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Gastroenterology News

Unknown interesting facts, Causes and health tips to deal with “leaky gut”

by Pragati Singh March 27, 2022

written by Pragati Singh

The term “leaky gut” has suddenly captivated everyone’s attention and has become a trendy buzzword, but do you know exactly what this health problem means? Lavleen Kaur, Co-founder and Head Dietitian of Diet Insight, says to HT Lifestyle, “Leaky gut, scientifically known as intestinal permeability, is a disease in which the small intestine lining becomes damaged.” This causes undigested food particles, harmful waste, and pathogens to “leak” into the circulation via the colon. When these foreign particles enter the circulation, they cause an immunological response, which leads to further health problems such as irritable bowel syndrome, chronic weariness, food allergies, inflammatory responses, rheumatoid arthritis, and other ailments. “

In layman’s terms, she explained that the damaged cells in our intestines fail to produce the enzymes needed for efficient digestion, and as a result, our bodies are unable to absorb critical nutrients, leading to hormone imbalances and a weakened immune system. Dr. Anish Desai, MD, Founder and CEO of IntelliMed Healthcare Solutions, added, “The human digestive tract is responsible for food digestion and nutrient absorption.” Small holes in the gut wall enable water and nutrients to flow while preventing hazardous substances from entering. “

He said, “As the tight connections between intestinal walls relax, the gut becomes more permeable, possibly allowing germs and toxins to pass from the gut into the circulation.” This disorder is referred to as “leaky gut.” Leaky gut syndrome is a common digestive disorder that affects the lining of the intestines. The break in the intestinal wall that arises during leaky gut syndrome allows bacteria and other poisons to enter the bloodstream. The main causes of the condition are a decrease in mucus thickness, increased permeability of the intestine, and a change in gut flora. “

The causes of leaky gut:

According to nutritionist Lavleen Kaur, there are several reasons for a leaky stomach, but the actual cause of the leaky gut is unknown. She believes that in many cases, leaky gut is caused by an overabundance of sugar, salt, processed and refined meals.

She did, however, disclose an intriguing and little-known fact: there is a nerve within our brain called the vagus nerve that is directly related to our abdomen. “It uses the same protocol as WhatsApp, meaning it sends messages to the stomach to perform correctly, and the gut responds by absorbing the required nourishment and preventing superfluous particles,” she explained.

Dr. Anish Desai identified many variables that contribute to leaky gut. They are as follows:

1. Excessive sugar consumption: a high fructose diet impairs the intestinal wall’s barrier function.

2. NSAIDs: Long-term use of NSAIDs increases permeability and produces leaky gut.

3. Excessive alcohol consumption: Excessive alcohol consumption increases intestinal permeability.

4. Nutrient insufficiency: Vitamin A, D, and zinc deficiency all have a role in intestinal permeability.

5. Stress: Chronic stress as a result of an unhealthy lifestyle is a factor in intestinal illness.

He also highlighted that some diseases are related to leaky gut and mentioned how numerous research has shown that increased intestinal permeability is becoming a cause of many ailments such as Crohn’s disease, Celiac disease, diabetes, and irritable bowel syndrome.

Suggestions for improving intestinal health:

If you want to cure a leaky gut, you must first address the fundamental causes of the disease, says dietitian Lavleen Kaur. While it is hard to determine whether or not a leaky gut can be repaired, it can certainly be improved. Everyone’s intestines are “leaky” to some extent; our small intestine is meant to allow particular particles into the rest of the body. It only becomes a problem when it starts emitting the incorrect kinds. “

Dr. Anish Desai highlighted a few strategies that help enhance gut health, despite the fact that there is no prescribed treatment for leaky gut. They are as follows:

1. Reduce carbohydrate consumption: Bacteria that are detrimental to the body often feed on sugar, and carbohydrates are a source of sugar.

2. Limit your use of NSAIDs: Long-term use of NSAIDs like ibuprofen contributes to leaky gut syndrome.

3. Eat fermented foods: Fermented foods like yoghurt contain probiotics, which help with intestinal health.

4. Exercise on a regular basis: Exercise on a regular basis helps to promote intestinal health.

5. Consume nutrients: A balanced diet rich in vitamins and minerals should be consumed on a regular basis to maintain the health of the hut.

March 27, 2022 0 comment

Gastroenterology News

Researchers have created coated probiotics that can be successfully administered into human stomach

by Pragati Singh March 26, 2022

written by Pragati Singh

Scientists at Nanyang Technological University, Singapore (NTU Singapore) have created probiotics with a unique edible covering that guarantees the helpful bacteria reach the colon after being consumed.

The World Health Organization defines probiotics as living bacteria that, when provided in sufficient proportions, provide a health benefit to the host [1]. They have been found to help prevent urinary and digestive tract infections, as well as to maintain healthy gut flora, which has been associated with a lower risk of obesity and general well-being.

However, numerous methods of distributing probiotics, such as supplements and dairy products, have not proved efficient in ensuring they survive conditions in the human stomach in sufficient amounts to enhance one’s health. Many studies suggest that the majority of probiotics in commercial supplements and yoghurts die within the first 30 minutes of being exposed to the stomach’s acidic environment.

In the NTU study, the probiotics, gut-friendly Lacticaseibacillus bacteria, were spray-coated with alginate, a carbohydrate produced from brown algae, in order to shield them from the severe acidic conditions in the stomach.

Only the probiotics with the NTU-developed coating survived studies replicating a passage through the human digestive tract. The bacteria are only released when they reach the small intestine, since the coating degrades by interacting with phosphate ions, which are abundant in the small intestine.

The development of the alginate coating technology underscores NTU’s dedication to the demands and problems of healthy living and ageing, which is one of four major challenges to mankind that the university aspires to solve through its NTU 2025 strategic plan.

