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Breast Cancer in males

Breast Cancer in males

The percentage of men with breast cancer is extremely rare, compared to the prevalence among women. For men, the lifetime risk of being diagnosed with breast cancer is about 1 in 1,000, representing 0.4-1.2% of all male cancers.

In 2018, about 2,550 men are expected to be diagnosed with the disease, compared with 2 million news cases for women in 2018.

However, while the numbers are low, the risk remains real and should not be ignored. The “breasts” of an adult man are like the breasts of a girl before puberty. In men, the tissue doesn’t grow, but because it is still breast tissue, men can get breast cancer.

In Western countries, the age of onset in men is approximately 60-65 years, about 8 to 10 years later than in women, and that risk increases with age.

Late diagnosis decreases the odds of recovery

Screening procedures for women are well established, with recommendations for regular mammograms, fundraising and awareness events to finance research and publicize the importance of early diagnosis.

None of these events is aimed at men and this lack of readily available information means that most men are unaware that it could happen to them.

Men are also less likely to be suspicious of something abnormal in that area. Also, the small amount of breast tissue in men makes it harder to feel and so more difficult to spot a problem early.

Symptoms of breast cancer in men

Like those in women and most male breast cancers are detected when a man complains soreness and lump in nipples.

But men usually procrastinate going to the doctor until they have more severe symptoms, like bleeding from the nipple.

At that point, cancer may have already spread to another part of the body. Men also find it embarrassing to talk to a doctor about their breasts.

Risk factors for men 

In 20-25% of men who develop breast cancer, there may be a genetic abnormality, a mutation of the gene Brca2. In other cases, certain risk factors may be identified.

If a close relative (male or female) has had breast cancer, the risk is higher and this risk increases if several close relatives are affected; if one of the affected parents was under 40; or if cancer has spread to both breasts.

Children whose fathers have breast cancer are also more likely to have the disease.

In addition, the risk is higher if the level of estrogen (female sex hormone) is significant, if the level of androgens (male hormone) is low as is the case for rare genetic diseases such as Klinefelter syndrome (a genetic disorder that affects men and is characterized by abnormalities in the genital tract).

Other risk factors are related to obesity, which increases the risk of breast cancer in women and could also increase the risk in men.

Fat cells turn androgens into estrogen, so men who have more fat cells have higher estrogen levels. A man who has had mumps in adulthood and has had inflammation of a testicle may also be at higher risk for this type of cancer.

The impact

The symptoms, diagnosis and management of breast cancer in men are largely identical to that in women.

In principle, men cannot undergo surgery that just removes the lump, because there is little tissue in the breast and the cancer is usually near the nipple.

Treatment options depend on the progress of cancer once it has been diagnosed. In general, treatment involves a mastectomy, an operation that involves removing the entire breast. Lymph nodes located nearby (e.g. under the arm) are also removed in case cancer has spread, followed by radiotherapy, chemotherapy or hormonal therapy.

Although the medical procedures are like those for women, the aftercare for men is very different. There is no discussion of breast reconstruction or any consideration of the emotional fallout post-cancer.

Yet the psychosocial impact on men is considerable. Support during and after treatment is crucial and much remains to be done in this area.

How to reduce your risk

Here are some tips to help lower your odds of getting breast cancer:

  • Keep your weight within a healthy range. Obesity can shift the hormone balance in your body, making you more likely to get breast cancer. If you’re overweight, talk to your doctor and a dietitian about making changes to your eating and exercise plan.
  • Daily workout. A lack of physical activity can alter your hormone levels, making you more susceptible to cancer.
  • Avoid or limit alcohol. Having two or more alcoholic drinks daily has been linked to an increased risk of breast cancer in women.

Keep checking for any abnormalities/unusual changes in your breast from time to time. Consult our expert Breast cancer Doctors at The Breast Centre to help detect breast cancer in its early stage.

Complications in diabetes and how to avoid them
Nov 7, 2019|Dr Manisha Arora

Complications in diabetes and how to avoid them

Diabetes has multiple long-term complications that develop gradually over a period of time. The longer a person is diabetic and lesser the control he has on his blood sugar, higher is the risk of complications.

