Blood in Stool (Hematochezia) / Rectal Bleeding
CAUSES
Anal fissure often occurs due to the passage of hard or large stools. Frequent diarrhea or chronic constipation can also result to the tearing of the skin around the anus. Other common causes for developing an anal fissure includes:
. Crohn’s disease or inflammatory bowel disease (IBD) that causes inflammation of the anorectal area.
. Straining episodes during child birth.
. Spastic or overly tightness of the anal sphincter muscles.
. Reduced or insufficient blood flow to the anorectal area.
. Constipation and excessive straining during bowel movements.
In rare cases, the following diseases may also cause an anal fissure:
. Anal cancer
. Tuberculosis
. HIV
. Herpes
. Syphilis
RISK FACTORS
There are various factors that increases the risk of getting an anal fissure. They are:
. Infancy: Infants in their first year are prone to developing anal fissure. However, experts are not sure of the reason behind the development in infants.
. Older Adults: Over the years, the veins of the body tends to become clogged due to accumulated fat, cholesterol and many other similar reasons. This results to inefficient flow of blood. Anal fissure can develop when blood flow in the anorectal area is reduced.
. Constipation: It remains as one of the leading reasons for developing anal fissure due to the episodes of straining involved during bowel movements and passage of hardened stools that increases the risk of tearing.
. Childbirth: Anal fissures are common in women upon the delivery of their baby.
. Crohn’s disease: The medical disorder causes chronic inflammation of the intestinal tract which may result to a lining rupture in the anal canal.
. Anal intercourse
SYMPTOMS
There are several symptoms that indicates for an anal fissure disease. They include:
. A visible rupture of the skin around the anus.
. Growing of a lump of skin or skin tag near the anal fissure.
. Severe pain may be felt during bowel movement which is localized in and around the anal area.
. Blood patches on stool or on the tissue paper used for wiping.
. Presence of itching or burning localized in the anal area.
COMPLICATIONS
There can be several issues or complications possible to arise following the development of anal fissures. These include:
. Inability to heal: Chronic anal fissures may fail to heal in less than 6 weeks’ time and needs further treatment. An unhealed anal fissure requires medication to reduce pain; or surgery for the removal/repair of the fissure.
. Recurrence: A patient diagnosed with anal fissure is more prone to suffer another one.
. Tear extending to closed muscles: Anal fissure may expand up to the internal anal sphincter (ring of muscle) which holds the anus tightly. This extension of the anal fissure makes the healing process more complicated.
PREVENTION
Total prevention to the occurrence of anal fissures may not always be possible. However, the risk of developing one can be prevented by adopting the following preventive measures:
. Having the anal area clean and dry.
. Gentle cleaning of the anal area with warm water and mild soap.
. Prevention of constipation by eating fibre rich foods, drinking enough fluids and practicing regular exercise.
. Immediate treatment of diarrhea.
. Frequent changing of diapers in infants.
DIAGNOSIS
In order to diagnose anal fissure, the doctor may perform rectal examination digitally. This involves examining the surrounding area of the anal canal either by using an anoscope (short, lighted tube) or simply inserting gloved finger into it.
. Rectal Exam: The rectal exam helps reveal the fissure’s exact location and provides clues about its occurrence. A fissure on either side of the anal’s opening is a sign of a medical disorder like Crohn’s disease. Further treatment may be recommended by the doctor when other underlying conditions are found.
. Colonoscopy: The entire colon is inspected by inserting a flexible and light tube into the rectum. This test is recommended for people older than 50 years of age, has risks of colon cancer, experiencing abdominal pain, diarrhea, etc.
. Flexible sigmoidoscopy: A flexible tube carrying a tiny video camera is inserted at the bottom of the colon. This test is done when there is no risk factors such as colon cancer or intestinal disease.
TREATMENT: NON-SURGICAL
Doctors often recommend the following non-surgical treatment methods:
. External application of Nitrogylcerine: This helps in increasing blood flow to the fissure in order to promote healing, and also helps in relaxing the closed muscle or anal sphincter. There could be some side effects such as severe headache.
. Anesthetic creams: Application of lidocaine hydrochloride (Xylocaine), a topical anesthetic cream which helps in pain relief.
. Botox Injection: Type A Botulinum toxin injection paralyzes the anal sphincter muscle which relaxes the spasms.
. Blood pressure medications: Cardizem (diltiazem) or Procardia (oral nifedipine) helps in relaxing the anal sphincter. They can be taken orally or can be applied externally.
TREATMENT: SURGICAL
The doctor may recommend for surgical treatment of the anal fissure when it has become chronic and unable to heal with the use of medication or other non-surgical treatments.
A surgical procedure known as LIS or lateral internal sphincterotomy may be performed to promote healing, where a small portion of the anal sphincter muscle is cut resulting to a reduction in pain and spasm. It has been found that in the treatment of chronic fissure, surgery is very effective than any other available medical treatments.
HOME REMEDIES
Most of the anal fissures don’t need expensive and extensive treatment. There are several home remedies available that can promote healing and ease against the uncomfortable symptoms. These includes:
. Using stool softners.
. Drinking enough fluids.
. Eating fibre rich foods such as vegetables and fruits, along with fibre supplements.
. Application of nitroglycerin to the anus to increase blood flow to the anorectal area; or application of hydrocortisone cream like Cortizone 10 to reduce inflammation.
. Taking sitz bath or warm bath to relax the anal muscles. It also helps relieve irritation and increases the flow of blood to the anorectal area.
. Application of pain relievers to the anus such as topical lidocaine which eases the discomfort in and around the anal area.
VISITING A DOCTOR
Visiting an specialized doctor for the particular disease should be considered. In order to achieve successful treatment of anal fissures, look for experienced doctors who can ensure you quality treatment for they have a successful recovery record with outstanding results.
Visit a Colorectal surgeon for chronic treatment of anal fissures. Two preferred departments for treating anal fissure are Gastroenterology and Hepatology, and Colon and rectal surgery.
Causes
When the veins around the anus are under pressure, there is a tendency to stretch which may cause the veins to bulge and eventually becomes swollen if not addressed immediately. These swollen veins which we call hemorrhoids can develop in the lower rectum as a result of the increased pressure that can be predisposed by the following:
. Low-fiber diet
. Pregnancy
. Anal sex
. Obesity
. Straining during defecation
. Sitting for long hours
. Constipation or chronic diarrhea
Hemorrhoids occur more likely in old aged individuals because the tissues that support the veins around the anus and the rectum become weak thereby giving it a higher chance to stretch in time.
Risk Factors
There are many cases when the cause of hemorrhoids remain unknown. However, these are the following conditions or lifestyle choices that can significantly increase the risk of developing hemorrhoids:
. Obesity
. Alcohol engagement
. Anal sex
. Constipation or chronic diarrhea
. Sitting for long hours
. Lack of physical activity
. A diet that is high in fat and low in fiber
. Loss of pelvic floor muscle tone due to pregnancy, age, surgery or childbirth
. Severe liver or heart disease
Symptoms
It is essential to ask why and when your body manifests unusual behaviors. Look for the occurrence of the following for they are likely to warn you of hemorrhoids:
. Itching or irritation of the anus
. Painless bleeding during defecation
. Swelling around the anus
. Discomfort or pain
. A lump near the anus, usually sensitive or painful
Other symptoms depend on the location of the hemorrhoids:
. Internal hemorrhoids: This can be found inside the rectum. They cannot be seen nor be felt thus rarely cause discomfort. However, during bowel movements, there can be irritation due to the damage in the hemorrhoids’ surface causing it to bleed. Occasionally, this pushes the internal hemorrhoid out in the anal opening. This becomes a protruding or prolapsed hemorrhoid that is usually painful and agitating.