In recent years, scientific investigations have demonstrated that an individual’s health is far more dependent on the support of “good bugs” in their gut than we previously assumed, said Associate Professor Joachim Loo of NTU’s School of Materials Science and Engineering, who conducted the study.

“Probiotics, on the other hand, are fragile bacteria that cannot withstand the harsh environment of our stomach. We intended to “parcel-wrap” and distribute probiotics to specific areas of the gut where they work best in order to maximise their efficacy as a dietary supplement. Through materials engineering, this moisture-stable packaging allows for more efficient probiotic distribution while also extending the shelf-life of the supplements. “

Ms. Tan Li Ling, a PhD student at NTU’s School of Materials Science & Engineering and the study’s first author, stated: “We chose alginate as the coating material because it is non-toxic to humans, of natural origin, and reasonably inexpensive.” Alginate also has acid-buffering qualities that help protect probiotics from the severe circumstances induced by stomach acid. “

The study’s findings were published in the peer-reviewed academic journal Carbohydrate Polymers in February. NTUitive, NTU’s enterprise and innovation organisation, has also submitted a patent application for the probiotic coating technique.

Extending the application of probiotics

The NTU probiotic coating technique is adaptable and can be used to make powder-like coated probiotics with a diameter of around 10 mm (0.0004 inch).

The approach employs protective sugars in addition to alginate to ensure that bacteria are not destroyed during the production process. Furthermore, the usage of calcium ions prevents the coating from deteriorating in liquids or in a wet environment, allowing it to have a longer shelf life.

The coated probiotics are also produced using the spray-drying approach. Spray-drying is a low-cost, high-throughput manufacturing process that is already widely employed in the food and pharmaceutical sectors. It would enable the NTU-developed coated probiotics to be mass-produced at a reasonable cost.

The scientists cultured Lacticaseibacillus bacteria before washing them in a salt solution to create the coated probiotics. Following that, the bacteria were packed together in a concentration that corresponded to the United Nations’ recommended probiotic dosage. Finally, the probiotics were spray-dried and alginate-coated. The entire procedure takes around an hour.

The coated probiotic bacteria may live in the refrigerator for up to eight weeks. During an eight-week testing period, the NTU-developed also did not degrade and was able to preserve probiotics from stomach acid.

Probiotic beverages, on the other hand, have a shelf life of up to seven weeks when refrigerated, but the probiotics in them begin to die out within a few hours at ambient temperature, according to the researchers.

Assoc Prof Loo continued, “With a paradigm shift toward illness prevention rather than therapy, probiotics may hold the key to moulding one’s health and maintaining one’s good health. By further modifying the coating technique, it will be feasible to apply it to a variety of additional probiotics as well as for other objectives, such as commercial uses in the agri-food and medical industries.

This technique is incredibly adaptable, Ms. Tan noted, since the coated probiotics may be included in a wide range of product types, including nutritional supplements and tablets, food and drinks, and even animal feeds.

Companies in the food and beverage sector have expressed interest in adopting and developing the NTU-developed technology.

The scientists will be testing their innovation on other types of probiotics, which will allow it to be applied to the agrifoodtech industry as it could be used to supplement the diets of reared animals, such as fish and chicken, with probiotics in order to find alternatives to antibiotics in agri-farming.

Pointers

Expert Consultation with the Food and Agriculture Organization and the World Health Organization (2001).
Harvard Medical School, Harvard Health Publishing, and Probiotics provide several health advantages (2020).
FEMS Microbes, Volume 1, Issue 1What’s in your cupboard when it comes to expired probiotics? (2020).
Food and Agriculture Organization and World Health Organization Report of a joint FAO/WHO working group on the development of recommendations for the assessment of probiotics in food. United Nations Food and Agriculture Organization, 2002.
Digestive system. Dying in yoghurt: the quantity of surviving bacteria in probiotic yoghurt reduces with room temperature exposure, 2014.

March 26, 2022 0 comment

Gastroenterology News

Uncomplicated diagnostic tool for gastrointestinal diseases

by Pragati Singh March 25, 2022

written by Pragati Singh

As food passes through the digestive tract, muscles flex to keep things moving smoothly. Loss of motility can result in acid reflux, inability to transfer food out of the stomach, or constipation.

Dysmotility disorders are often diagnosed with a catheter carrying pressure transducers that detect GI tract contractions. MIT researchers have created a novel gadget inspired by an old Incan technology, the quipu — a collection of knotted ropes used to transfer information — that might offer a cheaper and easier-to-manufacture alternative to existing diagnostics for GI dysmotility.

The MIT researchers and their collaborators at Brigham and Women’s Hospital demonstrated in animal tests that their simple device, a silicone tube filled with liquid metal and knotted many times, produces measurements similar to those produced by the state-of-the-art diagnostic technique known as high-resolution manometry.

“We’re able to make a measurement that would normally require devices that cost thousands of dollars and an instrument that is much more complicated,” says Giovanni Traverso, the Karl van Tassel Career Development Assistant Professor of Mechanical Engineering at MIT, a gastroenterologist at Brigham and Women’s Hospital, and the study’s senior author.

The study’s principal authors are MIT research scientists Kewang Nan and Sahab Babaee, and it was published today in Nature Biomedical Engineering.

Dysmotility Diagnosis

Contractions of the gastrointestinal system are essential for transporting food through the tract, and disruptions of these contractions at any point might result in health concerns. The gold-standard manometry test can be performed to determine if the GI tract muscles are correctly functioning to create those waves.

“High-resolution manometry can detect the pressure and speed of the contractile waves, but those devices are very expensive, in the tens of thousands of dollars, and they require maintenance and sterilising between patients,” Traverso explains.

Traverso (who grew up in Peru) and Nan believed that the Incan technique of quipu may be used to influence the development of a simpler diagnosis. Before writing, the Inca and other ancient Andean cultures employed quipu devices, which are made of colourful threads twisted in various ways, to record information and deliver messages.

