Periodontal surgery in dentistry means preventing or correcting anatomical, developmental, traumatic, or plaque-related defects in the teeth and Gums. The periodontal gums are tissues that surround the teeth. These tissues help form the base of the tooth and support it. If the gums get damaged or diseased, you may need periodontal surgery. This involves removing a small portion of gum tissue to relieve pain or correct an issue with your gums. Dental suturing provides strength and integrity to the decayed tissue post-surgery and controls bleeding. It is essential to understand different types of periodontal sutures used in dental surgery as each work differently and has its pros and cons. It is also essential to understand what kind of surgery you are undergoing to know which type of suture is right for you.
What is a Suture?
A suture is a material, primarily a type of thread used extensively and commonly in all kinds of surgery as a tissue closure. When a suture is used in periodontal surgery, it is used to close the gap between two teeth. Sometimes, doctors may use sutures to correct gum disease or relieve pain. The most common sutures used in dental surgery are Polypropylene, Polyglactin 910, Silk and Polyglactin 910 Antibacterial.
Types of Sutures based on the material composition
Polypropylene : These are made from Polypropylene monofilament and are very strong yet soft, making them suitable for various periodontal surgeries.
Polyglactin 910 & Polyglactin 910 with Antibacterial : These are made from Polyglactin 910, a synthetic absorbable material with excellent Histocompatibility with the Gum tissues. These can be also be had with Antibacterial properties
Silk : Non absorbable braided, coated suture made from natural silk filaments widely used across dental surgeries
Properties of good Sutures
Selecting the right suture depends on the anatomical structure and the area where surgery is to be performed, as much as the surgeon’s technique and experience. The properties of an ideal suture are
Durability – is the quality of a suture’s strength or ability to withstand stress.
Tensile Strength – is the amount of force needed to stretch a suture. Minimum tension force should be applied to the suture to enable wound closure.
Elasticity – is the degree to which a suture can be stretched without being torn and the ability to return to its original form and length after the stretch.
Knot Security – Is related to the suture knot not getting slipped once the surgeon has placed on the tissue
Minimal Tissue Reaction – A good suture should resist the bacterial growth and cause minimal reaction in the tissue post implantation
Suturing Techniques used in Periodontal Surgery
Simple Interrupted Technique : It is the most common suture technique where the suture passes from one side of the wound and exits on the other, with a knot on top.
Risks in Periodontal Surgery
The risks associated with periodontal surgery are-
Graft Infection – This is where infection occurs in the grafted area. The chances of this happening are low, but it is still a risk.
Wound Infection – This happens when an infection occurs in the surgical wound. The chances of this happening are high.
Bleeding – This happens when the suture tears during surgery or the surgical site ooze blood.
Pain – This is usually associated with surgery and caused by the cut tissue.
Advantages of Sutures Used in Periodontal Surgery
The advantages of sutures used in periodontal surgery are-
Quick Recovery – When compared to other types of surgery, oral surgeries have less recovery time because the muscles are not damaged.
No Reassessment Needed for Wound Care – Most oral surgeries require the patient to be reassessed for wound care, but sutures do not.
No Oral Surgery for Jaw Fusion – Oral surgeries such as extraction of teeth and periodontal surgery do not require a fusion of the jaw, making a recovery faster as less time is spent in the hospital.
No Oral Surgery for Orthodontic Treatment – Periodontal surgery can be performed on non-adherent gums, whereas extractions are usually performed on adherent gums. This makes recovery quicker as less time is spent in the hospital.
Conclusion
Periodontal or gum surgery is a surgical procedure in which the inflamed and septic Gums are treated by grafting healthy gums from the oral gum tissues. The most common periodontal surgeries are gum re-habilitation, gingival augmentation, and gum grafting. Due to the risk of infection, gum re- habilitation and gum grafting are the only two gums surgeries that need to be performed in a sterile environment. The patient’s gums are often too damaged to re- habilitate or graft them. In this case, a re-habilitation may be performed to help the patient eat soft foods again.
Many people suffer from piles, another term for Haemorrhoids, but the symptoms are always not the same and vary from person to person. These variations mean that not everyone will have the same experience with this common ailment. Therefore, there are varying degrees of severity depending on the presence or absence of symptoms.
What are Haemorrhoids?
Piles or Haemorrhoids are a widespread disorder that affects the large and/or small blood vessels of the rectum and/or anal canal. They cause localized swelling and painful inflammation of the tissues and veins in the lower anus and rectum, leading to tissue growths varying in and around the anus, leading to significant discomfort. It usually occurs due to straining during bowel movements and sitting on the toilet for long periods. This inflammation can cause bleeding, swelling, and itching, which is why it’s also known as anal fissure or anal itching. Although it can occur at any age, it is more likely to strike after middle age and especially after childbirth. The discomfort resulting from Haemorrhoids can be so intense that some people mistake it for a more serious medical condition such as appendicitis or internal bleeding.
