MedicoTips.Com

Note Please left click on the slide the for transitions instead of using the "Next & Previous" buttons, as left mouse button click triggers the intra-slide animations. Gastroenterology Experts Symposium held at Skardu Shagrilla Pakistan from 4th to 7th August 2016. Dr Tayyab Saeed Akhtar, FCPS (Internal Medicine) talked about the latest (2016) guidelines regarding the management of Upper GI bleed. If you have any questions, feel free to comment below.

This is the story of a 30 year old female patient who had recurrent abdominal pain for 3-4 months with no other obvious signs or symptoms. Her basic workup was normal. She underwent upper GI endoscopy. What is Ascariasis? Ascariasis is an infection of the human intestine caused by a worm or parasite called Ascaris lumbricoides (A. lumbricoides), which is a species of parasites called roundworms. Ascariasis is the commonest human parasitic intestinal infection. About 10% of the developing world which includes population of almost all of the south Asian countries, is infected with intestinal worms, according to the records of World Health Organization (WHO). Ascariasis is most common in places without modern sanitation. It’s transmitted through uncooked, or non-sterile/boiled food and water. What causes Ascariasis?  You can become infected with ascariasis after ingesting the eggs of the A. lumbricoides roundworm by any mean. The eggs are usually found in soil contaminated by...

This is a case of a 75-year-old male, who presented to the medical outpatient department of Capital Hospital Islamabad with history of dyspepsia for the last 6 months and vomiting since last fourteen days. He also had a significant history of weight loss. There wasn’t any history of black stools, constipation, diarrhoea, dizziness, headache. But he was feeling fatigued, dizziness and generalized weakness. He vomits right after eating or drinking fluids. The vomitus consists of the contents of recently eaten food. He was given medication for symptomatic relief but medication wasn’t of great help for him. Considering his age and the signs/symptoms, Dr. Siddique Akbar Satti who was on the case, went for an upper GI endoscopy. He did the endoscopy and got the following picture of the stomach. Dr. Satti says in his report that the gastric cavity is dilated with large amount of residual food and fluid, even after 12 hours of fasting. There is a large sized ulcer ...

A 53 year old male with medical history of   An episode of Hematemesis a day ago. Vomiting soon after taking meal since last one month Dyspepsia or indigestion sine last 3 years. Early satiety Abdominal fullness Epigastric discomfort   Presented to the Emergency Department of CDA hospital on 6th June 2015. Dr. Siddique Akbar Satti was on the case. Patient with such a long history of dyspepsia and an episode of hematemesis, without any history of any explainable risk factor such as, Portal hypertension, chronic hepatitis, esophageal varices , alcoholism, malena, Diabetes, was very unusual, and raise the suspicion that there is something wrong.   Dr. Siddique Akbar Satti, went for Upper GI endoscopy as he was of the view that the vomiting that follows soon after having meal, suggests that there is something wrong with the gastric outlet. So he did his endoscopy.   Following are the endoscopic views of the patient stomach.     ...

In Capital Hospital Islamabad A workshop on the basics of upper gastrointestinal endoscopic techniques was held on 30th of October 2014. Dr Siddique Akbar Satti the Patron, with cooperation and coordination of Dr Farhal Ali, managed to conduct this auspicious, educational and practical session with great success. The chief guest was Dr Shoaib Shafi, the Professor of Medicine from Rawalpindi Medical College, Pakistan, who is also well-known for his efforts to modernize the field of gastroenterology in Pakistan. “ The objective of this workshop is to educate the young doctors about the indications and prerequisites of upper of GI endoscopy, the basic technique and procedure, complications during and after the procedure, counselling of the patient ”, said Dr Siddique Akbar Satti, The Supervisor and patron of the course. The workshop started with the recitation of holy verses from The Holy Quran. After that, Dr Farhan Ali introduces the speakers, Dr Beenish, Dr Zahid ul Zahidin and Dr...