“Our objective was to create a device that was equivalent to existing commercially available catheter-based pressure transducers while also lowering the cost and making it easier to build and deploy,” Nan explains.

The researchers started with a basic silicone catheter, which they filled with gallium-indium eutectic, a liquid metal that is harmless in minute amounts, and sealed at both ends. This tube can respond to pressure changes in an unknotted condition, but it is not sensitive enough to detect pressure changes in the gastrointestinal system.

When the researchers added knots at regular intervals throughout the tube, the catheter became considerably more sensitive to pressure fluctuations and could detect pressures up to roughly 200 millimetres of mercury, which is about the greatest pressure encountered in the human digestive system.

The greater sensitivity is due to the knots elongating the cross-section of the tube, making it easier to compress, as demonstrated by the researchers using computer simulations. Furthermore, when the tube is knotted, three or four parts of the tube are stacked on top of one another, increasing its sensitivity to pressure fluctuations.

The researchers also discovered that pressure sensitivity varies depending on the type of knot and how firmly it is tied. The researchers utilised knots spaced approximately 1 centimetre apart to match the spacing of pressure transducers in a manometer for use in the digestive tract, but they might be positioned closer together for other uses, the researchers said.

The researchers utilised the quipu-inspired sensor to monitor pressure in the oesophagus while food was ingested in animal models. They also assessed the rectoanal inhibitory reflex (RAIR). The novel devices produced pressure measures that were comparable to the gold-standard manometry approach in both experiments.

Less complicated option

The researchers also demonstrated that the gadgets can resist high temperatures and can be sterilised using an autoclave, a typical medical equipment used to sterilise things using heat and pressure. This offers them a competitive edge over conventional manometry catheters, which cannot be autoclaved and must be chemically cleaned. Furthermore, because the devices are so cheap to build, they might be thrown after each use if autoclaves aren’t accessible.

“They’re incredibly quick and super cheap to create,” Nan explains. “Another reason for making GI manometers inexpensive and disposable is to encourage decentralised diagnosis. Being inexpensive increases accessibility by lowering costs, and being disposable further aids public acceptability by removing maintenance costs and minimising difficulty during usage.”

The quipu-inspired sensors might be beneficial in locations where current manometry equipment is unavailable, as well as in more industrialised areas as a less-expensive, easier-to-use alternative to manometry.

“I believe that this type of diagnosis might be widely employed in both developing and developed world settings,” Traverso adds. “The next stage is to find possible partners to assist us in manufacturing them, and then test them in patients.”

Walter Chan, director of the Center for Gastrointestinal Motility at Brigham and Women’s Hospital; Johannes Kuosmanen, an MIT technical associate; Vivian Feig, a postdoc at MIT and Brigham and Women’s; Yiyue Luo, an MIT graduate student; Shriya Srinivasan, a postdoc at MIT and Brigham and Women’s; Christina Patterson, an MIT undergraduate; and Ahmad Mujtaba Jebran

The MIT Department of Mechanical Engineering financed the study.

March 25, 2022 0 comment

Gastroenterology News

Ulcers: Diagnostics, Treatment and More

by Pragati Singh March 22, 2022

written by Pragati Singh

There is no clear evidence that modern life’s stress or a steady diet of fast food causes stomach and small intestine ulcers, but they are still common in our society: one out of every ten Americans will experience the burning, gnawing abdominal pain of a peptic (or gastric) ulcer at some point in their lives.

Peptic ulcers are holes or cracks in the protective lining of the duodenum (the upper section of the small intestine) or the stomach, which are in touch with stomach acids and enzymes. Duodenal ulcers occur more frequently than stomach ulcers.

Esophageal ulcers are very uncommon, forming in the oesophagus (or swallowing tube) as a result of pharmaceutical exposure, such as some antibiotics or anti-inflammatories, or alcohol addiction.

Until the mid-1980s, conventional thinking held that ulcers were caused by stress, a hereditary proclivity for increased stomach acid output, and bad living practises (including overindulging in rich and fatty foods, alcohol, caffeine, and tobacco). It was thought that such impacts lead to the accumulation of stomach acids, which destroy the protective lining of the stomach, duodenum, or oesophagus.

While increased stomach acid output undoubtedly contributes to the formation of ulcers, a relatively new viewpoint contends that bacterial infection is the major cause of peptic ulcers. Indeed, studies undertaken since the mid-1980s have revealed that the bacterium Helicobacter pylori (H. pylori) is present in more than 90% of duodenal ulcers and around 80% of stomach ulcers. However, new data show that such numbers are dropping.

Other variables appear to contribute to ulcer development, particularly in people infected with H. pylori:

Overuse of over-the-counter painkillers (such as aspirin, ibuprofen, and naproxen)
Heavy alcohol use
Psychological stress
Smoking

Other research indicates that stomach ulcers are more common in elderly persons. This might be due to:

Arthritic is common among the elderly, and relieving arthritis pain may include taking aspirin or ibuprofen on a regular basis.
The pylorus (the valve between the stomach and the duodenum) relaxes with age, allowing excess bile (a chemical generated in the liver to promote digestion) to leak into the stomach and erode the stomach lining.

People with type A blood are also more prone to develop malignant stomach ulcers for unknown reasons.

Duodenal ulcers are more common in patients with type O blood, presumably because they lack the material on the surface of blood cells that protects the duodenal lining.

DIAGNOSTICS

If your doctor suspects you have a peptic ulcer, they will most likely begin with a physical exam and certain tests:

They’ll feel your stomach and ask whether you’ve had any soreness, pain, or bloating. They may use a stethoscope to listen for any noises coming from your stomach.
The next step will be to conduct tests to search for H. pylori bacteria. For these, your doctor may collect blood, stool, or breath samples from you.
In certain situations, especially if you’re older and your symptoms include weight loss or loss of appetite, they may use a long, flexible tube called an endoscope to examine your neck and stomach for indications of an ulcer. (You will be given sleeping medication.) A tiny sample of tissue from an ulcer can also be taken with an endoscope and examined in a laboratory.
Before taking X-rays of your stomach, they may ask you to consume a milky liquid called barium. This drink covers your digestive tract, making issues like ulcers more visible.

