Nasal Endoscopy

Nasal endoscopy is a non-invasive diagnostic procedure performed to view the nasal and sinus packages. Nasal endoscopy provides a clear picture of the interior elements of the tissue or organs, allowing the physicians to access some hidden cavities of the body. These cavities are not ordinarily visible during a normal examination procedure.

Nasal endoscopy is also known as Rhinoscopy. It is performed with the help of a nasal endoscope, which is a rigid, thin tube that contains fibre-optic cables, mounted with light. This endoscope is connected to a camera, which projects the magnified images on a screen, allowing the physician to better assess the problem.

The procedure of a nasal endoscopy

In a nasal endoscopy, the physician inserts the endoscope into the nose of the patient by guiding it through the nasal and sinus passages. The endoscope then provides the internal images, helping the doctor make a diagnosis and understand the treatment for the issue detected. In other cases, a nasal endoscopy can also be used to collect tiny samples of tissue or perform other non-invasive tasks.

The requirement of a nasal endoscopy

A person who is experiencing symptoms and issues, such as below, can require a nasal endoscopy:

  • Nasal congestion
  • Blockage in the nose
  • Nasal polyps
  • Infection in the nose
  • Sinus issue
  • Bleeding on the nose
  • Nasal tumours
  • Loss of smell
  • Cerebrospinal fluid leak
  • Headaches
  • Facial pain, especially around the sinuses and the part above the eyes

An endoscopy can also provide specific details about the bleeding area and if there is any swelling inside the nose. Moreover, it can also be used to check for growth that might be cancer. Nasal endoscopy can also be used to treat a condition such as, remove a foreign object from the nose. This problem can be used to see the effectiveness of the treatment.

Preparation of a nasal endoscopy

To prepare for nasal endoscopy, the patient must confirm about precautions of the procedure. The physician will advise the patient to stop taking certain medications, such as blood thinners, to minimize the complications from the surgery. The person is allowed to drink and eat before the procedure. Depending on case-to-case, the healthcare provider will instruct about some special precautions.

The procedure of a nasal endoscopy

Before starting the nasal endoscopy, the healthcare professional sprays a topical decongestant into the nose of the patient. This spray helps to minimize swelling and allows the nasal endoscope to pass swiftly through the nasal and sinus cavity. Additionally, in some cases, the physician might also spray an anaesthetic to numb the nose of the patient. In some rare patients, the physician might need to inject an anaesthetic.

The patient will be sitting upright in an examination chair. Once the nose is numbed with the anaesthetic, the healthcare provider will insert the endoscope into one nasal passage. The procedure can make the patient a little uncomfortable. If this happens, the doctor must be informed and the patient can be given a stronger numbing medicine.

Once inserted, the nasal endoscope will be pushed further inside the passage to gain a clear view of the nasal cavity and sinuses. The procedure may be repeated multiple times until the doctor gets all the information required. Once done, the same procedure is repeated in the other nostril. In some cases, the doctor might also extract a part of the nasal tissue to be diagnosed for serious issues, such as cancer.

Post the nasal endoscopy

The patient must talk to the doctor about what to expect after the procedure. In some cases, the physician might have some special instructions. But generally, the patient can go home right after the nasal endoscopy. Also, they can resume normal activities right after the surgery. However, the patient must inform the doctor if they experience any complications such as a nose bleed that recurs or does not go away.

The nasal endoscopy provides the required information to the physician to direct the course of treatment. In some conditions, the doctor might also order certain tests, such as a CT scan, to gain more details. If a sample tissue has been collected, the results may come after a few days.

All instructions provided by the physician regarding precautions, medicines and follow-ups should be taken seriously. The healthcare provider would also schedule a nasal endoscopy in the future to assess the effectiveness of the treatment.

Risks of a nasal endoscopy

Nasal endoscopy is a minimally invasive procedure and hence, is considered safe. But some patients might experience a few risks and complications, including:

  • Bleeding of nose
  • Loss of consciousness
  • Allergic reaction to anaesthesia
  • Allergic reaction to the decongestant

Moreover, a person with an existing bleeding disorder has a greater risk of bleeding. Also, people who take blood-thinning medications are prone to a higher risk of nose bleeding. However, the risks depend on the age and the general health conditions of the patient.

