidneys begin to lose the capacity to reduce the amount of urine. This can result in increased urination, especially at night. It is normal for the elderly above the age of 65 to urinate more frequently at night.

Other causes of LUTS include urinary infections, bladder stones, diabetes mellitus, neurological conditions, and bladder and prostate cancer.

Symptoms of a urinary problem

Bladders seldom have consistent behaviour. But it is wise to keep an eye out for various symptoms that may signal a urinary problem.

• You are unable to hold urine or frequently leak urine. This is known as urinary incontinence.
• You experience a sudden and strong urge to urinate.
• There is a need to urinate more than 8 times a day.
• You wake up several times in the night to urinate.
• Your urine is cloudy or bloody.
• Only small amounts of urine pass after experiencing a strong urge to urinate.
• There is burning or pain before, during, or after urinating.
• There is trouble urinating or the stream of urine is weak. This can also show as an inability to empty your bladder.

If you experience any of these symptoms, talk to your urologist or your primary doctor.

What tests can diagnose urinary problems?

• Blood sugar is tested to diagnose diabetes mellitus.
• Rectal examination/ prostate examination can detect an enlarged prostate. Your doctor may prescribe further blood tests to rule out prostate cancer.
• Ultrasound of the Kidneys, Ureter and Bladder (KUB) is used to evaluate the urinary tract and check the size of the prostate, residual urine volume, state of the kidneys, and other urinary stone issues.
• Serum prostate-specific antigen (PSA) can be used to measure PSA levels to detect initial markers of prostate cancer. Other PSA-related tests are, however, required to confirm this diagnosis.

Shoulder Arthroscopy – What Should You Know?

The shoulder is one of the most complex joints in your body and is capable of more motion than any other joint. The shoulder joint comprises three bones: the shoulder blade, the upper arm bone, and the collarbone. Injury/ disease/ age-related wear and tear to the bones or tissues of the shoulder can cause pain, inflammation, reduced mobility, and instability.

Shoulder arthroscopy is conducted using a small instrument known as the arthroscope. The surgeon makes a small incision in the shoulder joint to insert the arthroscope into the surgical site. This instrument has a light system and camera that is used to project images of the inside of the joint onto a screen for a clear view. The arthroscope also has small surgical instruments within it that the surgeon can use to conduct certain medical procedures.

When is a shoulder arthroscopy recommended?

Your doctor or orthopaedic surgeon may recommend you a procedure called shoulder arthroscopy if you are suffering from shoulder pain that is not responding to traditional non-surgical treatments. Nonsurgical treatments include pain medication, physical therapy, rest, and injections.

Shoulder arthroscopy is used to treat injuries and diseases related to muscles, ligaments, tendons, cartilage, and bones of the shoulder joint.

These conditions include:

• Shoulder instability
• Damaged ligaments or cartilage
• Inflamed tissue or loose cartilage
• Tear in the rotator cuff
• Rupture in the biceps
• Arthritis of the collarbone
• Bony projections or bone spurs
• Stiffness in the shoulder joint

Procedures for repairing fractures, releasing nerves, and excising cysts can be performed on rare occasions with arthroscopy as well.

What are the risks associated with a shoulder arthroscopy?

Though shoulder arthroscopy is considered a low-risk alternative to more invasive procedures, there still are risks associated with the surgery.

The risks of shoulder arthroscopy are:

• Weakness in the shoulder
• Shoulder stiffness
• Delayed or failure of the repair to heal
• Nerve injury
• Injury to blood vessels
• Damage to shoulder cartilage

What are the advantages of this procedure?

The major benefit of shoulder arthroscopy over open surgery is the lowered risk of infection and a shorter time for recovery.

Shoulder arthroscopy offers benefits over open surgery such as:

• Fewer complications
• Less joint stiffness and pain
• Faster recovery
• Fewer stitches

How do you prepare for the procedure?

• You will have to inform the doctor of all the medication and supplements you may be taking before the procedure to avoid any adverse interactions. This holds true especially for common OTC medications such as aspirin and ibuprofen.

What happens during a shoulder arthroscopy?