Types of Haemorrhoids
There are two kinds of Haemorrhoids- internal and external.
Internal piles are typically not visible during an external examination and occur within the rectum. In contrast, an external one protrudes outside of the anus forming small lumps around the outside edge, the medical term being prolapsed hemorrhoid. They can be very itchy and painful should a blood clot develop, which can block blood flow. Such thrombosed external piles need immediate medical attention.
Doctors have graded internal piles as follows,
Grade 1, where the growth of tissues does not protrude out of the anus and cause any symptoms.
Grade 2, where the prolapsed Haemorrhoids go back inside on their own.
Grade 3, where the prolapsed hemorrhoid requires manual intervention to recede.
Grade 4, the piles prolapse outside of the anus, and manual intervention cannot push it inside.
Causes of Haemorrhoids
Haemorrhoids or piles are a result of increased pressure in the lower rectum, and several factors cause them,
an anal sphincter (the muscle that controls stool movement),
weakness and/or spasms,
sitting too long on the toilet,
not wiping enough in a sitting position,
straining during bowel movement
Chronic diarrhea
Chronic constipation
Lifting heavy objects
Diet may also play a role in the development of this condition. Bodies react to certain substances found in certain foods, and sometimes this reaction causes the veins of the anus to become irritated and swollen. A high-fiber diet may increase the risk of developing Haemorrhoids because it increases the amount of stool passed through the body. An increase in fiber in the diet may make it more difficult to fully evacuate the intestines, resulting in straining and, ultimately, Haemorrhoids.
Symptoms of Haemorrhoids
In most cases of piles, the symptoms are not very serious and go away on their own. The most common symptoms experienced are
Pain. Pain or discomfort in the anus that comes and goes, including lumps. Pain can be mild to severe and can be experienced as a burning sensation, aching, or pressure.
Bleeding. Haemorrhoids may also cause bleeding or an urgent need to pass stool due to anal spasms. Excessive bleeding can lead to anemia and infection.
Itching. Itching and discomfort around the anus or rectum.
Discomfort. Feeling of discomfort during and after passing stools, and/or a feeling of fecal incontinence like one needs to pass stool, but nothing is happening.
Blood in stools. Blood while passing stools is a common symptom of piles.
Risk factors of Haemorrhoids
Certain factors increase the risk of getting piles like,
Straining. Straining while having a bowel movement.
Toilet Overuse. Sitting on the toilet for extended periods.
Age. The condition is more likely to occur in older individuals.
Obesity. Overweight people are more likely to develop piles.
Diet. Haemorrhoids are more likely to occur in people who consume a low-fiber diet.
Pregnancy. Pregnant women often develop Haemorrhoids because of the increased amount of stool passing through their digestive tracts. In addition, the increased pressure on the veins in the anal canal can cause them to become swollen and painful.
When to See a Doctor
When there is persistent bleeding from the rectum for more than a week, the individual must see a doctor.
Diagnosis
At the time of physical examination of th anus for suspected piles, the doctor will ask the following,
Family history of piles
Presence of blood or mucus in the stools
Color of stool
Any recent unexplained weight loss
Any recent change in bowel movement
In case of internal piles, the doctor may use a proctoscope to perform a digital rectal examination (DRE) to see the anal canal up close and collect a tissue sample from inside the rectum for clinical analysis. In addition, the patient may be recommended to undergo colonoscopy if the signs and symptoms indicate a digestive system disease or risk factors for colorectal cancer.
Food to help treat and prevent Haemorrhoids
The following foods help in the management, treatment, and prevention of Haemorrhoids,
Bananas – This fruit’s high fiber content helps prevent and treat Haemorrhoids.
Whole-wheat bread – This is a high-fiber bread that helps to prevent and treat Haemorrhoids.
Oatmeal – This high-fiber food is also rich in essential vitamins and minerals.
Cucumber – This vegetable is high in water, which helps to keep the anal canal hydrated, reduces inflammation, and prevents and treats anal itching.
Grapes – This fruit is high in natural antioxidants that have anti-inflammatory properties.
Apples – Apples’ high fiber content helps prevent and treat Haemorrhoids.
Kiwi fruit – This high-fiber fruit is rich in vitamins and minerals, which have anti-inflammatory properties.
Pineapple – This high-fiber fruit is rich in vitamin C and anti-inflammatory properties.
Watermelon – This high-fiber fruit is also rich in vitamins and minerals.
Prevention and Treatment for Haemorrhoids
In most cases, Haemorrhoids resolve on their own and require no treatment. However, in some cases, medicines and treatment will be given to reduce the pain and discomfort of itching and make the symptoms more manageable.
Medications – Your doctor may prescribe anal fissure medications. These include over-the-counter (OTC) painkillers, anti-inflammatory agents, and antibiotics to reduce discomfort, stool softeners, and laxatives to soften the stool and make it easier to pass and reduce the pain. These medications are to be taken for a certain period of time and then stopped.
