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Rectal bleeding means bleeding from your back passage when you go to the toilet and pass faeces

Rectal bleeding can refer to any blood that passes from your anus, although rectal bleeding is usually assumed to refer to bleeding from your lower colon or rectum. Your rectum makes up the lower portion of your large intestine.

Rectal bleeding may show up as blood in your stool, on the toilet paper or in the toilet bowl. Blood that results from rectal bleeding is usually bright red in color, but occasionally can be dark maroon.

It is common to see blood on the toilet paper, around the faeces, or in the toilet after a bowel motion. This is known as rectal bleeding and it can occur for many reasons.

Most of the time rectal bleeding is not a sign of a serious illness, but it is important to see your doctor.

Various Causes of Rectal Bleeding

There are lots of possible causes for rectal bleeding. Some of the most common causes include:

Hemorrhoids

Hemorrhoids are a common and treatable cause of rectal bleeding. It’s normal for everyone to have hemorrhoids inside and outside of the anus. But there are several reasons they may become irritated.

 If you notice blood on your toilet tissue or in the toilet, the factors that may point to hemorrhoids include:

·         Constipation.

·         Diarrhea.

·         Low-fiber diet.

·         Heavy lifting.

·         Hard stools.

Hemorrhoids are inflamed anal blood vessels, and they are extremely common. They can develop on the outside or inside of the anus, appearing as small bumps that occasionally bleed during bowel movements or when wiping.

Hemorrhoids, which are also referred to as piles, can impact anyone of any age but are associated with a few risk factors, including:

·         pregnancy

·         chronic constipation and straining

·         chronic diarrhea

·         straining during bowel movements or sitting on the toilet for too long

·         obesity

·         low fiber or unbalanced diet

·         aging

Hemorrhoids usually respond well to over-the-counter creams and suppositories that contain hydrocortisone. Taking warm baths frequently, eating a high-fiber diet, and using stool softeners can also help reduce the discomfort of hemorrhoids.

Fistulas

A fistula occurs when an abnormal opening or pocket develops between two neighboring organs. Fistulas that appear between the anus and rectum, or anus and skin, can cause a discharge of white fluid and blood.

If there are tears in the tissue of the anus, then you may experience both rectal bleeding and pain during and after a bowel movement. Typical causes of anal fissures include:

·         Chronic constipation.

·         Diarrhea.

·         Straining.

·         Anal intercourse.

Fistulas are sometimes treated with antibiotics, but they may require surgery if they progress.

Fissures

Fissures occur when tissues lining the anus, colon, or rectum are torn, resulting in pain and rectal bleeding.

Warm baths, a high-fiber diet, and stool softeners can all help reduce symptoms of fissures. In severe cases, fissures may require prescription creams or surgery.

Proctitis or colitis

Proctitis occurs when the tissues that make up the rectum become inflamed, often resulting in pain and bleeding.

Colitis occurs when the tissues lining the colon become inflamed. A type of colitis called ulcerative colitis can also cause ulcers, or open, progressive sores, that are prone to bleeding.

Treatments for proctitis and colitis vary, depending on the causes and range from antibiotics to surgery.

Gastroenteritis

Bacterial infections can cause inflammation of the colon and stomach, causing diarrhea that may contain mucus and spots of blood. Viral gastroenteritis does not typically cause bloody diarrhea.

Sexually transmitted infections (STIs)

Unprotected sexual intercourse that involves the anal area can spread a wide range of viral and bacterial diseases. These can cause inflammation of the anus and rectum. Inflammation, if it occurs, increases the likelihood of bleeding.

Treatment for STIs usually involves either an antibiotic, antiviral, or antifungal medication, depending if the cause is bacterial, viral, or fungal.

Colon or rectal cancer

Cancer that impacts the colon or rectum can cause irritation, inflammation, and bleeding. As many as 48 percent of people with colorectal cancer have experienced rectal bleeding.

Colon cancer is a very common form of cancer and tends to progress slowly, so it is often treatable if caught early.

Rectal cancer, while far rarer than colon cancer, is also usually curable if detected and treated in time.

Some cases of colon and rectal cancer develop from initially benign polyps. All cases of gastrointestinal cancer require treatment, which usually involves a combination of chemotherapy, radiation therapy, and surgery.

Prevention of  Rectal Bleeding

If you have rectal bleeding, there are a number of things you can do to help manage the condition.

If you have constipation causing haemorrhoids, you can help ease it by:

·         drinking plenty of water, unless you have an existing medical condition that means this is not possible

·         eating fibre-rich foods, such as bran cereals, fruit, vegetables and wholegrain bread

·         avoiding processed foods, such as white bread and cheese

·         keeping active and mobile to reduce the risk of getting constipated

·         going to the toilet when you have the urge

If your doctor has confirmed that you have an anal fissure, you can ease the discomfort by:

very     carefully wiping the anal area after going to the toilet and using soft,     moist toilet paper or baby wipes, rather than dry toilet paper

pat     the area around your bottom rather than rubbing it

having     warm baths a few times a day

seeing     your pharmacist for topical creams to reduce the pain

try     not to strain when passing a stool

Do not apply creams and lotions to the area that were not prescribed by your doctor or pharmacist because this can cause more trauma.

Bariatric surgery is an operation that helps you lose weight by making changes to your digestive system.  These surgeries make changes to your digestive system to help you lose weight.

Bariatric surgery is designed to alter or interrupt this digestion process so that food is not broken down and absorbed in the usual way. Surgery is also an option for people with a body mass index between 35 and 40 who have health problems like type 2 diabetes or heart disease.

Endoscopic Sleeve

Endoscopic sleeve gastroplasty is the procedure to reduce the size of your stomach without need any surgery or incisions. This is a permanent procedure that reduces the size and capacity of the stomach.

The ESG procedure offers a safe, minimally invasive option for patients who are not ideal candidates for surgery or who prefer a nonsurgical solution. An outpatient procedure, ESG is associated with an even quicker recovery time than minimally invasive weight loss surgical procedures. It is a brief procedure and usual hospital stay is less than 24 hours.

During the procedure, your doctor will use an endoscope, a flexible tube with a tiny camera and suturing device attached, to pass down the mouth into the stomach. Although the procedure is relatively new, ESG is considered safe and effective in treating conditions related to moderate obesity.

            Using the endoscope, the doctor places approximately 12 sutures in the stomach. Recovery after Sleeve Gastrectomy is usually 1-3 weeks. Complications are also rare and include gastric leak, post-operative bleed, and pulmonary embolism.

Lifestyle Changes

Many people cannot lose weight on their own. Patient compliance with diet guidelines before and after the procedure and follow-up appointments greatly impact complications after the procedure.

Preclude Does not further weight loss intervention including surgery if needed later. The impact of ESG on obesity comorbidities needs to be formally assessed and will likely provide the information and impetus necessary to lobby for widespread coverage of the procedure.  