. External hemorrhoids: This can be found under the skin around the anus. It’s itchy when irritated and may sometimes result in bleeding.
. Thrombosed hemorrhoids: It is possible for blood to accumulate in the external hemorrhoid which causes it to form a lump. It may block the anus with displays of swelling, severe pain and inflammation.
Complications
Although complication in hemorrhoids is rare, such cases can include anemia and strangulated hemorrhoid. The occurrence of chronic blood loss may lead to anemia and disrupt the distribution of oxygen to your cells for there aren’t enough healthy red blood cells found in your system. Also, if blood supply is impaired, the hemorrhoid can be strangulated sourcing another cause of extreme pain.
Prevention
The best prevention against hemorrhoids is to maintain a soft bowel. This way the stool can easily pass through the anus. Eat high-fiber foods such as fruits and vegetables. Doing so can soften your stool which will help you avoid straining.
Drink plenty of water after eating. Six to eight glasses of fluids a day can do the trick but that goes with avoiding alcoholic beverages. If eating high-fiber foods is not enough for you, you may consider fiber supplements. Studies have shown that such supplements improve the overall symptoms of hemorrhoids.
Sometimes, the pressure exerted in the veins of the lower rectum causes the hemorrhoids to form. That’s why avoid straining as much as possible. Go as soon as you feel the urge because otherwise, your stool will become dry, making it harder to pass. Stay active and attend to your physical routines to promote bowel motility and support prevention of constipation. Also, avoid sitting for long hours as this can increase the pressure on the veins in the anus.
Diagnosis
Physicians conduct their diagnosis by health record inquiry and physical examination. They may perform digital rectal examination or anal inspection. Depending on the situation, there can be cases where the treatment may no longer require any further testing.
Unlike prolapsed internal and external hemorrhoids which can be visualized by examining the anus and thrombosed external hemorrhoid which can be diagnosed simply by looking at it, internal hemorrhoids, on the other hand, cannot be diagnosed by neither physical examination nor by digital rectal test.
However, if chronic bleeding occurs, health-care professionals may require a complete blood count to measure the hematocrit levels and blood hemoglobin. Also, PT or INR may be requested to measure the blood clotting levels in case the patient is on warfarin.
Treatment: Non-surgical
Rubber band ligation is the most common technique for a hemorrhoid removal. This can be performed within the doctor’s office but exclusive to internal hemorrhoids. The doctor simply puts a pair of tight rubber bands around the hemorrhoidal vein causing it to lose its blood supply.
For an alternative procedure, we can consider Sclerotherapy. This decreases the size of the hemorrhoid by injecting a chemical solution. However, if the internal hemorrhoid is still small- to medium-sized, the doctor can use infrared photocoagulation. The procedure is done one hemorrhoid at a time. It includes infrared light (others use laser or electrical current) which creates heat that causes a scar tissue to cut off the blood supply to the hemorrhoid.
If not effective, we have electrocoagulation which is a broad-spectrum technology to remove suspended solids, emulsified oils, bacteria, and other water contaminants.
Treatment: Surgical
There is a variety of surgical options in addressing persistent pain and uncontrolled bleeding. First in the list is laser therapy. This is an application which intends to scar and solidify internal hemorrhoids. Another option is hemorrhoidectomy. This is said as the most aggressive approach as the whole hemorrhoid is removed in an anesthetic surgery.
However, if you are looking for the best option to cure severe cases of hemorrhoids, best recommended is stapled hemorrhoidectomy. It is the newest technique for curing hemorrhoids and it has become known for not removing the hemorrhoids but rather tightening the homorrhoidal supporting tissue to prevent it from prolapsing downward. This technique involves much lesser pain and patients are able to return to normal activities way sooner than traditional hemorrhoidectomy.
Home Remedies
Itching and pain can be treated at home by considering the following: warm sitz baths, dietary changes, stool softeners and exercise. Warm sitz baths can help decrease the inflammation of the hemorrhoids. This is done by submerging half of your body in warm water three times a day for at least 15 minutes.
Dietary changes include increased water intake and roughage consumption. This helps keeping your bowels soft, therefore, preventing constipation and lessening pressure on the anal and rectal region. Although exercise does not sound very much inviting, it is important to keep your body moving in order to decrease pressure on the hemorrhoidal veins.
Visiting a Doctor
When symptoms occur, go visit a doctor. He can perform physical examinations and do other tests to confirm hemorrhoids and eliminate more-serious concerns. Do not easily assume bleeding as a sign of hemorrhoids as this can also occur in other medical disorders.
Furthermore, talk to your physician if you know you have hemorrhoids and bleed excessively, experience severe pain even after adhering to home remedies. Seek emergency care in the event of excessive rectal bleeding, dizziness and lightheadedness.
Causes
An anal fistula is a tunnel-like cavity between the surface inside the anus and the skin on the outside. A fistula may develop after one of the small glands inside the anus becomes blocked and infected, creating an abscess. There will be a buildup of pus which will have to be drained surgically if it does not occur naturally. In around a half of all cases, after the pus has drained from the infection, a fistula may form.
Risk Factors
The largest group of people who are at risk of anal fistulas are individuals who develop abscess/es in the anus. As previously mentioned, around 50% of all of these abscesses lead to fistulas, whether it drains naturally or performed surgically. You may be also at greater risk of developing a fistula if you have chronic diarrhea or other colonic or rectal problems, having the sufferers of Crohn’s disease being at particular risk.
Symptoms
Anal fistulas exhibit very similar symptoms displayed by the presence of abscesses. You may feel tired, sick or feverish in general, but the main symptoms to look for are exhibited at the problem area. There may be noticeable pus drainage around the anus as well as redness, soreness or itchiness, often accompanied by swelling. If you are exhibiting these symptoms you should seek help from a medical professional.
Complications
Anal fistulas may manifest symptoms in different ways. Some larger ones may even act as a second rectum, allowing excrement to pass through along with existing pus and blood.
Other complications that may develop relevant to the anal fistula can also be associated to the surgical process involved in their treatment. After surgery, a fistula may reoccur in the same location.
If a lot of the sphincter wall has to be removed during the treatment procedure, then fecal incontinence may follow. However, fecal incontinence is a very late symptom of anal fistula. Surgical procedure is performed in order to try to prevent this complication.
Prevention
There is very little you can actively do to avoid contracting an anal fistula. You need to maintain a consistent bowel pattern as much as possible, avoiding either diarrhea or constipation. Sufferers of Crohn’s disease need to be sure to always take their prescribed medication. These are the best thing anyone can do to avoid these problems.
Diagnosis
A general practitioner usually refer any suspected case of anal fistula to a colonic and rectal specialist. These specialists will inspect your anus in order to check for any excretions of pus or sore areas. They may choose to use more complicated diagnostic tools to understand your case in more depth. These may be performed under general anaesthetic which include but are not limited to:
– Ultrasound. The doctor may use sonic imaging technology to look at the extent of the fistula, to see where it opens out and if it has any branches.
– Fistula Probe. This is a specially designed tool which can be used to inject a small amount of ink into the anal fistula in order to see it in full.
Treatment: Non-Surgical
The only form of non-surgical treatment currently available for anal fistula is fibrin glue. This technique also relies on the patient being put under general anaethestic. Essentially the surgeon injects the fibrin glue into the fistula, which closes the canal and encourages it to heal together. It is a lesser effective method than other more invasive procedures and may not be as long lasting. It does not require any cutting of the anal sphincter making it advantageous in some cases.
Treatment: Surgical
The most common and effective treatment for an anal fistula is surgical methods. Depending on each specific case, the doctor may recommend any one or a number of different options available to the sufferer.
