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               GASTRITIS

It is the inflammation of the gastric mucosal membrane; it can be active or chronic.  The three important causes of gastritis are H.Pylori infection, NSAID (Non Steroid Anti-inflammatory Drugs and autoimmunity.

ACUTE GASTRITIS

Acute gastritis is often hemorrhagic and erosive.

Causes: Drugs like non steroid anti-inflammatory drugs (NSAID's), aspirin, etc.

Intake of corrosive substances (acids, alkalies),

Excessive use of alcohol,

Severe stress,

Chronic smoking,

Excessive use of spicy foods

Secondary to conditions like surgery (CVA, trauma, shock, sepsis, burns), portal hypertension with gastropathy)

Clinical features

Ò      Anorexia

Ò      Nausea

Ò      Vomiting

Ò      Upper abdominal pain

Ò      Hematemesis

Ò      Melena

Ò      Dehydration

Ò      Fever and Epigastric tenderness.

CHRONIC GASTRITIS

Chronic gastritis is divided into two types.

a) Type A gastritis: here proximal and secreting part of the stomach is involved. Pernicious anemia is the major cause. In this type, there is autoimmune gastritis involved in the fundal glands. Gastric carcinoid tumour without metastasis may be seen.

b) Type B gastritis: the causative organism is H.Pylori, and the mechanism of injury is not clear. It is transmitted from person to person, but the mode of spread is not clear. Sometimes there may be metaplasia of the gastric epithelium to the intestinal epithelium. However, this infection may give rise to peptic ulcer.

 Treatment

Avoid spicy foods, alcohol, etc.

Homeopathy is strongly recommended for gastritis. Both acute as well as chronic gastritis are proved to be benefited by homeopathy. The recurrence can also be prevented.

Regularly used medicines are Nux vom, Carbo veg, Pulsatilla, Abies Nigra, etc

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                                         GASTRO-ESOPHAGEAL REFLUX DISEASE

(GERD)- It is caused by re-flux of the stomach contents into the lower end of the esophagus.

The foods when reaches into the stomach mixes with hydrochloric acid in the stomach, it becomes acidic in nature. And these acidic foods cause damage to the inner lining of esophagus and thus heartburn.

In normal individual, the sphincter in the lower end of the esophagus prevents the back flow foods from the stomach to the esophagus because the sphincter is intact. However, once it becomes weak, the tone of the sphincter reduces and when intra-abdominal pressure raises the food reflux back.

Causes of GERD

Hiatus Hernia (HH)

Hiatus hernia develops due to the pressure difference between abdominal and thoracic cavities. Besides the angulations between cardia and esophagus is lost. Patients with Hiatus hernia may be symptomatic or asymptomatic. 

Delayed esophageal clearance

When esophageal clearance is delayed there is an increase in acid exposure time. Defective acidic clearance occurs after inflammation of the oesophagus.

Defective gastric emptying

The exact reason which causes defective gastric emptying is not known.

Gastric content

Since the gastric content is acidic there is a relationship between acid exposure time and development of symptoms.

Increased intra abdominal pressure

Factors which increase the intra abdominal pressure like pregnancy, obesity causes GERD. So weight loss may sometimes improve the symptoms.

Dietary and environmental factors

Non steroid anti-inflammatory drugs (NSAIDs), alcohol, smoking; chocolate, coffee, fatty food will relax the lower esophageal sphincter which leads to GERD.

SYMPTOMS AND CONDITIONS ASSOCIATED WITH GERD

 TYPICAL SYMPTOMS: heartburn, acid regurgitation.

Atypical symptoms: dysphagia, globus sensation, non-cardiac chest pain, dyspepsia or abdominal pain.

Extra esophageal symptoms: hoarseness or sore throat, sinusitis, Otis media, chronic cough, laryngitis or polyps on the vocal cords or both, dental erosions, non atopic asthma, recurrent aspiration or pulmonary fibrosis.

Other symptoms include sour or bitter taste in the mouth, water brash, coughing or choking.

Malignancy: esophageal adenocarcinoma,

Homeopathic treatment.

The treatment strategy-acute symptoms such as heart burn, dysphagia, and dyspepsia are given prime importance, because these symptoms are most distressing to the patient. So these symptoms should be cured first and for that medicines like Ars alb, Robenia, Carbo veg, Iris vers etc; are given based on the present symptomatology. This is followed by a deep acting anti miasmatic remedy to prevent the recurrence as well as complications. All these methods are safe and give permanent results.

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                                                ACHALASIA OF THE CARDIA (CARDIOSPASM)

It is the failure of relaxation of lower esophageal sphincter (LES) on swallowing. The lower esophageal sphincter cut off the esophagus from the stomach. The failure is due to nerve damage of esophagus or damage of LES.So after eating instead of food going to stomach, due to the damaged sphincter food accumulates in the lower end of the esophagus. The risk is more in people with autoimmune disorders.

Clinical features

1) Dysphagia: patient usually complaints about difficulty in swallowing solid foods. And there is a sensation of food sticking in the esophagus at first intermittent later, continuous and later after every meal.And it is more with solid foods. Emotional stress and eating icy cold foods will aggravate dysphagia...

2) Regurgitation: after eating food regurgitates back at first immediately and sometimes retained for hours.

3) Chest pain: spontaneous retrosternal pain (heart burn) during the night and day.   

4) Respiratory symptoms: cough, dyspnoea, pneumonia, bronchiectasis

5) Asymptomatic: sometimes the condition is discovered as the mediastinal swelling on routine chest.

X ray

Complications

1) Lung fibrosis

2) Carcinoma

3) Malnutrition

Treatment-

General measures- avoid spicy and ice cold foods. Since stress is an aggravating factor, mental relaxation is important.

Homeopathic treatment is based on symptomatology. Based on the aggravating and ameliorating factors and patient’s mental and physical peculiarities remedies are chosen. Usually, the prognosis is good.

Medicines like Ars alb, iris vers, Phosphorus, Nat mur etc

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ALCOHOLIC LIVER DISEASES

Alcohol is the most common cause of chronic liver disease.

Individuals who drank heavily for more than five years develop the liver disease for the majority of the cases.

However, there is no clear-cut linear relationship between the dose and liver damage.