Overall, nasal endoscopy is a very effective procedure to detect any problems related to the nasal passage and sinuses. This minimally-invasive technique has rare complications and offers a very fast recovery. However, the need for the procedure will be decided by the physician depending on the case.

Cause & Symptoms of Hernia, Treatment Operation

Hernia is a very common problem today; as per research every one in ten person is suffering from hernia. Hernia is a condition in which a structure or an organ of the body protrudes abnormally through an opening in the muscle body tissue that is holding it in place. Caused essentially because of weak muscles and stress, hernia is not life threatening (apart from very rare cases) and is completely curable through medical and home based treatment. The weakness or stress on the concerned structure or organ can be a result of pregnancy, constipation, heavy weight lifting, abdominal fluid, excessive body weight, persistent cough, continuous sneezing, etc. Some of the reasons that lead to weak muscles are – age, chronic coughing, damage from injury, complications from surgery, etc. Apart from weak muscles and consistent strain, a couple of factors can also increase a person’s risk of developing a hernia, these factors include:

  • Family history
  • Obesity or overweight
  • Chronic and prolonged cough
  • Severe constipation
  • Smoking
  • Cystic fibrosis

Hernia can develop in any part of the body including abdomen, upper thigh, groin and belly. Though some common hernias include – inguinal hernia (affecting the intestine), hiatal hernia (affecting the stomach), umbilical hernia (affecting the belly button) and incisional hernia, which is caused due to incompletely healed medical wound. Even though hernia is a very common, it is still important to know the symptoms of hernia to get timely medical help.

Symptoms of Hernia

Symptoms of a hernia depend on case-to-case and the affected area; where some hernias may produce symptoms other might exist but not produce any symptoms. However, some common symptoms that can help detect a hernia include:

  • A bulge or lump in a particular area
  • Pain or discomfort in an area while bending
  • Heavy or dragging sensation in an area
  • Abdomen weakness
  • Aching or burning sensation on the bulging portion
  • Acid reflux
  • Acute chest pain
  • Heartburn
  • Difficult in swallowing
  • Coughing
  • Shooting pain
  • Vomiting
  • Constipation

Also, hernias can cause the organs and structures to become very soft and also become infected, blocked or strangled. Sometimes, children can also develop hernia which can be detected easily while the infant is crying, coughing or straining during a bowel movement. Moreover, infants tend to become more irritable and lose appetite overtime. In a slightly older child, hernia can also be detected while the child stands for too long.

Also, hernia are soft and can be pushed inside; however in some cases hernia can become trapped, resulting in strangulation implying that the blood flow to the trapped tissue will be blocked, causing a life-threatening condition. Symptoms to identify a strangulated hernia condition:

  • Nausea and vomiting
  • Fever
  • Unexplained and growing pain
  • Red, purple or dark coloured hernia bulge
  • Problem in bowel movement or passing of gas

That said, most hernias are not complicated or life-threatening, though the complications depend on the severity of the condition. Hernia’s do not go away on their own and need medical intervention.

Treatment of Hernia

For hernias that lie silent and do not produce any symptoms, the best course of treatment is to wait and watch; treatment in such cases is only initiated when the hernia starts producing problematic symptoms. However, this methodology does not work in all types of hernia – some hernias even though silent are more risky than others, if not treated timely.

While the most preferred form of treatment of hernia is surgery but the type of surgery depends on case-to-case and also the location of hernia. Two main types of surgeries undertaken to cure hernia include:

  • Open surgery
  • Laparoscopic surgery

Open surgery: In this type of surgery, the doctor uses sutures, mesh or a combination of both to close the hernia. The wound in the skin is closed by sutures, staples or glue. In this surgery, the doctor makes an incision close to the hernia site and then pushes the bulging structure back inside.