• First, your surgeon will put you under general or reginal anaesthesia before performing the procedure. While regional anaesthesia will numb the arm or upper limb, general anaesthesia will put you to sleep.
• During the procedure, your doctor will decide to position you on your side (known as the Lateral Decubitus Position) or have you reclining in a semi-seated position (known as the Beach Chair Position).
• Sterile fluid will be injected into the shoulder joint to expand it to offer the surgeon a clearer view.
• Small incisions will be made to insert the arthroscopic camera. Your surgeon will be able to see clear images of the shoulder joint on his screen and diagnose the injured area.
• Surgical instruments will be introduced into the incision and the surgeon will repair or remove the damage to the joint.
• After the repairs are made, the sterile liquid will be drained from the shoulder joint and the incision(s) will be closed with stitches or sterile bandages.

Recovering from an arthroscopy

Your recovery will involve spending time at the hospital to rule out serious complications followed by recuperation at home.

Postoperative care

After the surgery, you will be under observation for a few hours before being discharged home. Medical personnel will monitor your responsiveness and provide medication to manage pain, if required.

Recuperating at home:

Though shoulder arthroscopy is less invasive than open surgery, it may still take you weeks to a few months for your shoulder joint to completely recover from the procedure and repairs.

• Expect pain and discomfort for several weeks after the procedure. A longer and extensive surgery will entail a longer recovery period as well. Rest and ice may help relieve some pain and swelling.
• You may be prescribed pain medication by your doctor to help control the pain. These medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) and local anaesthetics, will help you be more comfortable and help your body recover from the surgery.
• Your shoulder will, in most likeliness, be immobilised with a sling or a special immobiliser to protect your shoulder and provide stability.

Rehabilitation

Rehabilitation plays an important role in getting a patient back to daily activities with normal motion and strength. Your orthopaedic surgeon will develop a rehabilitation plan for you based on the procedures you have to undergo. This may involve seeing a physical therapist for a specialised exercise regimen to recover from complicated surgical repair. A strong effort with the rehabilitative plan will improve your success for your surgery.

A shoulder arthroscopic procedure involves fewer complications, a faster recovery, and less pain and stiffness than open surgery. Though the procedure involves some risk, as all surgical procedures do, an arthroscopy is a procedure that lowers risk due to its less invasive nature. The recovery time of an arthroscopic procedure depends on the nature of the surgery conducted and may still be a few weeks long. Though recovery may seem like a slow process, following your surgeon’s prescribed steps and rehabilitation plan is vital for the successful outcome of your surgery. Learn more about shoulder arthroscopy from the orthopaedic surgeons in Sagar Hospitals, the best orthopaedic hospital in Bangalore.

What you should know about Knee Arthroscopy

Knee pain and discomfort that require you to visit an orthopaedic doctor can be from an injury, overuse of the knee joints, weakness, or ageing. Knee arthroscopy is a relatively less invasive surgical procedure to diagnose as well as treat knee joint problems. The procedure involves the orthopaedic surgeon making a small incision in your knee to insert a small camera called an arthroscope to inspect the inside of your joint. The orthopaedic surgeon is then able to investigate the cause of the painful symptoms and, if required, take corrective steps with instruments within the arthroscope.

Knee arthroscopy is useful in diagnosing various issues, including:

• Inflamed joint linings
• Persistent stiffness and pain in joints
• Damaged or torn cartilage
• Build-up of fluid that must be drained
• Floating bone or cartilage fragments

Benefits of knee arthroscopy

Compared with other forms of open orthopaedic surgery, knee arthroscopy is less invasive. The procedure allows the doctor to investigate and diagnose problems using a small instrument and without making a big incision. In fact, in most cases, the arthroscopy is more than sufficient to solve a host of problems.

Knee arthroscopy can be the preferred and combined investigative and treatment procedure because of benefits such as:

• Faster healing or recovery time
• Less tissue damage as compared to open surgery
• Fewer stitches
• A lower risk of infection with a smaller incision
• Less post-procedure pain

What are the risks?

Knee arthroscopy is considered a low-risk procedure and serious complications from it are uncommon. However, as is the case with any surgery, there are some risks.

There are risks that exist with any surgical procedure that include:

• An increased risk of infection and bleeding during or after the procedure.
• Complications with anaesthesia. Some people may face allergic reactions or breathing difficulties.

