Sanitation in India has not kept up with the rest of our advances in the 21st century. We lack hygienic toilet facilities and 40 per cent of our population is forced to use open areas. This propagates a self-perpetuating cycle of diarrhoeal infections.
Most of the time, the diarrhoea settles in a day or two, with or without treatment. Sometimes, blood and mucous appear in the stool. This means that the diarrhoea has progressed to dysentery.
Often patients equate dysentery with amoebic infestation and the words ‘diarrhoea’ and ‘amoebic dysentery’ are interchanged. Most of the time they are right and the dysentery is due to the single celled amoebaEntamoeba histolytica. Around four per cent of the Indian population has antibodies to amoebae.
Amoebae have been around a lot longer than humans. They have perfected the art of survival. If exposed to extremes of temperature and medication, they can round themselves off into thick walled hibernating resistant cysts.
Once the cyst is swallowed, amoebic dysentery sets in with an explosive onset of loose bloody stools, cramping abdominal pain and low grade fever. Many people recognise these symptoms, complain of “amoebic dysentery” and self medicate. They use single inadequate suppressant doses of medication. They may eventually become chronic carriers. In some, the amoebae burrow into the intestinal wall, causing perforations, and produce life threatening abscesses in the liver and the brain.
Treatment for amoebic infection is the “azoles” — metronidazole or secnidazole — followed by a second drug like diloxanide furoate. The duration of the treatment is around two weeks.
All dysentery is not caused by amoebae. Infections by other organisms can also produce blood and mucous in the stool. Some bacteria and viruses cause dysentery.
Symptoms of dysentery may occur without any infection at all. In people with diabetes, hypertension or abnormal disordered elevated lipids, the blood vessels supplying the intestine may be partially blocked. The intestine may get damaged in those areas, causing bloody and painful diarrhoea. The person may be diagnosed to have “repeated attacks of dysentery” and given inappropriate antibiotic treatment.
In older people the colon (or the large intestine) can get weakened in certain areas, causing finger-shaped small pouches called diverticula. Food can become trapped and remain in these areas. Inflammation and infection will produce symptoms similar to amoebiasis.
Cells can grow and bulge into the intestine, forming grape-like protrusions called polyps. These can cause recurrent attacks of bleeding from the rectum with or without diarrhoea. Cancers of the intestines can cause intermittent diarrhoea and dysentery.
A number of illnesses, loosely classified as inflammatory bowel diseases (IBD), are characterised by inflammation of various parts of the intestine. One of the common forms is ulcerative colitis that affects the large intestine. It causes intermit attacks of loose stool, with blood and mucous, accompanied by abdominal pain. Although there may be weight loss, many patients remain well between the attacks, giving an initial false impression of repeated attacks of amoebic dysentery. The exact cause of IBD isn’t known. Genes, heredity, environmental factors, stress and autoimmune diseases (where the body attacks its own cells) are all put forward as possible factors.
Milk allergy can cause diarrhoea. If the person is unaware of the condition and overloads the system, severe diarrhoea can result.
Sometimes the cause of the dysentery is obvious. It may follow treatment for cancer with radiation or medication. It can occur after prolonged courses of antibiotics. It may also be due to cancer of the intestines.
A single attack of dysentery may be “amoebiasis”, which can be cured by a complete course of medication. If the symptoms of the dysentery are recurrent, a correct diagnosis is essential. More so if a person over 30 years presents a sudden change in bowel habits or has alternating constipation and diarrhoea. The other danger signals for cancer are blood and mucous in the stool, poor appetite and weight loss.
Diarrhoea needs to be investigated if it lasts longer than two weeks, is recurrent, with blood and mucous in the stool, and there is weight loss.
To prevent infective diarrhoea • Do not drink water that has not been boiled or purified
• Remember ice cubes in juice may be made from contaminated water
• Do not eat cut raw fruits or vegetables
• Eat food which is piping hot
• Always wash your hands before eating
Definition Colon polyps are fleshy growths that occur on the inside (the lining) of the large intestine, also known as the colon. Polyps in the colon are extremely common, and their incidence increases as individuals get older. As many as 30 percent of middle-aged and older adults have one or more colon polyps — a small clump of cells that forms on the colon lining. Although the great majority of colon polyps are harmless, some may become cancerous over time. Anyone can develop colon polyps, but you’re at higher risk if you are 50 or older, are overweight or a smoker, eat a high-fat, low-fiber diet, or have a personal or family history of colon polyps or colon cancer.
Sometimes colon polyps can cause signs and symptoms such as rectal bleeding, a change in bowel habits and abdominal pain. But most small colon polyps don’t cause problems, which is why experts generally recommend regular screening. Colon polyps that are found in the early stages usually can be removed safely and completely.
