Consult Now Appendicitis is an inflammation of the appendix, a finger-like glandular piece of tissue that connects to the beginning of the large intestine, usually at the lower right side of the abdomen. In older children, the classic symptoms of appendicitis are abdominal pain, fever, and vomiting. Abdominal pain usually begins in the center of the abdomen, around the area of the navel (“belly button”). Later, the pain may move downward and to the right – to an area called McBurney’s point, roughly corresponding to the location of the appendix in the lower right portion of the abdomen.

After his abdominal pain begins, a child with appendicitis usually develops a slight fever, loses his appetite, feels nauseous, and may vomit. The fact that abdominal pain begins before nausea and vomiting, rather than after, is one clue to suspect appendicitis rather than an intestinal infection

Other symptoms that may be seen in older children with appendicitis include: diarrhea (usually small stools with mucus); urinary tract symptoms (urinating very frequently and/or an uncomfortably strong urge to urinate); constipation; and, sometimes, respiratory symptoms.

Consult Now Cholera is the illness caused by a bacterium called Vibrio cholerae. It infects people’s intestines, causing diarrhea, vomiting and leg cramps.

Cholera can be mild or even without symptoms, but a severe case can lead to death without immediate treatment. The diarrhea and vomiting brought on by the infection quickly leaves the body without enough fluid. The following dehydration and shock can kill a person within hours.

Colic / Stomach, Abdominal Pain
Consult Now Constipation is passage of small amounts of hard, dry bowel movements, usually fewer than three times a week. People who are constipated may find it difficult and painful to have a bowel movement. Other symptoms of constipation include feeling bloated, uncomfortable, and sluggish.

Common causes of constipation are:
not enough fiber in the diet
not enough liquids
lack of exercise
irritable bowel syndrome
changes in life or routine such as pregnancy, older age, and travel
abuse of laxatives
ignoring the urge to have a bowel movement .
specific diseases such as stroke .
problems with the colon and rectum.
problems with intestinal function (chronic idiopathic constipation)

Consult Now Diarrhoea means there are frequent, loose or liquid stools. There may be a gripey abdominal pain (colic), which is less after a stool is passed.
Acute diarrhoea: comes on suddenly and lasts a short time.
Chronic diarrhoea: affects someone over a long period of time.
Some people pass frequent, small solid stools with a sense of urgency. This is not true diarrhoea and occurs when the rectum is irritable as in the irritable bowel syndrome or inflamed as in colitis.

What causes diarrhoea?
Too much fluid is passed (secreted) from the blood stream into the bowel, for example in gastroenteritis. This is how some laxatives work.

The bowel moves its contents through too quickly and too little fluid is passed back into the bloodstream. This is one way in which anxiety produces diarrhoea.
More liquid is drunk than the bowel can cope with – this seldom happens, but is one way in which drinking too much beer can cause diarrhoea.

What causes acute diarrhoea?
Food poisoning
Gastroenteritis (see separate leaflet on the prevention and treatment of travellers’ diarrhoea)
Sometimes treatment with an antibiotic
Alcohol (to excess).

What causes chronic diarrhoea?
When diarrhoea goes on for a long time, the most likely cause is irritable bowel syndrome. It is called a ‘functional’ condition. This means that the bowel produces stools, which are looser or more frequent than normal, although the bowel is not diseased.

Consult Now Signs and symptoms of dysentery

Severe, often bloody diarrhea, vomitting, fever; life-threatening if untreated. Dysentery is inflammation of the bowel resulting from infection.

There are two kinds – dysentery caused by a bacterial germ (bacillary dysentery or shigellosis), and amoebic dysentery, caused by an amoeba called Entamoeba histolytica.

Dysentery is a more serious form of diarrhea, where the stools are tinged with blood and mucus. The diarrhea can be quite severe, characterized by colicky pains and frequent urging. Stools can be passed as often as fifteen to thirty times per day. The onset is typically sudden, accompanied by a high fever and thirst. The illness causes great fatigue and depletion of strength. Dehydration is a serious side-effect, especially if the person becomes too weak to drink enough liquids. In cases of amebic dysentery, the symptoms are quite mild, with constipation and diarrhea alternating, combined with some intestinal cramping and gas. The danger of an amebic dysentery is involvement of the liver, and can lead to hepatitis, cysts and abscesses. These liver problems can remain dormant for many years.