There are risks that are particular toknee arthroscopy surgery:

• Tissue or nerve damage: The movement and placement of arthroscopic surgical instruments within the joint can cause damage to the joint structure. There can be injury or damage to the ligaments, cartilage, blood vessels, meniscus, or nerves of the knee.
• Infection inside the knee joint
• Bleeding in the joints
• Chronic stiffness in the knee joint
• Blood clots: The risk of blood clots in the legs increases with lengthier procedures than can extend beyond an hour.

These risks are fairly uncommon and most people make an uncomplicated recovery.

How to prepare for the procedure

The preparation plan that your orthopaedic surgeon will make for you will be specific to your condition and the problem that your doctor will be diagnosing and repairing in your joints. Your doctor may also have you prepare with gentle exercises to make the procedure easier for you.

A few basic precautions to keep in mind before your procedure are:

• Fast before your surgery: Depending on the kind of anaesthesia that will be administered to you during the procedure, you may be required to stop eating solid foods 8-12 hours before the arthroscopy.
• Avoid certain dietary supplements and medication: Your doctor may want you to avoid taking medication or dietary supplements (such as fish oil) that can increase the risk of blood thinning and excessive bleeding.
• Wear comfortable, loose clothing. Choose clothing that you can easily dress in after the procedure.
• Arrange for help or an attendant for the day: You will not be allowed to drive by yourself after the procedure, so it is advisable to arrange for someone to pick you up. Also, if you live by yourself, ask a friend or family member to help you through the rest of the day.

Recovery after the procedure

Most knee arthroscopy procedures do not take longer than one hour. After that, the patient is kept under observation for a few hours before being sent home.

Your post-procedure care after the arthroscopy may include the following:

• R.I.C.E: Rest, ice, compression, and elevation is the basic care that will be advised by your doctor after the procedure for a few days, at least, to minimise the swelling and pain. You should use an ice pack on your knee and keep the site of the incision under dressing as advised by your doctor.
• Medication and other instructions: In addition to keeping your knee elevated and on ice, your dressing will have to be changed periodically. Your orthopaedic surgeon will provide you with precise instructions regarding follow-up appointments and medication to be taken to relieve inflammation and pain.
• Protection: You may be required to use a sling or crutches to protect your knee and avoid stressing the joint after your procedure.
• Physical therapy and exercise: You may be recommended a physical therapist to see until you are able to gain full function of your knee(s). The exercise regimen that your doctor will have you follow at home is an important part of your post-procedure care. Physical rehabilitation and exercises will help you strengthen your muscles and help restore the full range of motion of your knee joint.

Of the many open surgical procedures that are available for investigating and repairing joint problems, knee arthroscopy is one of the intrusive and complicated. While there are certain risks that follow any surgical procedure, the minimal nature of a knee arthroscopy means that most patients make a simple recovery and do not undergo serious complications during the procedure as well.

The severity of the knee problem directly impacts the time it takes to recover fully and the long-term outcome of the treatment as well. However, following the recovery plan of your orthopaedic surgeon, which includes exercise/ physical therapy and proper self-care minimises post-procedure issues and maximises recovery. Learn more about knee arthroscopy from the orthopaedic surgeons in Sagar Hospitals, the best orthopaedic hospital in Bangalore.

Thoracic Back Pain: what it is, identifying, preventing, and treating it

Pain in the upper and lower back, in the region known as the thoracic spine, is almost as common an ailment as lower back pain. The thoracic spine is the region below the neck and above the ribcage with 12 backbones with disks ranging from the T1 to T12 vertebrae.The thoracic spine or the middle and upper back, as it is also commonly called, plays an important role in the body: it anchors the rib cage to protect vital chest organs, such as the lungs and heart, and provides core stability to the body.

While the cervical or lower spine is built for mobility, the middle and upper back provides your body proper stability. There are various ways in which the muscles, ligaments, bones, and disks in the spine can injure nerves in the thoracic spine and cause back pain.

Symptoms of thoracic back pain

Symptoms of middle and upper back pain vary with the cause of the pain.

Some common symptoms of mid back pain because of daily activity or extra exertion during exercise or added activities during the weekend are:

• Dull pain
• Muscle ache
• Muscle stiffness or tightness
• Sharp or shooting pain
• Tenderness
• Burning sensation
• Headache

The above symptoms are typical of musculoskeletal strain, though they are known to occur with spinal injuries as well. However, if your thoracic pain is related to the nerves, bones, or disks of your thoracic spine, you will experience:

• Chest pain
• Numbness or tingling in your legs, chest, or arms
• Incontinence (loss of bowel control and/or bladder leakage)
• Pain down the legs
• Pain in the lower back
• Weakness in your legs or arms

What causes thoracic or middle back pain?