Antispasmodics and Anal Sterilization – These are herbs or supplements that are to be taken orally or inserted into the anal canal to reduce anal spasms and relieve anal pain. These are non-prescription remedies that are to be taken for a certain period of time until the condition goes away.
Ointments – Corticosteroid creams and anal fissure ointments help to relieve itching and reduce inflammation and pain.
Home Remedies – Some people prefer to use natural remedies to treat their Haemorrhoids. These include eating cucumbers and drinking watermelon juice.
Lifestyle Changes – Doctors will recommend a bunch of lifestyle changes to manage and lower the risk of developing Haemorrhoids. Those measures include regular exercise to stay active, maintaining moderate weight, avoiding heavy lifting and caffeinated drinks, increased water intake and food high in fiber to prevent constipation, and not straining while going to the bathroom.
Natural Remedies – Haemorrhoids can be a source of great discomfort. If this is the case, talk to your doctor about the possibility of using natural remedies to reduce the pain and treat the condition.
Procedural Options
There are minimally invasive procedures should medications and home treatments fail to treat piles or in case of severe prolapsed piles or heavily bleeding internal piles.
Rubber Band Litigation: Employed to treat prolapsed piles, the doctor wraps a specific type of elastic band around the base of the Haemorrhoids, cutting off its blood supply. The banded component of hemorrhoid shrivels and falls off within a week.
Sclerotherapy – Especially effective for Grade 2 and Grade 3 Haemorrhoids, the doctor injects a medicine into the Haemorrhoids causing them to shrink and stop bleeding.
Infrared Coagulation – In this procedure, the doctor uses an infrared light devise to burn the tissues of the internal piles. As a result, scar tissues form, cutting off the blood supply and reducing the piles.
Hemorrhoidectomy: Hemorrhoidectomy as a surgical procedure involves complete removal of the prolapse of Haemorrhoids. There is always the risk of complications like difficulty in passing stools.
MIPH (Minimally invasive procedure for Hemorrhoid): In this procedure, the internal hemorrhoid tissue is removed, and the doctor will pull back the prolapse of internal hemorrhoid into the anus by using a special stapling circular device and cut off the blood supply to the hemorrhoid tissue.
FAQs
Will Haemorrhoids go away on their own?
Haemorrhoids may go away on their own if the underlying risk factors are addressed, such as straining while having a bowel movement and not sitting on the toilet for too long.
How can I prevent Haemorrhoids?
Regular exercise, a high fiber diet, and drinking plenty of water can help prevent and treat Haemorrhoids.
What are some home remedies for Haemorrhoids?
Some people prefer to use natural remedies such as nettle leaf, aloe vera, and honey to treat their Haemorrhoids.
Are Haemorrhoids common?
Haemorrhoids are common, but not every individual experiences pain or discomfort.
What should I do if I experience symptoms?
See a doctor if you experience any pain or discomfort during a bowel movement.
Are piles serious?
If left untreated, piles can be severe and debilitating, affecting one’s quality of life.
How do you know if you have piles?
If you experience pain at the time of passing stools and see blood in the stools, that is an indication of piles.
The natural aging process changes the body, biologically, physiologically and psychologically, along with other changes increasing older people’s susceptibility to disabilities and diseases. The term Geriatric means “of old age” and often refers to older people’s health conditions such as osteoporosis and dementia and healthcare. There is an increased risk for fractures in older people due to the bones getting weaker and losing strength and density. That’s why it is essential to know the signs of a fracture in the elderly so you can take action before an injury becomes more serious. If you have an older family member or friend, they’ve likely experienced a broken bone or two. After all, an estimated 71% of adults will break a bone at some point. However, this doesn’t mean that everyone experiences fractures in the same way or at the same rate as others.
What are Geriatric Fractures?
Geriatric fractures are broken bones that affect older people more often than not. There are several different types of geriatric fractures, each associated with a health condition and resulting in different symptoms. Fractures more often than not happen due to falls, accidents, or as a result of a direct impact or trauma to the affected body part.
Types of Geriatric Fractures
The two most common geriatric fractures are osteoporosis-related fractures and falls-related fractures. Osteoporosis-related fractures occur when older adults with osteoporosis have low bone mass, bone strength, and low bone density. This makes their bones more likely to fracture. Falls-related fractures occur when an older adult has low bone density and falls because they are not as strong as they used to be. This can happen because their balance is affected by a related medical condition such as dementia or the side effects of medication. Other types of geriatric fractures include fractures associated with poor muscle function and bone infections.
Symptoms of Geriatric Fracture
The most common symptom of a bone fracture in the elderly is pain and impairment of mobility. However, if the fracture is causing other symptoms, it’s necessary to see a doctor.
Pain in the limb that is difficult to explain, for example, or pain that goes away when the limb is bent, can be a sign of a fractured bone.
