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Chest/Heartburn not responding to anti-acidity medications.Long standing hyperacidity (to detect Helicobacter Pylori infection ).Severe nausea/recurrent vomiting.Upper abdominal (epigastric ) pain.Difficulty in swallowing (Dysphagia,odynophagia).Feeling of indigestion/Gas bloat/Excessive flatulence.Unexplained weight loss.Chronic anaemia.Chronic diarrhoea.Unexplained chronic cough.Hematemesis or malena (black stools).Diagnosis of early esophageal/stomach cancer.Endoscopic extraction of accidentally swallowed

Anal cancer is rare, but the number of new cases is rising. According to the American Cancer Society, in 2017, there are likely to be about 8,200 new cases, of which 5,250 will affect women and 2,950 will affect men. Around 1,100 people are expected to die from anal cancer, including 650 women and 450 men.Various risk factors are linked to anal cancer, but infection with two types of the human papilloma virus (HPV) appear to underlie 79 percent of cases.Anal cancer is rare before the age of 35 years. The average age of diagnosis is in the early 60s. Men have a 1-in-500 chance of getting anal cancer, and the risk is slightly higher in women.Symptoms and signsDiagram of the sphincterCommon symptoms of anal cancer may includerectal bleeding noticeable if there is blood on feces or toilet paperpain in the anal arealumps around the anus, which may be mistaken for piles, or hemorrhoidsmucus or jelly-like discharge from the anusanal itchingchanges in bowel movements, including diarrhea, constipation, or thinning of stoolsfecal incontinence, or problems controlling bowel movementsbloatingwomen may experience lower back pain as the tumor presses on the vaginawomen may experience vaginal dryness.CausesIn anal cancer, a tumor is created by the abnormal and uncontrolled growth of cells in the anus.The anus is the area at the very end of the gastrointestinal tract. The anal canal connects the rectum to the outside of the body. It is surrounded by a muscle known as the sphincter. The sphincter controls bowel movements by contracting and relaxing. The anus is the part where the anal canal opens to the outside.The anal canal is lined with squamous cells. These flat cells look like fish scales under the microscope. Most anal cancers develop from these squamous cells. Such cancers are known as squamous cell carcinomas.The point at which the anal canal meets the rectum is called the transitional zone. The transitional zone has squamous cells and glandular cells. These produce mucus which helps the stool, or feces, pass through the anus smoothly.Most anal cancers are squamous cell carcinomas, but adenocarcinoma can also develop from the glandular cells in the anus.Risk factorsMultiple risk factors have been studied that are linked to anal cancer. They include any or a combination of the following:Human papilloma virus (HPV): Some types of HPV are closely linked to anal cancer. Around 79 percent of people with anal cancer have HPV 16 or 18, and 8 percent have other types of HPV.Multiple sexual partners: This activity increases the risk of contracting HPV, which, in turn, increases the risk of anal cancer, which is a known risk factor.Receptive anal intercourse: Men and women who receive anal intercourse have a higher risk of developing anal cancer. Men who are HIV-positive and who have sex with men are up to 90 times more likely to develop anal cancer, compared with the general population.Other cancers: Women who have had vaginal or cervical cancer, and men who have had penile cancer are at higher risk of developing anal cancer. This is also linked to HPV infection.Age: Anal cancer, like most cancers, are more likely to be detected at an older age.A weakened immune system: People with HIV or AIDS and those who are taking immunosuppressant medications after a transplant are at greater risk.Smoking: Smokers have a significantly higher risk of anal and other cancers than non-smokers.Benign anal lesions: Irritable bowel disease (IBD), hemorrhoids, fistulae, or cicatrices have been linked to anal cancer. Inflammation resulting from benign anal lesions may increase the risk.TreatmentTreatment for anal cancer will depend on various factors, including how big the tumor is, whether or not it has spread, where it is, and the general health of the patient. Surgery, chemotherapy, and radiation therapy are the main options.SurgeryThe type of surgery depends on the size and position of the tumor.ResectionThe surgeon removes a small tumor and some surrounding tissue. This can only be done if the anal sphincter is not affected. After this procedure, the person will still be able to pass a bowel movement.Abdominoperineal resectionThe anus, rectum and a section of the bowel are surgically removed, and a colostomy will be established. In a colostomy, the end of the bowel is brought out to the surface of the abdomen. A bag is placed over the stoma, or the opening. The bag collects the stools outside the body. A person with a colostomy can lead a normal life, play sports, and be sexually active.Chemotherapy and radiotherapyMost patients will probably need chemotherapy, radiation therapy, or both.Radiation therapy may be combined with chemotherapy to destroy anal cancer cells. Treatments may be given together or one after the other. This approach increases the chance of retaining an intact anal sphincter. Survival and remission rates are good.Chemotherapy uses cytotoxic drugs that prevent the cancer cells from dividing. They are given orally or by injection.Radiotherapy uses high-energy rays that destroy the cancer cells. Radiation can be delivered internally or externally.Radiotherapy and chemotherapy have adverse effects, and combining them may make the side effects more acute.Side effects may include:diarrhea or constipationsoreness and blistering around the target area, which is the anusa higher susceptibility to infections during treatmentfatigueloss of appetitenausea or vomitingmouth ulcers or sore mouthloss of hairnarrowing and dryness of the vaginaa low white blood cell count, increasing the risk of infectionanemia, due to a low red blood cell counta low platelet count, raising the risk of bruising or bleedingdry skinrashesmuscle and nerve problemsexcessive coughing and sometimes breathing difficultiesfertility problems