– Fistulotomy. The most common type of surgery used to treat an anal fistula. A fistulotomy involves cutting the length of the fistula tunnel and causing it to heal as a flat scar. This is usually recommended by the surgeon unless there is too high a risk of incontinence due to cutting of the anal sphincter.
– Seton. A seton is a surgical thread that is placed into the fistula and left for a couple of weeks in order to allow the problem to try to solve itself. A seton is unfortunately not a perfect solution and more, tighter setons may have to be placed in order to tackle the problem more fully.
– Advancement Flap Procedure. This technique is surgical like the fistulotomy except it has a lower success rate. It can also be used to avoid cutting the anal sphincter. The flap procedure involves cutting the fistula and then using rectum tissue to cover the hole in the bowel wall.
– Bioprosthetic plug. A small cone shape plug is placed into the internal opening of the fistula which allows the bowel to continue normal function. This is a relatively new procedural practice and will require more research before it is widespread.
– LIFT procedure. Another new surgical idea meant to effectively treat fistulas that occur in the anal sphincter. It involves cutting and closing the fistula at both ends while leaving the anal wall intact.
Home Remedies
There are a lot of home and herbal remedies to help treat anal fistulas. These home remedies will never heal a fistula completely, although they may relieve the symptoms and help in the healing process.
The remedies focus and largely recommend keeping a high fibre diet, while avoiding particularly spicy food, using ring shaped cushions to keep weight off the anus and regular gentle cleaning of the anal opening with water.
Visiting a Doctor
Anal fistulas do require medical attention, but they are not classed as an emergency. As such you should do as much as you can to avoid making the problem worse and book an appointment with your general practitioner. From there you will be instructed proper course of action, which will likely involve seeing a special surgeon.
Causes
There are several viruses that are known to cause gastroenteritis. Among children, Rotavirus is the most common due to lack of immunity and relatively poor hygiene. Among adults, Norovirus is rather prevalent with more than 90% of all non-bacterial associated outbreaks. This kind of epidemic typically occurs when people spend close proximity with one another such as in hospitals, cruise ships or restaurants. A person who has previously been infected may still remain infectious for a short period of time after being treated.
In the developed world, bacteria such as Salmonella and Escherichia coli is a known cause of gastroenteritis. When contaminated food remains at room temperature for several hours, bacteria multiply which increases the risk of infection to the consumer. Usual food carriers include undercooked meat, seafood, poultry, eggs, soft cheese, unpasteurized milk and raw sprouts.
Parasites can also contribute in the spread of gastroenteritis. Although rare, you can acquire infectious organisms such as cryptosporidium and giardia in swimming pools or simply, by drinking contaminated water.
Risk Factors
We cannot deny the fact that gastroenteritis can occur unexclusively affecting individuals of any background, age and race. However, there are people who are more susceptible in catching the disease compared to others and these include:
Young children, as the immune system of children takes time to mature; older adults, as the immune system of the elderly tend to weaken later in life; churchgoers, schoolchildren or dormitory residents, as people tend to gather in close quarters where intestinal infection is at high risk of getting transferred from one to another; and anyone who has a weakened immune system because their resistance to infection is extremely low.
Take note that there can also be seasons where gastrointestinal virus is most active.
Symptoms
Gastroenteritis normally involves both the display of vomiting and diarrhea. Symptoms usually occur 12-74 hours after contact with the infectious agent. If due to virus; fever, headache, fatigue and muscle pain are common indicators which lasts for 7 days.
If the stool contains blood, the cause is more likely to be bacterial rather than viral. Bacterial infections can be linked to severe abdominal pain which typically persist for several weeks. Because of vomiting and diarrhea, the person can become dehydrated. Therefore, be aware of signs of dehydration such as deep thirst, dry skin, dry mouth, and a lightheaded feeling.
Complications
There can be several complications possible to very young children who catch gastroenteritis. For example, dehydration and electrolyte imbalance is reported to be very common as liquids withdrawn from the body are not usually immediately addressed. There can also be reactive complications, where other body parts react to infection that occurs in the intestine.
There are times when the infection spreads to the child’s bones, joints, or meninges that surround the spinal cord or the brain. Diarrheal symptoms may even be persistent. Bowel syndromes can become irritable. Worse, a child may develop lactose intolerance, acquire haemolytic uraemic syndrome (although this one is rare), and a common ground, a condition leveling to malnutrition.
Prevention
There are times when gastroenteritis cannot be avoided. However, it does not mean you cannot take necessary measures to lessen the risk or help it stop from spreading especially in case of an outbreak.
• Stay at home for 48 hours until symptoms have demised.
• Wash your hands with soap and water especially after using the comfort room or before dining. Do not depend on hand gels as they are not effective all the time.
• Use bleach-based household cleaner to disinfect any surface that is prone to contamination.
• Wash contaminated objects such as beddings or clothing with hot water.
• Do not share personal items such as utensils and towels when someone is ill.
• Keep your surroundings clean. Completely flush stools in the toilet and remove any animal manure in your house.
• Practice food hygiene. Refrigerate food properly and make sure they are always thoroughly cooked. Never consume food that has passed its expiration date.
There is another way to prevent gastroenteritis and that is through vaccination. In 2009, the World Health Organization suggested that rotavirus vaccine should be offered to all children.
Diagnosis
The medical professional can base diagnosis on physical examination and history of symptoms. Questions will be asked to determine whether the patient is at risk of dehydration. The doctor may inquire of the patient’s travel history; to see if there is a potential risk of acquiring E. coli bacterial infection or a parasite infection from recent food intake of the patient or maybe even norovirus infection if the patient has been confined in a closed space (i.e. a cruise ship).
Furthermore, the doctor can ask about food preparation habits and storage to consider food poisoning. In case the patient has taken antibiotics recently, the doctor will have to check if there is an irritation of the gastrointestinal tract which can be caused by Clostridium difficile infection.
During physical examination, the doctor may look for other causes of vomiting or diarrhea that are unrelated to gastroenteritis. These include appendicitis, gallstones, pancreatitis and diverticulitis. Non-infectious gastrointestinal diseases must also be considered. The doctor may require laboratory tests including complete blood count, electrolytes and kidney function tests. Stool samples may also be collected and screened for red blood cells, white blood cells and other possible infections.
Treatment: Non-surgical
Gastroenteritis is a self-limiting disease and it does not always require medication. Oral rehydration therapy or ORT can resolve those with mild to moderate dehydration. A single dose of anti-vomiting dehydration such as metoclopramide or ondansetron can relieve the discomfort brought about by vomiting. And in the event of intolerable abdominal pain, butyl scopolamine is best prescribed.
Antibiotics cannot treat viral infections. Therefore, they are not usually used for gastroenteritis unless a susceptible bacterial cause is suspected. Antiemetic medications are also helpful to treat vomiting in children. Ondansetron contains utility in a single dose and has been associated with fewer hospitalizations, less need for intravenous fluids and decreased vomiting.
To reduce the frequency of stools, probiotics can be prescribed.
Treatment: Surgical
Everyone needs not worry: gastroenteritis cannot be that critical to require any surgical treatment.
Home Remedies
The key to recover from having gastroenteritis is to keep your body hydrated from all the liquid lost due to diarrhea and vomiting. This allows the body to recuperate and can eventually help in fighting the infection itself. Also, get plenty of rest. Limit yourself to small amounts of plain food such as soup, bread and pasta. In case of fever or aches, intake of paracetamol and use of special rehydration drinks is recommended.
Anti-vomiting medication such as metoclopramide and antidiarrheal medication such as loperamide are advisable only if the need arises.