Some common complications of diabetes are:

  • Heart diseases: Different types of heart diseases, which include coronary artery disease, stroke, narrowing of arteries, heart attack and stroke are more likely to develop among diabetics than non-diabetic people.
  • Nerve damage or neuropathy: Excess sugar in the blood can cause injuries to the wall of the blood vessels, especially legs. This can lead to tingling sensation, numbness, pain or burning sensation in limbs which may gradually spread upwards. If left untreated, this can lead to loss of sensation in the affected limbs. When nerves of the digestive system are affected, they may cause digestive disorders. It can lead to erectile dysfunction among males too.
  • Nephropathy: Nephropathy or damage to the kidney is another important complication of diabetes. Glomeruli in the kidneys can get damaged due to excess blood sugar. Severe damage to the Kidney can lead to irreversible kidney failure which might even call for the need for a kidney transplant or dialysis.
  • Retinopathy: Diabetes can lead to damage to the blood vessels supplying the retina which can even lead to blindness. Diabetes also predisposes to other vision-related conditions like cataracts and glaucoma.
  • Skin complications: Diabetes can lead to various skin complications if left untreated. Cuts and blisters might develop in the feet due to reduced sensation, which might take very long to heal and can ultimately lead to amputation. Diabetes also predisposes to infections caused by bacteria and fungus.
  • People affected with diabetes are more prone to hearing impairment.
  • Diabetes also increases the risk of Alzheimer’s disease and dementia.
  • Symptoms of depression are common among diabetics can also affect the management of diabetes in the long run.

Tips to manage diabetes-related complications include:

  • Manage and monitor your blood sugar regularly. Follow doctors’ prescriptions and take diabetes medication as advised.
  • Maintain healthy body weight. Overweight people are more likely to develop complications as a result of diabetes.
  • Quit smoking. Smoking increases the chances of infection, heart diseases, nephropathy, neuropathy, and stroke among people suffering from diabetes.
  • Maintain blood pressure and keep cholesterol levels under check. Complications associated with high blood pressure and cholesterol are worsened when coupled with diabetes.
  • Conduct regular eye checkups to screen for the possibility of retinopathy, cataract or other eye disorders
  • Get regular health checkups to ensure that the condition is not affecting the kidneys or nervous system and hence prevent chances of developing complications.
  • Take regular vaccines as and when required. Diabetic people are more prone to be affected by seasonal and other illnesses, hence, taking vaccines can help in preventing untoward illnesses.
  • Diabetes often predisposes to gum problems. Bleeding of gum can be common. Hence maintaining good oral hygiene is important to prevent dental troubles.
  • Take proper care of your feet as any cuts and blisters can take too long to heal and might lead to the spread of infection.
  • Reduce stress. Practice yoga or meditate to keep yourself stress-free.

Lifestyle changes and Blood Pressure control
Nov 6, 2019|Ms. Deepali Sharma

Lifestyle changes and Blood Pressure control

High blood pressure or hypertension is a condition that almost every other individual we see around is affected with. It is also called a silent killer as it does not manifest symptoms but can lead to serious and life-threatening conditions like stroke and heart diseases.

Blood pressure has two components: systolic blood pressure and diastolic blood pressure. The systolic blood pressure represents the top number which is the pressure in the blood vessels when the heartbeats, the diastolic blood pressure or bottom number represents pressure in the blood vessels when the heart is resting or in between the beats. Optimal blood pressure is less than 120/80. Blood pressure lower than 90/60 mm HG is considered as low blood pressure, a pressure of 130/80 or higher is considered to be high blood pressure.

The positive aspect of blood pressure is that certain modifications in lifestyle can help in maintaining normal blood pressure and hence reduces the chances of developing conditions associated with the disease.

Some effective ways of maintaining blood pressure are:

  • Physical activity: Physical activity makes the heart stronger and it becomes more efficient in pumping blood with little effort. As per the recommendations of the American Heart Association 2013, a moderate to vigorous-intensity activity for about 40 minutes three to four times a week is helpful in maintaining a healthy heart.
    If one finds 40 minutes of physical activity too stressful, then he/ she may opt for 10 to 15-minute sessions 3 to 4 times over a day. Involving in physical activity can be as simple as choosing stairs and not elevators, walking to work or to the market instead of driving, doing household chores, and playing an outdoor sport.
    Exercises like aerobics, high-intensity interval training, short bouts of exercise throughout the day, even walking 10,000 steps may help in maintaining healthy blood pressure.
  • Losing weight is another important factor that can help in blood pressure. It not only helps in maintaining blood pressure but will also reduce the chances of other medical conditions.
  • Reducing sugar intake can significantly help in and controlling blood pressure.
  • A low carb diet is found to be more effective in reducing blood pressure when compared to a low-fat diet.
  • Increase potassium intake and reduce sodium intake. Potassium reduces the harmful effects of salt in the body. However, it is important to note that people having a Kidney Disease must abstain from diet rich in potassium.
  • Cutting on salt reduces sodium intake significantly.
  • Reducing processed food also helps in reducing salt intake in the diet. Processed foods have high quantity of salt in the form of preservatives. Foods carrying labels as low-fat are normally higher in salt and sugar content to replace for the low fat in them.
  • Develop the habit of checking food labels while buying. As per recommendations of the U.S FDA, the sodium content of 5% or lesser is considered to be healthy whereas a sodium content of more than 20% is considered to be unhealthy.
  • Quit smoking, doing this improves overall health condition. Smoking leads to an immediate short-term increase in blood pressure and heart rate. The chemical present in tobacco increases blood pressure, leads to injuries in the blood vessels, inflammation, and narrowing of arteries, etc.
    Secondhand smokers are equally affected by people smoking around them. Studies have shown that children who live in a house having smokers, tend to have a higher blood pressure than children living in nonsmoking homes.
  • Stress management by meditation, yoga, deep breathing, taking walks, reading books listening to music can help in controlling blood pressure. Stress has become one of the most important lifestyle factors that leads to many diseases in the long run. It is, therefore, of paramount importance to reduce stress.
  • Reduce caffeine intake. Though caffeine is believed to have some health benefits, for people who are already hypertensive caffeine can increase their blood pressure further and lead to serious consequences.

 

Coronary Artery Disease (CAD) in women

Coronary Artery Disease (CAD) in women

Women of all ages face the threat of coronary artery disease (CAD) commonly referred to as a “heart attack”. Recent data shows the overall prevalence of CAD is 6.2% in males and 10.8% in females. It commonly occurs at a later age in women, mostly in the 60’s while men have it at an earlier age. The female hormone, estrogen is “cardioprotective” and as its level in the body declines at menopause, the risk of CAD becomes higher.  Overall, CAD is a leading cause of death in both men and women.

CAD is caused by plaque buildup in the walls of the arteries that supply blood to the heart (called coronary arteries). Plaque is made up of deposits of cholesterol and other substances in the artery. Plaque buildup cause narrowing inside the arteries over time, which could partially or totally block the blood flow and eventually lead to angina or heart attack respectively.

The most common symptom of heart attack is severe central chest pain. One challenge always remains, that symptom in women differs from those in men. They usually have subtle or vague discomfort or pressure over the chest. Sometimes women may not experience chest discomfort but may have pain or discomfort in one or both arms, the back, neck, jaw or stomach, shortness of breath, nausea and vomiting, lightheadedness or fatigue. Recognizing the signs early and seeking treatment promptly is of utmost importance.

Women generally suffer from obesity, high blood pressure; high cholesterol levels and has higher chances of suffering from CAD. The risk increases manifold with diabetes, smoking, mental stress, physical inactivity and menopause.  Women <65yrs having family history of heart disease needs to pay more attention to these risk factors.

The golden rule to prevent heart disease is quit smoking, exercise regularly, eat healthy diet and maintains healthy body weight. Eat plenty of fruits and vegetables, lean meats, wholegrains. Eat less of salt, sugar, saturated fats, cholesterol and trans-fats, processed food. Regular brisk walk for 30-45 min per day for 5 days a week is good enough to stay fit. Regular check-ups are key in picking up heart problems at early stage. All healthy adults> 20 yrs should get their blood pressure checked once every two years, blood cholesterol levels checked once every 4-6 years, blood sugar levels checked once every 3 years.

To conclude CAD is no more a male disease, it equally affects female, in a more subtle form, with atypical manifestation, which tends to get ignored. Hence, recognizing symptoms early and seeking health support is of paramount importance. Regular exercise and eating healthy diet helps in maintaining healthy body weight eventually leading to decrease in heart problems.

Consult expert cardiologist in Gurgaon at the CK Birla Hospital to seek medical support and advice. Book an appointment today!

Common Vaginal Infections
Oct 16, 2019|Dr. Astha Dayal

Common Vaginal Infections

Vagina infections are common and almost every female in the world has been affected by some form of vaginal infection in her lifetime. The infection can be caused by various microorganisms like bacteria, virus, fungus, or parasite which might grow in the vagina or in the surrounding region. These infections can be treated very easily and quickly. It is important to initiate treatment as soon as an infection is detected to prevent other complications.