Limping or having a hard time walking can be a sign of a more serious injury and should not be ignored.
Redness, swelling or warmth, or bruising around the broken bone can indicate a more serious injury and should be a concern.
Loss of strength in the arm or leg can indicate a more serious injury.
A feeling of obvious deformity or change in how the broken bone feels can indicate that the bone has shifted or moved inside the joint, which can signify a more serious injury.
Risk Factors for Geriatric Fractures
Geriatric fractures like hip fractures can be debilitating with increased mortality, loss of independence, and long-term disability. Hence, we must pay enough attention to the risk factors for Geriatric Fractures and work towards fracture prevention and patient education.
Poor bone health: People with osteoporosis and low bone mass are at an increased risk for fractures. Osteoporosis is a condition that occurs when bones lose too much bone density. The bones become weak and more fragile, leading to associated disorders like low body weight, malabsorption syndromes like chronic liver disease (CLD) and inflammatory bowel disease, primary hyperparathyroidism, rheumatoid arthritis, and long-term immobility.
Dementia: People with dementia lose the cognitive functioning of the brain. They become forgetful, and their thinking gets impaired, affecting their daily life. These people are more prone to accidents and falls and are also likely to have low bone density, thereby increasing the risk of fractures.
Medication side effects: People who take medication to control blood pressure, reduce glucose levels, or control seizures are at an increased risk of fractures due to changes in their balance and strength.
Obesity: Obese are at an increased risk of osteoporosis and fractures. Obesity affects more than just your looks and is also associated with an increased risk of fractures.
Poor Lifestyle and Behavioral Factors: Sedentary lifestyle, poor eating, sleeping, lack of physical activity, and unregulated drinking and smoking contribute to poor bone health and associated complications. Those with low calcium intake, vitamin D deficiency and lack of physical activity are equally at risk.
How are Geriatric Fractures Diagnosed?
It is often difficult to diagnose a geriatric fracture with/without any health conditions causing them. The doctor will ask about signs and symptoms, complete medical history of both patient and general family health to determine if there are underlying health conditions or any other risk factors for fractures associated with advancing age, and physically examine and try to determine the type of fracture by ordering for the following tests to help make the diagnosis,
an X-ray
a magnetic resonance imaging (MRI) scan
or a Computed tomography (CT) scan
Prevention of Geriatric Fractures
It is beyond our control to prevent or predict geriatric fractures caused by falls, accidents, and other injuries. As a silent epidemic, increasing fractures among the elderly are becoming a major public health concern. It is a priority to prevent fractures in older people or people over 65. The challenge is to identify those at most risk, especially those who have previously had a fall, intervene and assess risk levels, and ensure timely and cost-effective treatment. Awareness about improving bone health and reducing any risk of injury is a must.
A calcium and Vitamin D-rich diet to keep bones healthy and strong.
Follow a weight-bearing exercise regime to keep bones strong.
Complete abstinence from smoking. Tobacco and nicotine increase bone fracture risk and slow down the healing process.
Treatment of Geriatric Fractures
As an older person, if you’re concerned about your symptoms or have a broken bone that doesn’t cause other symptoms, don’t wait to see a doctor. Do not attempt to treat the fracture yourself. The most important thing to do is protect the injured limb, put the broken pieces of the bone back in place, expedite medical intervention to heal to reduce the pain and trauma, and avoid any complications.
Treatments typically include –
putting the fractured bone in a splint or cast
medication to reduce/control the pain
traction to stretch the muscles and tendons around the injured bone to help alignment and healing, and
surgery to fix certain types of fractured bones into place. Surgery involves the installation of metal rods or pins inside the bone or outside the body to hold the bone fragments in place for them to heal.
The prognosis for Geriatric Fractures
The prognosis for a geriatric fracture is good if the fracture is diagnosed early and treated properly. But if it is not managed properly, it can result in serious complications. It’s crucial to protect an injured limb and see a doctor. In many cases, the fracture can be treated with medication, surgery, or a combination of these procedures. It’s important to know that even when the fracture heals, some changes in the bone may be permanent.
Conclusion
Fractures are a serious risk for older adults, especially those with low bone density, a fall-related or osteoporosis-related fracture, or a fracture associated with poor muscle function. For these reasons, it’s important to know the signs of a fracture and protect yourself from injury. If you notice any sign of a fracture, don’t hesitate to see a doctor. They can help protect your health and avoid serious long-term damage.
FAQs
What type of fractures is most common in the elderly?
Older people are at high risk of bone fragility, falls, and fractures. The most common fractures among the elderly are hip fractures, accounting for at least 90 percent. Typically, all appendicular fractures are precipitated by a fall.
Why are fractures common in the elderly?
Fractures are most common in the elderly because of advancing age, bones getting weaker and brittle due to osteoporosis, and an unfortunate fall. The bones get more fragile with age with the natural bone tissue changes. For women, especially after menopause, the bones get weaker and thinner with the decline in the female hormone estrogen.