Risk factors

Continuous drinking is more dangerous than the binge drinking.

Females are more prone to develop the liver disease than man.

Genetics plays a role for the development of alcoholic liver disease.

Alcohol is metabolized mainly in liver. This alcohol is converted into acetaldehyde, and this acetaldehyde acts with certain protein and causes the liver cell damage.

Clinical features

Ò       Most often liver is enlarged.

Ò       The liver function tested may be abnormal but without any symptoms.

Ò       The liver may be abnormal or enlarged.

Ò       In alcoholic hepatitis, there will be jaundice.

Ò       Malnutrition

Ò       Hepatomegaly

Ò       And if cirrhosis develops -then.

Ò       The liver will be large or normal or small.

Ò       There will be ascites.

Ò       Cancer of liver-*(hepatocellular carcinoma)

Investigations

Blood –complete blood count- increased macrocytes in the absence of anemia.

Liver function test.

X ray chest-unexplained rib fracture, especially both sides are suggestive of alcohol misuse.

Test for the jaundice-presence of jaundice is an evidence of alcoholic hepatitis.

Liver biopsy

Treatment

General treatment

Complete stoppage alcohol. It will not only prevent the progress against the disease but along with therapies, there is a chance to complete recovery.

Good nutrition is a must.

Homeopathic treatment.

As Dr Hahnemann has pointed out if the cause is stopped there will be a cure. So after stopping alcohol and with good nutrition, and the treatment if switched on to homeopathic treatment definitely, the life span be prolonged.

Medicines that are effective for alcoholic liver diseases are Nux vom, Chelidonum, Lycopodium, Carcinosinum, etc.

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ASCITES

Ascites is the accumulation of free fluid in the peritoneal cavity.

It may be due to heart failure, cirrhosis of liver or malignancy.

Clinical features-

The main feature is the distention of the abdomen. The umbilicus becomes everted, scrotal oedema, hernia, are the associated features.

Causes of ascites.

1-Malignantdiseases.

2-Cardiac failure.

3-Liver cirrhosis.

4-Infection like tuberculosis, inflammation in the peritoneum.

5-Nephrotic syndrome.

6-Hyperthyroidism.

7-Renal dialysis.

8-Lymphatic obstruction.

9-Pancreatitis.

Appearance of ascitic fluid.

a) Clear or light green in cirrhosis

b) Bloody fluid in malignancy.

c) Cloudy in infection.

d) Milky white in lymphatic obstruction

Grading of ascites

Grade 1

Mild and visible by ultrasound only

Grade 2

Bulging of both flanks and shifting dullness on percussion.

Grade 3

Abdomen distended with the fluid thrill on auscultation.

Investigation

Ultrasonography is the best choice.

Tapping the fluid (paracentesis) is useful for analysis the fluid.

Depending upon the concentration of protein the fluid may be exudates or transudate.

In cirrhosis of liver, it is transudate.

Treatment

General measures

The aim is to relieve the discomfort.

Reduce the sodium and fluid intake.

If there is too much discomfort tapping of the fluid is necessary.

Homeopathic treatment

Since the disease is a very complicated one, and the causes behind the ascites are severe the remedy and potency selection should be considerably cautious.

The medicine is better tried in the tincture form or in low potency. The discomfort should be relieved first in severe cases. For that, homeopathic remedies like Apis, Ars alb, Apocyanum is effective. Once the acute symptoms are over constitutional drugs are chosen after considering the mental and physical totality of the patient and with given importance to the underlying disease symptoms. The cause to the formation of ascites should be given importance. Because common symptoms in the disease should be avoided while selecting the deep acting homeopathic remedies.Anyway homeopathic is effectivein the treatment of ascites. Medicine can be tried even after paracentesis, so that further formation can be prevented. Even so, the treatment is a prolonged process.

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                                                                   STOMACH CANCER

Stomach cancer is otherwise known as gastric cancer. The basic pathology is that stomach cancer is that the normal cells of the stomach get converted into cancer cells. It is one of the leading causes of death worldwide.

The most common cancer of the stomach is gastric adenocarcinoma.

Risk factors associated with gastric cancer.

1) Genetic factor

Family history- A blood group person is more prone to get cancer of the stomach.

2) Environmental and dietary factors

Salted pickles, smoked meat and fish, cigarette smoking, poor-quality diets low in Vitamin C and high in starch.

3) Infection

H pylori infection

4) Pre malignant condition such as

Chronic atrophic gastritis

Benign gastric ulcer

5)Previous gastric surgery

6) Smoking

7) Alcohol

Clinical features

Indigestion

Weight loss

Dysphagia

Dyspepsia

Nausea and vomiting

Vomiting of blood (hematemesis)

Malena (blood in stool)

Profound anorexia

Flatulence 

On examination anemia, weight loss and palpable mass in the epigastrium may be seen. Jaundice and ascites reveal the spread to liver. Sometimes cancer may spread to left supraclavicular lymph node or umbilicus or ovaries.

Liver, lungs, bone marrow, and peritoneum are the common sites of spread.

Investigations

Upper gastrointestinal endoscopy

Biopsy

CT to rule out spread

Treatment

Surgery-partial gastrectomy if localized, and total gastrectomy for certain gastric tumors.

Radiation and chemotherapy

Homeopathic treatment.

Since the disease present with too many signs and symptom homeopathy has got a better treatment scope. These will not only prevent the spread but also will improve the quality of life.

In post surgical cases or even after radiation and chemotherapy homeopathy has also got a better treatment protocol to improve the unwanted after-effects of these methods. Usually, patients won't approach to the beginning stage but will approach the homeopathic doctor in terminal stages only. In that stage, the patients may be very weak, with difficulty in eating and drinking. In such cases also the homeopath takes the present pathological symptoms and medicines in low potency or in tincture forms are prescribed. In the majority of the cases, these methods give a better quality of life and survival.

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                                                             CIRRHOSIS OF LIVER

Cirrhosis of liver is one of the most common causes of death in younger age groups. It can occur in any age.

Causes of cirrhosis

Alcohol

Chronic viral hepatitis B or C

Genetic and immune causes

Biliary causes

Whatever may be the cause the basic reason is the recurrent or persistent death of liver cells or hepatocytes. Alcohol is considered to be the prime cause of cirrhosis worldwide.