Benefits of Endoscopic Sleeve

During your treatment, your medical provider will use an endoscopic suturing device to decrease the size of your stomach. This treatment may also help to decrease the chance that you develop weight-related health issues.  Possible health benefits of ESG may include:

·         Heart d isease or stroke

·         Improved mood and energy level

·         Desire for smaller meal portions

·         Severe sleep apnea

·         Relief from joint pain

·         Gastroesophageal reflux disease 

Gastric Sleeve

The Gastric Sleeve Surgery is a bariatric procedure that removes 75-80% of the stomach. Gastric sleeve surgery is one of several types of bariatric surgery options.

It is best to consult a doctor or dietitian for a personalized diet plan following gastric sleeve surgery. The most common bariatric surgery procedures are gastric bypass, sleeve gastrectomy, adjustable gastric band, and biliopancreatic diversion with duodenal switch.

When deciding which surgery is right for you, it is essential to compare your options. Part of the stomach that's removed makes hormones that increase appetite and help control insulin.

The surgery takes about an hour. The surgery entails dividing your stomach into two unequal parts. About 80 percent of the outer curved part of your stomach is cut away and removed.

The gastric bypass works by several mechanisms. Sleeve gastrectomy may also cause a decrease in appetite.  It produced by the stomach which may contribute to weight loss after this procedure.

Benefits of Gastric Sleeve

People generally lose 60% of their extra weight over 12 to 18 months. People need to start by consuming smooth, soft foods and progress to eating more solid foods over time.

It restricts the amount of food the stomach can hold, thus helping in weight loss. gastric sleeve surgeries can be effective tools in achieving long-term weight loss. Also including :

·         Diabetes

·         High blood pressure

·         Sleep apnea

·         High cholesterol

Endoscopic sleeve gastroplasty is a weight-loss procedure. A suturing device is inserted into your throat and down to your stomach. This procedure is ideal for those with a body mass index of 30 or more and for those where diet and exercise alone have not worked. ESG gives a good weight loss results, losing 30-60% of excess weight.

The Gastroenterologist

Gastroenterologists treat problems and diseases of the digestive system they perform endoscopic procedures, in which they use specialized instruments to view the GI tract and make a diagnosis. GI or gastroenterologists have 5 to 6 years of specialized education after the medical studies.

How to become a Gastroenterologist 

·         To become a gastroenterologist need to have one of the medical degrees.

·         Have totally 5 to 6 years of training in gastroenterology: minimum 3 years of training in residency and 2 to 3 years of fellowship training in gastroenterology.

·         One of the main things is certificates and the license, medical license is important for any type of doctors and voluntary certification is helping to your future growth

·         The Board certification requires passing an exam and holding a current license to practice medicine. Membership in a professional organization, such as the American Gastroenterological Association, can provide gastroenterologists with access to continuing education opportunities as well as other benefits for career advancement.

Why to need Gastroenterologist?

There are many reasons you may visit a gastroenterologist. A gastroenterologist manages few of the diseases and conditions. Such as

Crohn’s disease

Crohn's disease is an inflammatory bowel disease it can affect any part of the gut, from the mouth all the way down to the anus. Crohn's diseases have following symptoms,

·         Diarrhea

·         Blood in your stool

·         Abdominal pain

·         Perirectal abscesses

Ulcerative colitis

Ulcerative colitis is a chronic disease it causes irritation, inflammation, and ulcers in the lining of your large intestine. The inflammation causes your bowel to move its contents rapidly and empty frequently. Ulcerative colitis affects the innermost lining of your large intestine and rectum. They cause the inflammation and ulcers.

Hepatitis

Hepatitis refers to an inflammatory condition of the liver. Hepatitis viruses are the most common cause of hepatitis in the world. Each has different hepatitis symptoms and treatments. The virus is one of several types of hepatitis viruses that cause inflammation and affect your liver's ability to function.

Symptoms:

·         Fatigue

·         Loss of appetite

·         Dark urine

·         Intense itching

Cancer of the esophagus

Esophageal cancer is cancer that occurs when a malignant tumor forms in the lining of the esophagus. The cancer starts at the inner layer of the esophagus and can spread throughout the other layers of the esophagus and to other parts of the body.

Symptoms:

·         Chronic cough

·          Difficulty or pain when swallowing

·         Heartburn

·         Unintentional weight loss

Colon polyps that may turn into cancer

A polyp is a small growth of excess tissue that forms in the inner lining of the colon. It’s the third leading cause of cancer deaths.

Symptoms:

·         Rectal bleeding

·         Iron deficiency anemia

Stomach stapling is a surgical procedure during the first part of the weight loss surgery. Bariatric surgery is the only option today that effectively treats morbid obesity in people for whom more conservative measures such as diet, exercise, and medication have not been effective. After banding, the stomach can hold only about an ounce of food.

Adjustable gastric banding

Adjustable gastric banding is a type of weight-loss surgery. It is a type of weight loss surgery that involves wrapping a band around a part of the stomach to reduce its size and limit the capacity of food intake.

The surgeon puts an adjustable band around the top part of the stomach.  Squeezed by the silicone band, the stomach becomes a pouch with about an inch-wide outlet.

The band is connected to a port that is placed under the skin of the abdomen. A tube leads from the port to the band around your stomach.

The Lap-Band surgery is a restrictive weight loss surgery and does not involve cutting or stapling of the stomach as do other bariatric surgeries. The result is an increased feeling of fullness after eating a smaller amount of food.

Vertical banded gastroplasty

Vertical banded gastroplasty is surgery that divides the stomach into 2 parts to treat obesity. This procedure uses a combination of staples and a band to create the pouch.

Surgeries are performed laparoscopically, which allows the surgeon to use long instruments placed in the body via incisions. It sends images of your abdominal cavity to operate while viewing the area on this monitor.

Staples will be used to divide your stomach into two unequal portions.  Creating a hole in the stomach through which a restrictive band is threaded, decreasing the speed with which food can leave the stomach.

Vertical sleeve gastrectomy

Vertical sleeve gastrectomy is surgery to help with weight loss. This procedure is typically performed laparoscopically to remove part of your stomach and join the remaining portions together to make a new banana-sized stomach

Your surgeon will make a few small cuts in your belly and insert a laparoscope and the lateral side of stomach is divided as a two part that is new banana shaped stomach has about 20-25% of original stomach volume.

After surgery, you awaken in a recovery room, where medical staff monitors you for any complications. Increased stomach motility, which allows food to pass stomach and intestine quicker after surgery

Reason for need Stapling Surgery

·         Persons with a BMI greater than 40

·         Obesity type 2 diabetes, sleep apnea, or heart disease

·         Reduce or eliminate sleep apnea

·         Lower cholesterol levels

Procedures of the Stapling Surgery

Stomach stapling surgery is a restrictive bariatric procedure.  Despite the fact that some surgical techniques can be done laparoscopically with reduced risk, all bariatric surgery is considered to be major surgery. A gastroplasty is a surgical procedure that reduces the size of your stomach.