Why do the elderly take longer to heal fractures?
The elderly usually take longer to heal fractures because of the declining count of stem cells in the bone marrow due to old age. Recovery from a bone fracture requires sufficient vascularization and the formation of blood vessels in the tissue. Advancing age tends to hinder this process by preventing crucial bone healing sites.
Can the elderly recover from fractures?
When the elderly experience a fall and a fracture, many recover fully, get back on their feet, and lead normal lives. The key lies in prompt action and dealing with all kinds of falls and fractures with precision and timely medical intervention in the case of any type of fracture involving the upper leg, knees, pelvis, hip, skull, back and neck.
How do you know if a fracture is healing?
Never mind how big or small a fracture is, there are 4 tell-tale signs to tell if a fracture is healing or not.
Decreasing Pain – When the intensity of pain a fracture afflicted person experiences is on the decline.
Improved Mobility – The healing period of a fracture can render a fracture-afflicted elderly patient pretty immobile. As the healing takes over, the mobility of the affected limb will improve.
Lack of Bruising – When the area around a fractured bone shows no signs of bruising, the fracture is healing well.
Decreasing Swelling – When the area around a fractured bone displays less swelling, know that it’s healing well.
Can an old fracture cause problems years later?
An untreated bone fracture can result in either a nonunion or a delayed union. When the bone doesn’t heal at all, it is called nonunion fracture. As a result, swelling, tenderness, and pain will continue to worsen. Delayed union fracture is when the bone takes more than the usual time to heal.
Can broken bones cause dementia?
The quality of life after an older person suffers from a fracture significantly affects the onset of dementia. The after-effects of a bone fracture can result in less mobility and decline in physical agility, chronic pain, and prolonged inflammatory cytokine secretion during fracture repair can end up contributing to dementia.
When does a fracture stop hurting?
After a broken bone fracture of an older person is fixed by the doctor without surgery, the pain may subside significantly right after. However, an elderly person may experience some pain for up to 3-4 weeks and mild pain for up to 6-7 weeks after surgery.
What happens if a fracture doesn’t heal?
After a bone fracture, the body gets into a healing mode. If the broken parts of the bones are not properly aligned, the bone will go on to heal with a deformity called a malunion. This happens when a new bone occupies the huge space between the displaced ends of the broken bone.
What slows down bone healing?
High glucose levels and habits like smoking and drinking delay bone healing. For all elderly patients with fractured bones, being immobile for some time is a crucial factor in the treatment process. The healing process significantly slows down with any movement of bone fragments.
Bariatric surgery can be an extremely positive experience for your body. As you know, bariatric surgery involves getting you a smaller stomach through surgery toward your weight-loss goal. Most people who have this type of surgery feel better afterwards. It’s also one of the most successful weight-loss surgeries available today. If you’re considering undergoing Bariatric surgery, you should probably get ready as your hospital team will also have many questions for you. So ensure you have all the answers beforehand so there are no last-minute hiccups during your surgery.
What is Bariatric Surgery?
Obesity is a leading risk factor for diabetes and heart disease. There is no treatment for obesity that is predictive and consistent with results except for bariatric surgery. Bariatric surgery is a medical procedure used to help people with obesity lose weight by reducing the size of the stomach and the intestines. Such reduction and resizing of the stomach can help the patient feel full after eating smaller portions of food. This ensures fewer calories go into the body, thus enabling losing weight much faster.
Who should go for Bariatric Surgery?
Bariatric surgery may be suitable –
For a person who is morbidly obese (meaning the said patient is very overweight and at high risk of developing other health problems, such as diabetes or heart disease). Bariatric surgery candidates are generally either overweight than 500 pounds or obese with a Body Mass Index (BMI) of 40 or higher.
To someone who is unable to reduce weight through exercise and diet control.
In cases where it is safe, look at the patient’s medical condition.
Where the obesity-related health issues are life-threatening and need immediate addressing
One should also be ready to commit to the lifestyle change that comes with Bariatric surgery.
Advantages and Disadvantages of Bariatric Surgery
There are many benefits to undergoing bariatric surgery. First, you will likely feel better about yourself. You’ll also have more confidence and feel more in control of your life. And Bariatric surgery can help you lose weight much faster than dieting alone. Bariatric surgery can also help you avoid other weight-loss methods that may be unsafe or ineffective. That’s because Bariatric surgery is the only type of weight-loss surgery proven to work long-term. You may be wondering if there are any disadvantages to undergoing bariatric surgery. However, studies show very few disadvantages to this surgery.
Like any other surgical procedure, Bariatric surgery too has associated risks. The related risks or side effects could be infection, vomiting, stomach obstruction, inability to eat a specific food, failing to lose weight, and risks related to anaesthesia or acid reflux.
How and Why is Bariatric Surgery Performed?
