I write this article for my readers who may also have visited me for the consultation for bariatric surgery but have opted out for various reasons. To clear the common misconceptions, read on ……

1.  Is Bariatric surgery risky ?

Bariatric surgery currently is very safe. 99% patients go home the next day without any problems. Those who have a complication such as leaks and bleeds are now managed very effectively. In a paper published earlier, bariatric surgery was found to be as safe as an appendicectomy.

2.  Will I feel weak after bariatric surgery since I will be unable to eat more ?

It is very common for patients who undergo bariatric surgery to feel energetic and vivacious. Patients regain a lot of confidence, are increasingly mobile and are off their drugs for diabetes, knee pain, blood pressure and are usually are at the top of the world.

3.  Can diabetes be actually cured by bariatric surgery ?

Yes, there are now enough successful patients and evidence to suggest that a surgery can remit diabetes in many situations. Millions of diabetics who were on insulin and drugs to control their blood sugar are off medications. In addition, these patients do not need to live in the fear of diabetic complications such as the kidney failure, heart disease, stroke, infections, eye complications and limb-threatening feet infections.

4.  Is life tough after bariatric surgery ?

Life doesn’t change after the surgery. It is the same as those individuals who value their life and practice moderation in their diet and lifestyle. Eating less come naturally after surgery. Making the food choices sensible is taught.

5.  Is the process of bariatric surgery painful and bothersome ?

Thanks to improved technique and technology most patients can be sent home the next day. They are back to work within a week. The pain is minimal thanks to keyhole technique. Patients start eating normal solid food after a week after newer procedures.

Know about Bariatric Surgery with our YouTube video.

I have anal fistula. I have taken various medicines prescribed by alternative medical practitioners but it has not healed. I am scared of surgery since I have heard it is painful and fail most often.

Anal fistulas can be cured only by surgery. So don’t waste time and money on pills and creams. The fistula surgery has improved in recent times due to better MRI scans, techniques like VAAFT, LIFT, Seton and Plug for complex cases. Most cases can be sent home after a single day hospital stay with minimal pain and wound. The failure rate for a simple fistula is rare and 15% for complex fistulas. Also in traditional surgery there is a chance of damage to anal muscle that can lead to inability to hold stool. This is least likely in modern surgery.

I am suffering from Piles since last 2 years and I have taken various alternative medicines but if I stop taking these, the problem starts within 2-3 days. How long do I have to take this?  Do I need surgery?

Most alternative medicines have no scientific basis or evidence. On the basis of scientific evidence, if there are smaller piles (grades one or two) they may benefit from injection or banding treatment. If you have grade three piles (piles that come out of the anus and bleed profusely), you need surgery. Surgery can be open or stapler. I recommend stapler since there is no pain or wound after the operation. It does not require any dressings and patients can return to their work within a day or two. If I needed surgery I would (having done both types of operation extensively) choose staplers any time.

I have pain when I pass stool for years. What should I do?

You should see a doctor immediately since it can be due to a simple correctable cause such as an anal fissure or it may be due to a sinister cause such as a rectal cancer.

A simple day care surgery can cure anal fissure forever.

My rectum pops out of my anus when I pass stool (Rectal prolapse). What is the modern treatment for this disease?

This popping out of rectum on straining for defecation is called rectal prolapse. If not treated early, these patients will develop permanent damage to their anal sphincter and may lose ability to control their passage of stool. Nowadays rectal prolapse can be treated by laparoscopic surgery without the need for cutting the abdomen. This means less pain, less wound and a hospital stay of 2-3 days only.

What is the recent advancement in the management of cancers of colon and rectum?

Early detection and surgery is the key to a successful management of these patients. The surgery can nowadays be done by laparoscopy and hence the patients are spared the trauma of open long incisions.

The combination of radiotherapy in rectal cancer and chemotherapy in colon cancer has improved outcomes too.

Watch the video of Anorectal Surgery on YouTube.

Bariatric surgery – a weight loss surgery- is becoming an increasingly popular option for patients who are obese and diabetic. It not only helps to reduce weight and resolve diabetes, it also helps patients with arthritis, snoring, infertility substantially. The dramatic results and benefits it produces is the major reason for its popularity. The method in which it achieves this outcome is based on the fact that it reduces the capacity of the stomach and hence eating less can satisfy the patients. The consequent calorie deficit drives the body fat to melt to supply calories. This fat meltdown translates into remarkable weight loss.

So far, the more popular bariatric procedures utilized this principle of food restriction that worked well with many patients.  Be it a Lap-band, Sleeve Gastrectomy or a Gastric Bypass, all worked mostly on this principle. The procedure like Lap- Band are simpler but less effective whereas a Bypass is more effective but technically more difficult.  A procedure with advantages of both would be the optimum surgery.

Recently, a procedure that is effective and simple has been developed that utilizes the principle of malabsorption (causes only part of the food to be absorbed). This has joined the armamentarium of bariatric surgery. It is called the Mini Gastric Bypass.

The Mini Gastric Bypass was developed by an American Surgeon, Dr. R Rutledge and has significant advantages. It is simpler to do, takes less time- less than an hour mostly and involves a single day hospital stay.

It is claimed that this surgery works even after a few years when most of other procedures have stopped their restrictive potential significantly. This is important especially in India, where patients cannot think of a second surgery because of the costs and risks involved.

Additionally, if patients wanted the procedure to be reversed for any reason, it is possible.

Since the procedure works on the principle of malabsorption and relies less on restriction, the patients can eat and drink more- an effect that may be more than welcome to many food-loving patients. Since we Indians have primarily a cereal-based diet, this may come real handy.

The surgery has been accepted widely by thousands of patients in the last fifteen years and has become the procedure of choice for many.

Watch video of Bariatric Surgery on YouTube.

What is a Hiatus hernia ?

In a hiatus hernia, a part of the stomach that should normally be in the abdomen protrudes through the diaphragm into the chest (See picture). This hernia allows food and acid abnormally to travel upwards and may produce symptoms.

What are the symptoms in Hiatus hernia ?

These individuals experience heartburn when acid produced in stomach enters the chest. They also experience the distressful symptom of regurgitation (feeling of food coming up in the throat) when food travels into the chest due to this wide defect. Some hiatus hernias can lead to dysphagia (difficulty in swallowing) too.

What causes a Hiatus Hernia ?

Most of the time, the cause is not known. A person may be born with a larger hiatal opening. Increased pressure in the abdomen such as from pregnancy, coughing, or straining during bowel movements may also play a role. Being overweight and obese is a definite risk factor for hiatus hernia.

How is a Hiatus Hernia Diagnosed ?

A hiatal hernia can be diagnosed with a specialized X-ray (using a barium swallow or with endoscopy.

What is the treatment of Hiatus Hernia ?

Most heartburns can be controlled by dietary changes and medicines. Surgery is required if these measures fail.

When Is Hiatus Hernia Surgery Necessary ?

Hiatus hernia surgery (laparoscopic fundoplication) is needed if symptoms of GERD and regurgitation cannot be controlled effectively by medicines or when there is complication of hernia.

Hiatal hernia surgery is performed as a laparoscopic procedure. It involves minimal pain and scars and one day hospital stay. The patient is spared the misery of life long treatment and therefore is the treatment of choice for many patients.

Watch video on YouTube on Laparoscopic Hernia Surgery.