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FAQ

First, your doctor will look at the anal area, perhaps by inserting a lubricated gloved finger or an anoscope (a hollow, lighted tube for viewing the lower few inches of the rectum) or a proctoscope (which works like an anoscope, but provides a more thorough rectal examination).

More procedures may be needed to identify internal haemorrhoids or rule out other ailments that frequently cause anal bleeding, such as anal fissure, colitis, Crohn’s disease, and colorectal cancer.

To see further into the anal canal (into the lower, or sigmoid, colon), sigmoidoscopy may be used, or the entire colon may be viewed with colonoscopy. For both procedures, a lighted, flexible viewing tube is inserted into the rectum. A barium X-ray can show the entire colon’s interior. First a barium enema is given and then X-rays are taken of the lower gastrointestinal tract.

  • Anal fissures are cracks or tears in the anus and anal canal. They may be acute or chronic.
  • Anal fissures are caused primarily by trauma, but several non-traumatic diseases are associated.
  • The primary symptom of anal fissures is pain during and following bowel movements. Other symptoms that may occur are:
    • bleeding,
    • itching, and a
    • malodorous discharge.
  • Anal fissures are diagnosed and evaluated by visual inspection of the anus and anal canal.
  • Anal fissures are initially treated conservatively with home remedies and OTC products by:
    • adding bulk to the stool,
    • softening the stool,
    • consuming a high fiber diet,
  • utilizing sitz baths.
  • Prescription drugs used to treat anal fissures that fail to heal with less conservative treatment include:
    • ointments containing anesthetics,
    • steroids,
    • nitroglycerin, and
    • calcium channel blocking drugs (CCBs).
  • Surgery by lateral sphincterotomy is the gold standard for curing anal fissures. Following surgery, 93% to 97% of fissures heal, Recurrence rates after this type of surgery are low, 0% to 3%.

The partial lateral internal sphincterotomy as the technique of choice for the treatment of anal fissures or in an open fashion by cutting through the anoderm. The cut is made on the left or right side of the anus, hence the name “partial lateral internal sphincterotomy.” The posterior midline, where the fissure usually is located, is avoided for fear of accentuating the posterior weakness of the muscle surrounding the anal canal. (Additional weakness posteriorly can lead to what is called a keyhole deformity, so called because the resulting anal canal resembles an old fashioned skeleton key. This deformity promotes soilage and leakage of stool.)

Although many surgeons decline to cut out the fissure itself during lateral sphincterotomy.Remove the fissure is not always appropriate, and characteristics of the fissure itself should be taken into account. If the fissure is hard and irregular, suggesting anal cancer, the fissure should be biopsied. If the edges and base of the fissure are heavily scarred, there may be a problem after surgery with anal stenosis, a condition in which additional scarring narrows the anal canal and interferes with the passage of stool. In this case, it may be better to cut out the scarred fissure so that there is a chance for the wound to heal with less scarring and chance of stenosis. Finally, an associated large anal papilla or a large hemorrhoidal tag may interfere physically with wound healing, and removing them may promote healing.

There are a number of self-help measures your GP may recommend to relieve constipation and reduce the pain caused by anal fissures.

Relieving constipation can allow anal fissures to heal and reduce the chances of further fissures developing in the future.

Self-help measures include:

  • Increasing your daily intake of fibre by eating plenty of high-fibre foods, such as fruit, vegetables and wholegrain foods.
  • Avoiding dehydration by drinking plenty of water.
  • Trying to get more exercise – for example, by going for a daily walk or run.
  • Working out a place and time of day when you can comfortably spend time on the toilet.
  • Not delaying going to the toilet when you feel the urge.
  • If you use wet wipes, avoid products that contain fragrance or alcohol, as this could lead to discomfort or itching. If you use toilet paper, use a soft brand and avoid wiping too hard.

For more self-help measures, read our page on preventing anal fissures.

Complications from umbilical hernias rarely occur in children. However, if the umbilical cord is trapped, additional complications can occur in both children and adults.

Intestines that cannot be pushed back through the stomach wall sometimes do not get adequate blood supply. This can cause pain and even kill the tissue (gangrene), which could result in a dangerous infection. In addition, if an obstruction of the intestines occurs, emergency surgery might be required.

Can Umbilical Hernias Be Repaired?

In adults, surgery is usually suggested to make sure that no complications develop. In children, umbilical hernias often fix themselves. Before choosing surgery, doctors will normally wait until the hernia:

  • becomes painful
  • bigger than a half inch in diameter
  • does not shrink in size after one year
  • does not go away by the time your child is three or four years old
  • becomes trapped or blocks the intestines

Giant ventral hernias are those that have grown beyond 10 centimeters. They pose a serious surgical risk. The giant hernia fills the abdominal cavity, making it difficult to remove from the surrounding organs. As the hernia grows in size, the risk of a reoccurrence also becomes higher.