Types of polyps become cancerous:
The polyps that become cancerous are called adenomatous polyps or adenomas. Adenomas account for approximately 75% of all colon polyps. There are several subtypes of adenoma that differ primarily in the way the cells of the polyp are assembled when they are examined under the microscope. Thus, there are tubular, villous, or tubulo-villous adenomas. Villous adenomas are the most likely to become cancerous, and tubular adenomas are the least likely.
Other Factors that may determine a polyp’s chance of becoming cancerous
Another factor that contributes to a polyp’s likelihood of becoming cancerous is its size. The larger a polyp grows, the more likely it is to become cancerous. Once a polyp reaches two centimeters or approximately one inch in size, the risk of cancer is in excess of 20 percent. Therefore, it is advisable to remove polyps of any size, preferably when they are of a small size, to prevent their growth and progression to cancer.
Although adenomas are by far the most common type of colon polyps, there are several other types of polyps. Among the other types of polyps that have no malignant potential are the hyperplastic, inflammatory, and hamartomatous polyps
Symptoms
Colon polyps range from smaller than a pea to golf ball sized. Small polyps, especially, aren’t likely to cause problems, and you may not know you have one until your doctor finds it during an examination of your bowel. Sometimes, however, you may have signs and symptoms such as:
Rectal bleeding. You might notice bright red blood on toilet paper after you’ve had a bowel movement. Although this may be a sign of colon polyps or colon cancer, rectal bleeding can indicate other conditions, such as hemorrhoids or minor tears (fissures) in your anus. Hemorrhoids don’t usually bleed consistently over a period of weeks, however, so if your bleeding is prolonged, be sure to tell your doctor.
Blood in your stool. Blood can show up as red streaks in your stool or make bowel movements appear black. Still, a change in color doesn’t always indicate a problem — iron supplements and some anti-diarrhea medications can make stools black, whereas beets and red licorice can turn stools red.
Constipation or diarrhea. Although a change in bowel habits that lasts longer than a week may indicate the presence of a large colon polyp, it can also result from a number of other conditions.
Pain or obstruction. Sometimes a large colon polyp may partially obstruct your bowel, leading to crampy abdominal pain, nausea, vomiting and severe constipation.
Causes:
Your digestive tract stretches from your mouth to your anus. As food travels along this 30-foot passageway, nutrients are broken down and absorbed by your body to build cells and produce energy.
The last part of your digestive tract is a long muscular tube called the large intestine. The colon is the upper 4 to 6 feet of the large intestine; the rectum makes up the lower 8 to 10 inches. The colon’s main function is to absorb water, salt and other minerals from colon contents. Your rectum stores waste until it’s eliminated from your body.
Why polyps form
The majority of polyps aren’t cancerous (malignant), yet like most cancers, they result from abnormal cell growth. Healthy cells grow and divide in an orderly way — a process that’s controlled by two broad groups of genes. Mutations in any of these genes can cause cells to continue dividing even when new cells aren’t needed. In the colon and rectum, this unregulated growth can cause polyps to form, and over a long period of time, some of these polyps may become malignant.
Polyps can develop anywhere in your large intestine. They can be small or large and flat (sessile) or mushroom shaped and attached to a stalk (pedunculated). Small and mushroom-shaped polyps are much less likely to become malignant than flat or large ones are. In general, the larger a polyp, the greater the likelihood of cancer.
There are three main types of colon polyps:
Adenomatous. Once adenomatous polyps grow beyond the size of a pencil eraser — about 5 millimeters (mm), or 1/4 inch — there’s a small but increasing chance that they’ll become cancerous. This is especially true when their diameter exceeds 10 mm. For that reason, doctors normally take a tissue sample (biopsy) from polyps during a sigmoidoscopy and either biopsy or remove large polyps during a colonoscopy. Hyperplastic. These polyps occur most often in your left (descending) colon and rectum. Usually less than 5 mm in size, they’re rarely malignant. Inflammatory. These polyps may follow a bout of ulcerative colitis or Crohn’s disease of the colon. Although the polyps themselves are not a significant threat, having ulcerative colitis or Crohn’s disease of the colon increases your overall risk of colon cancer.
Anyone can get polyps, but certain people are more likely than others. You may have a greater chance of getting polyps if you
*Are over age 50
*Have had polyps before
*Have a family member with polyps
*Have a family history of colon cancer
*Most colon polyps do not cause symptoms. If you have symptoms, they may include blood on your underwear or on toilet paper after a bowel movement, blood in your stool, or constipation or diarrhea lasting more than a week.
A number of factors may contribute to the formation of colon polyps and colon cancer. They include:
*Age. The great majority of people with colon cancer are 50 or older. Your risk generally starts increasing around age 40.
*Your sex. More men than women develop colon polyps and colon cancer.
Inflammatory intestinal conditions. Long-standing inflammatory diseases of the colon such as ulcerative colitis and Crohn’s disease can increase your risk.