TREATMENT

If you have a peptic ulcer, your doctor will propose a treatment strategy based on the source of the problem:

The most frequent treatment is a combination of antibiotics to kill the H. pylori bacteria and medicines to reduce stomach acid. Proton pump inhibitors (such as Aciphex or Nexium) and antibiotics are common examples. PPIs will be prescribed to you for several weeks.
You must stop taking over-the-counter pain relievers if they are the cause of your ulcer.
They may also provide a protectant, which encapsulates ulcers to protect them from stomach acid.

Lifestyle changes can help, too. You might need to:

Quit smoking.
Drink less alcohol or caffeine.
Stay away from foods that make your symptoms worse.

After treatment, your doctor may want to keep a close eye on you, depending on:

The size of your ulcer and where it was
How well the treatment worked
If you had any other problems

If left untreated, an ulcer can lead to significant complications such as gastrointestinal haemorrhage. Untreated ulcers can potentially cause a hole in your stomach, which may require surgery to repair.

March 22, 2022 0 comment

Gastroenterology News Medicine News Nutrition News

Is Your Favorite Spicy Food Causing Stomach Problems?

by Pragati Singh March 18, 2022

written by Pragati Singh

Spice can transform an ordinary meal into something far more memorable. However, the signature heat that it produces can have an impact on more than just your taste buds.

Spicy foods were once blamed for causing peptic ulcers, which are sores in the stomach or duodenum (the first part of the small intestine) that cause dull or burning pain. Long-term use of nonsteroidal anti-inflammatory drugs like ibuprofen or aspirin, bacterial infection with Helicobacter pylori (H. pylori), or, in rare cases, tumours are now known to be the root causes of these ulcers.

Similarly, spicy foods do not cause gastroesophageal reflux disease, or GERD, which is a chronic condition in which the contents of the stomach wash back into the oesophagus due to a weak or malfunctioning muscle valve between the two. The stomach acids can then irritate the esophagus and cause heartburn, which feels like a burning sensation in the chest, behind the breastbone, and/or in the throat.

“All foods lead to the reflux of acid,” says Andrew Ippoliti, MD, a gastroenterologist at Keck Medicine of USC and professor of clinical medicine at the Keck School of Medicine of USC.

The stomach secretes acid during meals, and food can buffer the acid while it’s in the stomach. Once the food is digested and empties from the stomach, however, acid secretion continues without any food to neutralize it.

“This is the time when reflux occurs, and regardless of whether you’ve eaten spicy or bland food, the same process takes place.”

The one exception is coffee (both caffeinated and decaffeinated), because it stimulates acid secretion and has no capacity to buffer the acid.

On the other hand, intolerances or sensitivities to certain foods, including spicy foods, may be behind irritable bowel syndrome (IBS), a gastrointestinal condition that comes with symptoms like abdominal pain, diarrhea, constipation or bloating. One study found that people who consumed certain spices more than 10 times a week — chili pepper, curry, ginger, cinnamon and turmeric — were more likely to have IBS than people who never consumed them. If spicy foods trigger IBS symptoms for you, your doctor will probably suggest you take them off your menu.

Less conclusive at the moment is whether spicy food increases the risk for cancer. A recent meta-analysis looked at almost 40 studies and found that eating large amounts of spicy food was associated with an increased risk for gastric cancer. But more research needs to be conducted before there’s conclusive evidence that spicy food is a definitive risk factor for gastric cancer.

When it comes to spicy food and gastrointestinal issues like heartburn, bloating and diarrhea, however, the bottom line is this: “There’s no need to avoid spicy foods unless they regularly lead to symptoms.

March 18, 2022 0 comment

Gastroenterology News

Increasing chances of pregnancy with endometriosis

by Vaishali Sharma March 7, 2022

written by Vaishali Sharma

Endometriosis is a prevalent gynaecological illness, and a correct diagnosis might take up to ten years for the typical patient. When tissue that looks like uterine lining (endometrium) develops outside the uterus in areas it shouldn’t, it’s called endometriosis. It can affect your ovaries, fallopian tubes, bladder, and occasionally your bowels, intestines, or pelvic tissue.

Widespread pelvic discomfort, severe menstrual cramps, and painful intercourse are all possible side effects. It can sometimes, but not always, interfere with your ability to conceive. Although endometriosis does not always cause infertility, it can affect fertility. This does not mean that you can’t become pregnant if you have endometriosis. Instead, it suggests that getting pregnant will be more difficult for you.

If you have endometriosis, the abnormal tissue that develops outside of your uterus thickens before ovulation and swells and bleeds into locations where it shouldn’t be during menstruation. This swelling tissue has the potential to restrict the fallopian tubes or develop into the ovaries, making pregnancy more difficult.

Endometriosis is a progressive disease, meaning it will get worse over time. As endometrial tissue patches proliferate in the pelvic and abdominal regions, they might obstruct the reproductive organs. Sperm have a tougher time reaching the egg as a result of this. Furthermore, these tumours have the potential to harm the adjacent reproductive organs, reducing fertility.

With endometriosis, becoming pregnant might take a long time. Fertility issues may not be connected to the severity of endometriosis, as the physical structure of the reproductive organs is not the only factor to consider.

When you have endometriosis, you have a greater chance of not being able to conceive, and you may need to use assisted reproductive technology. Assisted reproductive technology (ART) or surgery to remove or decrease endometriosis growths outside the uterus can frequently enhance your chances of becoming pregnant.