An important key: keep your body clean and stay at home for 48 hours until the symptoms have demised so as to prevent yourself from passing the illness to others.
Visiting a Doctor
Get medical help when one of the following conditions occur: when diarrhea and vomiting persists for more than several days, when diarrhea becomes bloody, when fever exceeds 38.3 degrees Celsius, when fainting or lightheadedness occur even when standing, when confusion continually develops or when abdominal pain becomes unusual.
Causes
The digestive tract is coated with a layer of mucus which normally protects the stomach and the small intestine against acid. However, if the layer becomes decreased due to an increased amount of acid present, peptic ulcer can develop. The experience will be a painful open sore which may result to bleeding.
There are three common causes whereby peptic ulcer occurs. The first is related to a bacterium. Helicobacter pylori bacteria usually harbors in the mucus layer. Although it does not actually cause any serious problem directly, it can be the reason for your stomach’s inner layer to inflame, producing an ulcer. H. pylori can be transmitted to other people by saliva or by contaminated food and water.
Taking aspirin or nonsteroidal anti-inflammatory drugs can also inflame or irritate the lining of the small intestine and the stomach. Other medications besides the use of NSAIDs such as SSRIs, Actonel, steroids, alendronate, anticoagulants can also increase the risk of developing ulcers. This makes older adults who are frequently taking these medications become more prone to developing peptic ulcers.
Risk Factors
There are factors which may not necessarily cause ulcers but can increase your chances of developing one. These alone can make peptic ulcer worse or make it more difficult to heal. Common factors include smoking, drinking alcohol, chronic stress and eating spicy foods.
Symptoms
The most common symptom of peptic ulcer is developing episodes of burning pains which occurs between the breastbone and the belly button. You will usually experience the pain when your stomach is empty. This happens when gastric acids are given the chance to etch away the protective mucus layer of the digestive tract.
Peptic ulcer pain may stop for a while after eating foods that buffer stomach acid or by taking an antacid. However, it can also last for hours and may come and go for several days or weeks.
Less often, peptic ulcer may develop severe signs such as vomiting blood, dark blood in stools, nausea, appetite changes, trouble breathing and unexplained weight loss.
Complications
Peptic ulcers, if left untreated, can result to internal bleeding, infection and obstruction. Bleeding can lead to anemia where in severe cases, the patient will need blood transfusion and hospitalization. Bloody stools and dark vomits are two indicators of internal bleeding.
Peptic ulcers can also cause swelling or inflammation which may block food from passing through the digestive tract. It can also create a hole through the small intestine and stomach wall, putting you at risk of abdominal cavity infection.
Prevention
You can reduce the risk of developing peptic ulcer if you follow particular strategies in order to avoid it in the first place. You have to protect yourself from infections. You should wash your hands frequently with soap and water and make sure you eat foods that have been cooked thoroughly. Also, use caution in the use of pain relievers. The more you use it, the more you are at risk of developing peptic ulcer.
When using pain relievers, consult your doctor to identify the best possible dosage but can still give you pain relief. Take your medicines after meals and never drink alcohol while on medication.
Diagnosis
In order to diagnose ulcer, your doctor may initially inquire about your medical history and perform a physical examination. Afterwards, you may be referred to undergo diagnostic tests such as endoscopy, upper gastrointestinal series, and/or H. pyroli laboratory test.
During endoscopy, the doctor will use a hollow tube to examine your upper digestive system by passing it down your throat, into the esophagus, stomach and small intestine. This allows the doctor to probe for any signs of peptic ulcer.
Another method as mentioned above is upper gastrointestinal series. This is performed using a series of x-rays on your upper digestive system, to cast images of the stomach and small intestine. Furthermore, the doctor may advise you to undergo laboratory tests for H.pylori to check whether such bacterium is present in your body. However, inform your doctor if you have already been using antacids prior to testing as this can lead to false negative results.
Treatment: Non-surgical
Treating peptic ulcer usually depends on the cause. There are four medications that are proven to be effective in particular cases:
. Antibiotic medications to kill H. pylori – These include clarithromycin, tinidazole, levofloxacin, amoxicillin, metronidazole and tetracycline. Such antibiotics are recommended if H.pylori is found in the digestive tract.
. Medications that block acid production. Proton pump inhibitors prevent cellular activity of producing acid. These drugs include both over-the-counter and prescription medications such as lansoprazole, omeprazole, rabeprazole, pantoprazole and esomeprazole.
. Antacids that neutralize stomach acid. Your physician may consider including antacids as part of your drug regimen. These neutralize existing stomach acid and help induce instant pain relief. However, there may be side effects such as constipation and diarrhea.
. Medications that protect the lining of your stomach and small intestine. There are situations when the doctor may have to prescribe agents that can help protect the lining of your stomach and small intestine. They are called cytoprotective agents. If results are inconclusive, there are two other options, Sucralfate and misoprostol.
Treatment: Surgical
Surgical treatment is reserved for ulcer diseases that call for urgency due to complications such as severe bleeding as well as unresponsiveness to medicinal and therapeutic management. Surgical operations often include the following:
. Vagotomy: This involves cutting the vagus nerve, which has the role of transmitting messages from the brain to the stomach, in order to reduce acid secretion. However, this has the risk of interfering with other stomach functions. It needs the application of newer techniques that cuts only the part of the nerve affecting the secretion of acid.
. Antrectomy: This is usually performed in concurrence with vagotomy. It removes the lower part of the stomach, also called the antrum, which produces a hormone that intensifies the production of stomach acid.
. Pyloroplasty: This procedure enlarges the opening between the duodenum and the stomach encouraging the passage of partially digested food. Acid production ordinarily stops once the food has passed.
. Tying off an artery: If the primary problem is bleeding, it is best to cut off the blood supply to the ulcer.
Home Remedies
Here are the top 5 natural ulcer remedies: (1) Aloe vera. This helps in healing the intestinal lining. Take ¼ cup, three times daily. (2) Licorice root. This helps regenerate the mucus membranes of the stomach. Drink 500mg before meals. (3) Chamomile. Taking 4 cups a day is proven to sooth the nerves. (4) Probiotics. This allows healthy bacteria recolonize the digestive tract to further prevent infection. (5) L-glutamine. Intake 2g, three times daily.
Visiting a Doctor
It is important to know when to visit a doctor. If there is a burning sensation in your upper stomach that can be relieved by either eating or drinking antacids, seek professional advice. It is difficult to assume your health condition considering that other illnesses have similar symptoms. It is best to specifically identify any underlying serious disease/s. If you have much blood in your vomit or experiencing severe abdominal pain, it is highly suggested to proceed your visit to the emergency department right away. This may call for surgery or blood transfusion.
Causes
Diverticular disease result from the development of small bulges in the large intestine and usually inflamed. Once infection takes place, the symptoms of diverticulitis can become evident. Although the exact reason behind the development of diverticula is ambiguous, it is usually associated with lack of fiber intake. The pressure during defecation creates weak spots in the outermost layer of the muscle allowing the mucosa to heave through the weak spots resulting to the formation of diverticula.
Risk Factors
It still does not seem to be clear why only 1 in 4 people with diverticula exhibit the symptoms of diverticulitis. While diverticular disease is perceived as low-level diverticulitis, there are factors which can increase the risk of developing the disease. These include smoking, history of chronic constipation, obesity or being overweight, using non-steroidal anti-inflammatory drugs like painkillers, having a relative with diverticular disease.
Symptoms
A usual symptom of diverticular disease is a spasmodic pain in the lower abdomen, commonly on the left side. The pain becomes worse when eating or shortly afterward. Long-term symptoms, on the other hand, include bloating and a change in normal bowel habits where stools become like rabbit pellets.