Fissure, Anal
Consult Now An anal fissure is a small tear or cut in the skin lining the anus which can cause pain and/or bleeding. The typical symptoms of an anal fissure are extreme pain during defecation and red blood streaking the stool. Patients may try to avoid defecation because of the pain.
Gastric Affections
Hemorrhoids / Piles
Consult Now Haemorrhoids (often known as Piles) are enlarged and engorged blood vessels (varicosities) in or around the anus. These may be associated with pain, bleeding, itching and feeling as if a lump or bump is hanging down.

Symptoms of Hemorrhoids
The most common symptom of internal hemorrhoids is painless bright red blood covering the stool, on toilet paper, or in the toilet bowl. However, an internal hemorrhoid may protrude through the anus outside the body, becoming irritated and painful. This is known as a protruding hemorrhoid.
Symptoms of external hemorrhoids may include painful swelling or a hard lump around the anus that results when a blood clot forms. This condition is known as a thrombosed external hemorrhoid.
In addition, excessive straining, rubbing, or cleaning around the anus may cause irritation with bleeding and/or itching, which may produce a vicious cycle of symptoms. Draining mucus may also cause itching.

Causes of Hemorrhoids:
It is a known fact that constipation and prolonged straining at stool are main causes of piles but there are some other important aspects too.
Low fibre diet causing small caliber stool and straining during defecation.
Sitting for prolonged period at closet.
Hypertension mainly in portal vein.
Anal sex without proper use of lubricants stresses anus.
Sedentary life style.
Constipation as well as chronic diarrhea.
Pregnancy causes hypertension and increases strain during bowel movements.
Increased use of alcohol and caffeine.
Lack of erect posture.
Familial tendency.
Higher socio-economic status.
Colon malignancy.
Hepatic disease.
Spinal cord injury.
Loss of rectal muscle tone.
Rectal surgery.
Ageing – weakened support structures.

Prevention of Hemorrhoids/Piles:
Drinking more fluids in routine.
Eating more dietary fibers.
Practicing better posture.
Reducing bowel movement strain and time.
Avoid wearing tight under clothes.
Washing the anus with cool water and soap may reduce swelling and increase blood supply for quick healing.

Using squat toilets may help.
Self-Care at Home
Hot sitz bath.
Stool softeners – but overuse of laxatives should be avoided.
Improving posture and muscle tone.
Taking herbs and dietary supplements to strengthen vein walls.
Topical application of astringents and soothing agents (like honey and aloe Vera)
Drinking chamomile tea several times a day.
Eating fiber rich bulking agents like plantain to help create soft stool and to lessen irritation of existing hemorrhoids.
Horse chestnut – extract or Aesculus hippocastanum contains a saponin known as aescin that has anti inflammatory, anti edema and venotonic actions. It improves tone in vein walls.

Liver, Affections of
Pancreas, Complaints of
Peptic Ulcers
Consult Now The term peptic ulcer usually refers to an ulcer in the lower esophagus, stomach, or duodenum.
Couse of Peptic Ulcers
Heredity: Patients with peptic ulcer often have a family history of the disease, this is particularly so with duodenal ulcers which develop below the age of 20 years. The relatives of chronic ulcer patients have three times the expected number of ulcers.

Helicobacter pylori:This is the most important etiological factor in peptic ulcer disease, accounting for 90% of duodenal ulcers and 70% of gastric ulcers. By causing gastritis it reduces the resistance of the gastric mucosa to attack be acid and pepsin and a gastric ulcer may result.

Non Steroidal Anti Inflammatory Drugs (NSAIDS): These damage the gastric mucosal barrier and are an important etiological factor in up to 30% of gastric ulcers.

Smoking: confers an increased risk of gastric ulcer and to a lesser extent duodenal ulcer.