The stage of the disease, on the other hand, can make a difference. Endometriosis, which affects fertility by preventing an embryo from implanting, scarring the fallopian tubes, altering egg development, generating a hormonal imbalance, and causing chronic inflammation in the pelvic, is known to afflict nearly half of women with infertility.

Most medicinal therapies for endometriosis seek to inhibit ovulation, but you’ll stop taking them if you’re trying to conceive. The good news is that you can get pregnant even if you have endometriosis. Fertility problems caused by endometriosis can be caused by a variety of factors, especially if endometriosis affects your ovaries and/or fallopian tubes.

An egg normally travels from the ovary to the fallopian tube and then to the uterus for fertilisation before being implanted into the uterine lining. Endometriosis in the lining of your fallopian tubes may prevent the egg from reaching the uterus.

Endometriosis may potentially cause an egg or sperm to be damaged. Before you begin attempting to conceive, you may need to consult a fertility doctor. Surgery to identify places where endometrium-like tissue is present used to be the only approach to fully diagnose endometriosis.

However, be sure that these procedures don’t leave you with scars that might damage your fertility. Discuss the risks and advantages of surgery with your doctor. As a result, new guidelines no longer propose surgery as a gold standard for diagnosis.

A fertility expert can collaborate with your doctor to identify the severity of your endometriosis symptoms and the variables that are contributing to your reproductive problems. Because endometriosis might damage your ovarian reserve, it’s possible that you’ll be advised to freeze your eggs now in case you want to get pregnant later.

If you have endometriosis, the success rates of IVF are equivalent to those of those who have other causes for infertility. IVF therapies have helped many individuals with endometriosis become pregnant, so it’s no surprise that it’s commonly suggested for those with moderate to severe endometriosis or who haven’t responded to previous treatments.

When you have endometriosis and are attempting to conceive, strive to maintain as healthy a lifestyle as possible. This can help your baby develop and flourish throughout a healthy pregnancy by reducing inflammation.

When trying to conceive, keep in mind that your age might play a role. Younger age is linked to higher fertility rates. Fertility problems and miscarriage are more common in women 35 and older than in younger women.

March 7, 2022 0 comment

Gastroenterology News Endocrinology and Metabolism

Stages, symptoms, lifestyle changes to adapt and prevent Liver Disease

by Pragati Singh February 28, 2022

written by Pragati Singh

Before liver failure develops, all phases of liver disease or fatty liver are linked to an increased risk of cardiovascular disease, such as heart attack and stroke. Doctors discuss the stages, symptoms, and lifestyle modifications that should be made to avoid the cause.

The liver is responsible for continuously filtering blood as it circulates throughout the body and converting nutrients and medications received from the digestive system into ready-to-use chemicals, in addition to eliminating toxins and other chemical waste products from the blood. The liver is one of the body’s largest and most remarkable organs, as it is a super organ that performs a plethora of health duties while all other organs perform specific or limited functions.

Till date, over 500 functions have been attributed to the liver and scientists say more may be discovered over time. The most important function of the liver is processing of all that we consume, whether it be food, alcohol, drugs or poisons and the liver gets damaged by all the toxins we consume. Infections in blood also reach the liver and inflict damage while many other disease processes, inflammations and diseases, including cancer in other organs, also target the liver.

Symptoms:

In an interview with HT Lifestyle, Dr Gaurav Chaubal, Director – Liver, Pancreas, Intestine Transplant Program and HPB Surgery at Global Hospital in Mumbai’s Parel, listed possible symptoms that one should never avoid. They include:

1. Yellowing of your skin and eyeballs (jaundice)

2. Pain in your upper right abdomen.

3. Abdominal swelling (ascites)

4. Nausea.

5. A general sense of feeling unwell (malaise)

6. Disorientation or confusion.( hepatic encephalopathy)

7. Sleepiness.

5 stages of liver disease:

Explaining that fatty liver is accumulation of fat in the liver which can cause damage to the liver and may gradually progress to liver failure, Dr Sulaiman Ladhani, Consulting Chest Physician and MD Chest and Tuberculosis at Masina Hospital in Mumbai’s Byculla, elaborated, “It can be either due to excessive alcohol consumption or non-alcoholic fatty liver disease. It mainly occurs in overweight or obese people. Diabetic patients are at a more risk of having a fatty liver.”

“Fatty liver is the result of improper merabolism and excess calories, fat absorbed from meals that is carried to the liver and eventually stored as fat in the liver,” he continued. Because non-alcoholic fatty liver disease has no symptoms, it is referred to as a quiet illness. It’s generally discovered by chance during an ultrasonography or fibro scan.”

Dr Sulaiman Ladhani and Dr Gaurav Chaubal spilled the beans on the different stages of liver disease or fatty liver. They are:

Stage 1. Simple fatty liver – It occurs when the liver starts to build up fat. There is no inflammation or scaring in the liver at this point. There are no symptoms in the early stage. Thus many people are unaware that they have fatty liver. For many people, fatty liver does not progress with an unhealthy liver. With healthy diet and regular exercise, excess fat in the liver can be reduced. It is observed that approximately 10-20% of people with this simple fatty liver will go on to next stage.

Stage 2: Inflammation – Steato hepatitis occurs when the build up of fat in the liver cells is accompanied with some amount of inflammation. It affects around 5% of the population. If the amount of damage tissues increases the liver may eventually struggle to repair it fast enough. In this phase, the ongoing damage to liver cells from a number of agents and diseases cause the liver to get enlarged and the person experiences abdominal pain in the upper right. During this stage the condition may be treatable. However, in people with non-alcoholic fatty liver, there may be no prominent symptoms.