Case History: A 61-year-old male patient presented in the outpatient department of medicine in Capital Hospital Islamabad, complaining of severe epigastric pain that had been increased in intensity since last 15 days. The onset of pain was sudden, burning and pinching in character, aggravated by intake of food and relieved by strong painkillers and pain radiated to back. The patient also had low-grade fever since last 10 days and generalized weakness. Pain starts a few minutes after taking a meal. There was no history of dysphagia, melena, shortness of breath, cough, chest pain or discomfort, food regurgitation, vomiting, hematemesis, altered bowel habits and burning or difficult micturition. There was no significant past medical or surgical history. The patient was a non-smoker, had decreased appetite and sleep disturbance. There was no history of Diabetes mellitus , hypertension, heart diseases , asthma or cancer in the family. On examination, his pulse rate was 76 and blood ...

Erect abdominal X-ray is usually ordered to rule out intestinal obstruction or perforation. In erect abdominal X-Ray, intestinal obstruction shows dilated intestinal loops and air-fluid levels. The patient who has got intestinal obstruction usually presents in the emergency department of hospital complaining of; severe colicky abdominal pain and distension, vomiting, absolute constipation along with a history of a predisposing factor or a cause. For example; The most common cause of small bowel obstruction is post-surgical or post-infection adhesions. The most common surgical procedure that may lead to small intestine obstruction are; appendectomy, surgery involving colon, intestine, rectum, uterus, cervix, ovaries, fallopian tubes and other intraperitoneal structures. The other causes are hernias, intussusception, volvulus, gallstones, foreign bodies and inflammatory diseases, etc. On the other hand, intestinal perforation presents with signs of peritonitis, severe abdominal pain...

Bile is a golden or brownish yellow fluid that is secreted by the parenchymal cells of the liver. It is collected in small ductules that join together to form right and left hepatic bile ducts. The right and left hepatic ducts combine together to form a common hepatic duct. Common hepatic duct joins with the cystic duct to form common bile duct and common bile duct empties into the second part of the duodenum, after joining the pancreatic duct at Ampula of Vater. Cystic duct transport the bile secretion between the gallbladder and the common bile duct. The gallbladder stores the bile. Cholelithiasis and Choledocholithiasis mean the presence of stones in the gallbladder and common bile duct respectively, may occur due to a disturbance in the composition of bile. Composition of Bile Bile is composed of the following ingredients. It is composed mainly of water, inorganic and organic matter Inorganic constitutes: These include sodium, chloride, bicarbonate and potassium. Bicarbonate h...

Some people especially those who are elderly may feel dizziness and sleepiness after having a meal. This problem is less common in younger individuals but may occur if they are suffering from some underlying physical or emotional disorder. Why do you feel dizzy and sleepy after eating? (Causes and Mechanism) In the following paragraphs, we will discuss the causes and also the mechanisms of these causes, how they lead to this dizziness after eating. Postprandial hypotension means a fall in blood pressure after taking a meal. Blood pressure may fall in older individuals after taking meal and this fall in blood pressure may make them feel dizzy, sleepy and sometimes may make them unconscious. Why is this fall in blood pressure occur after eating? The mechanism behind this is stated below; When somebody takes a meal, his intestines start working to digest and make it absorbable. To work efficiently the blood flow to intestines increases several folds. Our body has this ability to in...

The area above the umbilicus and just below the end of middle chest bone is called epigastrium or epigastric region. In most of the cases, the causes of pain above the umbilicus or below the sternum (chest bone) are easily manageable. As for example, Heartburn, also called stomach acidity is the most common cause, In this condition, the affected person feels burning pain inside the abdomen. Such pain usually starts after taking a meal, especially spicy, oily or high-protein one. This can easily be treated by ant-acids. Sometimes, a person feels severe pain below the sternum or above the umbilicus, that aggravates by moving, or when a person tries to stand up or lie down straight, the pain aggravates and some thread like force makes him to bend again. Such type of pain occurs usually due to spasm of central abdominal muscle. This pain resolves suddenly and the patient feels like nothing has ever happened to him. The other causes of pain in this region may need emergency management. B...