Due to progressive wide-spread death of liver cell associated with inflammation and fibrosis, the normal architecture of liver is lost. The process is gradual and highly progressive unless and until abstain from the cause. For example, if the cause is alcoholism, complete stoppage of the alcohol will prevent the further damage of liver cells.

Clinical features of cirrhosis-

Cirrhosis may be asymptomatic or just an enlargement of the liver is the sign.

There is severe weakness, fatigue, nausea, vomiting, upper abdominal; discomfort, and weight loss will be there.

Along with hepatomegaly there will be jaundice

Ascites

Cyanosis (bluish discoloration)

Bleeding tendency

Enlargement of spleen

Pigmentation and digital clubbing.

Enlargement of the liver is the common accompaniment of alcoholism.

However, liver size is reduced in viral hepatitis and autoimmune liver diseases.

The enlarged liver is painless, hard, and there may be slight yellowish discoloration (jaundice).

 Sometimes dilated small blood vessels arranged like spider pattern (spider telangiectasia) can be seen above the nipple. Along with this if there is enlargement of breast in male (gynecomastia) and parotid gland enlargement; it is strong indication of alcoholic liver disease.

Prognosis

Usually, prognosis is very bad. However, when the underlying causes are corrected the prognosis is more favorable.

 Investigation

Complete blood count

Liver function test

USG abdomen

Treatment

If alcoholism is the cause, stoppage of the same is the primary need.

Diet for cirrhosis

Abstain from alcohol

Eat low sodium diet. Avoid added salt and tinned salted foods.

Can eat legumes, poultry and fish

Homeopathic treatment

The first and foremost thing is if there damage to the liver reversal to normalcy is a rare possibility. Nevertheless, there is a ray of hope, that, the further damage can be prevented by homeopathic remedies along with exactly formulated diet.

The better homeopathic remedies are Chelidonium, Cardus marianus, Lycopodium, Nux vomica, etc.

A better scope and prognosis are seen in a majority of the cases of cirrhosis if it is due to alcoholism.

In short, homeopathy is definitely an alternative to prevent the prognosis of the damaged liver and thereby to improve the quality of life.

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             COLORECTAL CANCER

Rectum is the last part of colon. It is the second most common internal cancer and other leading cause of cancer death in western countries.

Causes of colorectal cancer

Environmental factors and genetic factors play the major role in colorectal cancer.

Of these 80% of the share goes to environmental factors.

Of this dietary, factors are the major causes.

Red meat –it contains high saturated fat and protein. During cooking carcinogenic amines are formed.

Non dietary factors include long standing ulcerative colitis, crohn’s disease, pelvic radiotherapy.

Obesity

Sedentary lifestyle

Continuous use of aspirin

Smoking

Alcohol

Signs and symptoms

General features like

Ò      Weakness

Ò      Fatigue

Ò      Diarrhoea

Ò      Weight loss

Specific symptoms depend on the site of cancer.

Fresh rectal bleeding is the feature of tumor affecting left colon. And fecal obstruction occurs too early.

In tumor of right colon, there is anemia, and occult bleeding. Here the fecal obstruction occurs very late.

Rectal bleeding and abdominal pain are the major symptoms.

On examination, there is anemia, palpable mass, enlargement of liver due to spread. In tumors of the lower part of the rectum, the mass can be palpated by digital examination.

Investigations include

Sigmoidoscopy

Colonoscopy

Pelvic MRI

CT clonography

Measuring of carcinoembryonic antigen (CEA) help to detect early recurrence.

Homeopathic treatment.

Well proved homeopathic remedies are available in the homeopathic therapeutic system.

A well experienced homeopathic doctor can effectively manage the signs and symptoms of colorectal cancer. It is also equally effective in the terminal stage as a palliative measure.

Remedies usually indicated are Acid nit, Carcinosinum, Thuja, Ruta,  Hydrastis, etc.

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                                                                CONSTIPATION

It can be defined as infrequent or difficult passage of faeces. It can also be hardness of stools or feeling of incomplete evacuation.

Causes

Dietary factors- insufficient fiber into the diet.

Obstruction- tumors, inflammation, diverticular disease.

Disorder in the peristaltic movement as in Irritable Bowel Disease (IBD).

Ano-rectal diseases such as anal fissures, crohns disease, hemorrhoids.

Medications like diuretics, analgesics, antacids, antipsychotics and anticholinergic.

Metabolic/endocrine diseases like diabetes mellitus, hypothyroidism, and pregnancy.

Neurological causes like- cerebrovascular accidents (CVA), Parkinsonism, multiple sclerosis.

Gynecological causes like -pregnancy, ovarian cancer.

 Psychiatric disorders such as depression.

Treatment-

General measures

Avoid the following the foods

Ò      Meat

Ò      Cheese

Ò      Chips

Ò      Ice creams

Ò      Fast foods

Ò      Snacks

Try the following foods

Ò      Eat foods rich in fibers like

Ò      Beans

Ò      Raw vegetables

Ò      Fresh fruit

Ò      Whole-wheat bread

Ò      Oatmeal

Ò      Drink plenty of water- at least eight glasses per day

Ò      And mild to moderate exercise daily

Homeopathic approach

In clinical practice, it is seen that the patients who are on laxatives for constipation cannot avoid it. They develop a kind of dependency for the laxative. Of course, these laxatives give a temporary relief, but it cannot root the causes that play behind.  In homeopathy, the medicines are selected by considering the pathology behind constipation, and peculiarities in a patient with constipation. So a single remedy cannot be projected as the homeopathic laxative. Even so, there are a number of effective remedies in homeopathy that can prevent the constipation permanently.

The frequently indicated remedies are Nux vom , Sulphur, Lyco, Hydrastis, Ruta, etc.

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                                                       CROHN’S DISEASE

Crohn’s disease is one of the inflammatory bowel disease, the other being ulcerative colitis. Crohn’s disease may affect the whole intestine starting from the mouth to the anus. However, lower part of the small bowels has got the preference.

There are deep ulcers, and these ulcers may penetrate the bowel wall and cause abscesses or fistula.