Some common symptoms of vaginal infection are white vaginal discharge which may be white, green, or yellow in colour with a peculiar odour, soreness and itching in and around the vaginal region, dyspareunia (pain during intercourse), dysuria (pain during urination), intermenstrual bleeding, formation of ulcers or warts around the vulval region are some of the common manifestations. Some form of vaginal discharge which is colourless, odourless coma and does not irritate all lead to itching around the vaginal region normal. The amount and colour of vaginal discharge may vary according to the time of menstrual cycle and age.

Products like soaps, body washes, vaginal douches can lead to changes in the pH level of vagina which might cause vaginal discharge.

Diagnosis can be formed by examination conducted externally, looking for signs of inflammation and discharge around the vagina. A per vaginal or per speculum examination may be required in certain cases to view the interior. Vaginal swab can help in getting a clearer picture of the infection. A urine sample can often suggest probability of a spreading infection from the urinary tract to the vagina.

Some common infections of the vagina are as follows

Bacterial vaginosis, this is caused by an uncontrolled growth of a particular type of bacteria. It often remains asymptomatic and continues to be undiagnosed in many females. Some common symptoms are whitish vaginal discharge which is usually foul smelling, with itching and irritation. It is not a sexually transmitted infection, but a recent change in partner can increase the risk. Other important factors that can lead to this infection or increase the risk are using sprays, vaginal douching, inserting IUDs, using perfumes, and smoking. The infection is treated with the help of antibiotics. Some cases might require local application of gel or cream. It can lead to some complications if left untreated for a long period of time and interfere with pregnancy leading to frequent miscarriages, preterm labour or pelvic inflammatory disease.

Another common bacterial infection is Chlamydia. It is a sexually transmitted infection caused by chlamydia trachomatis. Most of the patients having Chlamydia infection remain asymptomatic. Those presenting with symptoms can have some form of vaginal discharge, bleeding, bleeding and pain during intercourse and urination. Chlamydia is treated with antibiotics. In this case, diagnosis and treatment of the partner is also important. A patient may be advised to take a re- examination within 3 to 6 months of completing the course of treatment to check if the patient has been free from infection completely or there are chances of a re- infection. It can lead to complications like pelvic inflammatory disease and might lead to preterm birth.

Genital herpes is caused by herpes simplex virus. It is a sexually transmitted infection, not everybody affected with this condition has symptoms, but if present, it usually leads to painful blister formation around the genitals. The patient might develop fever, headache and a general feeling of sickness. Once infected, the virus remains in the body, there is no cure for the condition. The symptoms are not evident all the time and subside for a certain period of time just to recur later on. Any factor that leads to triggering of the virus can flare up the inspection; stress, smoking, illness, and alcohol may become cause o flaring up of the infection. Antivirus can be taken, but the infection will not get eradicated completely from the body. Medicines can be given to control the symptoms and reduce the number of flair ups and complications.

Genital warts are also sexually transmitted diseases caused by human papilloma virus. It presents as small growth in the vulval, cervical, vaginal and anal region. The warts can be itchy and may have painful bleeding. They may subside on their own within a few months. Creams, ointment, cryotherapy, or electrocautery can be done to treat the warts. The infection, however, remains in the body.

Gonorrhea is caused by the bacteria Neisseria gonorrhoeae. This is a sexually transmitted infection. Almost 50% of the women affected with Gonorrhea do not develop any symptoms. In case one presents with symptoms, they usually appear within the first 10 days of being infected. Amount of vaginal discharge in Gonorrhea is usually higher than normal, pain and discomfort around the lower abdomen, pain during urination and intermenstrual spotting can be common in this condition. Treatment usually consists of antibiotics. Re-examination may be advised after a week of finishing the treatment to ensure that the infection has cured completely. As the condition spreads through sexual contact it is important to inform the current or recent sexual partner about it who may be required to be tested and treated accordingly.

