Inguinal hernia

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A hernia is a bulge caused by tissue pushing through the wall of muscle that’s holding it in. Most hernias are abdominal hernias. This means they happen in the belly and groin areas.

You may have a hernia if you can feel a soft lump in your belly or groin or in a scar where you had surgery in the past. The lump may go away when you press on it or lie down. It may be painful, especially when you cough, bend over, or lift something heavy.

Types of hernias include:

Inguinal hernia
Femoral hernia
Umbilical hernia
Incisional hernia
Epigastric hernia
Hiatal hernia

In an inguinal hernia, the intestine or the bladder protrudes through the abdominal wall or into the inguinal canal in the groin. About 96% of all groin hernias are inguinal, and most occur in men because of a natural weakness in this area.

During surgery to repair the hernia, the bulging tissue is pushed back in. Your abdominal wall is strengthened and supported with sutures (stitches), and sometimes mesh. This repair can be done with open or laparoscopic surgery. You and your surgeon can discuss which type of surgery is right for you.

Stones in Bile Ducts

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Choledocholithiasis is the presence of stones in bile ducts; the stones can form in the gallbladder or in the ducts themselves. These stones cause biliary colic, biliary obstruction, gallstone pancreatitis, or cholangitis (bile duct infection and inflammation).

People with biliary obstruction usually have:
  • light-colored stools.
  • dark urine.
  • yellowish skin or eyes, which indicates jaundice.
  • itching.
  • pain in the upper right side of the abdomen.
  • nausea.
  • vomiting.
  • weight loss.

The primary objective of medical or surgical treatment is to alleviate the blockage. Some of the treatment options include a cholecystectomy and an ERCP.

A cholecystectomy is the removal of the gallbladder if there are gallstones. An ERCP may be sufficient to remove small stones from the common bile duct or to place a stent inside the duct to restore bile flow.

Sports Hernias

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A sports hernia is a strain or tear of any soft tissue (muscle, tendon, ligament) in the lower abdomen or groin area. Because different tissues may be affected and a traditional hernia may not exist, the medical community prefers the term “athletic pubalgia” to refer to this type of injury.

Symptoms of sports hernia

Symptoms of sports hernia may include one or more of the following:

  • Sudden and severe groin pain at the time of the injury
  • Groin pain that goes away with rest, but returns during sports activity
  • Groin pain that is more commonly felt on one side of the groin area only (unilateral), rather than on both sides
  • Pain that only appears during twisting movements
  • Pain associated with other movements that involve the deep abdominal muscles, such as half sit-ups (stomach crunches) or coughing
  • Tenderness or bruising in the upper thigh and/or lower abdomen
  • Groin pain that gradually increases from intermittent to constant, and/or pain that develops to the point playing sports becomes impossible

Even if none of the above symptoms are present, the often-vague nature of the injury means some athletes may still have sports hernia if the only symptom is chronic groin pain or lower athletic performance.

Treatment protocols for sports hernia remain controversial. Some practitioners advise nonsurgical treatments such as rest, anti-inflammatory medications, and physical therapy. Others believe it can only be corrected with surgery.

Women Are At Increased Risk For Gallstones

DGALLSTONES_SymptomsPicid you know that women are at increased risk for gallstones?

Gallstones occur in up to 20% of American women by the age of 60. Women between the ages of 20 and 60 years are three times more likely to develop gallstones than men.

Risk Factors for Development of Gallstones

  • Multiple pregnancies
  • Family history of gallstones
  • Hispanic or American Indian heritage
  • Obesity
  • Rapid loss of weight

Signs of possible trouble in your gut

 

Diverticulitis: Symptoms and Treatments

People who pay attention to their digestive system are more likely to notice worrisome symptoms and seek medical attention sooner, said Dr. Amit Singal and colleague at the University of Texas Southwestern Medical Center in Dallas.

And when colon cancer is caught early, it is usually easier to treat, Singal explained.

“The old saying ‘listen to your gut’ holds true when it comes to your health. If you notice differences that persist more than a week, contact your physician,” he said in a hospital news release. Singal is a gastroenterologist and an associate professor of internal medicine and clinical sciences.

“Many conditions can cause digestive symptoms, but if it is cancer and you catch it early, you’ll have a better prognosis,” he added.

that should not be ignored include:

  • A change in the diameter of your bowel movements,
  • Bloody bowel movements,
  • Black stools,
  • Lower belly pain or discomfort that persists.