Laparoscopic surgery: In a laparoscopic surgery, the doctor uses a small camera and a tiny surgical equipment to repair the hernia by making only a few small incisions. This type of surgery does not cause any harm to the surrounding body tissues.

The kind of treatment operation depends on case-to-case. Also, it is very common for a hernia to comeback, even after a surgery. All precautions and post-operative care methods must be discussed with the doctor.

In case of a laparoscopic surgery, the patient is allowed to go home on the same day – in most cases. The recovery takes about 1 to 2 weeks, post which the patient can return to normal day-to-day activities, while strenuous activities can be undertaken only after 4 weeks and consultation with the doctor. In case of an open surgery, the patient is discharged on the same day of the procedure, but the recovery can take longer than a laparoscopic surgery. The patient can return to normal light activities in 3 weeks and strenuous activities should be undertaken only after 6 weeks and post-consultation with the doctor.

Preventing Hernia

Not all hernias can be prevented. Hernia’s caused due to genetic factors – such as congenital diaphragmatic hernia, weak muscles, etc. – cannot be avoided. However, in many cases, hernia can be avoided provided, if some precautions are followed:

  • Consuming smaller meals
  • Maintain healthy weight
  • Avoiding or reducing alcohol or tobacco intake
  • Avoiding or minimizing intake of certain foods such as spicy or fibre-rich items
  • Preventing strain on muscles
  • Intake balanced diet
  • Using proper lifting techniques for heavy objects
  • Avoiding chronic constipation

Hernia is a very common and easily treatable condition. Moreover, with the right diet, exercise and lifestyle choices, it is also possible to prevent hernia in the first place.

হার্নিয়ার চিকিৎসা (ট্রিটমেন্ট)

হার্নিয়া একটি খুবই সাধারণ সমস্যা, যা মহিলা ও পুরুষ, উভয়কেই প্রভাবিত করে থেকে থাকে। রেকর্ড অনুসারে, প্রকৃতপক্ষে, প্রত্যেক দশ জনে একজন হর্নিয়া দ্বারা প্রভাবিত। যদিও সমস্যাটি সম্পূর্ণ ভাবে নিরাময়যোগ্য এবং জীবন সঞ্চারে কোনো ভয় বা হুমকির সম্ভাবনা থাকে না, তবুও তার চিকিৎসকীয় অবিপ্রায় এবং বাড়িতে চিকিৎসার প্রয়োজন থেকে থাকে। যখন শরীরের কোনো কাঠামো বা অঙ্গ, যদি মাসলের (পেশী) বডি টিস্যুগুলোর মাঝখানে পাওয়া জায়গা দিয়ে অস্বাভাবিক ভাবে প্রসারিত (প্রোট্রুড) হয়ে যেতে দেখা দেয়, সেই পরিস্থিতিকে হার্নিয়া বলে সংজ্ঞায়িত করা হয়। শরীরের এই অবস্থা, যেখানে সম্পর্কিত অঙ্গ বা কাঠামো গর্ভাবস্থা, কোষ্ঠকাঠিন্যতা, ভারী ওজন তোলা, পেটে তরল পদার্থ জমা, দেহের অতিরিক্ত ওজন, সার্জারি, ক্রমাগত কাশি, ক্রমাগত হাঁচি, ইত্যাদি কারণের জন্য দুর্বল হয়ে পড়ে। বার্ধক্য, অতিরিক্ত কাশি, আঘাত, অস্ত্রোপচারের (সার্জারির) জটিলতা, এবং তা ছাড়াও আরও অন্য অনেক কারণেই পেশীগুলো (মাসলগুলো) দুর্বল হয়ে যেতে পারে। উপরোক্ত কারণগুলো ছাড়া, যে যে কারণে কেউ হার্নিয়া রোগে আক্রান্ত হতে পারে তা হল :

  • পারিবারিক ইতিহাস
  • মোটা শরীর বা অত্যাধিক ওজন
  • দীর্ঘস্থায়ী ও দীর্ঘায়তির কাশি
  • গুরুতর কোষ্ঠকাঠিন্য
  • ধূম্রপান
  • সিস্টিক ফাইব্রোসিস (অংশসমূহের বৃদ্ধি)
  • বারংবার বমি করা