In an autosomal dominant disorder, the mutated gene is dominant, which means you only need one mutated gene to have the disorder. A person with an autosomal dominant disorder — in this case, the father — has a 50 percent chance of having an affected child with one mutated gene (dominant gene) and a 50 percent chance of having an unaffected child with two normal genes (recessive genes). These chances are the same in each pregnancy. .
*Family history. You’re more likely to develop colon polyps or cancer if you have a parent, sibling or child with them. If many family members have them, your risk is even greater. In some cases this connection isn’t hereditary or genetic. For example, cancers within the same family may result from shared exposure to an environmental carcinogen or from similar diet or lifestyle factors.
*Diet. Eating a high-fiber diet — one plentiful in fruits, vegetables and whole grains — can reduce your risk of colon polyps and colon cancer. Fiber seems protective against colon cancer because it provides bulk that moves your stool more quickly through your bowel. This means that cancer-causing substances (carcinogens) in the foods you eat aren’t in contact with your bowel wall as long as they might be if you ate a low-fiber diet. Fruits and vegetables are also rich in antioxidants — substances that protect cells from damage caused by unstable molecules (free radicals) that may lead to cancer.
*Smoking and alcohol. Smoking significantly increases your risk of colon polyps and colon cancer. Smokers are 30 percent to 40 percent more likely to die of colon cancer than are nonsmokers. Drinking alcohol in excess also makes it more likely that you’ll develop colon polyps. If you smoke and drink, your risk increases even more.
*A sedentary lifestyle. If you’re inactive, you’re more likely to develop colon cancer. This may be because when you’re inactive, waste stays in your colon longer.
*Obesity. Being significantly overweight — 30 pounds or more — has been linked to an increased risk of several types of cancer, including colon cancer.
*Race. If you are black, you are at higher risk of developing colon cancer than if you are white.
Inherited gene mutations
Another risk factor for colon polyps is genetic mutations. A small percentage of colon cancers result from gene mutations. These cancers are autosomal dominant, meaning you need to inherit only one defective gene from either of your parents. If one parent has the mutated gene, you have a 50 percent chance of inheriting the mutation. Although inheriting a defective gene greatly increases your risk, not everyone with a mutated gene develops cancer.
One genetic defect that plays a key role in colon cancer occurs in the adenomatous polyposis coli (APC) gene. When the APC gene is normal, it helps control cell growth. But if it’s defective, cell growth accelerates, leading to the formation of multiple adenomatous polyps in your intestinal lining. Conditions related to APC gene defects include:
*Familial adenomatous polyposis (FAP). This is a rare, hereditary disorder that results from an APC gene defect. FAP causes you to develop hundreds, even thousands, of polyps in the lining of your colon beginning in your teenage years. If these go untreated, your risk of developing colon cancer is nearly 100 percent. The encouraging news about FAP is that in some cases, genetic testing can help determine whether you’re at risk of the disease.
*Gardner’s syndrome. This syndrome is a variant of FAP. This condition causes polyps to develop throughout your colon and small intestine. You may also develop noncancerous tumors in other parts of your body, including your skin (sebaceous cysts and lipomas), bone (osteomas) and abdomen (desmoids).
*Hereditary nonpolyposis colorectal cancer (HNPCC). This is the most common form of inherited colon cancer. It, too, results from a defect in the APC gene, but unlike people with FAP or Gardner’s syndrome, people with hereditary nonpolyposis colorectal cancer tend to develop relatively few colon polyps. They do, however, often have tumors in other organs. Hereditary nonpolyposis colorectal cancer includes Lynch I and Lynch II syndromes. People with Lynch I syndrome usually develop a small number of polyps that quickly become malignant. Those with Lynch II syndrome tend to develop tumors in the breast, stomach, small intestine, urinary tract and ovaries as well as in the colon.
Tests and diagnosis:
Nearly all colon cancers develop from polyps, but the polyps grow slowly, usually over a period of years. Screening tests play a key role in detecting polyps before they become cancerous. These tests can also help find colorectal cancer in its early stages, when you have a good chance of recovery. When early-stage cancers are found and removed during routine screening, the five-year survival rate may be as high as 90 percent.
Several screening methods exist — each with its own benefits and risks. Be sure to discuss these with your doctor:
*Digital rectal exam. In this office exam, your doctor uses a gloved finger to check the first few inches of your rectum for polyps. Although safe and relatively painless, the exam is limited to your lower rectum and can’t detect problems with your upper rectum and colon. In addition, it’s difficult for your doctor to feel small polyps. This test should not be used alone as a screening method.
*Fecal occult (hidden) blood test. This noninvasive test checks a sample of your stool for blood. It can be performed in your doctor’s office, but you’re usually given a kit that explains how to take the test at home. Be sure to follow the instructions carefully, because your diet and other factors can affect the results. You then return the test to a lab or your doctor’s office to be checked. The problem is that most polyps don’t bleed, nor do all cancers. This can result in a negative test result, even though you may have a polyp or cancer. On the other hand, if blood shows up in your stool, it may be the result of hemorrhoids or an intestinal condition other than cancer. For these reasons, many doctors recommend other screening methods instead of, or in addition to, fecal occult blood tests.