Weight reduction is generally obtained through two types of Bariatric surgery — Restrictive and Malabsorptive — each with its advantages and disadvantages or a combination of both. In Restrictive surgery, the surgeon removes a section of your stomach larger than the average amount. This will reduce the amount of food you can eat at one time. In Malabsorptive surgery, the surgeon removes some of your small intestine — which means one will not be able to eat food with high sugar content, such as bread, fruit and sugar-sweetened beverages. These bariatric surgeries are slightly different and are generally chosen based on the person’s lifestyle.
Restrictive Surgery aims at reducing the intake of food by reducing the size of the stomach
Malabsorptive Surgery aims at reducing the absorption of nutrients by the body by resizing the small intestine.
The various types of Bariatric Surgeries include-
Sleeve gastrectomy is a surgery where the portion of a stomach is removed along a greater curvature. The remaining portion of the stomach is a banana-shaped stomach.
Gastric Bypass Surgery- It is also known as Roux-en-Y. Here a portion of a stomach is created like a small pouch and directly connected to the small intestine.
Intragastric Air Balloon- A saline-filled silicone balloon is placed in the stomach through the endoscopic route.
Endoscopic Gastroplasty- Using an endoscope, the suturing device sutures the stomach reducing its shape and size to that of a tube.
Metabolic Surgery – This surgery specifically addresses diabetes and metabolic dysfunctions, which have stopped responding to any lifestyle or medication changes as opposed to obesity per se.
Biliopancreatic diversion– Also known as Duodenal Switch, this is a type of surgery where the food bypasses some part of the small intestine. This can be considered both a malabsorptive and restrictive type of surgery.
Preparation and Procedure of Bariatric Surgery
Before surgery, you should probably be completely ready for the change. It is a holistic approach and assessment by an inter-professional team of stakeholders. There will be a nutritional evaluation, psychological evaluation, a weight loss plan, and medical clearance from the concerned departments, including the anaesthetic one.
Start by researching the procedure carefully. Ask your doctor if they have had this surgery before and the expected recovery time. Make sure you talk to your doctor about the benefits and risks of the procedure.
Keep your expectations realistic – you will not wake up lean the day after surgery.
Rally for all kinds of support; you cannot do this surgery alone. Have someone from your family come in as your caregiver. Join an online support group.
Review your resources – medical assistance, nutrition guidance, exercise regime.
Identify and understand the risks of food cravings and addictions and seek medical help before the surgery.
Be ready for lifestyle changes in your daily life, such as taking it easy at work or not drinking liquids for 12 hours before bed.
Before surgery, you will have a pre-op appointment where you can ask your doctor any questions about the procedure, the procedure itself and what you will experience during your surgery. During this appointment, you and your doctor can review your diet and medications, if any. You may also want to ask about what you should do in the days before your surgery and what you can do to get yourself ready for surgery. And if you are undergoing pre-op testing, such as a blood test or an EKG, ensure you have all the results when you arrive at the hospital. Finally, if you have any pre-operative medications, bring them with you.
Procedure of Bariatric Surgery
Bariatric Surgery could be either an Open Surgery or Laparoscopic Surgery. Most of the weight loss surgeries are done laparoscopically unless the patient is highly obese, has undergone any stomach surgery previously, or has other health complications.
Depending upon the need of the patient the surgeon will perform either Restrictive or Malabsoptive Surgery. The surgery will be done under general anesthesia.
With Bariatric surgery, you can bypass the struggle of weight loss journeys not yielding results. The patient will get hospitalised for a day or two. In that time, the surgeon will make several small incisions in the abdomen and then insert a port so that the patient can get medication and fluids intravenously. Post-surgery, the patient will probably be free to go home. However, the patient may need to take it easy for a few days.
Comply With Your Post-Op Diet and Restrict your Food Choices
Post your Bariatric surgery, and your diet will be restricted once you return home. You will be able to eat only a tiny amount of food and nothing high in sugar. Your diet will consist of either clear liquids or thick, bland blended food. You will only be able to drink fluids with a straw or a cup with a lid. You will not be able to cook or eat anything that has sugar added to it. You must follow these rules the entire time you are on a post-op diet. If you need to eat something that has sugar, you are allowed to have fruit or honey. However, these are the only foods you can eat on your post-op diet. It is important to note that you will be allowed to eat only minimal food. Eating smaller portions throughout the day is better than eating a large meal in one sitting.
Stay Safe and Keep Track of When to Return to Normal Life
It is important to keep yourself safe during your recovery. Make sure you do not fall, get hurt, or go near any dangerous activity. It is also vital to track when it is safe to return to work or school. You should also ensure enough rest, especially during the first few weeks after surgery. It is also important that you drink plenty of fluids.
FAQs
1. Do we have to lose weight before bariatric surgery?
Answer – Yes, Some patients are asked to lose 10 percent of their weight before their weight loss surgery to avoid complications.