তলপেটে, উপরের উরুতে, গোপনাঙ্গের খাঁজে এবং পেটে, যে কোনো জায়গাতেই হার্নিয়ার গঠন হতে পারে। ইনগুইনল হার্নিয়া, হিয়াটল হার্নিয়া, অম্বিলিকল হার্নিয়া, এবং ইনসিশনল হার্নিয়া হল কয়েক প্রকারের হার্নিয়া যা অধিকাংশ মানুষকে প্রভাবিত করে। যদিও হার্নিয়া, রোগ হিসেবে খুবই পরিচিত, সময়মতো চিকিৎসার ব্যবস্থার জন্য লক্ষণগুলো জেনে রাখা খুব প্রয়োজনীয়। হার্নিয়া রোগের কিছু সাধারণ লক্ষণ হল, যে কোনো স্থানে অন্তর্ভুক্ত একটা স্ফীত অংশ বা পিন্ড; ঝুঁকতে গেলে, কাশতে গেলে বা জিনিস তুলতে গেলে ক্ষতিগ্রস্থ স্থানে ব্যথা হওয়া; তলপেটে দুর্বলতা; স্ফীত অংশে ব্যাথা বা জ্বালা; এ্যাসিড প্রতিপ্রবাহ (রিফ্লাক্স); বক্ষস্থলে প্রবল যন্ত্রনা; আর গ্রাস করতে অসুবিধে। এত কিছুর পরে, এটা বলা দরকার যে হার্নিয়া লক্ষণগুলো একই ধরণের হয় না এবং আলাদা আলাদা মানুষের ও হার্নিয়ার ধরণে ভিন্ন-ভিন্ন লক্ষণ দেখা দিতে পারে; এবং এটাও সম্ভব হতে পারে যে কোনো লক্ষণ না থাকা সত্বেও বিদ্যমান থাকতে পারে।

সাধারণত, হার্নিয়া রোগ থেকে জীবনের কোনো হুমকি যদিও দেখা যায় না, কিন্তু কিছু ক্ষেত্রে কোনো কোনো রোগীর তীব্র সমস্যা দেখা দিতে পারে। সকল ক্ষেত্রেই, যেখানে হার্নিয়ার থেকে সমস্যাজনক লক্ষণ উৎপন্ন হয়, চিকিৎসা করানো অপরিহার্য হয়ে দাঁড়ায়।

হার্নিয়ার চিকিৎসা

যে সকল হার্নিয়ার ধরণের ক্ষেত্রে যেখানে কোনোরকমের লক্ষণ দেখা দেয় না, দেখতে থাকে এবং অপেক্ষা করা ছাড়া কোনো গতি থাকে না, কারণ চিকিৎসা তখনই শুরু করা যাবে যখন কোনো সমস্যাযুক্ত লক্ষণ দেখা দেবে।         

যদিও হার্নিয়া চিকিৎসার সবচেয়ে জনপ্রিয় পদ্ধতি হল সার্জারি, কিন্তু সার্জারির ধরণ আলাদা আলাদা হার্নিয়ার ক্ষেত্রে ও তাদের অবস্থানের জায়গার হিসেবে নির্ধারিত হয়। হার্নিয়া চিকিৎসার জন্য ব্যবহৃত দুটি প্রধান সারজারির পদ্ধতি হল :

  • ওপেন সার্জারি
  • ল্যাপ্রোস্কোপিক সার্জারি

ওপেন সার্জারি : এই ধরণের সার্জারিতে বা অস্ত্রোপচারে চিকিৎসকেরা সাধারণত হার্নিয়া বন্ধ করতে সেলাই (স্য়ুচর্স) বা জালি (মেশ) বা দুটোর সংমিশ্রণ ব্যবহার করে থাকেন। ত্বকের ওপরে যে ক্ষতটি থাকে সেটা সেলাই দিয়ে, বা স্টেপেল করে বা আঠা দিয়ে বন্ধ করা হয়। এই ধরণের সার্জারিতে, চিকিৎসক হার্নিয়া অবস্থানের কাছাকাছি একটু চিরে স্ফীত অংশটিকে চেপে ঢুকিয়ে দেন।     