Stage 3: Fibrosis/Scarring – If the inflammation seen in stage 1 is left unchecked, the liver tissues slowly start scarring and the scarred tissue starts replacing the healthy liver tissue. The condition is called fibrosis. Here there is a persistence scar tissue in the liver and in the blood vessels around the liver. The liver can still function quite well at this stage and removing or treating the cause of the inflammation may prevent further progression or reverse some amount of damage. However if the scar tissue starts to replace a lot of normal tissue the function of the liver gradually starts getting affected. During this phase, proper medication and lifestyle changes can reverse the condition to a certain extent.

Stage 4: Cirrhosis of the Liver – At this stage, the scarring is complete and there is no possibility of the liver healing itself now. At this stage the liver stops functioning properly and the symptoms include jaundice where eyes and nails start looking yellow, dull ache in the lower part of the ribs or abdominal distension due to accumulation of fluid in the belly. The person starts losing appetite, weight loss occurs and other organs can get affected like kidneys brain and heart. Scar tissue in the cirrhosis is difficult to remove all though further progression can be halted if the positive agent is removed. Most of the people have early stage of the disease that is simple fatty liver or steato. Only a small number of it goes to next stages.

Stage 5: End-stage Liver Disease (ESLD) – Liver failure is of 2 types – acute liver failure happens quickly with span of 48-72 hours and is generally caused by reasons other than alcohol while chronic liver failure takes a long time to get there and is often caused by alcohol abuse, uncontrolled diabetes, hypertension or obesity. Other commoner reasons being viral hepatitis, autoimmune disease and some metabolic diseases. The cognitive or mental health also gets affected and the person feels confused or disoriented often. ESLD is generally fatal.

Stage 6: Liver Cancer – This results liver cancer which can happen any time in the liver and due to reasons other than liver disease (primary liver cancer). It can also develop during any of the above 4 stages and is not necessarily the last in the sequence. Just like ESLD, liver cancer is also fatal unless tumour is ablated, resected or liver transplant is done.

All you need to know about liver transplant:

Dr Gaurav Chaubal shared, “By and large liver transplant is required in three scenarios. First, when liver cirrhosis progress and symptoms are worsening despite medical treatment. Secondly, when other organs also start getting involved due to cirrhosis namely brain, kidneys and coagulation. Thirdly, when liver cancer develops on the background of liver cirrhosis.”

Dr Akash Shukla, Director, Hepatology at Sir HN Reliance Foundation Hospital revealed that following liver transplantation, there are 3 things which can affect the long term outcomes hence, need to be taken care of. He highlighted, “First, the medicines used to prevent rejection and ensure that the body accepts the liver these are called as immuno suppressant medicines, in the starting there are 3 medications and they gradually come down to just one medication a day beyond 1 year of the transplant but this one tablet has to be continued forever. There is no restriction to the lifespan of the new liver, if proper medication is taken. It can go on for a very long time.”

He added, “The second important precaution that a person has to take is the prevention of infection. The risk of infection is the highest in the first 3 months, and during this period one should avoid unnecessary contacts with people, has to live in a hygienic environment and has to eat well cooked or very clean food. However there is no need for complete isolation, and normal activities of the life can be continued, beyond 3 months the risk of infection goes down substantially and is usually not a problem unless there is a major exposure to a infecting causing microbes.”

The third point to be considered, as per Dr Akash Shukla, is taking care of other organs of the body. He stressed, “While the liver is doing very well, in the long run we need to take care of the other organs of the body and the important metabolic fictions like control of diabetes, blood pressure and ischemic heart disease by lifestyle modification into a healthy lifestyle and nutritious diet. Also, we have to be extremely vigilant about the development of cancers in people who have received organ transplant and for this a regular visit with the doctor and screening for the cancers, especially the head and neck cancers and skin cancers, is extremely important for the longevity of the people after transplants.”

Liver disease prevention tips:

According to Dr Sulaiman Ladhani, all the stages of the liver are associated with increased risk of developing cardiovascular disease such as heart attack and stroke before the liver failure occurs. Therefore maintaining a healthy diet and limiting sugar intake, quitting smoking and intake of alcohol along with exercise will help in the long run.

He advised, “Vitamin E is helpful in preventing further progression. It is very important to have more clarity on that. Diet modification and reduced calories, avoiding fast food, soft drinks and heavy meals must be done. Having healthy meals and increasing physical movement of the body, as advised by the doctor, is imperative. Regular liver check ups and appropriate medications are must. The progression of the disease is slow hence, the lifestyle is managed with proper diet as it can help to prevent the disease to progress further.”

“Making small changes in your lifestyle and eating pattern, such as – starting your day right by eating a healthy breakfast, reducing salt and fat intake, avoiding too much processed or junk foods, detoxifying your system by taking a lot of fluids, indulging in healthy snacking, including plenty of fruits and vegetables in your diet, avoiding excessive alcohol consumption, and daily exercise are some of the ways to prevent livable obesity,” Dr Gaurav Chaubal said.

February 28, 2022 0 comment

Gastroenterology News

Abdominal Lump

by Pragati Singh November 6, 2021

written by Pragati Singh

What exactly is an abdominal lump?

An abdominal lump is a swelling or bulge that appears in any part of the abdomen. It is usually soft, but it can be firm depending on the underlying cause.

A hernia is the most common cause of a lump. An abdominal hernia occurs when the structures of the abdominal cavity push through a weakness in the abdominal wall muscles. Typically, surgery can easily correct this.

In rarer cases, the lump may be an undescended testicle, a harmless hematoma, or a lipoma. In even rarer circumstances, it may be a cancerous tumor.

If you also have a fever, vomiting, or pain around an abdominal lump, you may need emergency care.

Possible causes of an abdominal lump

A hernia causes the majority of lumps in the abdomen. Hernias often appear after you have strained your abdominal muscles by lifting something heavy, coughing for a long period, or being constipated.

There are several types of hernias. Three kinds of hernias can produce a noticeable lump.