The surgery takes about an hour. Stomach stapling surgery involves placing a silicone band around the upper part of the stomach to decrease stomach size and reduce food intake. Part of the lower section of the small intestine is connected to the stomach pouch. Finally reattach the rest of your stomach to form the sleeve or tube.

Benefits of Stomach stapling surgery

·         Induces excess weight loss of approximately 40 – 50 percent the amount of weight you lose depends on your change in lifestyle habits.

·         There is a much lower chance for nutrient or vitamin deficiency with the Gastric Sleeve procedure.

·         You can follow some diet for this surgery not only this any of gastric surgery you must follow the diet, After 2 or 3 months, you can move on to regular meals.

·         Has the lowest rate of early postoperative complications and mortality among the approved bariatric procedures

Colonoscopy is a procedure and lasts approximately 30-60 minutes. It is used to checks for abnormalities or disease in your large intestine, particularly the colon.  The technology for colonoscopy has evolved to provide a very clear image of the mucosa through a video camera attached to the end of the scope.

A colonoscopy can help you prevent cancer. Getting ready is important, because your colon needs to be as clean as possible. Make sure not to drink any liquids containing red or purple dye because they can discolor your colon.

Why Colonoscopy treatment is need?

Colonoscopy may be done for much reason but doctor find the cause of symptoms, such as

·        Bleeding from your anus

Bright red blood may be seen only on toilet paper or visible blood or red-tinged stool in the toilet bowl.  The causes of rectal bleeding can vary from common and mild conditions to more severe and rare conditions that need immediate medical treatment.  While darker red blood is a sign of bleeding in the small bowel or upper colon.

·        Diarrhea

Usually, diarrhea happens because of a virus that gets into your gut. You have diarrhea if you have loose stools three or more times in one day. Feel watery stools or a frequent need to have a bowel movement. Diarrhea can happen for a wide variety of reasons and it usually goes away on its own in one to three days. Symptoms associated with diarrhea include abdominal pain, especially cramping.

·        Pain in your abdomen

Abdominal pain is pain that you feel anywhere that occurs between the chest and pelvic regions. His is often referred to as the stomach region or belly. The abdominal area includes organs such as the stomach, small intestine, colon, liver, gallbladder, spleen, and pancreas. Pain may be felt in the abdomen even though it is arising from organs that are close to but not within the abdominal cavity.

·        Colorectal cancer

These cancers can also be called colon cancer or rectal cancer, depending on where they start. Colon cancer typically affects older adults, though it can happen at any age. A cancerous tumor is malignant, meaning it can grow and spread to other parts of the body. It happens when abnormal cells grow in the lining of the large intestine or the rectum. 

·        Unexplained weight loss

Unexplained weight loss is a noticeable drop in body weight that would be about 8 pounds if you weigh 140 or 10 pounds if you weigh 200. Significant weight loss can also be the result of an eating disorder, such as anorexia or bulimia. Most people are very aware of the dangerous consequences of weight gain.

Colonoscopy procedures

Medications will be given into your vein to make you feel relaxed and drowsy. Sometimes a mild sedative is given in pill form.

During the procedure, you’ll lie on your side on a padded examination table. The doctor will insert a colonoscope into your rectum.

The first part of the colon is under visual control, into the rectum and through the colon usually as far as the cecum. A camera on the end of the colonoscope transmits images to a monitor that your doctor will be watching.  

            The air or carbon dioxide inflates the colon, which provides a better view of the lining of the colon. When this occurs, or when the doctor moves the colonoscope, the person may feel stomach discomfort or an urge to pass stool.

You can reduce the cramping by taking several slow, deep breaths during the procedure. The camera sends images to an external monitor so that the doctor can study the inside of your colon.

This is rare, but you might need surgery to repair it if this happens. In many cases, colonoscopy allows accurate diagnosis and treatment without the need for a major operation.

After the Colonoscopy procedures

This is takes about an hour to begin to recover from the sedative. You may feel cramping in your abdomen or bloating during the first hour after the procedure.

You should not drive a vehicle, operate machines, or make important decisions the rest of the day. You may feel gassy or bloated for a while after the procedure because of the air that was injected into your intestine during the colonoscopy.

If your doctor removed a polyp during your colonoscopy, you may be advised to eat a special diet temporarily. You should expect a full recovery and return to your normal diet by the next day.

Stress testing

Stress testing a Non-Functional testing technique that is performed as part of performance testing. The goal of Stress testing is measuring software on its robustness and error handling capabilities under extremely heavy load conditions and ensuring that software doesn't crash under crunch situations.  

Stress testing is particularly important for critical software but is used for all types of software. The term also refers to qualitative evaluation of factors such as availability or resistance to denial of service attacks. Stress testing is often done in conjunction with the more general process of performance testing.

Reasons for conducting Stress Testing

o   During festival time, an online shopping site may witness a spike in traffic, or when it announces a sale.

o   Stress testing makes system work in normal as well as abnormal conditions in appropriate way.

o   The main purpose of stress testing Make sure that the system fails and recovers easily this quality is also known as recoverability.

o   To verify if the system prints meaning error messages while crashing or did it print some random exceptions.

o   Stress testing determines the behavior of the system after failure and ensures that system recovers quickly.

Nuclear imaging

Nuclear imaging is a method of producing images by detecting radiation from different parts of the body after a radioactive tracer is given to the patient. The radiotracer travels through the area being examined and gives off energy in the form of gamma rays which are detected by a special camera and a computer to create images of the inside of your body. This branch of radiology is often used to help diagnose and treat abnormalities very early in the progression of a disease, such as thyroid cancer.

How nuclear imaging is done

·         As stated above, nuclear medicine scans may be performed on many organs and tissues of the body.  Nuclear medicine exams use a radioactive material called a radiopharmaceutical or radiotracer. These include chemistry, physics, mathematics, computer technology, and medicine. This branch of radiology is often used to help diagnose and treat abnormalities very early in the progression of a disease, such as thyroid cancer.

·         The collected tracer sends out gamma rays that are picked up by a special. The signals are processed by a computer, which turns them into 2 or 3-dimensional pictures, sometimes with color added for extra clarity. Special cameras detect this energy and, with the help of a computer, create pictures that offer details on the structure and function of organs and tissues.

·         Nuclear imaging enables visualization of organ and tissue structure as well as function. The extent to which a radiopharmaceutical is absorbed, or taken up by a particular organ or tissue may indicate the level of function of the organ or tissue being studied. Less intense areas or cold spots indicate a smaller concentration of radiotracer and less activity.