ল্যাপ্রোস্কোপিক সার্জারি : ল্যাপ্রোস্কোপিক সার্জারিতে, চিকিৎসক একটি ছোট ক্যামেরা ও একটি ক্ষুদ্র অস্ত্রোপচারের যন্ত্র দিয়ে, কয়েকটা ছোট ছোট চেরা লাগিয়ে হার্নিয়া সারিয়ে তোলেন। এই ধরণের অস্ত্রোপচারে আশেপাশের টিস্যুগুলোর কোনো ক্ষতে হওয়ার সম্ভাবনা থাকে না। 

সার্জারির ধরণ অবস্থা কতটা জরুরী এবং পরিস্থিতির ওপর নির্ভর করবে। অস্ত্রোপচার ছাড়া, যোগার মত শারীরিক অনুশীলনেও পরিস্থিতি মতে সাহায্য পাওয়া যেতে পারে। নিম্নলিখিত শারীরিক অনুশীলন হার্নিয়ার ক্ষেত্রে সাহায্য করে :

এক পা তোলা (সিঙ্গল লেগ রেস্ড) : এই অনুশীলনের দ্বারা পেট ও তলপেটের জোড় বারে এবং হার্নিয়ার থেকে যে সকল জটিলতা উৎপন্ন হতে পারে তার প্রতিরোধ করে। অনুশীলনের এই পদ্ধতিটিতে রোগীকে চিত হয়ে সোজা হয়ে শুয়ে, হার্নিয়ার ওপরে দুটি হাত রাখবে। এই পরিস্থিতিতে, একটি করে পা নারিয়ে ওপর নীচে করতে হবে; এবং মাটিতে পা পড়তে পারবে না। এই অনুশীলনটি দুটি পা দিয়ে দিনে ২ জোড়া করে করতে হবে।

আড়াআড়ি পা রাখা (লেগ ক্রসিং) : এই পদ্ধতিতে রোগীকে চিত হয়ে সোজা হয়ে শুয়ে, হার্নিয়ার ওপরে দুটি হাত রেখে, ওই অবস্থায় দুটি পা মাটির থেকে দু ফিট ওপরে তুলে ধরে, কাঁচির মত দুটো পা চালাতে থাকবে, যেখানে একবার একটা পা ওপরে থাকবে এবং পরের বার অন্য পা। এই অনুশীলনটা একটি সেটে ১০ করে, দুটি সেট করা উচিত। এই অনুশীলনটি পেট এবং তলপেটের কাছের অঙ্গগুলো যাতে স্থানচ্যুত না হয়ে, হার্নিয়ার কোনো জটিলতা না দেখা দেয়, তার জন্য প্রয়োজনীয়। 

গাছের ভঙ্গি অবলম্বন করা (ট্রী পোজ) : এই অনুশীলন পদ্ধতিতে, অনিশীলনকারীকে পায়ের আঙুলের ওপর দাড়িয়ে থাকতে হবে, আর ভেতরের পাটার ওপর জোড় দিয়ে, একটা হাঁটুকে একটু ভাঁজ করে রাখতে হবে। এই রূপ ধারণ করার পরে, ঝুঁকে গিয়ে সেই গোড়ালিটাকে ধরে ওপরের দিকে এনে ভেতরের উরুতে রাখতে হবে। এই অবস্থায় হাত দুটো জোড় করে মাথার ওপরে রাখতে হবে; এতে হার্নিয়ার অনুভূক্ত অঙ্গগুলোর অঞ্চলে টান পড়ে এবং মাংসপেশী (মাস্ল্স) ও বডি টিস্যুগুলোতে শক্তি প্রদান করে।

