New Manak Healthcare Hospital

Hello,

I am Dr. Rajesh Patil, General Surgeon, I am practicing general surgery. So we'll be talking on this important topic of pain in abdomen. Most of the time patients come to the hospital with two important complaints that is fever and pain and that too pain in abdomen. Now for this pain in abdomen there are a lot of people they want to know what are the causes and how to differentiate this causes of pain in abdomen. So we encounter a lot of patients for different causes for pain in abdomen symptoms remains the same that is pain in abdomen. Now if you compare the body with the house, so the house we will be what do you call fragmented into attic, then the upper floor, then the ground floor and basement and the backyard, the backyard also consist of the oil tank and the electrical installation. Now the electrical installation is compared to this central nervous system, then the attic is the chest region, then the ground floor is abdomen, then the pelvic is the basement and the oil tank is the blood, lymph and different bodily fluids and then the backyard is like all the retroperitoneal organs including the kidneys and ureters and lot of muscles and bones. So now pain in abdomen, now we will compare this scene or the electrical installation.

In this lot of cases are there where the central nervous system condition which causes pain in abdomen, so we cannot rule out any central nervous system conditions for ruling out pain in abdomen, then this central nervous system there are diseases of nerves, the brain which causes pain in abdomen then we will compare this attic with the chest region. Now the chest region it contains heart and lungs, so the lungs infection and inflammation of the lungs like pneumonia, pleurisy which made the base of the lungs will cause pain in the upper part of the abdomen, even the heart it will cause pain in the epigastric region and left hypochondriac region also. Now we will divide this abdominal part into 6 parts, so the upper central part is the epigastric region then the right hypochondriac region, left hypochondriac region, right lumbar region, umbilical region, left lumbar region, right iliac fossa, the pelvic region and the left iliac fossa.

So, now there are certain organs in this area which we look for abdominal pain. Like in the right hypochondriac region there is gallbladder, there is a liver and even some part of pancreas, so all this infection and inflammation of these organs may cause pain in the abdomen. Now in the epigastric region the pain can be referred from the heart region, then there is the stomach part, then the duodenum, the small intestine and the left hypochondriac region there is spleen and some part of the pancreas upon infection of all these organs and inflammation also may cause pain in the abdomen. Now if you come into right lumbar region there are the kidneys and the colon, so any diseases pertaining to these organs will cause pain in the abdomen.

Now coming to the umbilical region, the umbilical itself may cause some of the conditions like umbilical hernia or obstructed umbilical hernia or mesenteric lymph nodes and part of the intestine, infection inflammation of these parts me cause pain in the abdomen. Now the left lumbar region, there are kidneys and ureter and some part of the spleen which may cause pain in the abdominal region. Now you come down to the from the umbilicus to the pelvic region which we will compare to the basement of the house, so like right iliac fossa the main important organ lying there is appendix and this may cause pain in the abdomen along with this cecum, colon, small intestine also and also the kidneys and ureters. Now the pelvic region we will come across the the bladder and in female, the reproductive organs and in males also along with this genitourinary organs, there is prostrate and part of the cord structure of the testes even left iliac fossa there is sigmoid colon and anal region and the part of intestine also and along with this in female along, reproductive organs like uterus, fallopian tubes, any infection, inflammation or any menstrual cycle disturbance may cause pain in this region and in men the prostate gland which because of some infection, inflammation may cause pain in that region. Now coming to the cord structure of the testes.

Now this cord structure of the testis they arise from the testis, they pierce into the inguinal region and goes into the abdomen so any torsion of the testis or condition like infection of this cord structure may cause pain in the lower abdomen. Now coming to the oil tank or the blood or lymph diseases so lot of conditions are there of blood which may cause pain in the abdomen, long list of this but basically we should understand even blood diseases can cause pain in the abdomen. Now will be coming to the backyard, so comparing backyard there are the kidneys and ureters, then retroperitoneal organs which consists of muscles, then the bones and spine this may cause infection, pain in the abdomen because of their infection or inflammation.

Now coming to the diagnosis. The correct diagnosis is the essence of correct treatment or the right treatment, so when a patient comes to the doctor, the doctor physically examines him and then after thorough examination he asks some investigations to confirm that what we call is a provisional diagnosis, so then we advise them apart from this routine tests like CBC and ESR, urine routine test are there, stool routine test are there, then there are invasive tests, invasive tests are like upper GI endoscopy and colonoscopy all this interventional diagnostic procedure are there and then non-interventional diagnostic measures are there like sonography, x-ray, CT-scan, MRI, these are the non-interventional measures this investigation it assists the doctor in making correct diagnosis, if the diagnosis is correct then it is easy to treat the patient. Now coming to treatment part. In acute condition the doctor may advise you admission and then the treatment part starts so apart from this diagnosis because what happens in a lot of patients, if there is a misdiagnosis or wrong diagnosis the patient may pay a high price which can cause mortality and morbidity and some complications also.

So, the essence of correct diagnosis lies on the physical examination and investigations and after that the treatment part starts and it is easy to treat when there is correct diagnosis. So now what are the measures to be taken to avoid all these things? so it is likely said and very well accepted like eating right food at the right time, plenty of water, plenty of vegetables, plenty of food and taking these at the right time and also clean food for that matter and early detection, so if you have slight pain in abdomen, seek medical advice and see that it doesn't escalate more. I think most of the topics of the causes of pain in abdomen I have covered. If you have queries regarding any medical conditions or you want to contact me regarding any queries of this medical conditions you can go on lybrate for my other videos or contact me through lybrate, so that I can communicate with you and can solve all your medical queries or questions or anything which I will be doing through lybrate.