What is a bowel perforation or hole in your colon and what are the symptoms? Who is at risk? And how is a perforation treated?OverviewYour colon is composed of layers of smooth muscle and mucous membranes. The innermost layer, called the mucosa, is soft and pliant—similar to the tissues in your mouth. Bowel perforations occur when a hole is made in this lining, often as a result of colon surgery or serious bowel disease. A hole in the colon then allows the contents of the colon to leak into the usually sterile contents of your abdominal cavity.SymptomsThe symptoms of a bowel perforation can vary and may come on slowly or rapidly depending on the underlying cause. Symptoms may include:Abdominal pain (often severe and diffuse)Severe abdominal crampingBloatingNausea and vomitingA change in your bowel movements or habits.Rectal bleedingFever (usually not immediately)ChillsFatigueRisk FactorsScientists have found that a number of factors may increase your risk of developing a bowel perforation. These include both factors involved in surgery or a procedure (iatrogenic causes) and bowel diseases characterized by inflammation. Risk factors may include:Recent or prior abdominal.Recent or prior pelvic surgery.Age greater than 75.History of multiple medical problems.Trauma to the abdomen or pelvis (such as in an automobile accident.)A history of diverticular disease.A history of inflammatory bowel disease.Colon cancerUse of the monoclonal antibody immunotherapy drug ipilimumab.Pelvic adhesions (scar tissue, usually related to previous surgeries.)Female gender (women typically have a more flexible colon, which can lead to accidental perforation during medical procedures, including a colonoscopy.)Diagnostic and surgical procedures involving the digestive tract, abdomen, or pelvis. Risk factors for a perforation during a colonoscopy include being female, older age, a history of diverticular disease, and bowel obstructions.CausesBowel perforations may occur spontaneously (unexpectedly) as a result of a medical condition or instead be a complication of various diagnostic and surgical procedures which accidentally create a hole in the colon. Trauma, especially blunt trauma to the abdomen, is also an important cause of bowel perforations.Procedure associated causes include:Enema – An improperly or forcefully inserted rectal tube for an enema can rip or push through the colon lining.Bowel preparation for colonoscopy - Rarely, the bowel preparation for a colonoscopy can result in a perforation. This is more common in people with a history of constipation. Sigmoidoscopy – Although the endoscope for a flexible sigmoidoscopy is flexible, perforation remains a risk, but a rare one.Colonoscopy – The tip of the endoscope has the potential to push through the inner lining of the colon, although this is a rare complication of the procedure and is not seen in the virtual colonoscopy. Perforation of the bowel associated with a colonoscopy is more common in those who have the severe acute disease of the bowel as well as those who are on steroid medications. The colonoscopy perforation rate appears to be around 1 in 1400 people who have screening colonoscopies and 1 of 1000 people who have a therapeutic colonoscopy (for example, to remove a polyp.)Abdominal or pelvic surgery, particularly colon surgery as for colon cancer.Causes of spontaneous bowel perforation (those unrelated to surgery or procedures) include:Inflammatory bowel disease/colitis such as Crohn's disease and ulcerative colitis. The lifetime risk of a bowel perforation with Crohn's disease is between one and three percent, making this a very common cause.Severe bowel obstruction, especially when the colon is "weakened" by diverticular disease, another process, or cancer.Trauma.Ischemic bowel disease (when the blood supply to the colon is compromised.)Colon cancer.Foreign body ingestion - Most commonly due to the ingestion of fish bones, and bone fragments, as well as non-food items.Severe bowel impaction.DiagnosisIf your doctor suspects a bowel perforation, she can order tests to confirm her suspicion. A simple abdominal x-ray may show gas outside the colon but is not often diagnostic. A CT scan of your abdomen with or without contrast or a barium enema or swallow may be needed. A complete blood count may show an elevation of your white blood cell count if the perforation has been present for a while, or evidence of anemia due to bleeding. Small perforations may sometimes take several imaging studies and time to accurately diagnose.TreatmentPerforation of the bowel is considered a medical emergency and requires immediate treatment. Left untreated, the contents of the bowel can leak out and cause inflammation, infection and even abscesses in your abdomen. The technical name for this is peritonitis, which is a painful precursor to sepsis—or a body-wide infection.The majority of perforations are surgically repaired. Depending on the location and size of the tear, the doctor might be able to fix it through an endoscope, similar to the one used during a colonoscopy—but this is not an option for everyone. Open bowel surgery may or may not result in a stoma and colostomy: an artificial opening outside of your stomach where stool drains into a small bag until the bowel is healed.ComplicationsComplications of untreated perforation may include:BleedingInfection (peritonitis and sepsis)DeathComplications depend on a person's general health, as well as the amount of time it has taken to diagnose and treat the perforation.RecoveryDuring your initial recovery period, you will not be able to drink or eat anything by mouth. This is called resting the bowels and allows the inner lining time to heal properly. You will also have a nasogastric tube in place to drain the contents of your stomach for a period of time. You may receive intravenous antibiotics and nutrition for a few days if you're in the hospital. Although you may be anxious to return to your normal routine, it's important that you give your colon time to heal properly, and follow your doctor's orders.The Bottom LineBowel perforation may occur spontaneously, such as with inflammatory bowel disease, or during surgery or diagnostic tests. Symptoms may come on rapidly, or instead slowly, and should be considered in anyone who has risk factors for a perforation combined with risk factors for the condition.When caught early, there are different treatment options available, but even with surgery (which is most often required) the bowel can often be preserved and repaired without a colostomy. Recovery can take time, both for healing, and to correct and risk factors which led to the perforation.