Symptoms

Abdominal pain, diarrhoea, weight loss is the predominant feature. Pain is associated with diarrhoea, which may be watery and does not contain blood or mucus. Along with this, there is a weight loss. The patient refuses to take food, because food triggers abdominal pain, and so patient avoids eating. Not only that there may be malabsorption, fat and protein and vitamin deficiencies. In crohn's disease, rectum is not involved, and the presence of perianal abscess and fistula favors the diagnosis of crohn’s disease.

In crohn’s disease chances of cancer is comparatively low.

In blood examination, there is marked anemia and Erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) is raised.

Treatment

Aim of treatment

Treat the acute episodes            

Prevent relapse

Find out cancer at an early stage

Homeopathic treatment

The treatment aspect includes in a multifactorial approach.

The medicine should work to correct the immunity, to control the acute attack, and prevent relapse and also to prevent complications like abscesses and fistula and cancer.

So the remedy should be deep acting and an antimiasmatic.

A long treatment is needed to achieve the above target. So  a   classical approach though the path as pointed out by dr Hahnemann a complete cure in early cases and prevention and control for the disease, and its complication  in advanced cases are possible.

Medicines like Tuberculinum, Phosphorus, Merc sol, etc. will give excellent results .

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DIARRHOEA

Diarrhoea is the passage of loose stool more than two times a day. It is the decrease in consistency or increase in liquidity of stools.

Acute diarrhea

Causes

1-Viruses like adenovirus, astrovirus, rotavirus and herpes simplex virus             

2-Bacteria: E.Coli, salmonella, Shigella

3-Parasites: E.histolytica

4-Food poisoning or toxins

6) Drugs: antibiotics, antihypertensive, antineoplastic, CNS drugs, antidepressants

Chronic diarrhoea

Causes

1) Dietary factor: indigestion of fructose, sorbitol, caffeine

2) Infections: giardia, E.histolytica

3) Drugs: antacids, antihypertensive, antibiotics, NSAID s, digoxin

4) Lactose intolerance

5) Malabsorption: chronic pancreatitis, bacterial overgrowth,

6) Inflammatory bowel disease

7) Radiation colitis.

8) Neoplasm: pancreatic cancer, neuroendocrine tumors,

9) Idiopathic secretary diarrhoea: microscopic colitis, collagenous colitis, idiopathic bile salt diarrhoea.

10) Endocrine disorders: DM, hyperthyroidism, hypoadrenalism

11) Functional bowel disorders: purgative use and abuse

12) Feacal incontinence: anorectal surgery, autonomic neuropathy

Clinical features

Symptoms

1) Weight loss

2) Abdominal pain

3) Abdominal distension

4) Rectal tenesmus

5) Chronic bloody diarrhoea with systemic upset

Signs

1) Abdominal tenderness

2) Abdominal bruit

3) Mass-carcinoma

4) Anal abnormalities like: fissures, perianal abscess

Treatment

In acute diarrhoea, taking the present symptomatology and prescribing is the correct method. If it is due to drug, withdraw the drugs.   If it still persists, treatment should be according to the present symptomatology.

In chronic diarrhoea, the present symptoms along with the underlying disease symptoms are taken into consideration, and the potency selecting depends up on the chronicity of the disease.

In both cases, homeopathy is very effective.

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                                                       DYSPEPSIA

Dyspepsia also known as indigestion refers to upper abdominal symptoms usually following intake of food.

Causes

1 ) Gastric ulcers, gastritis, duodenal ulcer, duodenitis.

2) Functional dyspepsia-causes: duodenitis, gall bladder stones, chronic pancreatitis, duodeno gastric reflux, intestinal parasites, psychiatric disorders

3) Drug related- aspirin, NSAIDs, antibiotics, steroids, estrogens, potassium supplements.

4) Extra intestinal systemic disease like diabetes mellitus, hypothyroidism, hyperparathyroidism, uremia.

Flatulent dyspepsia has no pathological causes and symptoms like belching, bloating of abdomen and flatulency.

Symptoms of dyspepsia

Ò      Retrosternal burning

Ò      Regurgitation

Ò      Epigastric pain on an empty stomach relieved with bland food, antacids.

Ò      Distension, early satiety, nausea, post prandial fullness

Diagnosis

Due to varied and nonspecific symptoms, diagnosis is very difficult. Detailed narration of symptoms, including discomfort, nature and relation with food, etc., should be taken into consideration.

Esophago gastro duodenoscopy and after that a USG abdomen, etc. can be done in doubtful cases.

Treatment

Eat slowly and with an ease mind

Eat warm food and not hot food

Homeopathic medicines

Since dyspepsia nothing to do with organic causes it is easily manageable.  Symptoms like heart burn, belching; loss f sleep can be managed by Nux Vom, carbo veg and for evening   aggravation lycopodium are good

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                                                      DYSPHAGIA

Dysphagia is the difficulty in swallowing. And it indicates a delay in passage of solid foods or liquids from mouth to stomach. Dysphagia should be distinguished from odynophagia, which is discomfort or pain on swallowing hot and cold liquids and occasionally alcohol.

Causes of dysphagia

Acute causes

Inflammatory conditions

Example- Pharyngitis, Tonsillitis

Foreign body

Example-meat bolus, bone or other objects

Ingestion of caustic substances

Chronic causes

a) Oropharyngeal causes.

Neurological causes like- CVA, Parkinsonism, myasthenia gravis, multiple sclerosis, polyneuropathy.

Infections like-candida, herpes

Mechanical or compressive causes like-intervertebral disc degeneration, thyroid enlargement,  

Pharyngeal pouch

Psychosomatic cause like globus hystericus

b) Oesophageal causes

Mechanical block like mediastinal neoplasm, esophageal stricture

Muscular in-coordination like achalasia, diffuse oesophageal spasm, oesophagitis

Symptoms and signs

Ò      Inability to initiate swallowing properly

Ò      Occurrence of nasopharyngeal regurgitation

Ò      Aspiration of swallowed fluid into the air way

Ò      Coughing while swallowing          

Ò      Weak voice

Ò      Chest pain

Ò      Heart burns

Homeopathic treatment

If dysphagia is due to mechanical causes, removal of the cause is the primary treatment.