Thank you.

Hi,

I am Dr. Archana Rajesh Patil, Obstetrics & Gynaecology. I am practicing from last 20 years. Today we will talk about PCOS. I am sure many of you must have heard about this problem. PCOD is a disease which is not epidemically increasing. Many girls and newlyweds are suffering from this. Maybe because of the sedentary lifestyle, lack of exercise, unbalanced diet. What is PCOD? It is an appearance of multiple follicles in ovaries which gives a bulky ovary. Because of this, there are certain hormonal changes which represent many symptoms. First, let's talk about the incidence. 10% of the young girls today have PCOD. It is increasing. If it is a young girl then symptoms will start with irregular menses, increased weight, obesity, infertility. If it is not treated she might start getting hirsutism. Increase in facial hair, baldness, male pattern hair growth. Simultaneously there is hoarseness of voice if it is not treated.

How do we diagnose this? The first diagnosis can be done through sonography. Then we have to do little biochemical tests. When PCOS is diagnosed, normally the treatment is given for weight loss as it is a major component. Regular exercise regimen has to be given to the patient. The balanced diet needs to be followed where fatty foods need to be cut down. The best exercise is 1-hour walking which leads to regular ovulation. Every ovary has many follicles. And every month only 1 follicle will increase. And this follicle has an egg and an ovum. So, this follicle will rupture and ovum will come out. This process is called ovulation. But in PCOS, the follicle only grows in the size and ovum doesn't come out. So, there is ovulation which is failed which leads to the cystic spaces. It starts releasing different types of hormones. Again, the patient doesn't get the ovulation.

She will have breakthrough bleeding, long time of menses, loss of menses. So, there are chances that the patient may become infertile. So, there is a different protocol or the line of the management. If they are not married, we just give the insulin sensitizer, exercise, diet plan and we tend to regularize the menses, oral contraceptive pills are given so that periods are regularized. But in case, the patient is infertile, then 1st we tend to give ovulation induction drugs to them, we try to induce ovulation and help her conceive. In case, she has an advanced stage of PCOS where she got hirsutism, then there are certain laser therapies which can be given. There are some cosmetic treatments which are advised to the patient for the removal of excessive hair. In case, she is having obesity, we advise the weight loss plans to such patients. There are such situations where a patient becomes very obese, hirsutism, the patient tends to go in depression, so sometimes we need to counsel the patient.

We need to motivate the patient to lose weight. Proper treatment and regular follow up will give you a proper result for PCOS. There are chances that the patient might have diabetes mellitus in the future, there are high chances of infertility issues. So, it is better than she is treated on time. Many of the times these cosmetic problems are irreversible. There is no permanent treatment for that until and unless they go for high laser therapies. We also do ovarian drilling. This treatment is given with huge ovaries. So, this is one of the options. In PCOS, thyroid, and serum prolactin evaluation, insulin tests are necessary. Because there are chances that patient might land up in hypothyroidism and insulin resistance. Anything else, you want to know about PCOS, book an appointment through Lybrate.

Thank You!

Hi,

I am Dr. Archana Rajesh Patil, Obstetrics & Gynaecology. I am practicing from last 20 years. Today we will talk about gestational diabetes. Gestational diabetes means diabetes mellitus detected during pregnancy. It can be detected between 2nd trimester. If gestational diabetes is detected before this time, then we will call it diabetes mellitus. Now, why does gestational diabetes occur? It is because some metabolic changes occur during pregnancy, changes the insulin sensitivity of the mother. And when the pancreatic cells are not able to handle this, the patient goes into glucose intolerance and that leads to gestational diabetes. How can it be diagnosed? It can be done in the 2nd trimester by GTT. This test is done empty stomach or with light food, the blood is taken once and then the patient has given 75grams of glucose to drink then after 2 hours again we take the blood.

And then on the values we get, we decide whether the patient is gestational diabetics or diabetic mellitus. Normally when gestational diabetes is detected very much chances that before pregnancy her glucose intolerance was normal and even after pregnancy her glucose intolerance will again become normal. To treat this, most often insulin along with proper exercise and balanced diet is required. What are the high-risk factors? Which patients are likely to develop gestational diabetes? First is obesity. More BMI will indicate that she might suffer from gestational diabetes. History of family diabetes, if she has a history of PCOS or if she has a history of recurrent miscarriages, history of the malformed baby. If these histories are there then the patient should be screened for gestational diabetes. If a patient is having gestational diabetes then chances are there that patient may deliver a big baby. Or the chances of preeclampsia which is an increase in BP during pregnancy. She will have chances of increased incidence of operative intervention during pregnancy. She might require vacuum delivery, c-section delivery.

There are chances that she might land up with perineal trauma if she goes for normal delivery. These patients are more at the risk of developing diabetes in the future. What are the fetal complications? When are we talking about gestational diabetes? Fetal complications like a baby might become macrosomic. Baby has the risk of developing birth trauma. Baby might have shoulder dystocia. The shoulder might get stuck. Chances of prematurity, respiratory issues. There can be some metabolic disturbance. So, the baby has to be screened for all those things if the mother has gestational diabetes. So, whenever a patient is going for a check of pregnancy, they also should go for a diabetes check. So, we should know that glucose intolerance is normal. If everything is normal, then she should go for the screening in 2nd trimester. The best treatment can be given is a mother has to have regular exercises and a properly balanced diet. This is all about gestational diabetes. In case, you have any query regarding gestational diabetes or any other risk factor in pregnancy, you can contact me through Lybrate.

Thank You!