2. How long is the preparation for bariatric surgery?
Answer – The entire process from preparation to surgery involves an inter-professional team of stakeholders who will evaluate the patient on multiple aspects, which can be up to six months.
3. What is the preparation for bariatric surgery?
Answer – The preparation is a holistic approach and assessment by an inter-professional team of stakeholders. There will be a nutritional evaluation, psychological evaluation, a weight loss plan, and medical clearance from the concerned departments, including the anesthetic one.
4. Who cannot undergo bariatric surgery?
Answer – Those with BMI below 35 cannot undergo bariatric surgery.
5. What foods to avoid after bariatric surgery?
Answer – All forms of red meat, high fat, and greasy food, spicy and seasoned food, processed food, alcohol, sugars, and sweets.
6. What are the risks of bariatric surgery?
Answer – The risks are infection, blood clots, failure to lose weight, chronic nausea and vomiting, acid reflux, allergy to certain foods, etc.
There are different types of Hernia. All of them have common symptoms like a bulge, pain, and pressure. It is important to know what type of pain and at which part of the body so that you can administer the right treatment. Hernias are best treated with surgery.
What is a hernia?
A hernia is an abnormal bulging of abdominal organs when an internal organ pushes through a weak spot in muscle/tissue in the abdominal wall. Typically, you will discover most hernias within the abdominal cavity between the chest and the hips.
Types of Hernia
Hernias are divided into several types based on where the bulge is located. A hernia can be congenital, which is present at birth. Or it can be acquired, caused by trauma or other factors. An acquired hernia is a “wound hernia” when abdominal organs protrude through an unnatural opening in the abdominal wall.
The most common types are
a. Inguinal Hernia (Inner Groin) – Mostly occurs in men due to a natural weakness in the groin, where the bladder or the intestine protrudes through the abdominal wall or into the inguinal canal in the groin.
b. Femoral Hernia (Outer Groin) – Most common among women, especially obese or pregnant, where the intestine enters the canal carrying the femoral artery into the upper thigh.
c. Incisional Hernia (as a result of an incision) – Most common among elderly and overweight folks who are inactive after an abdominal surgery, where the intestine pushes through the abdominal wall at the site of abdominal surgery.
d. Hiatal Hernia (Upper Stomach) – Where the upper stomach pushes through the hiatus, an opening in the diaphragm through which the oesophagus passes.
e. Umbilical Hernia (Belly Button) – Most common among newborns and obese women or those who have had many childbirths, where a part of the small intestine passes through the abdominal wall near the navel (aka belly button).
The less common types are
a. Giant Abdominal Wall Hernia – Most typical among those with incisional Hernia or another kind that keeps coming back, is hard to treat and may need surgery to fix it.
b. Epigastric Hernia (Epigastric Region – above the belly button and below the rib cage) – Common among men than women and in some newborn babies, where fat tissues push through a gap between the two sides of the abdominal muscles, namely the belly button and the lower part of the breastbone.
c. Spigelian Hernia – Commonly affects the intestines and omentum, where a layer of fat tissues pushes through the muscle below your navel like split like opening in the fascia.
Causes of Hernia
Increased pressure causes all types of hernias in the abdomen, fascia, and a combination of the following reasons.
a. Bad diet – Poor nutrition and a diet high in sugar can lead to weak abdominal muscles.
b. Bad posture and Balance while lifting heavy objects/weights – Careless lifting of heavy weights and objects without stabilizing the abdominal muscles can lead to a hernia.
c. Disc problems – When the disc in your spine is compressed, it can pressure the nerves that control your muscles. This can cause your abdominal muscles to weaken.
d. Diarrhea, constipation, persistent sneezing, or coughing – These occurrences can weaken the muscles and lead to a hernia.
e. Pregnancy complications – While it’s rare, pregnancy-related weakening of abdominal muscles may lead to a hernia.
f. Poor lifestyle habits – Obesity and smoking can weaken muscles, leading to hernias.
Risk Factors of Hernia
The risk factors for Hernia are,
a. Obesity – If you have a high body mass index (BMI), you are at an increased risk of developing a hernia.
b. Sports injuries – If you’ve experienced frequent sports injuries to your abdomen, you are at an increased risk of developing a hernia.
c. Previous surgery – If you’ve had a previous surgery involving abdominal incisions and the abdominal wall is weak, you are at an increased risk of developing a hernia.
Symptoms of Hernia
The symptoms are many,
– A noticeable swelling, bulge, or lump in the abdomen/groin
– Mild to increased pain, pressure, or swelling at the bulge site.
– Nausea, heartburn, indigestion, constipation, difficulty in swallowing, chest pain, or frequent regurgitation
– Dull aching sensation and feel that something is lodged in your intestines.
– Pain while lifting, laughing, crying, sneezing, or coughing.
Foods and Activities that cause Hernia and relieve Hernia
Exercising too intensely can strain your abdominal muscles and lead to an underlying weakness. This increases your risk of developing a hernia. Binge drinking alcohol can lead to abdominal muscle weakening, which puts you at risk of a hernia.