If dysphagia due to obstruction by growth like mediastinal tumor, surgical removal followed by homeopathic treatment is the treatment of choice.

In all other cases symptomatic treatments with mental and physical totality as homeopathy implies.

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                                                                     FISSURE IN ANO

Fissure in ano or anal fissure is the longitudinal tear in the anal mucosa. The tear may be due to a trauma, scratch or friction.

Risk factors for anal fistula

Constipation

Ulcerative colitis

Crohn’s disease

Symptoms of anal fissure

Ò      Mucous discharge from the anus  

Ò      The skin next to the fissure become thickened severe pain during and after defecation.

Ò      Minor bleeding during defecation

Ò      Pruritis ani

Ò      Edematous and protrude and is called as the sentinel pile.

Treatment

General treatment

First  thing is to avoid is constipation.

To avoid the constipation drink plenty of fluids and bulk forming laxatives.

And also advise the patient for sitz bath. In sitz bath, patient sits in a wide basin with warm water for 15 to 20 minutes. Salt can be added to the water.

Homeopathic treatment

After a few months of treatment, complete cure is possible by homeopathic medicines.

Patient usually comes to get some relief for the intolerable pain. Medicines selected as per the nature of pain; time of aggravation of pain, etc. will give a speedy recovery. Homeopathy has an effective role not only to relive the acute symptoms but also for the complete cure. To get the permanent cure antisycotic remedies is the treatment of choice.  The following is the best antisycotic medicines for the complete cure.

Thuja, Nitric acid, Graphtis, Ratanhia, etc.

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          FISTULA IN ANO

Fistula in ano or anal fistula is a tube-like canal that opens at one end in anal canal and the other end in perianal skin. When the anal glands become infected with normal intestinal bacteria, the opening of the glands becomes blocked and began to suppurate and becomes an abscess. This abscess ruptures spontaneously and develops into a fistula. The abscess is extremely painful, and the pain will be relieved only after releasing the pus either through medicine or surgical drainage.

Causes of anal fistula

Majority of the cases the anal fistula develops spontaneously at its own, but tuberculosis and crohn’s may also cause a fistula.

Signs and symptoms

Pain

Swelling

Tenderness

Fever

Itching at the site of fistula-Due to constant discharge of pus there will be much irritation and itching at the site.

Discharge of pus or rarely faeces when the fistula opens.

Treatment

In modern medicine, the treatment of choice is only surgery. In ayurvedic treatment, there is a method called Kshara Sutra, which is a minimal invasive Para surgical procedure.

Homeopathic treatment

Whatever may be the cause the tendency to form a fistula is corrected by giving exact homeopathic remedies. The first line of treatment is to prevent the formation of abscess, which is the precursor of fistula.

If the patient comes with the abscess medicines for the abscess is selected according to the patient’s condition. Once it is controlled the next step is to prevent the recurrence.

Medicines for abscess-Bell, Heap sulph, Silicia, etc.

Medicines for fistula-Causticum, Acid nit, Calc sulph, Silicia etc

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           GALLSTONES

Gall bladder calculus may be pigment stone or cholesterol stone. Usually mixed varieties are seen.

Certain dietary factors said to play a role in the development of gall stones. Foods rich in cholesterol, fat, fewer dietary fibers, etc. are the factors. However, moderate intake of alcohol does not form gall stones.

Risk factors for the development of gall stones.

Old age

Obesity                                                  

Pregnancy

Female gender

Fasting

                                                                           

Clinical features

10% of the individuals with gall stones produce symptoms. Majority are symptoms free.

Symptoms include

Pain-Biliary colic

There is a sudden onset of pain, and pain extends for 2 to 3 hours. If it occurs, more than six-hour  complications such as pancreatitis or cholecystitis may be present.

Pain may be felt either in the pit of stomach or right upper quadrant and radiate to either to tip of right scapula or in between the scapular region.

Along with pain, there may be fat intolerance, loss of appetite and flatulence.

Complications of gall stones

Cholecystitis-the stone the gall bladder may cause inflammation of the gall bladder.

Jaundice-If the stone blocks the common bile duct. The flow of bile duct is obstructed, which result in jaundice.

Pancreatitis-Blockage of the pancreatic duct results in inflammation of the pancreas.

Investigations

X ray abdomen

USG

CT scan

Treatment

Small and medium-sized  stone can be managed by homeopathic remedies. But lager stones and multiple stones and impacted stones usually surgery is the treatment of choice. However, pain  and inflammation of gall bladder –cholecystitis-can be managed homeopathic medicines. Small-sized  stones can be expelled by homeopathic medicines like Lycopodium, Fell tauri, Kalmegh, China, etc. medium sized stone be reduced to small by homeopathic medicines and can make it symptoms free as seen in clinical practice. Care should be taken in mobile (moving) stones because there is a chance of the blocking the neck of gallbladder and thus causing the stasis of bile, which results in jaundice. If so also think of surgery.

Generally in clinical practice, gall stone colic and cholecystitis can be managed by homeopathic medicines.

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                                                  HAEMORRHOIDS (PILES)

Piles are inflamed or congested veins of the anal canal. Piles are very common among adults. It may be of two types.

Internal piles- internal piles are insides the rectum.

External piles- external piles are outside the anal opening.

According to the nature of occurrence piles may be-

First degree-in first degree piles only bleeding will be there.

Second degree –there will be a protrusion of pile mass during defecation and after defecation,   it will retract spontaneously.

Third-degree piles-in which there is a protrusion of pile mass, but won’t retract back spontaneously, instead it has   to be replaced manually.

Fourth degree- here the pile mass is always in the protruded state and cannot be replaced back.

Causes of piles

Ò      Constipation

Ò      Prolonged sitting

Ò      Sedentary life

Ò      Obesity

Ò      Pregnancy

Symptoms of piles

Ò      Pain

Ò      Itching of the anus

Ò      Mucus discharges from the anus.

Treatment.

Homeopathic medicines when tried in the beginning stage itself will cure the hemorrhoids totally and thus preventing surgery. Usually, the first degree and second degree piles are completely curable with homeopathy, but third and fourth degree; only relief from the symptoms is possible.