Meet our doctor

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Dr Jiten Chowdhry

Piles Surgeon ,General Surgeon, Laparoscopic Surgeon, GastroIntestinal Surgeon, Varicose-veins surgeon

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Dr. Jiten Chowdhry is a General Surgeon, Laparoscopic Surgeon and GastroIntestinal Surgeon & Piles Surgeon in Vikhroli, Bhandup & Mulund, Mumbai and has an experience of 20 years in these fields. Dr. Jiten Chowdhry practices at Godrej Memorial Hospital in Vikhroli, Mumbai and Ruby Hospital - A Venture of Arogyam Hospital in Bhandup West, Mumbai. He completed MS - General Surgery from Institute of Medical Sciences, Banaras Hindu University (IMS-BHU) in 1998,He updated his skills at Tata Memorial Hospital, KEM Hospital and SION Hospital during separate phases of time.During this time he acquired various fellowships ; FAIS ,FMAS,FICS(USA),FISC. He is a member of Association of Surgeons of India (ASI), Association of Minimal Access Surgeons of India (AMASI), Association of Colorectal Surgeons of India, Association of International College of Surgeons and Association of Medical Consultants. He is Executive Member of the International Society of Coloproctology. Some of the services provided by the doctor are: Laser Fistula Treatment, Laser Piles Treatment, Colorectal Surgery, Laser Fissure Surgery, Laser Pilonidal Sinus Treatment, Thyroid Swelling, G.I. Surgery and Gastroscopy & Colonoscopy. He also specialises in Laproscopic Surgery of Appendix, Gall-Bladder, Hernia, Varicocoele, Ovarian-Cyst, Rectal-Prolapse. He is among the few surgeons in Mumbai who are expert in Single Incision variant of Laproscopic Surgery. He also specialises in Laser Treatment of Varicose-Veins Consultant Fees : 600 Rs.

Testimonials

Laser Surgery that is no cut, no wound surgical piles treatment is the best treatment option being given by the doctor as i had a very good and absolutely painless recovery from my piles disease which were hanging out and were very painful Thanks to Dr. Jiten Chowdhry & his whole staff for very caring, friendly treatment and positive approach towards my care. One must go for this kind of surgery which is absolutely painless, easy and has quick recovery. He is one of the most econimoical Docto

Boben Phukan

Best Piles Treatment Center in Mumbai

We know dr jiten last years. For.most of our medical problem we consult him only as he recommends good.doctors as well . His charges our very economical and staff is friendly. Waiting time is not that much as compared to.other doctors. Highly recommended

Sahil Amin

Sahil amin

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PILONIDAL SINUSA pilonidal sinus (PNS) is a small cyst or abscess that occurs in the cleft at the top of the buttocks

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