·         Monoclonal antibodies mimic the antibodies naturally produced by the body's immune system that attack invading foreign substances, such as bacteria and viruses.  The most common type of detector is the gamma camera. Digital signals are produced and stored by a computer when the gamma camera detects the radiation.

Peripheral angioplasty, also referred to as peripheral arterial disease, is a common circulatory problem in which narrowed arteries reduce blood flow to the lower extremities. 

Angioplasty uses a medical "balloon" to widen blocked arteries. The balloon presses against the inside wall of the artery to open the space and improve blood flow. 

A metal stent is often placed across the artery wall to keep the artery from narrowing again. The test is also called a peripheral arteriogram.

Why Peripheral Angioplasty is needed

This procedure is commonly used to open narrowed arteries that supply blood flow to the heart. Peripheral angioplasty is one such procedure. It uses a balloon catheter to open the blocked artery from the inside. Peripheral angioplasty and stenting open a narrowed or blocked artery in your extremities, like your arms or legs. This treatment can prevent the need for more invasive procedures, such as bypass surgery.

Peripheral artery disease

It is a common circulatory problem in which narrowed arteries reduce blood flow to your limbs. Peripheral artery disease refers to diseases of the blood vessels located outside the heart and brain.

This buildup typically occurs gradually. If allowed to progress, blood flow in that artery can become limited or blocked all together. Peripheral artery disease is a narrowing of the peripheral arteries serving the legs, stomach, arms and head. It can also lead to you needing to have a limb removed.

Procedures for Peripheral Angioplasty

·         Angioplasty is a procedure to open narrowed or blocked blood vessels that supply blood to your legs. Fatty deposits can build up inside the arteries and block blood flow. Insert a tiny needle into the blood vessel in your groin or upper arm.

·         A nurse will clean and shave the area where the doctor will be working. This is usually an artery in your groin.

·         The balloon catheter is inserted through the skin into an artery. It is advanced to the site of the blockage where the balloon is inflated to open the vessel.

·         You may need to lie in bed with your legs straight for several hours. When an arm or wrist was used for access, you may have activity restrictions to follow.

·         Insert a stent a mesh tube made of metal. The stent serves as a permanent metal scaffold to keep the artery open.

Peripheral artery disease symptoms

You may have muscle pain or cramping because there’s less blood flow to your legs. While many people with peripheral artery disease have mild or no symptoms, some people have leg pain when walking. The most common symptom of peripheral artery disease in the lower extremities is a painful muscle cramping in the hips, thighs or calves when walking, climbing stairs or exercising.

Other common symptoms

·         Leg pain that does not go away when you stop exercising

·         Lack of growth of your toenails and leg hair

·         A foot or the lower leg may feel cold.

·         Pale, discolored, or blue leg or foot

·         Sores on your toes, feet or legs that won't heal

·         Pain or a feeling of pins and needles in your leg or foot

·         Poor nail growth on the toes or hair growth on the legs

Vascular ultrasound uses sound waves to evaluate the body's circulatory system and help identify blockages in the arteries and veins and detect blood clots. The echoes are recorded and transformed into video or photographic images.

Vascular imaging with ultrasound technology helps you and your doctor determine what’s happening in your body’s blood vessels. Ultrasound does not use ionizing radiation, has no known harmful effects, and provides images of soft tissues that don't show up on x-ray images.

Ultrasound is used to create images of soft tissue structures and can also be used to detect blockages in the blood vessels. Ultrasound may be used with other diagnostic procedures or by itself. hese painless, noninvasive, no-radiation tests can reveal plaque buildup or hardening in the arteries (atherosclerosis), blood clots, aneurysms or other abnormalities that may disrupt blood flow and raise your risk for heart attack or stroke. 

How vascular Imaging is works?

Ultrasound imaging is based on the same principles involved in the sonar used by bats, ships and fishermen. The ultrasound takes about 30 to 90 minutes to complete. The type of vascular imaging procedure used depends upon the suspected condition. Such as,

·         Carotid duplex ultrasound

·         Venous duplex ultrasound

·         Arterial duplex ultrasound

Carotid duplex ultrasound 

A carotid duplex ultrasound is performed to evaluate symptoms including dizziness, loss of memory, stroke, loss of musclecontrol and other symptoms that might result from narrowing or blockage of the vessels (carotid arteries) on either side of your neck.

Your carotid arteries are located along both sides of your neck. Blocked carotid arteries are a major risk factor for stroke. Doppler ultrasound uses sound waves that track moving objects. This allows your doctor to see how your blood is moving through your blood vessels.

 Can hear how fast blood is flowing through a blood vessel and in which direction it is flowing. No sound or a faint sound may mean that you have a blockage in the flow. Its most frequently used to screen patients for blockage or narrowing of the carotid arteries, a condition called stenosis which may increase the risk of stroke.

Venous duplex ultrasound

It produces pictures of the inside of the body using sound waves. Ultrasound is a procedure that uses sound waves to see inside your body. This procedure is performed to evaluate symptoms including leg pain or swelling, excessive varicose veins, shortness of breath, or suspected blood clots in your legs and/or lungs.

This test provides information to help your vascular surgeon make a sound diagnosis and outline a treatment plan. High-frequency sound waves travel from the probe through the gel into the body. The probe collects the sounds that bounce back. A computer uses those sound waves to create an image. During a lower extremity venous duplex scan, the veins in the legs and ankles are viewed.

Arterial duplex ultrasound

Arterial duplex scan is a painless exam that uses high frequency sound waves to capture internal images of the major arteries in the arms, legs and neck. A special jelly is placed on the area being examined while a wand-like device called a transducer is passed lightly over the skin above the artery. Sometimes during a duplex ultrasound of the legs, the health care provider may calculate an ankle-brachial index (ABI). You will need to wear blood pressure cuffs on your arms and legs for this test. The pressure is mild and lasts for a short period of time. The pressure should not cause any pain. You should tell the sonographer if you are uncomfortable during the test.

An electrophysiology study is a test performed to assess your heart's electrical system or activity and is used to diagnose abnormal heartbeats or arrhythmia. Natural electrical impulses coordinate contractions of the different parts of the heart.

This helps keep blood flowing the way it should. This movement of the heart creates the heartbeat, or heart rhythm. It can help find what’s causing your irregular heartbeat. It also helps figure out the best treatment for you.

Why should need of Electrophysiology

When someone’s heart doesn’t beat normally, doctors use EPS to find out why. Electrical signals usually travel through the heart in a regular pattern. This may be done when other tests have not been clear and your doctor strongly suspects you have a heart rhythm problem

To see how well medicine given to treat a rhythm problem are working. This may cause the heart to beat in an irregular pattern. Extra abnormal electrical pathways found in certain congenital heart defects can also cause arrhythmias.

How do you prepare before the Electrophysiology

·         Don’t eat or drink anything for 6 to 8 hours before the test.