এই অনুশীলনগুলো ছাড়াও হার্নিয়ার পরিচালনার জন্য আরও কিছু কার্যকারী পদ্ধতি আছে। য়েগুলো হল :

  • স্বাস্থ্যকর ওজন বজায় রাখা
  • মাংসপেশীতে শক্তি উন্নত করতে লক্ষ্যযুক্ত সহকারে শারীরিক ক্রিয়াকল্পে রত হওয়া
  • ওষুধের প্রয়োগ
  • ফাইবার সম্বৃদ্ধ খাদ্য
  • জল ও তরল পদার্থ

তদ্ব্যতীত, ট্রসেস, করসেট ও বাইন্ডার পড়লেও হার্নিয়াকে ঠিক জায়গায় ধরে রেখে, ত্বক ও অঙ্গ প্রাচীরের ওপর চাপ সৃষ্টি করতে সাহায্য করে। এ সকল বলার পরে, এটা বলা উচিত যে সঠেক পদ্ধতি অনুসরণ করলে খুব সহজে হার্নিয়ার পরিচালনা করে চিকিৎসা করানো যায়।

Stone operation – Understand the rays used in laser stone operations?

Laser stone operation also called lithotripsy, is a medical procedure that uses a laser or high-energy shock waves to break stones of the kidney, gallbladder or ureter. Once the stone is broken, the remaining particles are flushed out of the body while urinating. Stones in kidney, gallbladder or ureter, are a common phenomenon while some stones are small enough and pass on their own, while for others, medical intervention may be required because of their size. Large stones cause a lot of pain and also block the flow of urine; thereby, treatment becomes an immediate requirement.

Basically, stones are hard masses of tiny crystals formed due to excessive accumulation of certain minerals in the body and lack of fluids to dissolve the minerals. These minerals include calcium, oxalate, and uric acid. When the concentration of these minerals in the body exceeded a certain level, and there is not enough presence of fluids to dissolve these minerals – stones are formed. Apart from this, some other factors such as poor diet, severe diarrhoea, excessive weight, family history or certain medicines can also cause the formation of stones. 

Stones are generally brown or yellow in colour and have a smooth, as well as a rough texture. These can be the size of sand, gravel, pearl or even bigger and is usually painful since it blocks the flow of urine. In some cases, people do not even realize the presence of stones unless they start to stir and move, causing discomfort and pain. However, in case do stones do not pass on their own, they can cause immense damage to the kidneys and urinary tract. Thus, when medications fail to flush out stones, laser technique may be used to break down the stone into small pieces, enabling it to pass through. This method of using laser for stone operations is known as lithotripsy.

Types of Lithotripsy

There are two types of lithotripsy used for stone operations, including:

  • Extracorporeal Shock Wave Lithotripsy (ESWL)
  • Flexible Ureteroscopy and Laser Lithotripsy (FURSL)

Both the operations treat stone effectively; the usage of one over the other depends on the overall health of a person and the type of stones.

Extracorporeal Shock Wave Lithotripsy (ESWL): This method of treatment of stones uses high-frequency shock waves to break down the stones. In this operation, an instrument known as lithotripter is used to direct sound waves or focused ultrasonic energy directly at the stones, causing them to break into smaller pieces. These high-frequency sound waves only affect the stones and do not cause any harm to the surrounding organs and tissues. The shock waves travel into the body from the skin and tissue, breaking stones into smaller pieces. Post the operation, the broken smaller pieces are eventually passed through urine over several days or weeks. The stone operation is about an hour-long with a short hospital stay and quick recovery time. This enables patients with certain types of stones in the body to avoid invasive surgery to remove stones. 

Flexible Ureteroscopy and Laser Lithotripsy (FURSL): This surgical treatment involves using an endoscope – a flexible, thin tube with a light and high-definition camera mounted on top of it – to see inside the impacted organ and reach the stones. Thereafter, the laser is used to break the large stone into smaller pieces, allowing them to pass through the urine in the following days and weeks. The surgery time is approximately 30 minutes, and the patients are discharged on the same day, as well as the recovery time is really short, with average people returning to their normal activities within a week or two.