Furthermore, bleeding dark blood from the rectum may occur after diarrhea. However, take note that the disease does not cause weight loss. Therefore, if you are losing weight along with bowel changes, see your general physician.
Complications
Some patients may be at a higher risk of developing complicated diverticulitis. Common complications are discussed below:
. Bleeding – This is usually quick and painless. However, if it does not resolve by itself, blood transfusion may be required due to possible excessive loss of blood.
. Urinary problems – As diverticulitis can cause the inflamed part of the bowel to be in contact with the bladder, urinary problems may occur such as pain when urinating and in rare cases, escape of gas into the urine.
. Abscess – This is a lump or a pus-filled cavity in the tissue that is usually treated by a procedure known as PAD.
. Fistula – An abnormal tunnel that connects two organs together. It is particularly dangerous as it allows bacteria to travel from the large intestine to the other parts of the body.
. Peritonitis – A rare case wherein the lining of the abdomen is infected.
. Intestinal obstruction – This is a condition by which the large intestine has become badly scarred that it became partially or entirely blocked. When this happens, you need urgent medical attention as the tissues of the large intestine will begin to decay and soon might split.
Prevention
Foods rich in fiber can help prevent diverticular disease. Good sources of fiber include:
. Fruits – avocado pear, pear (with skin), orange, apple, raspberries, banana, tomato juice, apricots and prunes.
. Vegetables – baked beans in tomato sauce, boiled red kidney beans, boiled peas, boiled French beans, boiled Brussel sprouts, boiled potatoes, spring greens and carrots.
. Nuts – almonds, plain peanuts, mixed nuts and Brazil nuts.
. Breakfast cereals – all-bran, shredded wheat, bran flakes, Weetabix, muesli, porridge water or milk.
. Starchy foods – crispbread, pitta bread, pasta, wholemeal bread, naan bread, brown bread, brown rice.
. Fibre supplements – usually in sachets which you can mix with water. You can ask your doctor to prescribe them.
Diagnosis
The doctor cannot diagnose diverticular disease from the symptoms alone because similar signs may appear in other conditions. As a first step, the physician may ask for blood tests to rule out related diseases such as celiac disease or bowel cancer. Also, the doctor may refer you for colonoscopy – a procedure that involves a thin tube with a camera inserted into your rectum and directed into the colon.
Moreover, there is another technique called computerized tomography which uses x-rays to create images of your body parts or colonography which involves a tube used to pump air into the rectum.
Treatment: Non-surgical
If you have mild diverticular disease, the doctor can prescribe antibiotics to fight bacterial infections. He may also suggest a low-residue diet so that food particulates will be easily digested. This, in effect, may lessen the bulk and stool in the intestines to promote healing. However, if symptoms are severe and the doctor suspects perforation, abscess, or bleeding, he may ask you to be admitted for close monitoring and see if the treatment would improve or worsen the symptoms. Once admitted, the doctor usually recommends different diagnostic tests to examine the colon. Treatment will depend on the severity of any present complication.
If you begin to show any sign of diverticular bleeding, the doctor would instantly rush for colonoscopy to see where the source is coming from. If the bleeding source can’t be identified, a radiologist may maneuver a catheter that injects into the blood vessels a contrast dye to determine where the blood is leaking from. If the disease causes too much blood loss, the patient will need blood transfusion.
For those who have an abscess or micro perforation, the doctor may suggest antibiotics and bowel rest. Many times, the antibiotic is administered via vein access with intravenous infusion.
Treatment: Surgical
Years ago, doctors suggested surgery as a precaution for patients who had two episodes of the disease in order to prevent further complications. However, it has been discovered that in many cases, the risk of complication overweighs the benefits unless the patient has been recorded of serious complications, or the disease has already weakened the immune system.
In rare cases, diverticulitis can only be treated via surgery. This can be done by getting rid of the affected section of the large intestine, also known as colectomy. There are two ways to perform colectomy. One is open colectomy where the surgeon creates a large cut in your abdomen then remove a section of the large intestine. The other is laparoscopic colectomy. The surgeon creates several small cuts in the abdomen and uses a special instrument to take away a portion of the large intestine.
There are also cases wherein the doctor might decide to allow your large intestine to heal first before reattachment. In such cases, a procedure called stoma surgery makes way for the removal of waste materials without utilizing the entire large intestine. There are two ways to carry out this procedure – it can either be an ileostomy by which the stoma is placed in the right side of the abdomen or colostomy wherein the stoma is placed in the lower abdomen and the portion to be removed from the large intestine is connected to the stoma.
Home Remedies
Getting proper diet is a must even when you have no underlying disease. However, when things complicate, you can always resort to natural remedies in order to relieve the symptoms. For diverticular disease, barley, brown rice and garlic are great options you can find from the cupboard. Likewise, papaya, pear and potatoes are tasty and nourishing yet excellent for the digestive system. Skip the caffeine because this can upset your stomach. Also, you might want to create an exercise program in addition to your diet as studies have proven that exercise improves the overall welfare of a person.
Visiting a Doctor
If you have symptoms of diverticulitis, see a doctor as soon as possible. This allows ruling out other conditions carrying similar symptoms such as pancreatitis, stomach ulcer, bowel cancer and cholecystitis. However, if you have already been diagnosed before, you may no longer need to contact your GP since the symptoms by then can be treated at home as advised by your doctor.
Causes
There is no known definite cause of bowel cancer. However, studies have reported several factors that can put you at great risk.
Risk Factors
. Age – 18 in 20 cases of bowel cancer in the UK are over the age of 60.
. Family history – If you have a first-degree relative who displayed bowel cancer under the age of 50, the risk of developing the condition will likely increase.
. Diet – People who consume red and processed meat more than 90 grams a day are at a higher risk of developing bowel cancer. The Department of Health suggests cutting it down to 70g a day.
. Smoking – Cigarettes bring not just bowel cancer, but also other types of serious conditions such as heart and lung diseases.
. Alcohol – Drinking large amounts of alcohol on a regular basis are shown to increase the risk of developing bowel cancer.
. Obesity – Being obese or overweight has been associated to a greater risk of bowel cancer, especially among men.
. Inactivity – You can reduce the risk by becoming physically active every day.
. Digestive disorders – There are conditions that affect the bowel and heighten the chances of developing bowel cancer. For example, people who had extensive ulcerative colitis or Crohn’s disease are common to display bowel cancer within ten years.
. Genetic conditions – Inheritable forms of bowel cancer is a huge factor; such as familial adenomatous polyposis or FAP, a condition which prompts the development of non-cancerous polyps within the bowel, and hereditary non-polyposis colorectal cancer or HNPCC, an inherited mutation that has a high risk of cancer. If bowel cancer is found, people with HNPCC are often recommended for removal of the bowel as a precautionary measure.
Symptoms
The symptoms of bowel cancer can sometimes be subtle. More often than not, people with bowel cancer experience a persistent change in bowel habits. They may even experience abdominal pains or feel bloated when eating. There are cases when blood is present in stools, but in comparison, does not display others of hemorrhoid symptoms.
Complications
Bleeding and infection may occur after surgery. The individual may also experience urinary retention. Chemotherapy and biotherapy may result in vomiting, nausea and diarrhea. Radiation therapy may likely cause a skin reaction such as radionecrosis (a tissue destruction due to radiation). Below are other complications significant to bowel cancer:
. Internal obstruction – This happens when waste products can no longer move through the intestine which is usually caused by a scar tissue that is obtained from radiation or surgery.
. Recurrence – There are cases when surgery fails to completely remove the primary tumor or perhaps, some cancer cells remain hidden. This makes it likely for recurrence to occur.
