Early Indicators

• If you are aged over 18 years
• If you have a BMI greater than 37.5 or greater than 32.5 with co-morbidities like hypertension, diabetes, etc. or if you weigh more than 30 Kg above your average weight.
• If you have tried all other methods of losing weight like diets, exercise, medication and failed
• If you are fit enough to undergo an anaesthetic procedure and surgery

If the above reasons are true in your case, then you are a Bariatric Surgery Candidate.

Childhood obesity is a medical condition that negatively affects the health and well being of children and adolescents. It occurs when a child is well above the normal weight for his or her age and height.

What are the various health risks involved?

Obese children are more likely to have:

• High blood pressure and high cholesterol, which are risk factors for heart diseases
• Increased risk of insulin resistance and type 2 diabetes
• Breathing difficulties, such as sleep apnea, and asthma
• Joint problems and musculoskeletal discomfort
• Fatty liver disease, gallstones, and gastro-esophageal reflux (i.e., heartburn)

Emotional risks may involve:

• Low self esteem and bullying
• Behavior and learning problems: Obesity in children leads to anxiety and poor social skills. It may cause overweight children to socially withdraw and may even affect their learning.
• Depression: Low esteem can cause feeling of hopelessness to creep in and children might go into depression and become emotionally flat.

How can it be prevented?

Proactive measures should be taken at an early stage to prevent your child from hitting the obesity track.

• Knowing the Body Mass Index (BMI) of your child and monitoring it periodically could be the first step to prevention of obesity
• Promote healthy eating habits by encouraging low calorie foods, vegetables and fruits, low-fat dairy foods, and whole grains. Your entire family should participate in healthy eating habits. After all, children do what they see and learn
• Encourage physical activity in the form of fun activities and outdoor games rather than indoor games

What are piles?

Piles or hemorrhoids are swollen blood vessels in the anal passage. There are two circular bunches of veins, one inside the anal canal and the second at the anal verge. Accordingly they are called internal and external hemorrhoids

Why do piles develop?

There are certain conditions which predispose to formation of piles. These are

• Excessive straining while passing stools e.g. chronic constipation, low fibre diet, poor bowel habits
• Increased backward pressure on pelvic blood vessels e.g. Pregnancy, pelvic tumors

Diagnosis is usually done by direct examination and proctoscopy. A colonoscopy may sometimes be advised if a mass lesion or other pathology is suspected in the colon.

At Max Healthcare, we follow the minimally invasive technique for treatment.

Advantages of Minimally Invasive procedures for Piles

• Minimal post operative pain
• Much faster recovery
• Shorter hospital stay
• Less post operative discomfort
• No dressings
• Early resumption of normal activities

What is an anal fissure?

An anal fissure is a small tear or cut in the skin at the anal opening. Fissures typically cause pain and often bleed. Fissures are quite common, but are often confused with other causes of pain and bleeding, such as hemorrhoids. Most fissures occur along the mid-line - the top or bottom - of the anus.

What are the symptoms of an anal fissure?

The typical symptoms of an anal fissure are pain during or after defecation and fresh bleeding. The pain may be severe enough to cause the patients to avoid defecation.

What causes an anal fissure?

• Injury: Most commonly due to a hard, dry bowel movement. Many women during childbirth develop an anal fissure
• Digital insertion (during examination)
• Foreign body insertion
• Anal intercourse

A fissure may also develop following diarrhea or inflammatory conditions of the anal area.

How can a fissure be treated?

The principle of treating an anal fissure is relieving the anal spasm and correcting the constipation. At least 50 percent of anal fissures heal by medical management alone.

• Drinking more fluids.
• Eating a high-fiber diet to avoid constipation.
• Using stool softeners.
• Allowing enough time for a bowel movement
• Sitz baths (soaking anal area in plain warm water)
• Avoid foods that may not be well-digested (i.e., nuts, popcorn, tortilla chips)
• Topical ointments

Medical treatment of an acute anal fissure may take a few days or weeks, while healing of a chronic anal fissure may take more than 6 weeks.

In case a fissure does not heal should be reexamined to determine if an underlying problem exist that prevents healing.

What is rectal prolapse?

A condition where in the rectum (distal most part of large intestine just above the anal canal) protrudes out of the anal opening due to stretching or disruption of its attachments to the posterior abdominal wall.

Causes of rectal prolapse?

The primary cause of rectal prolapse remains unclear. Predisposing factors include:

• Prolonged straining while passing stools (chronic constipation)
• Multiple pregnancies
• Neurological illnesses causing muscular weakness or connective tissue disorders (genetic predisposition)

It is often seen in the elderly as aging causes the supporting ligaments to stretch the anal sphincter muscle to weaken.Diagnosis of rectal prolapse is made on history and physical examination. In case of an internal rectal prolapse sometimes a defecography is required.

How is Rectal Prolapse Treated?

Rectal prolapse occurring in children, during pregnancy and following childbirth are known to correct spontaneously and most often do not require any intervention. In most cases however surgery is required to correct rectal prolapse in adults and in some children. There are 2 procedures described for repair of rectal prolapse- Perineal Approach and Abdominal Approach.

Both procedures can be performed by Laparoscopic approach.