Preparation for Laser Stone Operations

Before any laser stone operation, the doctor will determine the number of stones, the size and location of the stones in the body. This is done by injecting a dye into a vein to conduct an intravenous pyelogram (IP) to help locate the stones in the body. The injected dye travels through the bloodstream into the kidneys, ureter and bladder, highlighting the stones as dark spots in an X-ray. 

Possible events that you will witness post the surgery but need not be panicked about: 

  • Light-headedness
  • Blood in the urine for the first few days
  • Extreme pain in the back and flank
  • Bruising on the skin

Certain points should be kept in mind before the surgery, such as:

  • Inform the doctor about any ongoing medication, especially blood thinners and painkillers
  • Stop smoking several days before the surgery
  • The surgery is done under anaesthesia which implies there needs to be fasting of 8 to 12 hours before the surgery
  • Surgery can cause some nausea and drowsiness; hence all arrangements of commuting and care should be made before the surgery
  • Do not drive back after the operation. Instead, ask someone to pick you up and take home from the hospital.
  • Take enough rest and avoid any physical activity at least for 2-3 days. Even after this duration, if you do not feel energetic enough to take on normal routine activities, take some more rest.
  • Drink a lot of water after the procedure an in the weeks to follow after the operation. Overall, maintain the quantity of 8 glasses of water each day.
  • Take all medications as suggested by the doctor even if you tend to feel fine. Completing the full course is essential. 
  • East less salt
  • Reduce foods that are high on calcium
  • Drink fluids such as lemonades (without sugar) eat lemons and organs
  • Do not consume a lot of protein, eat lean meats instead
  • Opt for a low-fat diet
  • Avoid alcohol
  • Avoid calcium supplements for some time and seek advice on when to restart the doses
  • Avoid high doses of vitamin c supplements
  • Visit the doctor on all appointments as suggested.

Further, one must consult the doctor about any precautions to follow post the laser stone operation. Precautions might also vary a condition on the condition, and proper consultation is very critical. However, in the general scenarios, one must carefully follow these rules to recover well after a laser stone operation.

An ultimate guide on Liver Transplant

The liver is the largest internal organ in the human body and is placed on the right side of the abdomen, right below the diaphragm. The liver performs various vital functions such as:

  • Detoxifying the body
  • Breaking down food and nutrients to form energy
  • Stores vitamins, minerals and sugar
  • Produces bile – a compound used to digest fat and absorb vitamins
  • Prevents blood clotting
  • Helps fight infection by filtering bacteria from blood
  • Regulating immune responses

A healthy functioning liver is very critical for a healthy life because a liver performs various vital functions. When this essential organ of the body becomes diseased or severely compromised, a transplant may be required. A liver transplant is a surgical procedure aims to replace the diseased liver with a healthy liver from another person – known as a donor. A diseased liver is a liver that does not function properly. In a liver transplant, a part of the liver or the whole liver can be replaced, depending on the condition of the liver of the patient requiring the transplant.

Reasons of a liver transplant

A liver transplant is recommended for patients that have end-stage liver disease or whose liver no longer functions adequately; this condition is also called liver failure. A liver failure may occur suddenly due to viral hepatitis infection, injuries from drugs or any other infection. In some cases, liver failure can also occur because of a prolonged liver problem. A liver transplant can be used to treat both acute liver failure and chronic liver failure; the main cause of which is scarring of the liver tissue known as cirrhosis. Cirrhosis replaces the healthy tissue with scar tissue, hampering the functioning of the liver. It is the most common reason for a liver transplant in patients.