·         You will be asked to sign a consent form that gives your permission to do the test. Read the form carefully and ask questions if anything is not clear.

·         Have someone drive you to your appointment and take you home.

·         If you are pregnant or think you may be, tell your healthcare provider.

·        Based on your medical condition, your healthcare provider may request other specific preparation.

Procedures for Electrophysiology

A nurse will put an IV in your arm. You’ll get medicine that will help you relax. But you’ll be awake and able to follow instructions during the test. To prevent infection, a nurse will shave and cleanse the groin and possibly neck area where the catheters will be inserted. 

You will remove your clothing and put on a hospital gown. You’ll be given a shot a local anesthetic will be given   to make the area numb. Your doctor will make a needle puncture through your skin and into your blood vessel.

A local anesthetic will be administered with a tiny needle to numb the area where the catheters are inserted. You will feel a pinprick and possibly a stinging sensation for a few seconds. The doctor will gently guide several specialized EP catheters into your blood vessel through the sheath and advance them to your heart. A video screen will show the position of the catheters.

This procedure will take a time of minimum 1 hour to maximum 4 hours.

One or more catheters, which are thin, long, flexible wires, will be inserted into a large vein in your groin or neck. Your doctor will send small electric pulses through the catheters to make your heart beat at different speeds. You may feel your heart beat stronger or faster.

You may feel pressure when the catheters are inserted. The incision site is less than a quarter of an inch. Your doctor will remove the catheters and the IV line. Your nurse will put pressure on the puncture site to stop any bleeding. 

Ultrasound

An ultrasound scan is a medical test that uses high-frequency sound waves to capture live images from the inside of your body. t is suitable for use during pregnancy. An ultrasound scan can be used to monitor an unborn baby, diagnose a condition, or guide a surgeon during certain procedures.

Ultrasound is safe, noninvasive, and does not use ionizing radiation. Ultrasound waves to produce images of structures within your body. The images can provide valuable information for diagnosing and treating a variety of diseases and conditions.

Needs of ultrasound

·         These scans can provide an expectant mother with the first view of her unborn child. Ultrasound is a useful way of examining many of the body's internal organs.

·         Many women find it reassuring to know if they have a healthy pregnancy and to help prepare for the birth. If any abnormalities are seen, it may also be possible to arrange immediate specialist care to help manage your pregnancy and prepare for the birth.

View     the uterus and ovaries during pregnancy and monitor the developing baby's     health

·         Ultrasounds do have some diagnostic limitations, however; sound waves do not transmit well through dense bone or parts of the body that may hold air or gas, such as the bowel.

·         Ultrasounds sometimes are used to detect and treat soft-tissue injuries.

How Ultrasound is work?

A small device called an ultrasound probe is used, which gives off high-frequency sound waves.

An ultrasound technician, called a sonographer, will apply a special lubricating jelly to your skin. This prevents friction so they can rub the ultrasound transducer on your skin. 

The gel will help the transducer make secure contact with the body and eliminate air pockets between the transducer and the skin that can block the sound waves from passing into your body.

The transducer is placed on the body and moved back and forth over the area of interest until the desired images are captured. This information is relayed in real time to produce images on a computer screen.

After the procedure, the gel will be cleaned off of your skin. The whole procedure typically lasts less than 30 minutes, depending on the area being examined. This image is displayed on a monitor while the scan is carried out.

Types of ultrasound

Diagnostic ultrasound

Diagnostic ultrasound is a non-invasive diagnostic technique used to image inside the body. In medical sonography, sound waves which have a frequency range of >20,000 Hz are used to create a real time image of internal body structures for medical diagnostic purposes. Diagnostic ultrasonography is an ultrasound-based diagnostic screening technique used for visualizing subcutaneous body structures including tendons, muscles, joints, vessels and internal organs for possible pathology or lesions.

Therapeutic ultrasound

Therapeutic ultrasound is a treatment modality commonly used in physical therapy. One of the therapeutic effects for which ultrasound has been used is in relation to tissue healing. Ultrasound in physical therapy is not to be confused with diagnostic ultrasound, which is an ultrasound that is used to see the inside of the body, such as checking on a fetus during pregnancy.  It is not intended to be a complete explanation of these phenomena or a comprehensive review of the current literature. It may, none the less, provide some useful basic information for clinical application.

          In a laparoscopic  sleeve gastrectomy, also known as a  vertical sleeve gastrectomy or gastric sleeve procedure. it has also been used as a staging procedure prior to a gastric bypass or duodenal switch in very high risk patients. A sleeve gastrectomy is a purely restrictive procedure. 

 The laparoscopic sleeve gastrectomy, by reducing the size of the stomach, This involves making five or six small incisions in the abdomen and performing the procedure using a video camera (laparoscope) and long instruments that are placed through these small incisions. The sleeve gastrectomy, unlike the Lap-band, does not require the use of a banding device to be implanted around a portion of the stomach.   Procedure of Laparoscopic Sleeve Gastrectomy surgery

           Laparoscopic sleeve gastrectomy surgery is done in a hospital under general anesthesia. Starting the surgeon with some cuts in your belly then using a telescope with the tine camera at the end. The instrument is placed through these small incisions. During this process about 75% of the stomach is removed.

Who will need of Laparoscopic Sleeve Gastrectomy surgery

 Peoples who have a body mass of above 60, If you are older or have other risk factors for surgery like heart, lung, or liver problems, These include stomach ulcers or poor food absorption than other forms of weight-loss surgery

In patients who undergo LSG as a first stage procedure, the second is performed 12 to 18 months later after significant weight loss has occurred and the risk of anesthesia is much lower.

The risks with some forms of bariatric surgery are much higher for people with a BMI over 60

Advantage of Laparoscopic Sleeve Gastrectomy surgery

 o   In the first 2 years after LSG, most people will lose between 40% and 50% of their body weight.

o   Surgical risk is lower than with gastric bypass while weight loss is similar

o   Much obesity-related comorbidity improves or resolve after bariatric surgery

o   The weight loss that occurs after LSG results in dramatic improvement in these medical conditions in the first year after surgery

o   Less food intolerance than with the gastric band

o   No dumping syndrome or nutritional deficiency

o   Appealing option for people not fit for malabsorptive or combined procedures

Risks of Laparoscopic Sleeve Gastrectomy surgery

  The risk of major post-operative complications after Laparoscopic Sleeve Gastrectomy is 5-10 percent, which is less than the risk associated with

gastric bypass

or malabsorptive procedures such as duodenal switch this is primarily because the small intestine is not divided and reconnected during Laparoscopic Sleeve Gastrectomy as it is during the bypass procedures.