Some common causes of thoracic back pain related to daily lifestyle are:

• Overuse injuries: Also known as overuse injuries. This involves repeatedly using the thoracic part of the spine (for sport or work) for prolonged durations.
• Muscular irritation
• Lack of muscular strength
• Poor posture or sitting or standing in a slouched position for long durations.
• Prolonged sitting at a computer
• Using a backpack
• Obesity: There is a strong correlation between obesity and back pain. When body weight increases, so does the risk of back pain.

Middle or upper back pain can also be caused by some medical conditions. Though they are less common, thoracic back pain is likely to originate from them as well. They are:

• Trauma or injury from sports-related activities or whiplash from a car accident.
• Degenerative, metabolic, inflammatory, infective, or neoplastic conditions.
• From medical conditions such as osteoporosis, osteoarthritis, ankylosing spondylitis, or Scheuermann’s disease.

Preventing thoracic back pain

You can also work towards preventing everyday musculoskeletal strain that, over prolonged periods, causes thoracic back pain:

• Improve your posture:

  - Keep your shoulders back while standing

  - Avoid slouching while sitting or standing

  - Take breaks to stand and stretch if you sit for long durations of time through the day.

  - If you have a sedentary job that requires you to spend long hours at the desk, use an ergonomic chair that supports your back properly and adjust your computer monitor, mouse, keyboard, and mouse positioning to maintain good posture while working.

• Change your sleeping position: If you sleep on your back, you are more likely to cause misalignments in your spine and have upper back pain. It is suggested that you sleep on your side in the foetal position with a pillow between your knees.

Treatment for thoracic back pain

Though middle or upper back pain is painful and inconvenient, it is usually not a cause of serious concern. Many cases settle down on their own over time without any specific treatment. However, medical treatment and intervention should be sought immediately when the pain develops suddenly and severely, as in the cases of accidents and other injuries, and worsens progressively.

Treatment for thoracic back pain ranges from home remedies and everyday changes to surgeries. They include:

Home remedies:

Musculoskeletal strain can be treated at home with:

• Gentle stretches and rotations
• Application of ice to reduce inflammation and pain
• Heat compress to ease stiffness and improve mobility
• OTC pain medication such as paracetamol, ibuprofen.

Medical treatments:

• Prescription medication: Prescription anti-inflammatory or muscle relaxants may be given by your doctor to ease your middle or upper back pain. If depression is suspected to play a role, anti-depressants for long-term use may also be prescribed.
• Injections: Pain medication is injected at trigger points to provide relief and as means to pursue interventions such as exercise and physiotherapy.
• Physical therapy: Physical therapy and chiropractic care may be combined with medication or other interventions to ease and treat thoracic pain.
• Surgery: Surgery is rarely sought as means to provide relief for upper or middle back pain, but it can be chosen as the course of action if the problem is in the spine as in the case of vertebrae fracture, deformity, or a herniated disc.

The most common procedures for thoracic spine injury are:

• Spinal laminectomy/spinal decompression: Bony walls of the vertebrae may be removed by surgery to ease pressure on the nerves.
• Microdiscectomy: A minimally invasive procedure can be carried out to remove a spinal disc that is bulging and pressing on a nerve causing pain.
• Vertebroplasty or kyphoplasty: A glue-like bone cement can be injected to repair compression fractures caused by osteoporosis.

The outlook or prognosis for thoracic back pain depends on your general level of fitness, age, and the underlying cause. Most cases of upper or middle back pain resolve by themselves with some rest and without explicit medical intervention within a week or two. It is advisable to resume normal activities gradually to interfere with the recovery and avoid risking re-injury. Medication, physical therapy, and surgeries are often reliable and means to provide long-term relief from thoracic back pain. To learn more about pain in the thoracic spine, its prevention, and treatment, consult the orthopaedicsurgeons at the Sagar Brain & Spine Institute, the best orthopaedic hospital in Bangalore.

Responding to Sudden Cardiac Arrest

What is sudden cardiac arrest?