Starting at age 50, everyone should be screened for colon cancer—even if no symptoms are present.

Singal said there are a few ways doctors test for colon cancer, including:

  • Colonoscopy: This test examines the colon and allows doctors to remove polyps before they can grow and become cancerous.
  • FIT (fecal immunochemical test): This test detects blood in the stool.

A new colon cancer blood test, approved this year by the U.S. Food and Drug Administration, may be an option for patients who are not at high risk for the disease, Singal said.

Be aware of your family history and whether any of your relatives have had colon cancer, especially before age 50, he advised.

Ventral Hernia

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a Vinci® Hernia Surgery

Cross Section Ventral Hernia-and-Repaired HerniaIf you have a hernia it can be done using open surgery or minimally invasive surgery. During hernia surgery, the weak tissue in the wall of the stomach or groin is secured and any holes are closed.

If minimally invasive surgery is an option for you, ask your doctor about da Vinci Surgery.

Why da Vinci Surgery?

Early clinical data suggests that as a result of this technology, da Vinci Ventral Hernia Surgery offers the following potential benefits:

Low rate of the hernia returning
Low rate of pain
Low rate of surgeon switching to open surgery
Short hospital stay
da Vinci technology enables your surgeon to operate through a few small incisions (cuts), like traditional laparoscopy, instead of a large open incision. The da Vinci System is a robotic-assisted surgical device that your surgeon is 100% in control of at all times. The da Vinci System gives surgeons:

A 3D HD view inside your body
Wristed instruments that bend and rotate far greater than the human hand
Enhanced vision, precision and control
The da Vinci System has brought minimally invasive surgery to more than 3 million patients worldwide. da Vinci technology – changing the experience of surgery for people around the world.

Gallstones in the Common Bile Duct

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About 1 in 7 people with gallstones will develop stones in the common bile duct. This is the small tube that carries bile from the gallbladder to the intestine. Risk factors include a history of gallstones. However, choledocholithiasis can occur in people who have had their gallbladder removed.

Usually, the stones pass from the gallbladder into the bile ducts. They may remain there without blocking the flow of bile or causing symptoms, or they may pass on into the small intestine without being noticed. However, if the gallstones cause a blockage in a bile duct, a person will have pain.

Serious complications (such as a blocked duct) rarely occur. So you and your doctor may decide to delay treatment to see whether symptoms go away on their own. This is especially true if your doctor is not sure that the symptoms were caused by gallstones. Sometimes surgery for gallstone problems is needed right away.

Appendicitis

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Appendicitis is an inflammation of the appendix, a 3 1/2-inch-long tube of tissue that extends from the large intestine. No one is absolutely certain what the function of the appendix is. One thing we do know: We can live without it, without apparent consequences.

Appendicitis is a medical emergency that requires prompt surgery to remove the appendix. Left untreated, an inflamed appendix will eventually burst, or perforate, spilling infectious materials into the abdominal cavity. This can lead to peritonitis, a serious inflammation of the abdominal cavity’s lining (the peritoneum) that can be fatal unless it is treated quickly with strong antibiotics.

Sometimes a pus-filled abscess (infection that is walled off from the rest of the body) forms outside the inflamed appendix. Scar tissue then “walls off” the appendix from the rest of the abdomen, preventing infection from spreading. An abscessed appendix can perforate or explode and cause peritonitis. For this reason, all cases of appendicitis are treated as emergencies, requiring surgery.

In the U.S., one in 15 people will get appendicitis. Although it can strike at any age, appendicitis is rare under age 2 and most common between ages 10 and 30.

What Causes Appendicitis?

Appendicitis occurs when the appendix becomes blocked, often by stool, a foreign body, or cancer. Blockage may also occur from infection, since the appendix swells in response to any infection in the body.

What Are the Symptoms of Appendicitis?

The classic symptoms of appendicitis include:

Dull pain near the navel or the upper abdomen that becomes sharp as it moves to the lower right abdomen. This is usually the first sign.
Loss of appetite
Nausea and/or vomiting soon after abdominal pain begins
Abdominal swelling
Fever of 99-102 degrees Fahrenheit
Inability to pass gas
Almost half the time, other symptoms of appendicitis appear, including:

Dull or sharp pain anywhere in the upper or lower abdomen, back, or rectum
Painful urination and difficulty passing urine
Vomiting that precedes the abdominal pain
Severe cramps
Constipation or diarrhea with gas
If you have any of the mentioned symptoms, seek medical attention immediately, because timely diagnosis and treatment is very important. Do not eat, drink, or use any pain remedies, antacids, laxatives, or heating pads, which can cause an inflamed appendix to rupture.