Along with medicines some control over the diet is needed. Person has to avoid meat and chicken for a period of time. And diet should contain plenty of leafy vegetables, which is the rich source of fiber and fiber type foods help to relieve constipation.

However, even after the diet changes and constipation persist in, the tendency can only be relieved by removing the cause behind it. This can be achieved  through homeopathic medicines, which go deep into the constitution and make the body capable of getting rid of this constipation.

The main remedies are Nux vom, Suphur, Aesculus, Muriatic acid, Aloes, etc.

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               HEPATOCELLULAR CARCINOMA

Hepatocellular carcinoma (liver cancer) is one of the common liver tumors.

Causative factors are-

Chronic hepatitis B infection.

Cirrhosis of liver.

Cirrhosis of liver due to alcohol is one of the major risk factor.

Sex-Men are more prone to hepatocellular carcinoma.

The tumor may be single without cirrhosis or multiple numbers with cirrhosis. Spreads to lung and bone are rare.

Clinical features

Weight loss

Anorexia

Abdominal pain

Evidence of cirrhosis like ascites, jaundice

Deranged liver function test

Investigations

Alfa –fetoprotein (AFP) usually increased. But if the tumor is small, the level is normal and high if the tumor is large.

AFP is also risen in presence of active hepatitis B with hepatitis C viral replications.

 However, AFP is not a definite screening tool for liver cancer.

Ultrasound of the abdomen.

CT abdomen

MRI

Liver biopsy

Management

The final decision is of liver transplantation. But hepatitis B and C may recur in transplanted liver.

Homeopathic treatment

Since the liver is one of the cardinal organs within the body, the disease like tumor of liver is a serious health problem as the homeopathic philosophy says.

So cure of cancer if it is in the early stage or in the end stage is a little difficult.

The miasm travels from sycosis to syphilitic, the destructive procedure speed up when the mental and physical health of individual worsens. But in view of symptomatic relief, homeopathy stands at the forefront of other systems of treatment. Likewise, in palliative aspect,  homeopathic medicines work very well and the survival rate and thereby the quality of life also improves.

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                                                         IRRITABLE BOWEL SYNDROME

IBS consists of a group of gastro intestinal symptoms particularly associated with lower bowel in the absence of demonstrable organic pathology. There is recurrent abdominal pain with altered bowel habits. Also is there is diarrhoea or constipation and at times there is diarrhoea alternate with constipation. It is also known as functional bowel disease or nervous colon.

The prevalence of IBS is becoming more common in young adults. Since there is no recognizable pathology it is believed to be the after effect of stress and strain and sometimes when this situation is over the symptoms may also subside. But it may relapse after some time, and in short it is a functional disorder. Young women are affected 2-3 times more often than men. Majority of the patients have a history of physical or sexual abuse.

About 50 % patients with IBS meet the criteria for psychiatric diagnoses. However, it is not life-threatening diseases. Whatever may be the symptoms patients do not lose weight and are constitutionally well.

Criteria for IBS

Recurrent abdominal pain or discomfort for at least three days per month in the last three month associated with two or more of the following,

1) Improvement after defecation

2) Onset associated with change in frequency of stool.

Other symptoms are

a) Abnormal stool frequency

b) Abnormal stool form

c) Abnormal stool passage

d) Passage of mucus

e) Bloating or feeling of abdominal distension

Clinical types

1) Chronic abdominal pain with constipation

2) Diarrhoea predominant IBS

3) Mixed IBS

4) Disturbance of GI motility

Etiology            

Marital difficulties and childhood physical abuses are reported more commonly in chronic IBS symptoms.

Post infective cause

Onset of symptoms may follow an enteric infective episode and IBS symptoms are common in patients with inflammatory disease.

Abnormal regulatory physiology

Patients with IBS have been reported to exhibit exaggerated GI responses, either as intrinsic reflexes or to exogenously infused drugs.

Diet

Colonic fiber fermentation may be a source of perceived excess gas, and has led to a suggestion of a role of abnormal colonic bacterial flora. Lactose and wheat are the main dietary factors.

Features of IBS

Altered bowel habit

Colicky abdominal pain

Rectal mucus

Abdominal distention

Feeling of incomplete defecation

Treatment

General

Diet regulation

Diet regulation is a must not only to control but to cure IBS. Chocolate, caffeine, carbonated drinks, milk and milk products, are to be avoided.

Alcohol and alcoholic beverages are also should be avoided.

Stop smoking

Avoid large and heavy meals

Include fiber-rich food in the diet. Whole-wheat bread, cereals, vegetables, fruits are good sources of fibers. These fiber foods help to distend the colon and thereby prevent the spasm.

Practice relaxation therapy and hypnotherapy for relieving stress

Homeopathic treatment and scope.

As we have seen from the article that IBS has no demonstrable organic pathology, only homeopathy has got a better scope in the treatment.

The reason behind in the majority of the cases is a conflict in the life situations as well bitter experiences throughout the life. So this type of incidents will cause a stamped type of impact on the mind, and that in due course will manifest as physical symptoms. Here the science of homeopathy comes up. So a medicine that can penetrate into the subconscious mind and unlock the conflicts, and the impacts, can only cure the physical manifestations.

There are medicines in homeopathy that has a special action in the mental sphere. By choosing the exact medicines based on the causative factors, the conflicts and also assuming the physical symptoms complete cure is possible. This is clinically verified several times and the patients who are benefited certify the efficacy of homeopathy on IBS.

Medicines

Ignatia. Nat mur, Sepia, Arg nit, Nux vom etc. are the commonly indicated remedies.

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                         NON ALCOHOLIC FATTY DISEASE

NAFLD disease prevalence is increasing in the society. It is increasing as the cases of obesity are increasing, and it is one of the common causes for chronic liver disease.

It can be classified as simple non alcoholic fatty liver disease (NAFL) and non alcoholic steatohepatitis (NASH).

NHFL usually causes no serious health problems, but NASH may progress and cause liver disease like cirrhosis in the future.

NAFLD increases with diabetes and certain drugs and exposure to petrochemicals.

Clinical features

Most patients are asymptomatic but only with deranged liver function tests. Jaundice occurs in advanced cases of cirrhosis. If a patient present with increased serum transaminases in liver function test and also not alcoholic and screening in chronic liver disease is negative, he should be suspected to NAFLD.