Sudden cardiac arrest (SCA) is a fast occurring and potentially life-threatening situation where the heart unexpectedly malfunctions and stops pumping blood. During an SCA, blood flow to the brain and other vital organs is disrupted. Unless medical attention is provided almost immediately, the risk of fatality increases rapidly.

A sudden cardiac arrest is different from a heart attack – an SCA is an electrical problem in the heart. A heart attack, on the other hand, occurs when there is a disruption of blood flow to some part of the heart muscle. The heart’s electrical system regulates the rhythm and rate of the heartbeat. Complications with this electrical system can cause irregularities in heartbeats known as arrhythmias. Arrhythmias can cause the heart to beat too slowly, too fast, or in irregular patterns. Such irregular heartbeats can result in the heart to stop pumping blood – these result in sudden cardiac arrest.

Patients suffering from cardiovascular conditions are at a higher risk of suffering a sudden cardiac arrest. However, SCA can occur in seemingly healthy people with no known history of heart disease or obvious risk factors to SCA.

What causes sudden cardiac arrest?

There are several risk factors that can cause irregularities in heart rhythms leading to a sudden cardiac arrest:

• Scarred or thickened heart muscle from coronary artery disease, prior heart attack, cardiomyopathy, viral infections, hereditary conditions, and other conditions that can damage and scar the heart tissue.
• Electrical abnormalities
• Poorly managed heart failure
• Coronary artery disease
• Blood vessel complications
• Use of recreational drugs
• Cardiomyopathy
• Family history and genetic conditions
• Smoking

Signs and symptoms of a sudden cardiac arrest

In order to respond to a sudden cardiac arrest, it is important that you are able to recognise the symptoms in this emergency situation. Watch carefully for signs such as:

• Lack of consciousness/ sudden loss of responsiveness: The person is not conscious, is collapsing, has collapsed, or isnot able to respond to your query when you ask if he or she is okay.
• Lack of pulse: During SCA, the heart stops beating and you may not be able to feel a pulse.
• No or abnormal breathing: The person may be breathing weakly or not at all.

How to respond during a sudden cardiac arrest (SCA)?

In the event that you observe the abovementioned symptoms in a person, you must act quickly and follow these steps immediately:

• 1. Check for responsiveness: Ask the person if they are all right and tap them to check for any signs of response. If the person is not moving, speaking, able to blink or react to your question in any way, and is unresponsive, follow through with the following steps.
• 2. Alert people around you and call for emergency medical services immediately. You can call 108, 102, or 112 for medical emergency help in India.
• 3. If the person is not breathing at all, perform cardiopulmonary resuscitation (CPR).
• 4. To administer CPR:

  - Clasp your hands together and place both your hands on the person’s breastbone.

  - Push hard and fast in the centre of the chest, making the chest move inward about an inch.

  - Push fast and at a controlled rate of 100 to 120 pushes a minute, and let the chest resume a normal position after each push. (Pushing to the beat of the song Staying Alive will get you approximately the 100-120 pushes.)

  - Continue performing CPR until medical help arrives or an AED is made available.

• 5. Use an automatic external defibrillator (AED) if available: A portable defibrillator comes with a mechanism for voice commands that gives you step-by-step instructions. AEDs are designed to provide audible commands to an untrained person at a time of cardiac emergency. The AED will diagnose the rhythm of the person’s heart before delivering a shock. The electric shock to restore normal heart rhythm will be delivered by the AED only if the person is suffering a cardiac arrest
• 6. In case there is no AED available and you are still waiting for emergency medical help to arrive, continue delivering CPR.

Most people who have suffered a sudden cardiac arrest survive if they receive help very quickly. The fatality rates of SCAs, however, are very high – 95%. Most fatalities occur because the person is alone, the people around did not know CPR or call emergency medical help, or if the emergency medical help does not arrive within the 10 minutes to avoid brain death. Though such statistics may seem discouraging, a healthy lifestyle with regular exercise, a balanced diet with low sugar and oil, and avoiding habits such as smoking and drinking go a long way in preventing heart disease and cutting risks of sudden cardiac arrests. For more information regarding your heart health and risks of cardiac disorders, book an appointment with the best cardiologists in Bangalore at the Sagar Heart and Vascular Institute.