*Flexible sigmoidoscopy. In this test, your doctor uses a slender, lighted tube to examine your rectum and sigmoid — approximately the last 2 feet of your colon. Nearly half of all colon cancers are found in this area. Yet a sigmoidoscopy only looks at the last third of your colon, and doesn’t detect polyps elsewhere in the large intestine. It’s often combined with a barium enema to better visualize the entire colon, or your doctor may recommend performing a colonoscopy instead. A sigmoidoscopy can be somewhat uncomfortable, and though there’s a slight risk of perforating the colon, the risks are less than they are for colonoscopy.
*Barium enema. This diagnostic test allows your doctor to evaluate your entire large intestine with an X-ray. Barium, a contrast dye, is placed into your bowel in an enema form. The barium fills and coats the lining of the bowel, creating a clear silhouette of your rectum, colon and sometimes a small portion of your small intestine. Air may also be added to provide better contrast on the X-ray. The test typically takes about 20 minutes and can be somewhat uncomfortable because the barium and air distend your bowel. There’s also a slight risk of perforating the colon wall. Because barium enema has a higher miss rate for colon polyps, it’s not nearly as reliable as other screening tests. It also doesn’t allow your doctor to take a biopsy during the procedure to determine whether a polyp is cancerous.
*Colonoscopy. This procedure is the most sensitive test for colorectal polyps and colorectal cancer. It’s better at detecting polyps than is a barium enema X-ray alone. Colonoscopy is similar to flexible sigmoidoscopy, but the instrument used — a colonoscope, which is a long, slender tube attached to a video camera and monitor — allows your doctor to view your entire colon and rectum. If any polyps are found during the exam, your doctor may remove them immediately or take tissue samples (biopsies) for analysis. A colonoscopy takes about a half-hour. You’re likely to receive a mild sedative to make you more comfortable. The risks of diagnostic colonoscopy include hemorrhage and perforation of the colon wall. Complications are more likely to occur when polyps are removed.
*Genetic testing. If you have a family history of colorectal cancer, you may be a candidate for genetic testing. This blood test may help determine if you’re at increased risk of colon or rectal cancer, but it’s not without drawbacks. The results can be ambiguous, and the presence of a defective gene doesn’t necessarily mean you’ll develop cancer. Knowing you have a genetic predisposition can alert you to the need for regular screening.
*Pill camera. Colonoscopy is effective at detecting polyps in the colon, but the colonoscope can’t reach the small intestine. Until recently, a barium X-ray was the only way to screen the small intestine, but the test is often inaccurate. Now doctors have found that a tiny camera fitted inside a capsule that you swallow can identify polyps in the small intestine with a high degree of accuracy. But because small intestine polyps are rare, the test isn’t routinely performed.
*New technologies. New technologies such as virtual colonoscopy (CT colonography) may make colon screening safer, more comfortable and less invasive. In virtual colonoscopy, you have a two-minute computerized tomography scan, a highly sensitive X-ray of your colon. Then, using computer imaging, your doctor rotates this X-ray in order to view every part of your colon and rectum without actually going inside your body. Before the scan, your large intestine is cleared of any stool, but researchers are looking into whether the scan can be done successfully without the usual bowel preparation. Although virtual colonoscopy potentially is a tremendous step forward, it may not be as accurate as regular colonoscopy, it is highly dependent on the skill of the doctor reading the test, and it doesn’t allow your doctor to remove polyps or take tissue samples during the procedure.
Another new test checks a stool sample for DNA from abnormal cells. In preliminary studies, the test proved highly accurate, but results in the first large trial of the test were disappointing. In that trial, the DNA test found more colon and rectal cancers than did the fecal occult blood test, but fewer than did colonoscopy.
Treatments and drugs:
Although some types of colon polyps are far more likely to become malignant than are others, a pathologist usually must examine a polyp under a microscope to determine whether it’s potentially cancerous. For that reason, your doctor is likely to remove all polyps discovered during a bowel examination.
The great majority of polyps can be removed during colonoscopy or sigmoidoscopy by snaring them with a wire loop that simultaneously cuts the stalk of the polyp and cauterizes it to prevent bleeding. Some small polyps may be cauterized or burned with an electrical current. Risks of polyp removal (polypectomy) include bleeding and perforation of the colon.
Polyps that are too large to snare or that can’t be reached safely are usually surgically removed — often using laparoscopic techniques. This means your surgeon performs the operation through several small incisions in your abdominal wall, using instruments with attached cameras that display your colon on a video monitor. Laparoscopic surgery may result in a faster and less painful recovery than does traditional surgery using a single large incision. Once the section of your colon that contains the polyp is removed, the polyp can’t recur, but you have a moderate chance of developing new polyps in other areas of your colon in the future. For that reason, follow-up care is extremely important.