 

Your Gallbladder

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Hanging out just below the liver’s right lobe is your hollow, pear-shaped gallbladder. When it’s full of bile that’s waiting to help digest some food, the organ can grow as long as 8 to 10 centimeters (cm), and as wide as 4 cm.

Unless you’ve had a gallstone or your gallbladder has been surgically removed, you probably think little of it. And that’s fine. But if it’s causing you serious pain or other problems, you may need to ditch this little organ.

Your gallbladder serves as a storage pouch.

While the liver is hard at work making the dark green bile that helps with digestion, the gallbladder holds the bile until you actually need it.

Gallstones are formed mostly from hardened cholesterol.

Gallstones form when one of two substances — cholesterol or bilirubin — become supersaturated in the bile and crystallize, much the way sugar crystallizes when someone makes rock candy. Bilirubin is a brownish-yellow substance found in bile that results when old red blood cells in the liver break down. Your body normally eliminates bilirubin through your bowels (it’s the reason for the color of feces). Bilirubin-caused gallstones are rarer than those formed from hardened cholesterol, and are more common in those with blood disorders, such as sickle cell anemia.

A low-cholesterol and low-fat diet is best for a healthy gallbladder.

A diet good for your heart is good for your gallbladder, too.

Any diet that would qualify as “heart-healthy” is “gallbladder-healthy,” too. That means a diet with some healthy monounsaturated fats, such as those in nuts, avocados, seeds, olives, peanut butter, and the oils from these products. Polyunsaturated fats should be part of that balanced diet, too, and are found in fatty fish, walnuts, flaxseeds, and vegetable oils. Avoiding foods that increase your cholesterol levels also reduces the risk of gallstones.

Almost as important as what you eat, however, is how frequently you eat. If you eat one large meal a day, it increases the likelihood of stones, because the bile sits in the gallbladder for a long period of time before it’s excreted.

The most common sign of gallstones is intense pain.

Up to 80 percent of people will never have symptoms for their gallstones, and nothing needs to be done about that. But if there is a problem, you’ll usually know it: the pain can be intense. The pain is generally described as sharp, stabbing, and very excruciating — a 10 on a scale of 1 to 10. The pain most commonly comes after eating a fatty meal because fat is the strongest trigger for the gallbladder to empty.

The pain typically occurs on the right side where your gallbladder is, below your breastbone, and can radiate to your back, Dr. Khandelwal says. It can last several hours and may be accompanied by nausea, she adds.

But the pain can also be a dull ache on the right side, like an upset stomach or heartburn with bloating.

The best test for gallstone is an ultrasound.

The best test for gallstones is an ultrasound. It’s quick and safe and gives us a lot of information about how the gallbladder looks, and it has pretty high accuracy. The ultrasound tech will be able to see gallstones or gallbladder irritation, such as a thickened wall or fluid around the gallbladder.

Some patients may be referred for a second kind of test called an HIDA (hepatobiliary) scan, in which a radioactive chemical is injected into your arm and the tech watches what happens when it reaches your gallbladder. Generally, HIDA scans are only performed on patients who have other underlying conditions or who have gallbladder pain symptoms, but no stones on an ultrasound.

Escaped stones could lead to jaundice or pancreatitis and require surgery.

If it’s not causing symptoms, or if you pass it as a few lucky people do, nothing. But if they are causing trouble,the gallbladder may need to be removed. If the person is experiencing pain, called biliary colic, or develops a gallbladder infection, called cholecystitis, gallbladder surgery is probably needed.

If the stones get outside your gallbladder and travel down the duct, they can cause some pretty serious complications, so it’s important to have them taken care of if you’re having a problem.

Escaped stones can cause obstructions in the ducts that lead to jaundice or pancreatitis, Any of these symptoms would require gallbladder surgery, called cholecystectomy.

Gallbladder removal surgery is usually an outpatient procedure, with a short recovery time and for most people,no long-lasting effects.

 

From Everyday Health