Inguinal hernia

An inguinal hernia occurs when there is a weakness in the abdominal wall and a part of the intestine or other soft tissue protrudes through it. You’ll most likely see or feel a lump in your lower abdomen near your groin and feel pain when coughing, bending, or lifting.

In some cases, there are no symptoms until the condition gets worse. A hernia isn’t typically harmful by itself. However, it needs to be repaired surgically because it can cause complications, such as a loss of blood flow to the intestine and/or obstruction of the intestine.

Umbilical hernia

An umbilical hernia is very similar to an inguinal hernia. However, an umbilical hernia occurs around the navel. This type of hernia is most common in babies and often disappears as their abdominal wall heals on its own.

The classic sign of an umbilical hernia in a baby is outward bulging of tissue by the belly button when they cry.

Surgery is required to fix an umbilical hernia if it doesn’t heal on its own by the time a child is four years old. The possible complications are similar to those of an inguinal hernia.

Incisional hernia

An incisional hernia happens when a prior surgical incision that has weakened the abdominal wall, allows intra-abdominal content to push through. It requires corrective surgery to avoid complications.

Less common causes of an abdominal lump

If a hernia isn’t the cause of an abdominal lump, there are several other possibilities.

Hematoma

A hematoma is a collection of blood under the skin that results from broken blood vessels. Hematomas are typically caused by an injury. If a hematoma occurs by your abdomen, a bulge and discolored skin may appear. Hematomas typically resolve without needing treatment.

Lipoma

A lipoma is a lump of fat that collects under the skin. It feels like a semi-firm, rubbery bulge that moves slightly when pushed. Lipomas typically grow very slowly, can occur anywhere on the body, and are almost always benign.

They can be removed surgically, but in most cases, surgery isn’t necessary.

Undescended testicle

During male fetal development, the testicles form in the abdomen and then descend into the scrotum. In some cases, one or both of them may not fully descend. This may cause a small lump near the groin in newborn boys and can be corrected with hormone therapy and/or surgery to bring the testicle into position.

Tumor

Although rare, a benign (noncancerous) or malignant (cancerous) tumor on an organ in the abdomen or in the skin or muscles can cause a noticeable lump. Whether it requires surgery or another type of treatment depends on the type of tumor and its location.

How is it diagnosed?

If you have a hernia, your doctor will likely be able to diagnose it during the physical exam. Your doctor may want you to undergo an imaging study, such as an ultrasound or CT scan of your abdomen. Once your doctor confirms an abdominal hernia is present, you can then discuss arrangements for a surgical correction.

If your doctor doesn’t believe the lump is a hernia, they may require further testing. For a small or asymptomatic hematoma or lipoma, you probably won’t need further tests.

If a tumor is suspected, you may need imaging tests to determine its location and extent. You’ll likely also need a biopsy, which involves tissue removal, to determine if the tumor is benign or malignant.

When to seek medical help

If you feel or see a lump in your abdomen that you can’t identify, make an appointment to see your doctor. If you also have a fever, vomiting, discoloration, or severe pain around the lump, you may need emergency care.

At your doctor’s appointment, you can expect to receive a physical examination of your abdomen. Your doctor may ask you to cough or strain in some way while they’re examining your abdomen.

Other questions they may ask include:

When did you notice the lump?

Has the lump changed in size or location?

What makes it change, if at all?

Do you have any other symptoms?

November 6, 2021 0 comment

Uncategorized Gastroenterology News

UTI: all you need to know

by Pragati Singh November 5, 2021

written by Pragati Singh

A urinary tract infection (UTI) affects any component of your urinary system, including the kidneys, ureters, bladder, and urethra. The bladder and urethra are the most often infected parts of the urinary system.

Women are more likely than males to have a urinary tract infection. A bladder infection may be both painful and inconvenient. If a UTI spreads to your kidneys, though, it might have significant implications.

Doctors typically treat urinary tract infections with antibiotics. But you can take steps to reduce your chances of getting a UTI in the first place.

Symptoms

Urinary tract infections don’t always cause signs and symptoms, but when they do they may include:

A strong, persistent urge to urinate
A burning sensation when urinating
Passing frequent, small amounts of urine
Urine that appears cloudy
Urine that appears red, bright pink or cola-colored — a sign of blood in the urine
Strong-smelling urine
Pelvic pain, in women — especially in the center of the pelvis and around the area of the pubic bone

UTIs may be overlooked or mistaken for other conditions in older adults.

Types of urinary tract infection

Each type of UTI may result in more-specific signs and symptoms, depending on which part of your urinary tract is infected.

Part of urinary tract affected	Signs and symptoms
Kidneys (acute pyelonephritis)	Back pain or side (flank) pain High fever Shaking and chills Nausea Vomiting
Bladder (cystitis)	Pelvic pressure Lower abdomen discomfort Frequent, painful urination Blood in urine
Urethra (urethritis)	Burning with urination Discharge

When to see a doctor

Contact your doctor if you have signs and symptoms of a UTI.

Causes

Urinary tract infections typically occur when bacteria enter the urinary tract through the urethra and begin to multiply in the bladder. Although the urinary system is designed to keep out such microscopic invaders, these defenses sometimes fail. When that happens, bacteria may take hold and grow into a full-blown infection in the urinary tract.

The most common UTIs occur mainly in women and affect the bladder and urethra.

Infection of the bladder (cystitis). This type of UTI is usually caused by Escherichia coli (E. coli), a type of bacteria commonly found in the gastrointestinal (GI) tract. However, sometimes other bacteria are responsible.
Sexual intercourse may lead to cystitis, but you don’t have to be sexually active to develop it. All women are at risk of cystitis because of their anatomy — specifically, the short distance from the urethra to the anus and the urethral opening to the bladder.
Infection of the urethra (urethritis). This type of UTI can occur when GI bacteria spread from the anus to the urethra. Also, because the female urethra is close to the vagina, sexually transmitted infections, such as herpes, gonorrhea, chlamydia and mycoplasma, can cause urethritis.