In cases of rare, inherited syndromes, such as FAP, your surgeon may perform an operation to remove your entire colon and rectum (total proctocolectomy). Then, in a procedure known as ileal pouch-anal anastomosis, a pouch is constructed from the end of your small intestine (ileum) that attaches directly to your anus. This allows you to expel waste normally, although you may have several watery bowel movements a day.
Prevention:
You can greatly reduce your risk of colon polyps and colorectal cancer by having regular screenings and by making certain changes in your diet and lifestyle. The following suggestions may help lower your risk of colon polyps and colon cancer:
*Pay attention to calcium. Calcium can significantly protect against colon polyps and cancers, even if you’ve had them before. For example, studies have shown a 19 percent to 34 percent reduction in recurrence of polyps in those who take daily calcium supplements. Good food sources of calcium include skim or low-fat milk and other dairy products, broccoli, kale and canned salmon with the bones. Vitamin D, which aids in the absorption of calcium, also appears to help reduce the risk of colorectal cancer. You get vitamin D from foods such as vitamin-D fortified milk products, liver, egg yolks and fish. Sunlight also converts a chemical in your skin into a usable form of the vitamin. If you don’t drink milk or you avoid the sun, you may want to consider taking both a vitamin D and a calcium supplement.
*Include plenty of fruits, vegetables and whole grains in your diet. These foods are high in fiber, which can cut your risk of developing colon polyps. Fruits and vegetables also contain antioxidants, which may help prevent cancer. The American Cancer Society recommends eating five or more servings of fruits and vegetables every day. Look for deep green and dark yellow or orange fruits and vegetables such as Swiss chard, bok choy, spinach, cantaloupe, mango, acorn or butternut squash, and sweet potatoes, as well as vegetables from the cabbage family, including broccoli, brussels sprouts and cauliflower. Lycopene, a nutrient found in tomatoes and other red fruits and vegetables, such as strawberries and red bell peppers, may be a particularly powerful anti-cancer chemical.
*Limit fat. People who eat high-fat diets have a higher rate of colorectal cancer than do people who consume less dietary fat. Be especially careful to limit saturated fats from animal sources such as red meat. Other foods that contain saturated fat include whole milk, cheese, ice cream, and coconut and palm oils. Restrict your total fat intake to less than 35 percent of your daily calories, with no more than 8 percent to 10 percent coming from saturated fats.
*Limit alcohol consumption. Consuming moderate to heavy amounts of alcohol — more than one drink a day for women and two for men — may increase your risk of colon polyps and cancer. A drink is considered to be a 4- to 5-ounce glass of wine, a 12-ounce can of beer, or a 1.5-ounce shot of 80-proof liquor. Curbing alcohol consumption can reduce your risk, even if colon cancer runs in your family.
*Stop smoking. Smoking can increase your risk of colon cancer and a wide range of other diseases. Talk to your doctor about ways to quit that might work for you.
*Stay physically active and maintain a healthy body weight. Controlling your weight alone can reduce your risk of colorectal cancer. And staying physically active may significantly cut your colon cancer risk. Exercise stimulates movement through your bowel and reduces the time your colon is exposed to harmful substances that may cause cancer. The American Cancer Society recommends at least 30 minutes of physical activity five or more days a week. Forty-five minutes of moderate or vigorous activity can lower your risk of breast and colon cancer even more. If you’re overweight, lose weight until you are at a healthy level and maintain it.
*Talk to your doctor about aspirin. Studies on the role of aspirin in colorectal polyp and cancer prevention are mixed. Some show a 13 percent to 28 percent reduction in relative risk of these conditions with aspirin use. Others show no risk reduction. Aspirin appears to decrease the risk of these conditions primarily when taken at a high dose, such as 325 milligrams or more a day, and for more than 10 years. But aspirin use can increase your risk of gastrointestinal bleeding, and in high enough doses, stroke. So check with your doctor before starting any aspirin regimen.
*Talk to your doctor about hormone therapy (HT). If you’re a woman past menopause, hormone therapy may reduce your risk of colorectal cancer. Women who use HT have a somewhat lower risk of colorectal cancer than do women who don’t use HT. But not all effects of HT are positive. Taking HT as a combination therapy — estrogen plus progestin — can increase your risk of breast cancer, dementia, heart disease, stroke and blood clots. Discuss your options with your doctor. Together you can decide what’s best for you.
*If you’re at high risk, consider your options. If you’re at risk of FAP because of a family history of the disease, consider having genetic counseling. And if you’ve been diagnosed with FAP, start having regular colonoscopy tests in your early teens and discuss your options with your doctor. To prevent cancer from developing, most experts recommend having surgery to remove your entire colon when you’re in your 20s. The risk for people with hereditary nonpolyposis colorectal cancer isn’t quite as great as it is for those with FAP. Doctors recommend that people at risk of HNPCC begin having regular colonoscopies around age 20, but less often recommend removing the colon.
