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DYSSYNERGIC DEFECATION

WHAT IS CONSTIPATION?

Constipation is one of the most common gastrointestinal complaints in the worldwide population, and more so in females and the elderly. It is not a complaint, but a symptom of various diseases/disorders of mixed etiologies and mechanisms.

Constipation is described as the phenomenon of 2 or more of the following symptoms in the past 12 months (without the use of medicines):

  • Less than 3 bowel movements per week,
  • Extreme straining during at least 25 % of bowel movements,
  • A feeling of incomplete evacuation after at least 25 % of bowel movements, and
  • A journey of hard or pellet‐like stool during at least 25 % of bowel movements.

Primary constipation consists of several overlapping subtypes, among which Dyssynergic Defecation (DD) is almost common. Patients withdyssynergic defecation have symptoms of obstructive defecation, such as

  • Exacting straining during defecation,
  • A sensation of a “blockage”,
  • Digital manipulation during defecation and
  • A feeling of incomplete evacuation.

The physiological mechanisms of DD include the inability to coordinate abdominal, rectoanal, and pelvic floor muscles during defecation because of causes such as:

  • Inadequate rectal and/or abdominal propulsive force,
  • Impaired anal relaxation or
  • Increased anal outlet resistance as a result of the paradoxical external anal sphincter or puborectalis contraction (muscles in the pelvis).

 

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Jaundice treatment

Jaundice treatment in nashik | Acidity & GI tretament | Gastroenterologist In Nashik |Dr. Nitin Borse
What is Jaundice?

Jaundice is described as a yellow discoloration of the eyes, which may be accompanied by deep yellow colored urine. Usually, patients have a decreased appetite. Jaundice per se is a symptom but not a disease.

There are many causes of jaundice.

  • Hepatic causes (Inflammation in the liver)
  • Post Hepatic causes (Obstructive causes)
Hepatic Causes / Hepatitis:

Inflammation in the liver is hepatitis and is the most common cause of jaundice.

The common causes of hepatitis are:

(a) Viral Hepatitis ( Hepatitis A, B, C, & E ):

This is the most common cause of jaundice in the community. In the majority of patients, the disease has got a self- limiting course. Very few patients have a fatal course and need for hospitalization. Hepatitis B & C are transmitted via infected blood and the liver completely recovers, However, some patients of HEPATITIS B & C GO INTO CHRONIC HEPATITIS AND CIRRHOSIS.

How can Hepatitis B and C be prevented

HEPATITIS A & B can be prevented by VACCINATING the person against it. There is no vaccine to prevent hepatitis C. Hepatitis B and C can be prevented by using SAFE AND SCREENED BLOOD, which is negative for these viruses.

 

(b) Alcoholic Hepatitis:

 

Alcoholic hepatitis is caused by EXCESS DRINKING of alcohol for a prolonged period of more than 10 years. This is a serious condition and can lead to complications which can be:

 

  • Jaundice.
  • Blood in vomitus.
  • Black colored stools.
  • Swelling of feet and abdomen.
  • Coma.

 

This condition can be prevented by limiting the quantity of alcohol intake to 2-3 pegs/ day. Those who drink daily should refrain from drinking at least 2 days a week. This gives time for the liver to recover from the toxic effects of alcohol.

 

Obstructive causes:

The Common causes of obstructive jaundice are:

  • Stone in the bile duct.
  • Cancer of the pancreas.
  • Cancer of the bile duct and the gall bladder.

These patients should be properly investigated to diagnose the disease at an early stage. Most of the times the disease is detected at an advanced stage and cure them is not possible. NON SURGICAL THERAPY WITH THE HELP OF ENDOSCOPES IS NOW AVAILABLE IN.

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