. Metastasis – This is caused by cancer cells that detach from the primary tumor and travel to other parts of the body through the bloodstream.
. Development of a second primary cancer – a second primary colon cancer is a metachronous colon cancer. This develops in another site six or more months after the primary tumor.
Prevention
Basically, in order to prevent bowel cancer, you have to consider the risk factors. As a first step, see a doctor and get screened. It is better to be vigilant even before any symptoms are present.
You can make changes in your lifestyle choices – eat a healthy high-fiber diet, engage in a regular physical activity, reduce consumption of red and processed meat, do not smoke, maintain healthy body weight, drink alcohol in moderation, and lastly, know your family history. Sometimes you just have to know your chances.
Diagnosis
The first time you meet your doctor, you will be asked about any symptoms and if your family has a history of bowel cancer. Afterwards, he’ll likely conduct a digital rectal examination to check whether lumps are present.
The doctor may also ask for a blood tests to confirm or rule out other conditions like iron deficiency anaemia. If results do not eradicate the doubt, the doctor may further ask for more hospital tests.
. Flexible sigmoidoscopy – an examination of the large bowel using a sigmoidoscope, a flexible tube with a small camera and light attached to it. The camera sends images to the monitor and can be used to take biopsies.
. Colonoscopy – an examination similar to sigmoidoscopy but the device is a bit longer.
. CT colonography – involves the use of a computerized tomography scanner to create 3d images of the rectum and the large bowel.
Treatment: Non-surgical
Chemotherapy uses cytotoxic drugs in order to destroy cancer cells in the body. In stage 0 or 1, cancer can be removed by surgery thereby no longer needing chemotherapy. In stage 2, if there is no evidence of cancer in the pelvis or lymph nodes, chemotherapy may not be necessary. However, if the tumor is found to be invading within the bowel wall, chemotherapy may still be offered to eliminate any present cancer cells that have not been visible to the surgeon. In stage 3, chemotherapy is followed after surgery to prevent reoccurrence. In stage 4, the spread of cancer can only be slowed down by combining surgery, radiotherapy, chemotherapy and other appropriate therapies.
Radiotherapy, on the other hand, uses x-rays to destroy cancer cells. The treatment will not make you radioactive making it safe to socialize even during the course of treatment. Usually, it is used in anal or rectal cancer.
Treatment: Surgical
Surgery is performed in order to remove a tumor. It may be performed before any other treatment or after reducing the size of the tumor through chemotherapy and/or radiotherapy. There are different methods in removing a tumor from the bowel, depending on the location, size, and extent the cancer cells may have reached.
. Surgery for cancer in the colon – this can be either open surgery or laparoscopic surgery.
. Transanal endoscopic microsurgery or TEMS – this is appropriate for small and early cancers in the rectum. Using diathermy and specialist forceps, the surgeon inserts a sigmoidoscope into the anus and removes the tumor from the rectum wall.
. Total mesorectal excision or TME – this involves the removal of the entire rectum including the fatty tissues around it. Depending on the position of the tumor, size and its distance from the anal sphincter, the surgeon may employ one of the following techniques:
a. Low anterior resection – a removal of the tumor without affecting the anus.
b. Colo-anal ‘J pouch’ surgery – a removal of the rectum and direct attachment of the colon to the anus.
c. Abdominoperineal resection – a removal of an affected part of the rectum, the anus and the anal sphincter. A permanent stoma is usually followed to enable the exit of stools from the body.
Home Remedies
Here are some recommendations for patients with bowel cancer:
. Ginseng – contains a high concentration of antioxidants that impedes the increase of cancer cells.
. Green tea – a rich source of epicatechins and catechins that numbers down the existence of free radicals and lessens the risk of cancer.
. Garlic – contains allicin that repairs tissue damage and can be used to hinder the proliferation of cancer cells.
. Flaxseed oil – rich in omega-3 fatty acids, a good cholesterol, which hinders pro-inflammatory molecules inside the body to discourage the spread of cancer.
. Salmon – carries the same benefit as to flaxseed oil due to its antioxidant behavior but is far more contributive to other health issues such as heart disease, obesity and diabetes.
. Blueberries – a grail of antioxidants which can remove free radicals and mitigate cellular mutations.
. Spinach – high in fiber to regulate normal bowel movements.
. Olive oil – a vegetable oil of choice due to its phenolic content that functions to eradicate cancer. It also promotes enzyme production in the intestine so that nutrient uptake can be improved thereby protecting it from cancerous invasion.
. Turmeric – contains curcumin which has been linked to apoptosis. It releases a wave of antioxidants that attempts to stop cancer along its tracts.
Visiting a Doctor
If you are experiencing symptoms of bowel cancer, see your doctor so that he can further assess your condition and see whether tests are necessary. He may decide to conduct a simple examination to check if you have lumps or maybe, arrange a blood test to check for anemia. This will also help identify internal bleeding, particularly in the bowel, for which you may not be aware of.
Causes
What directly causes Crohn’s disease remains unknown up to this day. Doctors suggest that studies have only seen factors that can play a role in its development. A primary factor is the immune system. It has been found to be possible that a bacterium or virus can trigger Crohn’s disease.
When an invading microorganism is fought by your immune system, it may develop an abnormal immune response causing it to attack the cells in the digestive tract too.
Another is heredity. There have been several cases where the patient display a family history that indicates members to have also suffered the same. This clearly suggests that genes can play a role in putting people more susceptible to the disease.
Risk Factors
There are several risk factors for Crohn’s disease. These include:
. Age – Most people who are diagnosed with Crohn’s disease are below 30 years old.
. Ethnicity – Although any ethnic group can be affected by Crohn’s disease, whites and people of the Eastern European pose the highest risk.
. Family history – You have higher chances of developing Crohn’s disease if you have a close relative who is diagnosed with one.
. Cigarette smoking – This is a risk factor wherein you have total control. Smoking can cause severe complications that also puts you at greater risk for the need of surgery.
. Nonsteroidal anti-inflammatory medications – While the medication does not necessarily cause Crohn’s disease, they can trigger inflammation of your bowel which makes Crohn’s disease worse.
. Where you live – Environmental factors suggest that living in the urban area creates a higher risk of developing Crohn’s disease.
Symptoms
Generally speaking, people with Crohn’s disease are mostly affected in either the last part of the small intestine or the colon. Symptoms vary from mild to severe. It may develop gradually, although there can be cases where the symptoms come suddenly and without warning. In fact, you may also have remission.
When the disease becomes active, symptoms usually include fever, abdominal pain, cramping, diarrhea, fatigue, mouth sores, blood in the stool, weight loss, reduced appetite and pain around the anus. If severe, the patient may also experience inflammation of the liver, skin, eyes, joints and delayed growth in children.
Complications
Crohn’s disease can lead to at least one of the following complications:
. Bowel obstruction – Over time, the intestinal wall may become thinner due to Crohn’s disease which could block digestive contents, requiring surgery to get rid of the diseased portion of the bowel.
. Ulcers – Chronic inflammation can cause ulcers anywhere from your digestive tract, to your mouth, anus and the genitals.
. Fistulas – Ulcers can enter as far through the intestinal wall creating a fistula – an abnormal small tunnel-like connection between body parts. It can develop between your skin and intestine, or the most common, near or around the anal area.
. Anal fissure – This is a tear of a tissue in the anus where infection usually occurs. Bowel movements under the condition is typically painful.
. Malnutrition – With all the symptoms interfering with comfort, it makes your intestine develop a difficulty in absorbing nutrients which eventually compromises nourishment.
. Colon cancer – Crohn’s disease, which affects the colon, increases the risk of developing colon cancer.