In the past, researchers believed that folate could help prevent colon polyps, but subsequent research indicates that it has no protective effect and should not be taken for that purpose.
You may click to learn more about Colon Polyps:->………...…(1).…(2)….(3)
Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.
Human beings ate raw grass, leaves, bark and uncooked cereals, like rabbits and other herbivorous animals, before they became refined carnivores who cooked and softened their food. And like these animals, we too had a long appendix.
As the nature of our diet changed, we did not require this organ and it eventually became small and rudimentary. It still nestles in the lower part of the right side of the abdomen, an appendage loosely attached to the transition point between the small and large intestines. The organ does not serve any discernible useful function. But in almost 40 per cent of the population it gives trouble at some time in their lives.
Digested food gets pushed in and out of the appendix during its transit through the intestine. As long as the opening remains patent, this does not pose a problem. Sometimes the opening of the appendix becomes narrowed and obstructed. This can occur because of intestinal worms, a hard stony piece of stool called a fecolith, or even undigested food particles. Contrary to popular opinion, orange pits and other swallowed seeds have not been shown to block the appendix.
The appendix is lined by abundant lymphoid tissue. This can swell and secrete infected fluid if there is a bacterial or viral infection. If this is sufficient to partially or completely block the opening, there is pain and swelling. If the symptoms are neglected, the appendix can “burstâ€, spilling the infection fluid into the surrounding area. The entire abdominal cavity can then become infected, causing peritonitis. The infection may get localised, forming an appendicular abscess.
Appendicitis initially produces non-specific symptoms like fever, vomiting, diarrhoea and abdominal pain. The pain may eventually localise in the lower part of the right side of the abdomen. There may also be acute pain in an anatomical area called McBurney’s point, situated a little away from the umbilicus.
The presentation of appendicitis may be atypical in the young (less than 10 years) and in the old (more than 60). The pain fails to localise in any particular area of the abdomen and may pose a diagnostic enigma. The symptoms may be confusing and the diagnosis missed if the appendix is situated in an abnormal location, too high, too low or at the back, or on the left side of the abdomen. Houdini, the magician, had an appendix on the left side. The diagnosis was missed and it perforated during a performance. He collapsed on stage, dying shortly afterwards.
Unfortunately, there are no confirmatory diagnostic blood tests for appendicitis as there are for other illnesses like typhoid or urinary tract infections. The suspicion of appendicitis can, however, become a certainty with an ultrasound or CT scan. But these procedures have an inherent latent period (waiting for the facility to become available) and the appendix can rupture in the interim.
Around 45 per cent of women are suspected to have appendicitis during their reproductive years. This is because the pain of appendicitis can be confused with tubal infection (salpingitis), urinary tract infection, ectopic pregnancy or even normal mittleschmerz, the mid-cyclic ovarian pain caused by rupture of the mature ovarian follicle and release of the ovum. In 30 per cent of surgeries, the diagnosis of appendicitis is wrong and a normal organ is removed. The mortality, however, is 50 per cent if the inflamed appendix is not treated surgically.
A laparoscopy clinches the diagnosis. The appendix itself can often be removed at the same time with a minimally invasive, no scar laparoscopic procedure, thus providing an investigation method that also cures. The appendix can also be removed through a classical incision.
Sometimes it is possible to control the infection with antibiotics, allowing the person to opt for an interval appendectomy at a convenient time. Some people have a “grumbling appendix†that causes repeated attacks of pain which can be managed conservatively. This delays the need for surgery. It is not a very wise course of action as the infection can flare up at inopportune moments. Women who have repeated attacks of appendicitis are also likely to develop adhesions and scars. This can distort the anatomy of the pelvic area and result in undesirable relative infertility.
The digestive system is a series of hollow organs joined in a long, twisting tube from the mouth to the anus(see the figure below) . Inside this tube is a lining called the mucosa. In the mouth, stomach, and small intestine, the mucosa contains tiny glands that produce juices to help digest food…..click & see
Two solid organs, the liver and the pancreas, produce digestive juices that reach the intestine through small tubes. In addition, parts of other organ systems (for instance, nerves and blood) play a major role in the digestive system.
Why is digestion important?
When we eat such things as bread, meat, and vegetables, they are not in a form that the body can use as nourishment. Our food and drink must be changed into smaller molecules of nutrients before they can be absorbed into the blood and carried to cells throughout the body. Digestion is the process by which food and drink are broken down into their smallest parts so that the body can use them to build and nourish cells and to provide energy.
How is food digested?
Digestion involves the mixing of food, its movement through the digestive tract, and the chemical breakdown of the large molecules of food into smaller molecules. Digestion begins in the mouth, when we chew and swallow, and is completed in the small intestine. The chemical process varies somewhat for different kinds of food.