Vaginal thrush, also called as, Candidiasis is caused by candida albicans. Most of the women wo have this condition are asymptomatic. Some common symptoms are itching, irritation, and soreness around the vulva region. Thick cottage cheese like vaginal discharge is a common presentation of vaginal thrush. Pain during intercourse and urination are common. Common triggers for trash are usage of certain types of antibiotics, pregnancy, and diabetes. Certain types of soaps, shower gels, feminine sprays and washers, and wearing extremely tight undergarments can increase the chances of developing a thrush. This is not a sexually transmitted infection, but intercourse can act as a trigger for the condition. Fungal tablets, creams or pessaries may be advised for treatment of this infection.

Trichomoniasis is developed by a parasite called Trichomonas vaginalis. It is a sexually transmitted infection. Symptoms can be yellow coloured frothy discharge, with a foul smell. Itching and soreness are common in this condition. Antibiotics are usually the preferred line of treatment. Partners need to be treated even if they remain asymptomatic to prevent chances of re- infection.

Prevention strategies include using condoms to prevent spread of infection from one person to another, avoiding strong soaps, feminine hygiene products, washing of vagina too aggressively can lead to disruption of the normal flora of the vagina and hence make it more prone to infections.

Back Pain during Pregnancy
Oct 16, 2019|Dr. Astha Dayal

Back Pain during Pregnancy

Back pain during Pregnancy is very common, especially in the second half of pregnancy. Some common causes of back pain during pregnancy are as follows:

  • The prime cause of the back pain is the weight that the growing uterus and the baby exerts on the back. In a normal healthy pregnancy, women tend to gain around 10 to 15 kgs of weight. The growing uterus on the lower back leading to.
  • Postural changes is again a common cause of backache. The growing foetus and the uterus often leads to shifting of the body’s centre of gravity. This eventually results in the women changing the way they walk in order to adjust their posture.
  • Hormonal changes during pregnancy act on the ligaments of lower abdomen and back. The action of these hormones leads to loosening of the joints in an attempt to prepare the body for delivery. The loosening of joints also increases instability in the body causing further postural changes.
  • As the uterus keeps on expanding, muscles from the centre of the chest to the pelvic bone separates along the central line. This separation increases the intensity of pressure on the back.
  • Emotional stress can lead to increase in muscle tension along the region of the back and hence manifest as back pain.

Back pain resulting from pregnancy usually subsides after delivery. Certain steps can be taken to relieve back pain to some extent:

  • Regular exercise can help in improving flexibility of the body and strengthen muscles and joints. This can help in some easing of pain and stress. Simple exercises like walking, swimming, stationary cycling can be done during pregnancy. A physical therapist or an antenatal exercise specialist can be consulted to help learn proper exercise techniques.
  • Alternate application of hot and cold packs to the back can ease pain to some extent. One should make sure that they do not apply hot packs to the abdomen during pregnancy.
  • Improving overall postures can help in reducing the stress on spine. Proper posture while sitting, working or sleeping is highly recommended. Simple step like sleeping on the sides with a pillow kept between the knees helps in reducing pressure from the back. Keeping a rolled towel behind the back while sitting as a support can help in keeping back muscles relaxed. Proper sitting posture is also helpful.
  • Some women may even try wearing a support belt.
  • Back pain, as a result of stress, requires counselling.
  • While trying to lift some object off the ground one should try bending knees than bending the back.
  • Avoiding high heels during pregnancy is another important step to reduce back ache.

Treatment might consist of some pain killers or muscle relaxants. One should seek medical treatment in case of severe pain, cramps, difficulty in urination or feeling of needle like pain in the extremities.

Consult Dr. Astha Dayal, expert obstetrician in Gurgaon at the CK Birla Hospital to learn more about this condition and possible treatment. Book an appointment today!

Case Study | Successful birthing post umbilical vein varix detection in the fetus
Oct 10, 2019|Dr. Anjali Kumar

Case Study | Successful birthing post umbilical vein varix detection in the fetus

A second time pregnant woman was diagnosed with isolated umbilical vein varix at 31 weeks of gestation. Isolated Umbilical vein varix is a rare anomaly diagnosed on ultrasonography which has been reported to be associated with fetal anomalies and intrauterine fetal death but inconsistently. Since the cause of this variation is unknown, the consulting Obstetrician and Gynaecologist recommended the patient to get a thorough evaluation done for associated fetal anomalies. She also recommended a close follow up with regular doppler as intrauterine demise is known to be caused in cases of umbilical vein varix.