Investigations.

Liver function tests

Ultrasound of the abdomen

Liver biopsy

Treatment

In case of obesity -exercise and diet control

Avoided fatty foods, eat vegetables and fruits.

In diabetics- control the blood-sugar level.

Homeopathic treatment.

Along with exercise and diet control, homeopathic medicines are highly effective in the treatment of NAFLD. Medicine like Lycopodium, Nux vomica, Calc carb, Cholestrium are also effective as seen in clinical practice. The efficacy can be confirmed by infrequent examination of Liver function test.

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                     PEPTIC ULCER

Peptic ulcers are acute or chronic ulcers in any part of the gastro intestinal tract caused by combined action of hydrochloric acid and pepsin.

Acute peptic ulcer (Cushing's ulcer): these are acute ulcers, which are multiple and superficial. They are located in the oesophagus, stomach or duodenum. They are caused by septicemia, drugs, burns, physical or mental trauma, operations of brain, CVA, anoxia, stressful condition, etc.

GASTRIC AND DUODENAL ULCERS

The main cause of the gastric ulcer (70%) and duodenal ulcer (90%) is due to the H pylori infection. And 30% of the gastric ulcers are due to non steroid anti-inflammatory drugs (NSAID)

H pylori are gram-negative motile bacteria. It is found in the duodenum in association with patches of gastric metaplasia.

Other causes include-

Ò      Smoking

Ò      Spicy and pungent foods

Ò      Emotional stress

Ò      Alcohol

Ò      Heredity

Clinical features

Ò      Ulcer can be moderate, very mild or severe. It can be located over an area about one inch in diameter between xiphoid and umbilicus.

Ò      Pain in upper part of the abdomen - (in the pit of stomach or epigastrium)

Ò      Hunger pain-pain becomes worse when the stomach is empty.

Ò      Water brash

Ò      Heart burn

Ò      Nausea vomiting

Ò      Night pain causes the patient to wake up from sleep.

Signs:1) Deep tenderness over the epigastrium (stomach pit).

2) Muscle guarding or rigidity may be present with active ulcer or deeply penetrating ulcer.

3) Peristaltic waves may be observed in presence of obstruction.

4) Occult blood in stools.

Chronic peptic ulcer: these are chronic ulcers in the GI tract bathed in peptic juice. The site may be on lower end of the oesophagus, lesser curvature of the stomach, duodenum, or in the Meckels diverticulum.

Complications

1-Perforation-if it occurs the contents of the stomach leaks to peritoneum causing peritonitis.

In perforation the patient experiences sudden, severe pain usually in upper abdomen and then it spread to the whole abdomen. Due to irritation of the diaphragm, the pain radiated to the tip of the shoulder (referred pain). Pain is accompanied by shallow respiration and shock. Abdomen become rigid and is ‘board like’

Diagnosis- in 50% of cases erect chest x ray show air under the diaphragm.

2-gastric outlet obstruction-nausea vomiting and abdominal distention are the main features. Food eaten 24 hours before or more is vomited out. Visible gastric peristalsis is diagnostic.

3-bleeding.   

Investigations of peptic ulcer-

Complete blood count.

Plain x ray abdomen.

Endoscopic examination.

Biopsy.

Barium meal.

Stool examination for occult blood.

Differences between gastric and duodenal ulcer.

Chance of malignancy is more common in gastric ulcer than duodenal ulcer.

There may be vomiting of blood in gastric ulcer, but in duodenal ulcer black stool due to presence of blood.

In gastric ulcer since pain become worse after eating .Due to this patient refuses to eat, so weight loss. But in duodenal ulcer, eating relieves the pain; so patient eats frequently so weight gain.

In gastric ulcer, pain is felt over the umbilicus and left of the mid line, but in duodenal ulcer, pain felt above the umbilicus and right to midline.

In gastric ulcer, there is no radiation of pain, but duodenal ulcer pain radiates to back.

Treatment

Stop smoking, and alcohol

Avoid Spicy food and pungent food

Eat at frequent intervals

Homeopathic treatment

Out of my years of experience, it is clearly evident that homeopathic medicines are far superior to than any other system of treatment. It, being a constitutional disorder, a treatment through constitutional approach as homeopathy implies gives a permanent cure. It not only prevents the recurrence but also prevents any chance of complication.

Usual homeopathic medicines are.

Nux vom, Ars alb, Phosphorus, Lycopodium, Robenia, etc.;

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                                                          ULCERATIVE COLITIS

As the name indicates it is the inflammation and ulceration of the colon. Another name of colon is the large intestine.

The inflammation may be restricted to rectum or lower part of colon but sometimes the entire colon may be affected.

It is one of the inflammatory bowel diseases.

Types of UC depending up on the part affected are-

1) Pan colitis

The entire colon is affected.

2)-Proctitis

The disease limited to the rectum only.

3) Proctosigmoiditis

The disease limited to rectum and the part above it ie: sigmoid colon

Etiology

The disease may subside over a period but may relapse again. And in between the period, the patient may be completely symptoms free.

The main causative factors include-

1) Genetic

Ulcerative colitis may run in families.

2) Associated with autoimmune thyroiditis and systemic lupus erythematosus (SLE)

3) Environmental                           

4) Smoking

More common in nonsmokers and ex-smoker

Associated with low-residue and high refined sugar diet

Appendicectomy protects against ulcerative colitis.

Anti-inflammatory drugs

Dietary factors

Clinical features

Onset is gradual, bloody diarrhoea is the major symptoms. The first attack is the severe, and it is followed by relapses and remission. There are many provocative factors like gastroenteritis, NSAID, emotional stress, etc.

Bleeding is the main symptoms if the rectum is affected. Some develop constipation and pass pellet like stools and some in small quantity at frequent intervals.
Bloody diarrhoea and mucus discharge is the main feature in proctosigmoiditis.

Majority of the patients are constitutionally well but some may develop mild fever, lethargy and abdominal discomfort.

In severe cases weight loss, malaise, abdominal pain, anorexia, and with fever and tachycardia.

Treatment.

General measures

Patients with ulcerative colitis need to follow a healthy diet. Avoid high refined sugar, meat and high fatty foods.