Bleeding

Bleeding, or hemorrhage, can occur if a blood vessel is not sealed off during surgery which happens in approximately 0.5% of cases, a blood transfusion may be required

Leaks at the staple line

Gastric leak is one of the most serious and dreaded complications of LSG. Most suture line leaks, also known as suture line disruption or SLD, are discovered shortly after surgery. This happens in about 1% of cases and can be life threatening

Infection

Infection may occur, in which case antibiotics and sometimes repeated surgery are needed. This complication is common with all types of weight loss surgeries and is the result of skin stretching during the period of obesity

Nutritional deficiencies

           It is a common one done after laparoscopic sleeve surgery. A high rate of nutritional deficiencies is common at 4 years post-LSG along with low adherence to the nutritional supplementation regimen. Therefore, the number of patients undergoing this procedure will continue to rise

       Gastric bypass is also called Roux-en-Y is a type of weight-loss surgery that involves a small pouch from the stomach then connecting the newly created pouch directly to the small intestine by the way to loss excess body weight with follow some diet. 

Procedure for Roux-en-Y

           The surgery usually takes several hours. There are two components to the procedure. This is a endoscopic and laparoscopic technique, the surgeon cuts across the top of your stomach, sealing it off from the rest of your stomach.  

Next, the first portion of the small intestine is divided, and the bottom end of the divided small intestine is brought up and connected to the newly created small stomach pouch. Then your surgeon may test for leaks with a dye study or an upper endoscopy.

You may stay in the hospital for 1 to 2 days after the surgery and continue to tall your doctor about what are the diet should be followed and what are the physical activities need to be done.

After this surgery you will face some followed symptoms, it’s simple to talk your doctor if any problem means.

ü  Fever

ü  Pain in belly or hot to touch or any leaks fluid in to your belly

ü  trouble breathing

ü  diarrhea

ü  Vomiting

ü  chest, shoulder, or legs pain

Diet is must

            The first 1 to 2 weeks after gastric surgery you will followed some dietary such as fully liquid diet or follow your doctor’s instruction what would be taken. No limits for taking liquids after the surgery it’s allowed but you can take slowly that is very imported one. Continue for this diet at least 2 or 3 weeks, after you can take low fat foods. This diet helps to get a better result. Most of the doctors is advice to take some nutritional diet as followed.

Multivitamins

Take some more vitamins after this surgery it gives a better result for you

Calcium supplements

You may need to take 1,500 to 2,000 IU vitamin D and more than 1,000 mg calcium daily.

Vitamin B-12 supplements

It will help to prevent your bone fracture after this surgery.

Iron supplements

Iron supplement is preventing for anemia. You can take 50 to 100 mg of iron supplements  

Gastric bypass is a type of weight-loss surgery that involves creating a small pouch from the stomach and connecting the newly created pouch directly to the small intestine. There are two components to the procedure. First, the surgeon makes a small stomach pouch by stapling part of the stomach together or by vertical banding.  Next, the first portion of the small intestine is divided, and the bottom end of the divided small intestine is brought up and connected to the newly created small stomach pouch.

Eligible for gastric bypass

The average BMI range of 18-24.9 is considered optimal. Basically qualify for the gastric bypass if you have a BMI of 35-40 that is more than 100 lbs. Age between 14 and 75 years old. If you have a negative health, such as high blood pressure or diabetes, is related to being severely overweight.

Dietary plays important role

Before going the gastric bypass surgery, you must understand the risks and benefits involved and how to get better benefits for this gastric bypass surgery. Dietary is very important to before the surgery because pre-surgery weight-loss helps the surgeon by making the laparoscopic approach easier and safer and increases the likelihood that the surgery can be completed less invasively.

Liquid diet

           This diet will start a clear liquid diet the first day after your surgery while you are in the hospital. Also liquid diet must be followed 7-14 days before gastric bypass surgery.

·         fruit juices

 ·         soup broth

·         gelatin

·         honey

·         tea

·         coffee

·         strained or pureed soups

·         milk

·         baby food

·         strained oatmeal

·         smoothies

·         ice cream

·         milkshakes

  High Protein diet

               You must follow your diet is high in protein and low in carbohydrates. Its convert your body to use your fat stores as an energy source. The result is the fat in your liver shrinks considerably in a short amount of time.

·         Soy

·         Dairy

·         Beans

·         Eggs

·         Cottage cheese

·         Poultry

·         Fish

·         Nuts

 Pureed diet

         After Gastric Sleeve diet need high protein food and soft in texture when you are healing. After about a week of tolerating liquids, you can begin to eat strained and pureed foods.

·         Sugar-free low fat yogurts without fruit pieces. Needs to be smooth and thin.

·         Soft scrambled eggs

·         Blended poultry, fish or eggs

·         Blended cooked non-starchy vegetables like carrots, zucchini, green beans

·         Soft fruits and cooked vegetables

              Losing weight may not be easy, but there are many options helps to lose your weight. Losing weight on your own its not working but you can choose weight loss surgery, or non-surgical medical procedures it’s the best way to reduce your excess body weight.

Methods

           There are two methods are available to reduce your excess body weight. You can choose which methods suitable for you.

·         Surgical method

·         Non surgical method

Surgical methods

                   Weight loss surgery helps you lose weight and lowers your risk of medical problems associated with obesity. There are several procedures available in surgical methods.

Restrictive surgeries  

              This method is used to shrinking the size of the stomach and slowing down digestion, is used to physically limit the amount of food the stomach can hold, which limits the number of calories you can eat.

Malabsorption

              Surgery is used to shorten or bypass part of the small intestine, which makes it harder for your body to absorb calories. 

Non surgical methods

         Most of the peoples choose the non surgical methods because of these non surgical methods are easiest way to take weight loss procedures.  It can be a little more difficult to find the best non-surgical weight loss procedures.

·         Intragastric balloon

·         Aspiration therapy

·         Endoscopic sleeve gastroplasty

·         Endoscopic gastric outlet repair

Procedures for non surgical methods

Intragastric balloon

           The intragastric balloon is a non-surgical weight loss method. The gastric balloon is inserted orally through your esophagus and placed directly into your stomach during a quick, non-surgical procedure. This procedure offers less risk than bariatric surgery, and you may be eligible if you meet certain criteria. Ask your doctor to see if intra-gastric balloon is right for you.

Aspiration therapy

The procedure uses a device that reduces the number of calories your body processes. It’s a reversible solution for significant weight loss. The physician uses an endoscope with a tiny, lighted camera to place a tube in your stomach that leads to the skin outside your abdomen. The tube connects to a button on the surface of your skin. The tube and port can remain in your body as long as you want to continue aspiration for weight loss.

Endoscopic sleeve gastroplasty

           The endoscopic sleeve gastroplasty (ESG) procedure is designed for patients who are not morbidly obese, but are also not able to undergo bariatric surgery. ESG patients have had good weight loss results, losing 30-60% of excess weight.