Many women with Crohn’s disease complain of missed and irregular periods. They want to know whether it is the Crohn’s disease that is responsible for irregular menstrual periods or there’s something else happening with them. The answer to this question is described below. Yes, a relationship between Crohn’s disease and irregular menstrual periods does exist. Those women who have Crohn’s disease frequently complain of irregular and missed periods. Missed periods cause them to think about whether they are pregnant. But pregnancy tests come negative. The problem becomes very severe and women complain of missed, irregular or late periods more often when Crohn’s disease is active. Many women get normal and somewhat regular periods back when remission of Crohn’s disease occurs. What causes irregular and missed periods in Crohn’s disease? Exact causes of irregular and missed periods in Crohn’s disease are not known. But it is proposed that the inflammatory process in the body disturbs the ...

Avoid Wheat if you have Barrett Esophagus. In Barrett’s oesophagus , the cell lining of the lower end of oesophagus changes to the abnormal form. And it is considered a potential risk factor of oesophagal cancer. The exact cause of this condition is unknown but Gastroesophageal reflux disease also known as GERD is considered as the main culprit in the pathology of Barrett's oesophagus. Celiac disease is a disease that results from taking wheat and other similar products that contain a chemical substance known as gluten. Those individuals who are allergic to this gluten develop celiac disease. Therefore then should avoid wheat and other gluten-containing products such as barley and rye. Gastroesophageal reflux disease which is the main cause of getting Barrett oesophagus may result from insufficiency of the lower oesophagal sphincter, peptic ulcer disease, H-pylori induced peptic ulcer, and indigestion etc. The authors of a study published in a medical journal called Gastroente...

Avoiding Fatty Fried Foods in heartburn, digestive upset and Barrett's oesophagus . Fatty fried foods can’t be included in the healthy food category. They should be avoided in all circumstances. But taking non-fat foods only is also not good for health. Various hormones in our body are made up cholesterol. Fatty acids also perform various functions in our body. So we can say that we should take low-fat foods and the fat content of our diet should not be more than the recommended amount. Fatty and greasy foods must be avoided in case of heartburn or Barrett oesophagus. Fatty foods are difficult to digest. The stomach has no enzyme to digest fats. So fats stay in the stomach for a longer period of time. They distend the stomach and their greasy nature also affects the lower oesophagal sphincter. The LES (lower oesophagal sphincter) become loose and stomach contents can come back to the oesophagus. The oesophagal lining can’t resist the corrosive action of stomach acid. The inner ...

Baking Soda to Treat Barrett Esophagus Barrett’s oesophagus or Barrett's oesophagus is a condition in which the lower end of the oesophagus is involved. The innermost lining of the lower end of oesophagus changes from oesophagal to intestinal form. The main cause of this change is the reflux of acids from the stomach. These acids damage the lower end of the oesophagus and our body tries to combat this damage. Our body has the ability to adapt itself according to the new situation. The intestinal type of tissue lining withstands the acids better than the oesophagal type. Therefore, our body changes the innermost tissue lining of the lower end of the oesophagus into the intestinal type to minimize the damage caused by acid. The reflux of acid content has given the name of GERD (Gastro-esophageal reflux disease). Treating the GERD at a proper time reduce the risk of getting Barrett oesophagus. The risk of getting Barrett oesophagus is not very high. So if you have any symptom of ...

Drink green tea every day. Green tea has many benefits. It is good for weight loss, it contains a lot of useful antioxidants, it protects us against cancer, it lowers cholesterol, it protects us against many other diseases such as heart attack, stroke, vascular diseases and many others. Green tea is different from black tea. Black tea is completely fermented. It contains a lot of caffeine and tannin and both of these substances are responsible for having acid reflux. Chronic acid reflux is one of the major causes of Barrett’s oesophagus and oesophagal cancer. On the other hand, green tea has a much lesser amount of caffeine and tannin as compared to black tea. Moreover, it contains abundant antioxidants and other useful substances that boost immunity and protect us against many diseases. Tannin makes the tea bitter so if your tea is bitter in taste it means this is not good for your stomach so avoid it. The McKinley Health Center recommends green tea for the patients of acid reflux ...