The large, hollow organs of the digestive system contain muscle that enables their walls to move. The movement of organ walls can propel food and liquid and also can mix the contents within each organ. Typical movement of the esophagus, stomach, and intestine is called peristalsis. The action of peristalsis looks like an ocean wave moving through the muscle. The muscle of the organ produces a narrowing and then propels the narrowed portion slowly down the length of the organ. These waves of narrowing push the food and fluid in front of them through each hollow organ.
The first major muscle movement occurs when food or liquid is swallowed. Although we are able to start swallowing by choice, once the swallow begins, it becomes involuntary and proceeds under the control of the nerves.
The esophagus is the organ into which the swallowed food is pushed. It connects the throat above with the stomach below. At the junction of the esophagus and stomach, there is a ringlike valve closing the passage between the two organs. However, as the food approaches the closed ring, the surrounding muscles relax and allow the food to pass.
The food then enters the stomach, which has three mechanical tasks to do. First, the stomach must store the swallowed food and liquid. This requires the muscle of the upper part of the stomach to relax and accept large volumes of swallowed material. The second job is to mix up the food, liquid, and digestive juice produced by the stomach. The lower part of the stomach mixes these materials by its muscle action. The third task of the stomach is to empty its contents slowly into the small intestine.
Several factors affect emptying of the stomach, including the nature of the food (mainly its fat and protein content) and the degree of muscle action of the emptying stomach and the next organ to receive the contents (the small intestine). As the food is digested in the small intestine and dissolved into the juices from the pancreas, liver, and intestine, the contents of the intestine are mixed and pushed forward to allow further digestion.
Finally, all of the digested nutrients are absorbed through the intestinal walls. The waste products of this process include undigested parts of the food, known as fiber, and older cells that have been shed from the mucosa. These materials are propelled into the colon, where they remain, usually for a day or two, until the feces are expelled by a bowel movement.
The glands that act first are in the mouth—the salivary glands. Saliva produced by these glands contains an enzyme that begins to digest the starch from food into smaller molecules.
The next set of digestive glands is in the stomach lining. They produce stomach acid and an enzyme that digests protein. One of the unsolved puzzles of the digestive system is why the acid juice of the stomach does not dissolve the tissue of the stomach itself. In most people, the stomach mucosa is able to resist the juice, although food and other tissues of the body cannot.
After the stomach empties the food and juice mixture into the small intestine, the juices of two other digestive organs mix with the food to continue the process of digestion. One of these organs is the pancreas. It produces a juice that contains a wide array of enzymes to break down the carbohydrate, fat, and protein in food. Other enzymes that are active in the process come from glands in the wall of the intestine or even a part of that wall.
The liver produces yet another digestive juice—bile. The bile is stored between meals in the gallbladder. At mealtime, it is squeezed out of the gallbladder into the bile ducts to reach the intestine and mix with the fat in our food. The bile acids dissolve the fat into the watery contents of the intestine, much like detergents that dissolve grease from a frying pan. After the fat is dissolved, it is digested by enzymes from the pancreas and the lining of the intestine.
Digested molecules of food, as well as water and minerals from the diet, are absorbed from the cavity of the upper small intestine. Most absorbed materials cross the mucosa into the blood and are carried off in the bloodstream to other parts of the body for storage or further chemical change. As already noted, this part of the process varies with different types of nutrients.
Carbohydrates. It is recommended that about 55 to 60 percent of total daily calories be from carbohydrates. Some of our most common foods contain mostly carbohydrates. Examples are bread, potatoes, legumes, rice, spaghetti, fruits, and vegetables. Many of these foods contain both starch and fiber.
The digestible carbohydrates are broken into simpler molecules by enzymes in the saliva, in juice produced by the pancreas, and in the lining of the small intestine. Starch is digested in two steps: First, an enzyme in the saliva and pancreatic juice breaks the starch into molecules called maltose; then an enzyme in the lining of the small intestine (maltase) splits the maltose into glucose molecules that can be absorbed into the blood. Glucose is carried through the bloodstream to the liver, where it is stored or used to provide energy for the work of the body.
Table sugar is another carbohydrate that must be digested to be useful. An enzyme in the lining of the small intestine digests table sugar into glucose and fructose, each of which can be absorbed from the intestinal cavity into the blood. Milk contains yet another type of sugar, lactose, which is changed into absorbable molecules by an enzyme called lactase, also found in the intestinal lining.
Protein. Foods such as meat, eggs, and beans consist of giant molecules of protein that must be digested by enzymes before they can be used to build and repair body tissues. An enzyme in the juice of the stomach starts the digestion of swallowed protein. Further digestion of the protein is completed in the small intestine. Here, several enzymes from the pancreatic juice and the lining of the intestine carry out the breakdown of huge protein molecules into small molecules called amino acids. These small molecules can be absorbed from the hollow of the small intestine into the blood and then be carried to all parts of the body to build the walls and other parts of cells.