Endoscopic gastric outlet repair

              An endoscopic gastric outlet repair is a nonsurgical procedure to reduce an enlarged stomach pouch or stoma after the surgery. The surgeon uses the tiny camera with the endoscope to see and operate inside your stomach without making incisions in your abdomen. And the stomach pouch has also stretched, parts of the pouch can be sewn together to reduce the size.

Heel pain is common in kids. Although it’s typically not serious, proper diagnosis and prompt treatment is recommended.

Severs Disease is probably the most frequent cause of heel pain in children. The condition occurs most commonly in children between the ages of 8 and 14 years but it can occur in younger children. Both boys and girls are equally vulnerable to its debilitating effects.

Severs Disease is characterized by activity-related pain that occurs on the back of the heel, where the Achilles Tendon attaches on the heel bone, or Calcaneus.

The child may have swelling in the area, and tenderness to the touch. Sports requiring lots of running, jumping, and other high impact activities are particularly associated with Severs.

The three main factors that contribute to Severs Disease are:

Between  8 and 14 years old.

Involved in youth sports or other activities.

Actively growing

If your child comes to you with complaints of heel pain, tenderness in the back of the foot or ankle, or is limping or walking on their toes, they may have an injury such as Achilles tendinitis or Severs disease.

Here are a few different causes of heel pain and how you can help your child heal.

Causes for Heel Pain

The cause of the heel pain in Severs disease is thought to be the tractional forces applied to the growth plate of the heel bone by the Achilles tendon at the rear of the heel bone and the plantar fascia just beneath the heel bone. 

Heel pain is most often caused by the child’s foot repeatedly striking hard surfaces, which stresses the growth plate in the heel. This plate, called the physic, becomes inflamed and painful. If your child plays basketball or soccer, or runs track, they are more likely to develops.

Other causes of Heel Pain include:

A tight Achilles tendon

Arches that are high or flat

Having one leg that’s shorter than the other

Obesity

The foot rolling at the ankle (pronation)

Calcaneal apophysitis (Sever’s disease)

It’s an overuse injury caused by repetitive micro trauma during sports or running activities. It’s thought to be due to the pull of the Achilles tendon on the growing heel bone.

Young girls who jump rope are also at risk for calcaneal apophysitis. Symptoms include pain in the back of the heel and tenderness when squeezing the back of the foot.

Warmth and swelling may also occur.

Achilles tendinitis

Achilles tendinitis can occur in children, often after a sudden increase in activity.

The Achilles tendon attaches the two muscles of the calf to the heel bone and helps push the foot forward during walking or running.

When inflamed, it can cause pain, swelling, warmth, and difficulty walking. Pain may start off mild and gradually get worse. Children who do repetitive activities like running, jumping, or pivoting, like basketball players and dancers, may develop Achilles tendinitis.

Treatment includes resting and elevating the foot as well as ice to relieve swelling.

Plantar fasciitis

Plantar fasciitis occurs when the band connecting the heel to the rest of the foot becomes inflamed due to overuse. It is more common in adults but may occur in children.

Plantar fasciitis is an overuse injury that involves irritation of the plantar fascia, the thick band of connective tissue that runs along the arch from the heel to the front of the foot.

It can occur in people of all ages, including children. Symptoms include: pain in the bottom of the foot close to the heel, difficulty walking, tenderness or tightness along the arch of the foot.

Treatment may include:

·         Ice and elevation to relieve inflammation and discomfort

·         Massage and compression

·         Resting the foot

 Fractures

Heel fractures may occur due to acute injury or repeated stress. They’re most common in children who play high-impact sports. Conservative treatment includes immobilizing the foot, rest, and medication to manage pain. 

Children who play hard or engage in high-impact sports may also be at risk of a heel or foot fracture. Although rare, heel fractures can occur after a fall or sudden impact. 

Symptoms include: severe pain, swelling, bruising, inability to put weight on the affected foot. 

The Best Heel Pain Treatment for Children

Treatment for heel pain in children usually involves a combination of:

A child walking at Podiatry Care

·         An accurate analysis of your child’s gait, muscles, tendons, ligaments and joints is a crucial first step;

·         Specific stretching and strengthening exercises often make up part of the treatment;

·         Anti-inflammatory measures such as ice baths after exercise can be helpful in the short term;

·         Footwear review, assessment and advice is important;

·         Orthotic devices are often needed to firstly control any abnormal traction or tension on the heel growth plate and, secondly, to unload the ground reaction forces on the heel bone.

Podiatry Care has podiatrists with specific paediatric training enabling them to utilise treatment options to relieve heel pain in children very quickly. Kid’s heel pain should not stop your child playing sport if the right treatment is administered. Heel pain relief is fast, simple and effective in the hands of experienced Podiatrists.

If your child is struggling to play sport, see a Podiatry Care podiatrist near you.

Treatment of Severs disease does NOT require surgery. This foot condition responds very well to conservative treatment.

Many adult foot problems have their origins in childhood. During the first year of a child’s life their feet grow rapidly, reaching almost half their adult size.

By 12, a child’s foot is about 90 percent of its adult length. This is why podiatrists consider the early years to be the most important in the development of feet care of children. Neglecting foot health can also lead to problems in other parts of the body, such as legs and back.

Children’s feet differ from those of adults, as they are not yet fully formed. Around 10cm long at birth, the feet will double in size by the time your child is one year old. At 6 months of age the foot is still mostly cartilage which means abnormal pressure on their feet can lead to deformities.

Your baby will be aware of and will begin to play with both feet, the only footwear babies need is socks for warmth, as they are not constrictive and allow the feet to grow normally.

Some suggestions to help ensure normal development of your baby’s feet are:

·         Provide an opportunity for your baby to exercise their feet. By covering your baby loosely, you allow your child to kick and perform other related motions, preparing their feet and legs for walking.

·         Try to avoid placing your baby on their stomach for prolonged periods as this can place excessive strain on their feet and legs.

Common Children’s Foot Care problems treated by Podiatrists

·         Pigeon-toes (in-toed) and duck feet (out-toed)

·         Knock Knees

·         Sever’s Disease

·         Kohler’s Disease

·         Freiberg Infarction

If you have any concerns about your child’s foot health development, seek the advice of a podiatrist. To be assured that there is no problem is better than being told You should have come earlier when we could have done something about it.

At the Foot and Ankle Clinic our highly qualified team of Podiatrists are all members of the  Podiatry and offer a combined several experience. They are trained to diagnose and effectively treat children’s foot care problems via a range of treatments.

Testing and diagnosis

Children with flat feet are often diagnosed by their paediatricians. If your child is not experiencing any pain or other symptoms, no further testing is usually needed.

Children who have symptoms should be examined by experts in pediatric foot conditions. The podiatrist may observe your child walking, standing or running regularly and on their toes to better understand the mechanics of your child’s feet.