Have to avoid smoking and also abstain from alcohol.

Homeopathic treatment

Since ulcerative colitis is a deep-seated disease, complete cure needs a prolonged treatment. The miasm behind is syco syphilitic, deep acting drug is needed to complete cure. And by prescribing anti miasmatic remedies the immune mechanism will be corrected, and the patient will improve without relapse.

The curability and duration of treatment depend upon-

The chronicity of the disease

Age of the patient-good and speedy prognosis in and young and middle-aged people.

Duration of allopathic medication. Patient cannot withdraw these medicines suddenly if they are on medication for a long time. Instead when the symptoms are under control, gradual withdrawal is possible.

At first depending upon the present symptomatology medicines is given to control the symptoms. The frequency of the repletion of dose and selection of potency depends up the severity of the symptoms.

Once the patient is freed from the acute symptoms the follow-up is with deep acting anti miasmatic remedy covering all the mental and physical peculiarities of the patients.

In acute condition, the medicines usually prescribed are –Merc sol, Merc cor, Acid nitricum, Ars alb, etc. and the potency of the choice depend upon the prescriber.

In chronic cases to prevent relapses are syphilinum, Thuja, Acid flour, etc. usually in high potency.

The overall prognosis is very good.

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                                                          VIRAL HEPATITIS

The most common cause of jaundice is viral hepatitis.

Viral hepatitis may be due to-

Hepatitis

Hepatitis B

Hepatitis C

Hepatitis E

Viral hepatitis may also be due to the virus like Epstein-Bar virus, herpes simplex virus or due to yellow fever.

Clinical features.

Very vague signs and symptoms are there in hepatitis.

Headache, nausea, vomiting, myalgia, joint pain precedes the development of jaundice.

This is followed by diarrhoea and abdominal discomfort.

Urine becomes dark and stool is pale, there is pain on palpation over the site of liver, but liver is minimally enlarged.

Investigations.

Liver function tests

Serum transaminases rises between 200 to 2000U/L.

Alkaline phosphatase rarely exceeds twice the upper limit of normal.

White cell count is normal.

But lymphocytes are increased.

                                                                 HEPATITIS A

Hepatitis A (HAV) –it is highly infectious and spread is through oro-faecal route.   Infected individual shreds the virus through the faeces about 2-3 weeks before the onset of symptoms and 2 weeks after the onset of symptoms. Poor sanitation and overcrowding are the main source of infection. Sometime water and shellfish may act as a vehicle of transmission. But chronic carrier state is not there. Diagnosis is the evidence an anti HAV in the blood.

Improving the social situations like overcrowding, poor sanitation will prevent the outbreak.

Prognosis is usually good. But patients in chronic liver disease cause serious problems to health.

           HEPATITIS B

 In Hepatitis B -Humans are only the source of infection. It is one of the most common causes of chronic liver failure and hepatocellular carcinoma in the world. The peculiarity of acute infection of Hepatitis B is that, acute infection is asymptomatic, especially when acquired by birth. And majority among the people with chronic hepatitis   is also asymptomatic. When it is associated with serum transaminases in blood, there is a chance of cirrhosis of liver after a period of years.

The source of infection determines the progression of the chronic liver disease.

The transmission from mother for the child in the perinatal period is the most common cause of infection and carries the highest risk.

Route of transmission of hepatitis B -

Injection ,drug use.

Infected blood products.

Acupuncture needles, tattoos.

Homosexual and heterosexual activities.

90% of transmission is from HbsAg positive mother.

       HEPATITIS D

Hepatitis D - (HDV) virus has no independent existence. The source and mode of spread are same as Hepatitis B VIRUS. An individual can get hepatitis D virus infection simultaneously with HBV or as an added infection in a carrier of HBV.

The blood finding of anti-HDV is the evidence of HDV infection.

Prevention of hepatitis B effectively prevents hepatitis DD.                                                                                

                                                         HEPATITIS C

Acute symptomatic infection with hepatitis C is rare. So the infection is identified only after development of chronic liver disease. But it is not necessary that everyone who got infected with hepatitis C should develop cirrhosis. 20% of the persons infected with hepatitis may get cirrhosis within 20 years.

Risk factors for hepatitis C infection-

Intravenous drug misuse

Needles stick injury, unclean vaccination needles.

Sharing tooth brushes, razors, and brushes.

Liver biopsy is needed to stage the degree of liver damage.

                                                      HEPATITIS E

The spread of hepatitis E is through oro-faecal route like hepatitis A. In the majority f the cases it is self-limiting, and does not cause cirrhosis.

However, if a pregnant lady gets an infection with hepatitis E, the chance of acute liver failure is very high and also the mortality.

Treatment.              

The treatment of hepatitis A and E is comparatively safe with homeopathy.

As a primary measure, keeping good hygiene and drinking boiled and cooled water will prevent the spread.

Homeopathic medicine is highly recommended for the above type of hepatitis.

Medicines like chelidonium, Merc sol, Nux vom etc.are usually very effective and  the symptoms as  well as the blood reports become normal within a week's time.

 Hepatitis B and C-since the outcome of Hepatitis B and C is very serious and fatal, deep acting medicines are necessary.   And the patient can continue homeopathic medicines along with the present medication or can take homeopathic medicine only.

There are many remedies that are effective for Hepatitis B and E. The duration of treatment depends on the chronicity of the disease, age of the patient.

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                     What is HBsAg?

HBsAg is the surface antigen detected in  the blood from  a person infected with Hepatitis B virus (HBV).It is also known as Australia antigen, since it was first isolated in the serum of an Australian.

If the blood test is positive for HBsAg, it indicates that person is infected with hepatitis B. Majority of HBsAg patients may be healthy without any symptoms, but some may have biochemical or histological evidence of chronic liver diseases.

Nowadays, blood donors are screened for HBsAg before transfusion, and this has reduced the post transfusion infection almost completely.

 In blood examination, if it says HBsAg positive means, you have active hepatitis B infection and can pass the virus to others through their blood or infected body fluids.

In blood examinations if the level of HbsAg is less than 1s/c (signal per cutoff) it is considered as negative. And the value above 5 s/c is positive. Since there is no clear-cut standardization between laboratories the values are noted as positive or negative.

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