Fats. Fat molecules are a rich source of energy for the body. The first step in digestion of a fat such as butter is to dissolve it into the watery content of the intestinal cavity. The bile acids produced by the liver act as natural detergents to dissolve fat in water and allow the enzymes to break the large fat molecules into smaller molecules, some of which are fatty acids and cholesterol. The bile acids combine with the fatty acids and cholesterol and help these molecules to move into the cells of the mucosa. In these cells the small molecules are formed back into large molecules, most of which pass into vessels (called lymphatics) near the intestine. These small vessels carry the reformed fat to the veins of the chest, and the blood carries the fat to storage depots in different parts of the body.
Vitamins. Another vital part of our food that is absorbed from the small intestine is the class of chemicals we call vitamins. The two different types of vitamins are classified by the fluid in which they can be dissolved: water-soluble vitamins (all the B vitamins and vitamin C) and fat-soluble vitamins (vitamins A, D, and K).
Water and salt. Most of the material absorbed from the cavity of the small intestine is water in which salt is dissolved. The salt and water come from the food and liquid we swallow and the juices secreted by the many digestive glands.
How is the digestive process controlled?
Hormone Regulators
A fascinating feature of the digestive system is that it contains its own regulators. The major hormones that control the functions of the digestive system are produced and released by cells in the mucosa of the stomach and small intestine. These hormones are released into the blood of the digestive tract, travel back to the heart and through the arteries, and return to the digestive system, where they stimulate digestive juices and cause organ movement.
The hormones that control digestion are gastrin, secretin, and cholecystokinin (CCK):
Gastrin causes the stomach to produce an acid for dissolving and digesting some foods. It is also necessary for the normal growth of the lining of the stomach, small intestine, and colon.
Secretin causes the pancreas to send out a digestive juice that is rich in bicarbonate. It stimulates the stomach to produce pepsin, an enzyme that digests protein, and it also stimulates the liver to produce bile.
CCK causes the pancreas to grow and to produce the enzymes of pancreatic juice, and it causes the gallbladder to empty.
Additional hormones in the digestive system regulate appetite:
Ghrelin is produced in the stomach and upper intestine in the absence of food in the digestive system and stimulates appetite.
Peptide YY is produced in the GI tract in response to a meal in the system and inhibits appetite.
Both of these hormones work on the brain to help regulate the intake of food for energy.
Nerve Regulators
Two types of nerves help to control the action of the digestive system. Extrinsic (outside) nerves come to the digestive organs from the unconscious part of the brain or from the spinal cord. They release a chemical called acetylcholine and another called adrenaline. Acetylcholine causes the muscle of the digestive organs to squeeze with more force and increase the “push” of food and juice through the digestive tract. Acetylcholine also causes the stomach and pancreas to produce more digestive juice. Adrenaline relaxes the muscle of the stomach and intestine and decreases the flow of blood to these organs.
Even more important, though, are the intrinsic (inside) nerves, which make up a very dense network embedded in the walls of the esophagus, stomach, small intestine, and colon. The intrinsic nerves are triggered to act when the walls of the hollow organs are stretched by food. They release many different substances that speed up or delay the movement of food and the production of juices by the digestive organs.
National Digestive Diseases Information Clearinghouse
Avoid high-fat meals :
Eating a high-fatmeal can generate a large amount of carbon dioxide, some of which is released as gas. That’s because carbon dioxide is produced in the small intestine when bicarbonate is released to neutralise stomach acid and fat during meals. Eat smaller, more frequent meals instead of three large meals
1. Eat smaller, more frequent meals instead of three large meals.
2. Avoid high-fat meals.
3. Consult your doctor to rule out the possibility of fat malabsorption. Signs of fat malabsorption include loose and light-coloured stools.
Odorous Flatulence and Gas :
Gas that has a strong odour usually results from the metabolism of sulfur-containing proteins and amino acids in the intestines. 1. Chew meat and other protein foods carefully. Avoid excessive protein in your diet.
2. Taking activated charcoal tablets can help to remove the odour.
Eating Foods that Produce Gas:
Certain foods are inherently gas-producing. Gas-producing foods include beans, cabbage, onions, brussels sprouts, cauliflower, broccoli, fluffy wheat products such as bread, apples, peaches, pears, prunes, corn, oats, potatoes, milk, ice cream, and soft cheese.
Foods that produce minimal gas include rice, bananas, citrus, grapes, hard cheese, meat, eggs, peanut butter, non-carbonated beverages, and yogurt made with live bacteria.
When someone has persisting bloating and flatulence, lab tests and x-rays are first conducted to exclude the presence of medical disease. Colorectal cancer often presents with the symptoms of abdomen discomfort and bloating. Celiac disease and inflammatory bowel disease may have similar symptoms. It’s important to remember that gas and bloating are vague symptoms that can be associated with many medical diseases, so consultation with your primary care provider should always be the first step.
![Reblog this post [with Zemanta]](https://i0.wp.com/img.zemanta.com/reblog_e.png?w=580)