Risk factors

Urinary tract infections are common in women, and many women experience more than one infection during their lifetimes. Risk factors specific to women for UTIs include:

Female anatomy. A woman has a shorter urethra than a man does, which shortens the distance that bacteria must travel to reach the bladder.
Sexual activity. Sexually active women tend to have more UTIs than do women who aren’t sexually active. Having a new sexual partner also increases your risk.
Certain types of birth control. Women who use diaphragms for birth control may be at higher risk, as well as women who use spermicidal agents.
Menopause. After menopause, a decline in circulating estrogen causes changes in the urinary tract that make you more vulnerable to infection.

Other risk factors for UTIs include:

Urinary tract abnormalities. Babies born with urinary tract abnormalities that don’t allow urine to leave the body normally or cause urine to back up in the urethra have an increased risk of UTIs.
Blockages in the urinary tract. Kidney stones or an enlarged prostate can trap urine in the bladder and increase the risk of UTIs.
A suppressed immune system. Diabetes and other diseases that impair the immune system — the body’s defense against germs — can increase the risk of UTIs.
Catheter use. People who can’t urinate on their own and use a tube (catheter) to urinate have an increased risk of UTIs. This may include people who are hospitalized, people with neurological problems that make it difficult to control their ability to urinate and people who are paralyzed.
A recent urinary procedure. Urinary surgery or an exam of your urinary tract that involves medical instruments can both increase your risk of developing a urinary tract infection.

Complications

When treated promptly and properly, lower urinary tract infections rarely lead to complications. But left untreated, a urinary tract infection can have serious consequences.

Complications of a UTI may include:

Recurrent infections, especially in women who experience two or more UTIs in a six-month period or four or more within a year.
Permanent kidney damage from an acute or chronic kidney infection (pyelonephritis) due to an untreated UTI.
Increased risk in pregnant women of delivering low birth weight or premature infants.
Urethral narrowing (stricture) in men from recurrent urethritis, previously seen with gonococcal urethritis.
Sepsis, a potentially life-threatening complication of an infection, especially if the infection works its way up your urinary tract to your kidneys.

Prevention

You can take these steps to reduce your risk of urinary tract infections:

Drink plenty of liquids, especially water. Drinking water helps dilute your urine and ensures that you’ll urinate more frequently — allowing bacteria to be flushed from your urinary tract before an infection can begin.
Drink cranberry juice. Although studies are not conclusive that cranberry juice prevents UTIs, it is likely not harmful.
Wipe from front to back. Doing so after urinating and after a bowel movement helps prevent bacteria in the anal region from spreading to the vagina and urethra.
Empty your bladder soon after intercourse. Also, drink a full glass of water to help flush bacteria.
Avoid potentially irritating feminine products. Using deodorant sprays or other feminine products, such as douches and powders, in the genital area can irritate the urethra.
Change your birth control method. Diaphragms, or unlubricated or spermicide-treated condoms, can all contribute to bacterial growth.

November 5, 2021 0 comment

Gastroenterology News

Study examines age-related changes to the small bowel

by Vaishali Sharma October 4, 2021

written by Vaishali Sharma

Researchers at Cedars-Sinai have found that aging produces significant changes in the microbiome of the human small intestine distinct from those caused by medications or illness burden. The findings have been published in the journal Cell Reports.

“By teasing out the microbial changes that occur in the small bowel with age, medication use and diseases, we hope to identify unique components of the microbial community to target for therapeutics and interventions that could promote healthy aging,” said Ruchi Mathur, MD, the study’s principal investigator.

Research exploring the gut microbiome, and its impact on health, has relied predominantly on fecal samples, which do not represent the entire gut, according to Mathur. In their study, investigators from Cedars-Sinai’s Medically Associated Science and Technology (MAST) Program analyzed samples from the small intestine-which is over 20 feet in length and has the surface area of a tennis court-for examination of the microbiome and its relationship with aging.

“This study is the first of its kind to examine the microbial composition of the small intestine of subjects 18 years of age to 80. We now know that certain microbial populations are influenced more by medications, while others are more affected by certain diseases. We have identified specific microbes that appear to be only influenced by the chronological age of the person,” said Mathur, an endocrinologist and director of the Diabetes Outpatient Treatment & Education Center.

The 21^st century has been referred to as the “era of the gut microbiome” as scientists turn considerable attention to the role trillions of gut bacteria, fungi and viruses may play in human health and disease. The microbiome is the name given to the genes that live in these cells. Studies have suggested that disturbances in the constellations of the microbial universe may lead to critical illnesses, including gastroenterological diseases, diabetes, obesity, and some neurological disorders.

While researchers know that microbial diversity in stool decreases with age, Cedars-Sinai investigators identified bacteria in the small bowel they refer to as “disruptors” that increase and could be troublesome.

“Coliforms are normal residents of the intestine. We found that when these rod-shaped microbes become too abundant in the small bowel-as they do as we get older-they exert a negative influence on the rest of the microbial population. They are like weeds in a garden,” said study co-author Gabriela Leite, PhD.

Investigators also found that as people age, the bacteria in the small intestine change from microbes that prefer oxygen to those that can survive with less oxygen, something they hope to understand as the research continues.

“Our goal is to identify and fingerprint the small intestinal microbial patterns of human health and disease. Given the important role the small bowel plays in absorption of nutrients, changes in the microbiome in this location of the gut may have a greater impact on human health, and warrants further study,” said Mark Pimentel, MD, director of the MAST program and a co-author of the study.

This research is part of Cedars-Sinai’s ongoing REIMAGINE study: Revealing the Entire Intestinal Microbiota and its Associations with the Genetic, Immunologic, and Neuroendocrine Ecosystem.

Source:Cedars-Sinai Medical Center

October 4, 2021 0 comment

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