Signs and symptoms of Peptic Ulcers
Abdominal pain: Pain is referred to the epigastrium and is often so sharply localized that the patient can indicate its site with tow or three fingers – the ‘pointing sign’
Hunger pain – Pain occurs intermittently during the day, often when the stomach is empty, so that the patient identifies it as ‘hunger pain’ and obtains relief be eating.
Night pain – Pain wakes the patient from sleep and may be relieved by food, a drink of milk or antacids. This symptoms if found, is virtually pathognomonic of peptic ulcer disease..
Episodic pain/ Periodicity: Characteristically pain occurs in ‘on again/off again’ episodes, lasting one to three times a week at a time, three to four times in a year. In temperate climates seasonal variation may be noted with an increased frequency of symptoms during winter and spring.

Other symptoms
• Waterbarsh
• Heartburn
• Loss of appetite
• Vomiting

Peptic Ulcers – How DIagnosis is Done?
Endoscopy is the preferred method.
Double contrast barium meal examination may be done.

Peptic Ulcers – Complication
The ulcer may occasionally perforate leading to peritonitis and other complications.

Peptic Ulcers – What to differnt from?
Occasional dyspepsia (indigestion)
Malignant ulcer/ carcinoma

Consult Now Peritonitis is an inflammation (irritation) of the peritoneum, the membrane that lines the wall of the abdomen and covers the abdominal organs. Peritonitis can result from infection (such as bacteria or parasites), injury and bleeding, or diseases.

Signs and Symptoms of peritonitis include
• Swelling and tenderness in the abdomen; pain can range from dull aches to severe, sharp pain causing board-like rigidity
• Fever and chills
• Loss of appetite
• Nausea and vomiting
• Increased breathing and heart rates
• Shallow breaths
• Low blood pressure
• Limited urine production
• Inability to pass gas or feces

Spleen, Affections of
Consult Now Hypersplenism is a type of disorder which causes the spleen to rapidly and prematurely destroy blood cells.
Hypersplenism may be caused by a variety of disorders. Sometimes, it is brought on by a problem within the spleen itself and is referred to as primary hypersplenism. Secondary hypersplenism results from another disease such as chronic malaria, rheumatoid arthritis, tuberculosis, or polycythemia vera, a blood disorder.

Symptoms of hypersplenism include easy bruising, easy contracting of bacterial diseases, fever, weakness, heart palpitations, and ulcerations of the mouth, legs and feet. Individuals may also bleed unexpectedly and heavily from the nose or other mucous membranes, and from the gastrointestinal or urinary tracts. Most patients will develop an enlarged spleen, anemia, leukopenia, or abnormally low white blood cell counts, or thrombocytopenia, a deficiency of circulating platelets in the blood. Other symptoms may be presents that reflect the underlying disease that has caused hypersplenism.
An enlarged spleen is one of the symptoms of Malaria, Cirrhosis of the liver, leukaemia, lymphoma, Hodgkin’s disease, polycythaemia, etc. Spleen enlarges when called on to remove massive numbers of red blood cells, defective cells, or bacteria from circulation. Splenomegaly occurs in about 10% of systemic lupus erythematosus patients. Sometimes, it is caused by recent viral infection, such as mononucleosis.

Consult Now Worms are intestinal parasites, which infest human beings as well as animals like cats, dogs etc. The common ones are round worm, pin worm, tape worm, hook worm etc.
WORMS, Intestinal Worms in Humans

Signs & Symptoms
Anemia, Worms leach nutrients from bodies causing anemia. When they are present in large numbers, they can create enough blood loss to cause anemia or iron deficiency in some people.
Constipation, Some worms can obstruct certain organs like the colon, liver and the bile duct, causing constipation and other problems.
Diarrhea, Most of the time diarrhea is nature’s way of removing toxins.
Fatigue, Symptoms include tiredness, flue-like symptoms, apathy, depression and a lack of concentration.
Gas and Stomach Bloating, Some parasites live in the upper intestine, which can cause both gas and stomach bloating.
Immune Dysfunction, Worms in Humans depress the immune system by decreasing immunoglobulin A.
Nervousness, The waste products from parasites irritate the nervous system, resulting in anxiety and restlessness.

Other Signs & Symptom of Worms & Parasites in Children
Blisters appear on the inside of the lower lip, wiping of the nose, restlessness and grinding of the teeth at night, dark circles under the eyes, hyperactive, bed wetting, headaches, sensitive to light, twitching eyelid, gum, rectum, or nose bleeding are signs they may have worms & parasites.