Other complications of untreated hernias include:

  • incarceration: the intestines become trapped outside of the abdomen; this may cause blockage to the intestines or stop blood supply
  • strangulation: occurs when blood is cut off to the intestines. Part of the intestines may die or begin to decay. Immediate surgery is required as the bowel may also become blocked off

Ventral hernias should be fixed unless the patient cannot undergo surgery or refuses it. If left untreated, they continue to grow slowly until they are able to cause serious complications.

Options for surgical treatment include:

  • mesh placement surgery: a surgeon pushes tissue back into place and then sews in a wire mesh to keep it in place; this is considered safe and reliable
  • laparoscopic removal: multiple small openings are made and the hernia is fixed using a small camera inside the body to direct the surgery
  • open surgery (nonlaparoscopic): large opening is made so surgeon can enter the body to push the tissue back into place and then sew it

Benefits of laparoscopic removal include:

  • a much smaller cut site (lowers chance of infection)
  • reduced postoperative pain
  • reduced hospital stay (generally able to leave day of or day after procedure)
  • absence of large scar

Some concerns of open surgery include:

  • longer stay in the hospital after surgery
  • greater amount of pain
  • medium to large scarring

Results may vary depending on the type of procedure and each patient’s overall condition. Common advantages may include:

  • Less post-operative pain
  • Shortened hospital stay
  • Faster return to regular diet
  • Quicker return to normal activity

First, your doctor will ask you about your medical history and perform a physical examination. During the exam, the doctor will gently push against your abdomen to pinpoint the source of your abdominal pain.

Your doctor may order blood tests and imaging tests if appendicitis is caught early. These could include CT scans or an abdominal X-ray. However, your doctor may skip these tests if he or she believes an emergency appendectomy is necessary.

Before surgery, you’ll be hooked up to an IV so you can receive fluids and medication. You’ll likely be put under general anesthesia so that you will be unconscious during surgery.

There are two types of appendectomy: open and laparoscopic. The kind of operation your doctor chooses depends on several factors, including the extent of the infection and your medical history.

Open Appendectomy

During an open appendectomy, a surgeon makes one incision into the lower right portion of your abdomen. Your appendix is removed and the wound is closed.

Reasons your doctor may choose an open appendectomy include:

  • bleeding problems during the operation
  • extensive infection
  • a history of prior abdominal surgery
  • obesity
  • a perforated appendix

Laparoscopic Appendectomy

During a laparoscopic appendectomy, the surgeon accesses the appendix through several small incisions in your abdomen. The surgeon uses narrow, tube-like instruments to operate on the infected organ. A camera in one of the tubes allows the surgeon to see inside your abdomen to guide the instruments.

After the appendix is removed, the small incisions are cleaned, closed, and dressed. The risk of infection from laparoscopic appendectomy is lower than from open appendectomy because the incision wounds are smaller.

Advantages of Laparoscopic Appendectomy

1. Shorter hospital stay

2.Faster recovery time.

3.Least post operative pain.

4.Fewer post operative complain.

5.Minimal scarring.

A vaginal delivery is the birth of babies in humans  through the vagina. It is the natural method of birth for all mammals except monotremes, which lay eggs into the external environment. The average length of a hospital stay for a normal vaginal delivery is 36–48 hours or with an episiotomy (a surgical cut to widen the vaginal canal) 48–60 hours, whereas a C-section is 72–108 hours.[citation needed] Different types of vaginal deliveries have different terms:

  • A spontaneous vaginal delivery (SVD) occurs when a pregnant female goes into labor without the use of drugs or techniques to induce labor, and delivers her baby in the normal manner, without forceps, vacuum extraction, or a cesarean section.
  • An Assisted vaginal delivery (AVD) occurs when a pregnant female goes into labor (with or without the use of drugs or techniques to induce labor), and requires the use of special instruments such as forceps or a vacuum extractor to deliver her baby vaginally.
  • An Instrumental vaginal delivery (IVD) is another term for an assisted vaginal delivery.
  • An Induced vaginal delivery (also IVD) is a term for a delivery involving labor induction, where drugs or manual techniques are used to initiate the process of labor. Use of the term “IVD” in this context is less common than for instrumental vaginal delivery.
  • A Normal vaginal delivery (NVD) is a term for a vaginal delivery, whether or not assisted or induced, usually used in statistics or studies to contrast with a delivery by cesarean section


TechniqueBenefitsDisadvantages
Abdominal hysterectomy
  • No limitation by the size of the uterus
  • Combination with reduction and incontinence surgery possible
  • Longest duration of hospital treatment
  • Highest rate of complications
  • Longest recovery period
Vaginal hysterectomy
  • Shortest operation time
  • Short recovery period
  • Combination with reduction operations are possible
  • Limitation by the size of the uterus and previous surgery
  • Highest blood loss
  • Limited ability to evaluate the fallopian tubes and ovaries
Laparoscopic supracervical hysterectomy
  • Low risk of complication
  • Less blood loss
  • Short inpatient treatment duration
  • 10-17% of patients continue to have minimal menstrual bleeding
Laparoscopic-assisted vaginal hysterectomy
  • Possible even with larger uterus and after previous surgery
  • Combination with reduction operations are possible
  • Long operation time
  • High instrumental costs by changing the access path
Total laparoscopic hysterectomy
  • Less blood loss
  • Short inpatient treatment duration
  • None to date