. Other health problems – Having Crohn’s disease can greatly affect other parts and functions of the body. Among common outcomes are anemia, osteoporosis, arthritis, skin disorders and liver or gallbladder disease.
Prevention
There is no prevention for Crohn’s disease. Although in many cases, managing stress levels and changing the diet can help avoid the flare-ups. Patients should heed the advice of a physician regarding nutrition and medications.
Diagnosis
The doctor will diagnose Crohn’s Disease only after negating other possible roots for your symptoms. More often than not, there will be a combination of tests that allows the doctor to make the right seal in diagnosing the said disease.
. Tests for anemia or infection – The doctor may ask for blood tests to see if you have anemia.
. Fecal occult blood test – You may be requested to provide a stool sample to check if there is hidden blood in your stool.
. Colonoscopy – The procedure will allow your doctor to get a view of your entire colon with the use of a thin tube that has a camera attached to it.
. Computerized tomography – You may undergo a CT scan to probe the entire bowel including the tissues outside the bowel.
. Magnetic resonance imaging – This creates a detailed image of your organs and tissues using radio waves and magnetic field.
. Capsule endoscopy – This is performed by swallowing a capsule that has a camera in it. It takes pictures of your small intestine and transmits it to a recorder attached to your belt. The camera then exits your body painlessly through your stool.
. Balloon-assisted enteroscopy – This is a scope that allows the doctor to look further on locations where standard endoscope cannot reach. Such technique is usually useful when capsule endoscopy suggests abnormalities.
Treatment: Non-surgical
There is no exact cure for Crohn’s disease. The goal of treatment is to control the inflammation that causes the manifestation of symptoms and to improve prognosis by limiting possible complications. Also, the result of treatment differs from one patient to another.
. Anti-inflammatory drugs – These include corticosteroids (usually used for short-term treatment) and oral 5-aminosalicylates (although with limited benefits).
. Immune system suppressors – Drugs that reduce inflammation by targeting the immune system. They are usually prescribed in combinations rather than in a single drug alone. Types of these are azathioprine, mercaptopurine, infliximab, adalimumab, certolizumab pegol, methotrexate, natalizumab, vedolizumab, and ustekinumab.
. Antibiotics – They lessen the amount of drainage and at times, heal abscesses and fistulas. Antibiotics help kill harmful bacteria in the intestine allowing a reduction in the inflammation.
. Other medications – Aside from controlling the inflammation, other medications can also help relieve the symptoms. Examples of these are anti-diarrheals, pain relievers, iron supplements, vitamin b-12 shots, and calcium and vitamin D supplements.
. Nutrition therapy – This is a special diet injected into the vein or via a feeding tube. It is usually combined with medications like immune system suppressors.
Treatment: Surgical
The doctor may recommend surgery only when drug therapy, diet changes, or other treatments do not relieve the symptoms. Nearly half of the patients will undergo at least one surgery.
The problem, however, is that surgery does not directly cure Crohn’s disease. The surgeon only removes the damaged portion of the digestive tract to reconnect the healthy ones, where the benefits are usually temporary. The disease usually recurs, commonly near the reconnected areas of the tissue.
The most effective approach is to take medications after surgery in order to minimize the chances of recurrence.
Home Remedies
You may feel helpless when battling with Crohn’s disease. However, changing your diet and lifestyle choices can help you win over your symptoms and render more time between flare-ups. Here are some helpful advice:
. Diet – Limit your intake of dairy products. This may help address related problems such as abdominal pain and diarrhea. Also, try low fat foods especially because your small intestine may find it difficult to digest fat which in the latter end can make diarrhea worse. Lastly, drink plenty of liquids but not alcohol because it will only serve as an irritant to your digestive tract. Best if you consult a dietitian in order to make sure you consider other factors as well.
. Smoking – Not only does smoking contribute to a larger count in the development of Crohn’s disease, but it also causes a lot of other health issues that would definitely call for an intervention. To quit smoking means giving yourself far more benefits than you can possibly think.
. Stress – Although there can be situations wherein you cannot avoid stress, all you can do is at least manage it. Exercise, do some regular relaxation and breathing exercises. These can improve the overall welfare of a person.
Visiting a Doctor
Call your doctor if you have unusual changes in your bowel habits or if you demonstrate the symptoms of Crohn’s disease such as blood in your stool, abdominal pain, unexplained fever and unexplained weight loss.
The doctor will most probably ask you questions. These may include details like when you first began experiencing the symptoms, course of onset (whether continuous or on and off), how severe they have become, or how it’s affecting your daily activities. He may also further inquire of your lifestyle choices like frequency of smoking, or activities that makes your symptoms worse such as the medications you have been taking.
Causes
The exact cause of angiodysplasia is unclear. However, some associate it to the effects of aging considering that it generally poses a huge factor in many of similar diseases. Any subsequent rupture, as a result of blood vessel degeneration, may further lead to severe blood loss.
The enlargement of the blood vessels may cause angiodysplasia due to changes in tissue integrity that may be brought about by colon spasms. Moreover, the blood vessels may become inflamed and create a straight passage between the vein and the artery. This is known as arteriovenous fistula where the patient will start to experience a bleeding.
In addition to these, mucosal hypoperfusion which is a result of a cardiac problem can also be the root of angiodysplasia. It could be by other vascular, pulmonary or cardiac diseases that entails hypo-oxygenation of the microcirculation.
Furthermore, underlying diseases affecting the blood vessels may also be responsible for causing the medical condition. It may be diseases likes Osler-Weber-Rendu syndrome, also called hereditary hemorrhagic telangiectasia or HHT, Heyde’s syndrome, scleroderma, and renal failure. Be careful of other factors that thrust high stress for this can contribute to the cause of the disease.
Risk Factors
There are factors that can increase the risk of angiodysplasia. These include a history of heart complications such as aortic stenosis as well as the intake of blood thinning medications or anticoagulants.
Symptoms
Angiodysplasia can become undetected and occur without pain. It may even have subtle symptoms like anemia – where later could cause bleeding and lesions in the GI tract.
When your red blood cells drop lower than the normal count, oxygen reduction throughout your body may occur. If this happens, there is a big chance that you will experience a wide range of symptoms starting from shortness of breath to tiredness, pale skin, weakness, dizziness, lightheadedness, and a fast heartbeat. Moreover, Angiodysplasia can also cause rectal bleeding.
Complications
Paying attention to the signs of angiodysplasia is important. Make an appointment with your healthcare professional if you experience weakness, unusual fatigue, rectal bleeding or dizziness. Leaving it untreated can result to massive amounts of blood loss. And once you develop anemia, it can become extreme to a point where blood transfusion becomes necessary.
Prevention
There are no known prevention for Angiodysplasia.
Diagnosis
When your doctor finds symptoms of angiodysplasia in your system, he may recommend a series of test to countercheck the abnormalities and bleeding in the gastrointestinal tract. These may include:
. Upper endoscopy – The doctor inserts on your throat a tube with an attached camera in it, then down into the stomach to examine the lining of the esophagus and the stomach.
. Stool test – The doctor may request for stool samples to see if there are traces of blood.
. Complete blood count or CBC – This evaluates the number of red blood cells to confirm anemia.
. Colonoscopy – This is like endoscopy but inserted into your anus in order to examine the lining of the large intestine and check if there is bleeding or other abnormalities.
. Angiogram – This is an x-ray of your blood vessels to help identify the bleeding location. The doctor usually suggests the method after a negative result from colonoscopy but still suspects active bleeding.
Treatment: Non-surgical
There are cases when the bleeding stops on its own even without medical intervention. However, you would want to seek treatment if bleeding can no longer be controlled and if anemia calls to be reversed.