The couple had a non-consanguineous marriage and had conceived the baby spontaneously. She had a history of caesarean delivery 7 years ago for placental abruption with gestational hypertension. In this pregnancy, she had a normal detailed anomaly scan, screen negative for quadruple marker and had normal fetal echocardiography. She was on regular aspirin from second trimester onwards as she had a history of high BP and placental abruption in the previous pregnancy.

At 31 weeks of gestation, the ultrasound scan showed a well-defined cystic lesion in the upper abdomen which was seen to communicate with the umbilical vein suggestive of intraabdominal umbilical vein varix. Doppler colour flow imaging of both uterine arteries, umbilical artery, middle cerebral artery and ductus venosus were within normal limits. Amniotic fluid index was also within normal limits.

The patient was counselled in length about the uncertainty of this finding and the associated risk of still birth and fetal anomalies. Regular follow up scans were done to monitor the size of the umbilical vein and rule out complications like turbulence, thrombosis and rupture. Weekly follow up dopplers thereafter showed no change in the size or appearance of umbilical vein. A satisfactory interval fetal growth was also appreciated.

At 37 weeks 3 days gestation, an elective caesarean section was performed in view of poor Bishop’s score (also known as Pelvic Score, the most commonly used method to rate the readiness of the cervix for induction of labour). The woman delivered a healthy appropriately grown male baby of 2.8kg and the baby also showed no clinical signs of abnormalities.

Staying ahead of Urinary Tract Infections
Oct 10, 2019|Dr. Shalabh Agrawal

Staying ahead of Urinary Tract Infections

Urinary tract infections, or UTI is an infection in any part of the urinary system – be it your ureters, kidneys, urethra and the bladder.  In most cases, infections involve the bladder and the urethra which form the lower urinary tract. If you are a woman, you are at a great risk of contracting UTI. Infection restricted to your bladder can be soring and bothersome. However, serious conditions can occur if the infection reaches the kidneys.

Doctors typically treat UTI’s with antibiotics, but you can take steps to reduce your chances of getting a UTI in the first place by doing these things:

  • Drink plenty of liquids, especially water. This helps dilute your urine and ensures that you’ll urinate more frequently- letting microorganisms to be flushed from your urinary tract before an infection can initiate.
  • Wipe completely from front to back. This supports in preventing germs in the anal region from spreading to the vagina and urethra.
  • Emptying your bladder soon after intercourse.
  • Women should avoid potentially irritating feminine products like douches and powder.
  • Opt for another birth control method. Certain ones can contribute to bacterial growth.

Symptoms

UTI’s don’t always cause signs and symptoms, but when they do, they may include:

  • a sturdy uncontrollable urge to urinate
  • a burning sensation when urinating
  • passing frequent, little urine
  • urine that appears cloudy
  • a blood sign in the urine
  • strong-smelling urine
  • pelvic pain, in women

UTI’s may be overlooked or mistaken for other conditions in older adults. It may surprise you to know that according to studies, the population most likely to experience UTI’s is the elderly. Elderly people are more vulnerable to UTI for many reasons, including their overall defencelessness to infections due to a weakened immune system. Elderly men and women also have to bear a weakening of the muscles of the bladder and pelvic floor, which can lead to increased urinary retention (incomplete emptying of the bladder) and incontinence. These all contribute to infection.

We just discussed the typical signs and symptoms of UTI’s, but older individuals with UTI’s may not exhibit any of the hallmark signs listed above because their immune systems are unable to mount a noteworthy response to the contagion. On top of the lack of noticeable symptoms, many seniors do not or cannot express their discomfort to caregivers.

Since elders’ bodies respond differently to infection, it’s important to look for different signs and symptoms. One tell-tale symptom of UTI’S in the elderly is often mistaken for the early stages of dementia or Alzheimer’s disease, according to researches.

Here are some lesser-known UTI symptoms in seniors. You will notice that they are markedly different from the typical signs and symptoms.

  • diabetes
  • helplessness to empty the bladder totally (urinary retention)
  • use of a urinary catheter
  • bowel incontinence
  • bladder incontinence
  • enlarged prostate
  • immobility
  • surgery on any area around the bladder
  • kidney stones

People with urinary incontinence (loss of bladder control) are at an increased risk for UTI’s

Stay Ahead of Urinary Tract Infections

  • change briefs promptly and frequently
  • encourage front-to-back wiping and cleansing
  • keep the genital area clean
  • set reminders/timers for elderly people who are memory-impaired to attempt to use the bathroom as a replacement for an adult brief.