Doctors most often find ovarian cysts during routine pelvic exams. The doctor may feel the swelling of a cyst on the ovary. Once a cyst is found, tests are done to help plan treatment. Tests include:

  • An ultrasound. This test uses sound waves to create images of the body. With an ultrasound, the doctor can see the cyst’s:
    • Shape
    • Size
    • Location
    • Mass — if it is fluid-filled, solid, or mixed
  • A pregnancy test. This test may be given to rule out pregnancy.
  • Hormone level tests. Hormone levels may be checked to see if there are hormone-related problems.
  • A blood test. This test is done to find out if the cyst may be cancerous. The test measures a substance in the blood called cancer-antigen 125 (CA-125). The amount of CA-125 is higher with ovarian cancer. But some ovarian cancers don’t make enough CA-125 to be detected by the test. Some noncancerous diseases also raise CA-125 levels. Those diseases include uterine fibroids (YOO-tur-ihn FEYE-broidz) and endometriosis. Noncancerous causes of higher CA-125 are more common in women younger than 35. Ovarian cancer is very rare in this age group. The CA-125 test is most often given to women who:
    • Are older than 35
    • Are at high risk for ovarian cancer
    • Have a cyst that is partly solid

Watchful waiting. If you have a cyst, you may be told to wait and have a second exam in 1 to 3 months. Your doctor will check to see if the cyst has changed in size. This is a common treatment option for women who:

  • Are in their childbearing years
  • Have no symptoms
  • Have a fluid-filled cyst

It may be an option for postmenopausal women.

Surgery. Your doctor may want to remove the cyst if you are postmenopausal, or if it:

  • Doesn’t go away after several menstrual cycles
  • Gets larger
  • Looks odd on the ultrasound
  • Causes pain

  • Laparoscopy – Done if the cyst is small and looks benign (noncancerous) on the ultrasound. While you are under general anesthesia, a very small cut is made above or below your navel. A small instrument that acts like a telescope is put into your abdomen. Then your doctor can remove the cyst.
  • Laparotomy – Done if the cyst is large and may be cancerous. While you are under general anesthesia, larger incisions are made in the stomach to remove the cyst. The cyst is then tested for cancer. If it is cancerous, the doctor may need to take out the ovary and other tissues, like the uterus. If only one ovary is taken out, your body is still fertile and can still produce estrogen.

You need to take right care of your health during your pregnancy to ensure natural delivery. Have a quick look at the pregnancy tips for having natural delivery.

Diet: You should pay attention to your diet from the time you are confirmed the news of pregnancy. Stick to nutritious diet and add fresh fruits and vegetables to your daily intake. Focus on the intake of iron and calcium rich food items. Take multivitamins suggested by your doctor regularly.

Active Lifestyle: Maintain an active lifestyle and this means performing light and permissible yoga asanas and regular walk while you are pregnant. Consult a yoga guru or join a class that can teach you typical exercises that helps in progressing towards normal delivery. You might feel fatigued and lethargic in the early days, but things will get to normal as you proceed through weeks.

Water: Increase your water intake and make sure you drink at least 8 – 10 glasses of water daily.

Stress: Check your stress level and try to remain stress free throughout your pregnancy period. Keep yourself happy and contented. This has positive effect on the child and helps you stay healthy. Music can help you stay relaxed and comfortable.

Birth Plan: Make a birth plan after consulting with your doctor and discuss with her before finalizing it. This will help you have a smooth and hassle free childbirth.

Prenatal Class: Attend a prenatal class where you will be helped out with any problems that might come during childbirth and how would you handle it. Also, they will teach you some exercises and actions so as to have easy, less painful and fast childbirth.

Yoga: Yoga increases flexibility and helps you stay relaxed. It helps you in having normal delivery and that too with minimum pain and discomfort. Make sure the yoga asanas you are performing is safe for you and your baby.

Tubal ligation or tubectomy (also known as having one’s “tubes tied” (ligation)) is a surgical procedure for sterilization in which a woman’s fallopian tubes are clamped and blocked, or severed and sealed, either method of which prevents eggs from reaching the uterus for implantation. However, fertilization can still occur in the fallopian tubes. Tubal ligation is considered a permanent method of sterilization and birth control.

Procedure

Tubal ligation (incorrectly referred to as tubectomy) is considered major surgery requiring the patient to undergo spinal anesthesia. It is advised that women should not undergo this surgery if they currently have or had a history of bladder cancer. After the anesthesia takes effect, a surgeon will make a small incision at each side of, but just below the navel in order to gain access to each of the two fallopian tubes. With traditional tubal ligation, the surgeon severs the tubes, and then ties (ligates) them off thereby preventing the travel of eggs to the uterus. Other methods include using clips or rings to clamp them shut, or severing and cauterizing them. Tubal ligation is usually done in a hospital operating-room setting.