Drinking warm fluids, such as water, herbal tea, or sugary drinks, can relax the abdominal muscles and relieve hernia pain. Stay hydrated to prevent dehydration and maintain normal urine pressure. Pushing hard during pregnancy or after giving birth can help work out the pressure in your abdominal muscles, relieving the pain of a hernia.
Prevention and Detection of Hernia
Hernias cannot be prevented since they occur due to an accidental combination of medical history and genetic makeup. However, in the interest of good health, we can do the following,
– Make sure you visit your doctor regularly for regular check-ups so they can detect any hernias early.
– Your doctor will likely check your abdomen to feel for a bulge.
– You should inspect your belly button to look for any abnormal bulges.
– Exercising regularly can help you maintain healthy, strong abdominal muscles and prevent them from weakening.
– Avoid any pressure on the abdominal wall like lifting weights
– Refrain from poor lifestyle habits like smoking, drinking, or straining during bowel movements.
– Eat a high-fibre diet and stay hydrated.
Treatment of Hernia
The best treatment for hernias is to prevent them from happening. You should avoid activities that strain your abdominal muscles if you have a hernia. This will help to avoid a hernia. For most hernias, doctors will wait and watch for the abdominal wall to repair and heal but most hernias do not get healed on their own. More significant types of hernias like intestinal hernias may require surgical correction to improve the Hernia and the abdominal wall or prevent an emergency in case of an incarcerated hernia or a strangulated hernia.
Hernia surgery is minimally invasive in most cases for faster recovery and better outcome. In case of umbilical hernia in children, hernia surgery may be recommended if the hernia is large or has not healed by the age of 4-5 years. In case of adults, there are two kinds of surgery available for hernia which the doctor will take a call on the final recommendation –
Open Surgery – where a cut is made at the site of the hernia, and the protruding tissue is reset and the weakened muscle walls are sutured. A type of mesh is implanted for extra support.
Laparoscopic surgery – unlike an open surgery but with the same set of repairs, here tiny incisions are made for surgical tools to complete the procedure
Recovery from Hernia
You may be able to resume normal activities after hernia repair. One may need to rest and strengthen their abdominal muscles to prevent a recurrence. In some cases, it is likely to experience pain and discomfort for a few days and may experience constipation or nausea.
The following needs to be kept in mind,
a. It would help if you avoid heavy lifting or straining your abdominal muscles.
b. You should also avoid coughing or straining to pass urine because these can further weaken your weak muscles.
c. You should also drink lots of water to prevent dehydration and maintain normal urine pressure.
d. Follow-up care is essential after hernia surgery. You should return to your doctor for check-ups to ensure no complications.
e. You should also wear a compression garment after surgery to help to reduce swelling and pressure on your incision.
FAQs
1. What is the most common type of Hernia?
Answer – The most common types of Hernia are
– Inguinal Hernia (Inner Groin)
– Femoral Hernia (Outer Groin)
– Incisional Hernia (as a result of an incision)
– Hiatal Hernia (Upper Stomach)
– Umbilical Hernia (Belly Button)
2. What is the most common type of Hernia in males?
Answer – The most common type of Hernia in males is Inguinal Hernia ( Inner Groin) which mainly occurs due to a natural weakness in the groin, where the bladder or the intestine protrudes through the abdominal wall or into the inguinal canal in the groin.
3. What is the most common type of Hernia in females?
Answer – The most common type of Hernia in females is Femoral Hernia (Outer Groin), especially in obese or pregnant women, where the intestine enters the canal carrying the femoral artery into the upper thigh.
4. Are there rare hernias?
Answer – Yes, Spigelian Hernia is a rare hernia.
5. Is Hernia life-threatening?
Answer – An incarcerated hernia can become strangulated and life-threatening if not treated on time.
6. What are the signs of Hernia?
Answer – Hernia signs are pain and a bulge around the abdomen or affected site.
7. What happens if the Hernia is not treated?
Answer – If the Hernia is not treated, it can become life-threatening.
8. Does Hernia require major surgery?
Answer – Yes, an intestinal Hernia may require surgery.
9. How painful is hernia surgery?
Answer – Hernia surgery is not painful because, at the time of surgery, the patient would be administered general anaesthesia. It is the period before surgery and post-surgery during recovery that the patient might experience pain.
10. What is the best treatment for Hernia?
Answer – Timely diagnosis of symptoms, proper lifestyle habits, and medical surgery, where applicable, is the best treatment for Hernia.
11. What foods cause Hernia?
Answer: Fatty, fried food, citrus fruits, spicy food, garlic, onion, and chocolate can trigger hernia symptoms.
12. What foods to avoid in case of Hernia?
Answer – Hernia patients should avoid foods with high sodium, fats and spices, chocolate, garlic and onion, citrus fruits, and fried food in case of Hernia.