Treatment will depend on the severity of the case and whether you developed anemia. If no signs of anemia is found, the doctor may suspend the treatment until the symptoms become more apparent. Treatment may include angiography or cauterizing. Angiography is a procedure that involves the provision of medicines to the bleeding blood vessel with the use of a thin plastic tube. This closes up the blood vessel to stop the bleeding. Cauterizing, on the other hand, is a method to close off only a part of the bleeding vein. This can be performed using an endoscope.
Treatment: Surgical
In severe cases, the patient is suggested to undergo surgery. This procedure may entail partial or complete gastrectomy. Take note that this option should be the last resort when no other treatment procedure could longer cure Angiodysplasia. The patient must abstain from using non-steroidal anti-inflammatory medications for it can aggravate the situation. After considering all these factors, it is important for the patient to undergo proper treatment before the condition becomes fatal.
Home Remedies
. Avoid Alcohol – Alcohol irritates the intestine. Excessive drinking can lead to varices, dilated blood vessels in the esophagus and rupture in some parts of the GI tract which sometimes can cause massive hemorrhage. Your doctor may advise you not to drink alcohol and not even a sip. Taking non-steroidal anti-inflammatory drugs or aspirin together can increase the risk of having stomach irritation or ulcer.
. Fiber – Getting enough fiber in your system can help keep your stools soft to avoid developing constipation. Foods that are high in fiber include fruits, vegetables, cereals, prune juice, and whole grain. These also contain nutrients or vitamins that help repair damaged tissues.
. Iron-rich foods – Train yourself to eat healthy proteins such as lean meat, fish and poultry. It helps rebuild the iron pockets which you may have lost while having bleeding episodes. Also, consider non-heme sources of iron like vegetables; such as spinach, beans and other legumes, fortified cereals and whole grains. Having them along with foods high in vitamin C increases the absorption of iron.
. Potential irritants – Spicy foods, citrus and caffeine can irritate your GI tract. Tea, coffee, chocolate, energy drinks and soda all contain caffeine. Re-introduce them into your diet gradually until your GI tract can easily manage to take them.
Visiting a Doctor
The outlook of having angiodysplasia is fine if the treatment successfully overruns the bleeding because once the bleeding stops, there is a possibility that anemia would resolve by itself. Be reminded, however, that even after successful treatment, bleeding may occur again in the future. See your health provider when it does.
Causes
When blood flow in the liver is blocked, esophageal varices form. This is usually caused by scarred tissues that has developed due to liver disease such as hepatitis infection, alcoholic liver disease, primary biliary cirrhosis and fatty liver disease. A blood clot in the portal vein forces the blood to find other pathways in smaller veins causing them to balloon, and sometimes, leading to rupture and bleeding.
Esophageal varices can also occur if infected with a parasite called schistosomiasis as it damages the liver, as well as the intestine, lungs and bladder.
Risk Factors
Bleeding is seldom, even to those with advanced liver diseases. However, there are factors that can highly contribute to the chances of bleeding. These include high portal vein pressure, large varices, red marks on the varices, severe cirrhosis or liver failure and continued use of alcohol. The risk of variceal bleeding is far greater if you manifest these medical conditions and lifestyle choices.
Symptoms
Symptoms of esophageal varices are not apparent unless bleeding is present. Some signs include lightheadedness, bloody stools, bloody vomits and, if severe, loss of consciousness. The doctor may also suspect varices in case you demonstrate signs of liver diseases such as yellow coloration of the eyes and skin, easy bruising, and fluid build-up in the abdomen.
Complications
The most serious complication is bleeding. Once you experience a bleeding episode, the risk of reoccurrence increases. And if you lose too much blood, this may result to shock which eventually can lead to death.
Prevention
As of the moment, there is no certain method that prevents a person with cirrhosis to develop esophageal varices. While bleeding can be prevented by beta-blocker drugs, that does not prevent esophageal varices from forming. Therefore, to avoid esophageal varices means you need to keep your liver healthy. How?
First of all, do not drink alcohol. Eat a healthy diet to maintain a normal weight. Also, use chemicals carefully and sparingly. Since the liver functions to remove the toxins in your body, give it some rest time by limiting the amount of toxins it should process. Then lastly, avoid unprotected sex and other activities that could heighten the risk of acquiring hepatitis.
Diagnosis
If you are diagnosed with cirrhosis, the doctor will have to test you for esophageal varices. Main tests are:
. Endoscope exam – Healthcare specialists suggest upper gastrointestinal endoscopy to screen for varices. During the exam, the doctor will have to search for dilated veins to see if there are red spots and streaks that has a significant risk of bleeding. Treatment can be performed while conducting the examination.
. Imaging tests – Either Doppler ultrasounds of the portal and splenic veins or abdominal CT scans to indicate the presence of esophageal varices.
. Capsule endoscopy – This is an option for those who are unwilling to undergo endoscopy and performed by swallowing a vitamin-sized capsule that contains a tiny camera with a purpose of taking pictures of the esophagus down to the digestive tract.
Treatment: Non-surgical
The primary goal when treating esophageal varices is to restrain bleeding. There will be two sets of treatment, one to prevent bleeding while the other is performed when bleeding is already present.
Treatment method to prevent bleeding:
. Medications to reduce pressure in the portal vein – a beta blocker may help lessen blood pressure in the portal vein, therefore, decreasing the chances of bleeding.
. Using elastic bands to tie off bleeding veins – the doctor may suggest band ligation in the event your esophageal varices is at high risk of bleeding. The procedure is performed by strangling the veins with the help of an endoscope to prevent bleeding.
Treatment method when bleeding is present:
. Tying off bleeding veins using elastic bands.
. Medications to slow down blood flow into the portal vein – After a bleeding episode, the doctor may prescribe octreotide to slow down blood flow from the internal organs to the portal vein. This is continued for five days and usually performed hand-in-hand with endoscopic therapy.
. Restoring blood volume – you will be offered different methods to replenish the amount of blood you may have lost.
. Preventing infection – As the risk of infection is closely associated with bleeding, the doctor will likely prescribe antibiotics to prevent infection.
. Liver transplant – Replacing the liver with a healthy one is an option to those patients with severe liver diseases or have experienced multiple bleedings from esophageal varices.
Treatment: Surgical
The doctor might suggest transjugular intrahepatic portosystemic shunt or TIPS in order to place what we call a shunt. This is a small tube with the function to carry blood from the liver to the heart and placed between the hepatic vein and the portal vein. It makes the pressure in the portal vein reduced, which means bleeding should stop.
The problem, however, is that TIPS can cause serious complications including mental confusion and liver failure. This develops when the toxins are delivered through the shunts directly into the bloodstream. Only when all other treatments have failed will the doctor resort to TIPS unless otherwise, the patient urgently needs a temporary measure while waiting for liver transplant.
Home Remedies
Knowing the vital role that the liver play in the development of esophageal varices, following some dietary consideration to promote a healthy liver will be useful.
To begin with, we must understand that eating a soft diet is a must. This limits esophageal irritation unlike hard or rigid foods that could tear enlarged veins in the esophagus. Also, it is essential to promote bowel regularity. Straining too hard can lead to a rupture of esophageal varices.
It is advised to prevent constipation by: (1) eating high fiber foods such as beans and bran, (2) drinking plenty of water for it helps in making bowels pass easier and (3) drinking prune juice as this is a natural laxative.
Visiting a Doctor
Bleeding from esophageal varices can put your life in danger. In a short period of time, patients can lose large amounts of blood which may cause extremely low blood pressure and shock. Therefore, if you notice blood in your stool or vomit, seek immediate medical attention.