Clinicians may ask you to bring your child’s everyday shoes to the appointment so they can evaluate the wear patterns and pinpoint what may be causing their pain.

If your child is experiencing significant foot pain, podiatrist may also order imaging tests such as:

·         X-rays, which produce images of bones.

·         EOS imaging, an imaging technology that creates 3-dimensional models from two flat images. Unlike a CT scan, EOS images are taken while the child is in an upright or standing position, enabling improved diagnosis due to weight-bearing positioning.

·         Computed tomography (CT) scan, which uses a combination of X-rays and computer technology to examine bones and produces cross-sectional images of the body.

·         Magnetic resonance imaging (MRI), which uses a combination of large magnets, radiofrequencies and a computer to produce detailed images of organs, soft tissues, muscles, ligaments and other structures within the body.

Treatment Options

We always try to treat patients with the use of conservative, nonsurgical methods, but this especially holds true for children.

 The good news is that many of these common child foot issues are treated effectively without the need for surgical intervention. Some of the methods that we may include in your son or daughter’s treatment plan might include:

 ·         RICE method. Rest, ice, compression, and elevation can be quite effective to relieve painful symptoms, lower levels of inflammation, and help the body perform its natural healing processes.

·         It is important to always check with our office for the best types of pain relievers and dosage recommendations, but they can be especially helpful for relieving pain and inflammation.

·         Orthotic devices. Customized orthotic devices can be used as a highly-effective treatment tool for a wide range of issues. When we prepare orthotics, they are crafted to work in a specific manner with your child’s unique feet.

·         As noted, we will take every measure possible to treat a young patient’s condition with the use of nonsurgical care, but sometimes surgical procedures are necessary. When this is the case, you can find comfort in the knowledge that your son or daughter is in the hands of skilled, expert foot surgeon who has your child’s health firmly in mind.

 Advice to Parents

·         Most foot and lower leg problems in children do not cause pain.

·         Don’t restrict a baby’s development with tight bed clothes, booties, socks or blankets. Allow them to kick and exercise legs and feet.

Discourage poor circulation, sleeping and sitting positions (ie, sleeping on stomach or kneeling with feet turned out). Sitting with legs crossed is preferred.

When your child begins walking, look for signs that may indicate abnormalities in their structure and development. Signs to look for include:

·         Awkward walking style

·         Feet turned out excessively

·         Painful, tired legs at the end of the day (also known as growing pains)

·         Abnormal wear patterns on shoes

·         Skin lesions (i.e. corns, blisters, calluses)

·         Constant tripping or clumsiness

Teach Children About Proper Foot Care

Your child may begin to walk at about 12 months of age. Recent research has shown that it’s beneficial to walk barefoot as much as possible, which may help strengthen the foot muscles. It’s important to measure the feet every few months in the early years to ensure a proper fit while choosing shoes.

As your child gets older, common ailments that can occur may include athlete’s foot, ingrown toenails, and plantar warts. It’s crucial to maintain daily foot care, which includes washing the feet in lukewarm water and drying thoroughly between the toes.

Additionally, complaints about heel pain can be a common occurrence, typically resulting from playing sports. If the pain becomes severe, a consultation with a podiatrist may be suggested to alleviate any discomfort and to learn about possible treatment options.

Flat feet are normal in babies and toddlers because the arches in their feet haven’t yet developed. The foot arch develops throughout childhood for most individuals; however, some will never develop arches in their feet.

Flat foot can also develop in adulthood, but that is not the same pathology that is referred as flexible flat feet. Arches can fall due to age, wear and tear on the body, or from an injury.

Flat feet are a common condition, often runs in families and is usually painless. In some cases, flat feet can affect the body’s alignment, which can cause knee and ankle discomfort.

If the flat feet are not causing pain, no treatment is necessary.

Causes of Flat Feet

The causes of flat feet are varied. Some inherit the condition from their parents as an isolated trait, this is particularly true for children with hypermobility or double jointed.

Others develop flat feet as part of another genetic condition. Still others develop the condition over time.

Certain factors can increase the risk of developing flat feet over time including:

·         Obesity

·         Diabetes

·         Rheumatoid arthritis

·         Foot or ankle injuries

symptoms of Flat Feet

Most of the time, a child with flat feet experiences no symptoms beyond the actual appearance of the foot. In this case, the condition is considered asymptomatic. 

Most people recognize the appearance of flat feet. Namely, the foot lies flat on the ground, with little to no arch visible. When standing behind the child, you likely can see the outer toes but not the big toe. 

If your child experiences any of these symptoms, schedule an appointment with a pediatric podiatrist.

Most people with flat feet have no complaints or symptoms of the condition. However, some people may experience:

·         An outward tilt at the heel

·         Changes to gait or awkwardness when walking

·         Feeling pain or tenderness anywhere from the foot to the knee

·         Foot pain, specifically in the heel or arch area

·         Foot pain that increases with activity

·         Ankle swelling

·         Tight heel cords

Treatments of Flat Feet

 If your child’s flat feet are not causing pain, no further treatment is usually necessary.

Non-surgical treatment

For children who are experiencing pain associated with their flat feet, doctors may recommend a variety of non-surgical treatments to relieve the pain, including:

Arch supports 

Your child’s doctor may recommend arch support orthotic devices that fit inside your child’s shoes to relieve pain and reduce symptoms. These devices are available over-the-counter or can be custom-designed to mold to the contours of your child’s feet. 

Curved foot:

The issue usually takes care of itself by the time your baby is six months old. If your little one still has a severe or particularly rigid curved foot by nine months old, your doctor may recommend casts or special shoes, which are very effective. Surgery isn’t usually needed.

Encourage your child to wear structurally supportive shoes instead of sandals, flip-flops and shoes without arch support.

Stretching exercises And Physical therapy 

Exercises to stretch the Achilles tendon may help some children with flat feet.

Flat feet can lead to overuse injuries in some active children and runners. A video analysis of how your child runs may help identify problems with form and physical therapists can work with your child to correct it.

Surgery

Surgery is not usually needed for flexible flat feet, but if your child has a related foot or leg problem, such as a torn tendon, accessory or extra bone, fusion between bones in the foot and other conditions, surgery may be recommended.

Twisted shin bone:

The tibial torsion rarely requires treatment because the tibia bone usually untwists itself naturally as your child grows taller. If, however, tibial torsion remains when your child is around nine or 10 years old and it’s affecting his ability to walk, an orthopedic surgeon may reset the bone with surgery.

Twisted upper thigh bone:

Studies show that devices such as braces don’t help with femoral anteversion, but, again, it fixes itself in almost all children as they grow. In the rare case that surgery is needed, an orthopedic surgeon may cut the upper thigh bone (femur) to place it in the proper alignment.

This surgery is recommended only in older children with severe rotational deformity in which the intoeing causes the child to frequently trip or fall, or causes severe gait disturbances or problems walking and running.