Role of BlackBerries in the Treatment of Barrett’s Esophagus, Heart Burn and Digestive Upset Barrett’s oesophagus possesses a major risk of progressing to deadly oesophagal cancer. In case of a patient of Barrett’s oesophagus, there is a 30% risk of getting oesophagal cancer after 10 years. The major cause of Barrett’s oesophagus is the reflux of stomach acid back to the oesophagus which converts the innermost lining of the lower oesophagal portion to an abnormal type. This abnormal type can convert to cancerous tissue more easily as compared to the normal type. Eating bad quality and unhealthy food is one of the major causes of GERD (Gastro-esophageal reflux disease). Eating right is a key to get rid of bad gastric acid reflux. But if you have already got Barrett's oesophagus then every effort should be made to halt its progress to oesophagal cancer. Fruits and vegetables protect against many cancers. It has also been proved through scientific research studies. New researches c...

Our intestine is a natural habitat of many species of bacteria. But these naturally occurring bacteria do not have any harmful effect on the human body. In fact, they are beneficial in many ways. · They provide us with some good vitamins such as vitamin K · They protect us from obesity and diabetes mellitus · They protect us from gastrointestinal infections · They protect us from indigestion and heartburn · They help in the breakdown of toxic waste products into a less toxic form. Obesity, diabetes mellitus, gastrointestinal infections, indigestion and heartburn, all are the risk factors of Gastroesophageal reflux disease (reflux of stomach acids into the oesophagus) and chronic reflux may cause metaplastic changes in lower oesophagal portion and thus, convert normal oesophagus to Barrett's oesophagus. The normal bacteria present in the gut prevent the growth of disease-causing bacteria through competing for food and space. Thus they protect us from getting infection and dis...

Ginger is a very useful herb. It has been used as a flavouring agent in Asian food. It has a great medicinal value. It was used by people of ancient times to treat wounds and gastrointestinal diseases. Nowadays, scientific research proved the medicinal value of ginger. Ginger has the following important health benefits. It relieves gastrointestinal upset It provides safe and effective relief against pregnancy-induced nausea and vomiting. It has an anti-inflammatory effect and It promotes healing. It protects against colorectal cancer It causes the death of cancerous cells. It boosts immunity and protects against bacterial and viral infections. Ginger promotes digestion and absorption of food in the gut. Ginger is very useful in case of flatulence. Ginger has aphrodisiac properties. Ginger reduces pain. These are the few benefits of ginger. Ginger can be consumed in many forms. Ginger root can be added to the meal, you can add ginger roots in your juice and you may make Ginge...

Probiotics and Barrett Esophagus Probiotics are supplements that contain useful or good bacteria. The gastrointestinal tract of the human body is full of natural bacteria, especially the large intestine and the last part of the small intestine. These bacteria are not harmful to the human body, instead, they are useful. They perform some good function including, production of vitamin K and suppressing the growth of harmful bacteria that can produce disease. There are 400 types of good bacteria in the human gastrointestinal tract. The most important of these 400 types is lactobacillus acidophilus or lactic acid bacillus (LAB). These good bacteria suppress the growth of harmful bacteria. They do so by competing for space and food. The good bacteria occupy space and consume food, and don’t allow harmful bacteria to take their place. The harmful bacteria don’t get enough space and food for their growth and hence their growth is suppressed. Probiotics are used in a number of disorders. The...

DGL (deglycyrrhizinated licorice) to Treat Barrett’s Esophagus Licorice is a legume and member of pea family (Fabaceae). It is used to treat variety of diseases and it also has a historical medicinal value. Now scientific studies also proved that it is very useful in inflammatory bowel disease, stomach ulcer and Barrett's oesophagus. Glycyrrhizin is a component of licorice. This is a dangerous substance and can increase blood pressure to very dangerous level. It causes retention of salts and water also. If it is consumed, human body converts it to Glycyrrhetinic acid. It also causes retention of sodium and elevation of blood pressure. Because of these harmful effects, Glycyrrhizin is removed from licorice and it is used in the form deglycyrrhizinated Licorice (DGL). It doesn’t cause any harm to body, doesn’t cause elevation of blood pressure and retention of salt and water. Liquorice is very useful in case of a stomach ulcer (or peptic ulcer) and Gastroesophageal reflux disease....