Some major causes of cirrhosis leading to a liver failure and the need for liver transplant include, but are not limited to:

  • Hepatitis B and Hepatitis C
  • Excessive consumption of alcohol
  • Excessive consumption of tobacco products
  • Non-alcoholic fatty liver problem that creates masses of fat in the liver leading to damage
  • Wilson’s disease that leads to accumulation of copper in the liver
  • Genetic problem such as hemochromatosis that leads to build-up of iron in the liver
  • Bile duct conditions such as primary biliary cirrhosis, primary sclerosing and biliary atresia

Also, to assess if a patient qualifies for a liver transplant, the doctor might evaluate:

  • Severity of the problem
  • Overall health
  • Medical history including infections such as HIV and tuberculosis
  • Mental health
  • Provision of support and care post the surgery
  • Willingness of the patient to alter lifestyle patterns and habits

Moreover, before doing the transplant, the doctor will also assess if the donor liver will benefit the condition of the patient concerned and increase his life span considerably. A patient with chronic health conditions may not qualify for a liver transplant.

Risks involved in a liver transplant

A liver transplant surgery is a significantly risky surgery with risks associated with the procedure, as well as with the medications given to the patient to prevent rejection of the donor liver. Some basic risks associated with a liver transplant include:

  • Bleeding
  • Blood clots
  • Rejection of the donor liver
  • Failure of the donor heart
  • Infection
  • Leakage from bile ducts
  • Shrinking of bile ducts
  • Seizures
  • Confusion

Moreover, in some cases the liver disease might recur in the transplanted liver. Also, post a liver transplant, the patient would need to continuously take medications to prevent rejection of liver; these medications are called anti-rejection medications and can cause a host of side effects, such as:

  • Thinning of bones
  • Diabetes
  • Diarrhoea
  • Severe headache
  • High blood pressure
  • High cholesterol level
  • Higher chances of infection
  • Weakened immune system

Procedure of a liver transplant

Before the procedure the doctor will conduct some tests to assess the overall health of the patient. These include blood and urine test, ultrasound, heart test, cancer tests, etc. Moreover, liver function tests will be performed to know the severity of the problem and the urgency of the transplant. Accordingly, the patient is put on the liver transplant waiting list. The wait for a donor liver to be available can vary greatly from case-to-case; where some patients might get a matching donor liver within days, others might not get the donor liver for months or years. In fact, some patients might not receive the donor liver. During the waiting process, the doctor will make the patient as comfortable as possible by treating symptoms.

An alternative to this could be a living donor liver in which a living person donates a part of the liver to the patient in need for the transplant. The donor’s liver grows back to its size within some weeks. This procedure is done after careful consideration. Foremost, there needs to be a person who is healthy, willing and also matches the donor’s criteria such as age, health, blood type, and organ size, etc. In most cases, the living donors are close family members or friends of the patient. A living donor transplant is safe and also as successful as a deceased donor transplants, but a lot of evaluations and tests need to be conducted to ensure the donor is a match; also the surgery carries risks for the donor.

No matter whether the patient is waiting for a liver or has the surgery already scheduled, it is critical for the patient to stay healthy and be ready for the transplant surgery. All medications need to be taken regularly, a healthy diet needs to be followed, all medical check-ups and appointment should be taken, and the patient should stay reasonable active.

Once the liver is available or the surgery, the patient will be admitted to the hospital and an examination to assess the overall health of the patient will be done. When cleared, the patient is given general anaesthesia and sedated before beginning the surgery. Then the surgeon makes a long incision across the abdomen to access the liver and remove the deceased liver while replacing it with a donor liver in the body. Once the donor liver is placed properly, the surgeon then connects the blood vessels and bile ducts to the new liver. Post this, staples and stitches are used to close the incision and then the patient is transferred to the intensive care unit for follow-up and recovery.  A liver transplant surgery can take up to 12 hours or more depending on the condition of the patient.  In case of a living donor operation, the surgeon first removes the liver from the donor and then performs the surgery on the patient similar to that of a deceased donor liver transplant surgery.

Post the surgery, the patient is kept under observation for a period of time to check for any complications and the response of the donor liver. Once, the patient is discharged, the doctor advises on the complete care routine regime, medications, home precautions, etc. that should be followed to ensure speedy recovery and effective functioning of liver.

That said, chances of a liver transplant surgery being successful depend on the patient’s condition and the complexity of the case. Though, survival rates are high and hence, the surgery is retorted as the ultimate step to treat fatal liver conditions.

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