Although anyone of any age can get a UTI, there are significant differences in symptoms in the elderly. If you think your loved one might have a UTI, see your doctor right away to avoid further complications. A urine sample for lab analysis is one of the easiest ways to diagnose a UTI and that is sometimes followed by a urine culture. If detected early, a simple follow up of antibiotics stereotypically cures the infection in no time.

Consult Dr. Shalabh Agrawal, best urologist in Gurgaon at the CK Birla Hospital to learn more about this condition and possible treatment option. Book your appointment today!

Kidney or Renal Stones
Oct 10, 2019|Dr. Mohit Khirbat

Kidney or Renal Stones

Kidney stones are also known as Renal stones or renal calculi. They are made up of different types of crystals. The usual site of their origin is kidneys, but they might migrate to any part of the urinary tract; ureter, bladder or urethra. They are usually painful and may present as an acutely painful condition, requiring immediate medical intervention.

Types

  • Oxalate stones: They are the commonest type of kidney stones. A diet low in oxalate can help in preventing development of this type of renal stones. Food items that are rich in oxalate are spinach, cocoa, beet etc. Most of the stones are originated from oxalate, good amount of dietary consumption of calcium reduces the risk of developing calcium stones.
  • Uric Acid Stones: These are commoner among males as compared to their female counterparts. People diagnosed with gout are more likely to develop this type of stones. Patients on chemotherapy are at high risk of developing this type of stones. Excessive acidity in the urine often predisposes to this type of stones. A purine rich diet tends to increase the acidity of urine, this is found in animal proteins mainly, like some fishes and meats.
  • Struvite stones: Women having urinary tract infections are at risk of developing struvite stones. This form of stones can be large and may cause obstruction of the urinary tract. They usually result from infections in the kidney. Treatment of the underlying infection can help in reducing the chances of developing this form of stones.
  • Cystine stones: Cystinuria is a genetic defect that leads to leaking of cystine from the kidneys into urine. This leads to the chances of developing cystine stones.

Risk Factors

  • Less consumption of water, and hence less production of urine increases the chances of renal stones.
  • Males are more likely to develop renal stones
  • Past history of renal stones
  • Hyperparathyroidism
  • Inflammatory bowel disease
  • Certain medications like diuretics, anti-seizure drugs, etc.
  • High Salt intake
  • Obesity

Symptoms

Acute pain is one of the most important manifestation of renal stones. The pain is usually felt when the stone starts migrating from the kidneys to the ureters. The pain may be felt in the affected side of the abdomen or back. In males, the pain may radiate to the groin area. The pain may be felt on and off or may be continuous. Other important symptoms of renal stones are:

  • Fever
  • Chills
  • Vomiting
  • Haematuria or blood in urine
  • Nausea
  • Frequent urge to urinate

In some cases, the stones may be too small and may pass down the ureter and eventually through the urethra without any pain. For cases where the stones are considerably larger, they may cause obstruction of urine in the ureter leading to infection in the kidneys. When stuck in ureters, the stone may irritate the walls and cause pain and bleeding.

Diagnosis

Diagnosis of a renal stone can be made through a complete physical examination along with some basic radiological and blood examinations:

  • X-ray abdomen
  • Kidney function tests
  • Urine routine and microscopic examination
  • Intravenous pyelogram
  • Retrograde pyelogram
  • Ultrasound of kidneys
  • MRI abdomen
  • CT Abdomen

Treatment

The line of treatment is decided depending upon the type of stone. Increasing water intake to up to 10 to 12 glasses can help in keeping the patient well hydrated, especially in case of nausea and vomiting.

Pain killers may be prescribed to subside the pain to some extent. Antibiotics are given for treatment of infection when the same is the underlying cause.

Extracorporeal Shock Wave Lithotripsy is a procedure where sound rays are used to dissolve the stones and break them into smaller fragments. This is usually conducted under anaesthesia.

In some cases, a percutaneous nephrolithotomy may be advised where a hole is made in the lower back to remove the stones with the help of an endoscope.

Ureteroscopy may be done in many cases to visualize and remove the stone.

Prevention

Adequate water intake is the key to prevention of renal stones. Reducing intake of food rich in oxalate and increasing citrate intake can help in reducing certain types of stones. Keeping salt in diet low and maintaining a healthy weight are very helpful.

Consult with the expert urologist at the CK Birla Hospital in Gurgaon to learn more about this condition and possible treatment. Book your appointment today!