Dr Ajesh Bansal

GI DISEASES

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CIRRHOSIS

Cirrhosis is a late stage of scarring (fibrosis) of the liver caused by many forms of liver disease and conditions, such as hepatitis and chronic alcoholism. The liver carries out several necessary functions, including detoxifying harmful substances in your body, cleaning your blood and making vital nutrients.Cirrhosis occurs in response to damage to your liver. Each time your liver is injured, it tries to repair itself. In the process, scar tissue forms. As cirrhosis progresses, more and more scar tissue forms, making it difficult for the liver to function.

Causes A wide range of disease and conditions can damage the liver and lead to cirrhosis. The most common causes are
  • Chronic alcohol abuse
  • Chronic viral hepatitis (hepatitis B and C)
  • Fat accumulating in the liver (nonalcoholic fatty liver disease)
Symptoms Cirrhosis often has no signs or symptoms until liver damage is extensive. When signs and symptoms do occur, they may include
  • Fatigue
  • Bleeding easily
  • Bruising easily
  • Itchy skin
  • Yellow discoloration in the skin and eyes (jaundice)
  • Fluid accumulation in your abdomen (ascites)
  • Loss of appetite
  • Nausea
  • Swelling in your legs
  • Weight loss
  • Confusion, drowsiness and slurred speech (hepatic encephalopathy)
  • Spiderlike blood vessels on your skin
  • Redness in the palms of the hands
  • Testicular atrophy in men
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CHRONIC HEPATITIS B

Hepatitis B is a serious liver infection caused by the hepatitis B virus (HBV). For some people, hepatitis B infection becomes chronic, meaning it lasts more than six months. Having chronic hepatitis B increases your risk of developing liver failure, liver cancer or cirrhosis — a condition that permanently scars of the liver.

A vaccine can prevent hepatitis B, but there's no cure if you have the condition. If you're infected, taking certain precautions can help prevent spreading the virus to others.

Hepatitis B signs and symptoms may include:
  • Abdominal pain
  • Dark urine
  • Fever
  • Joint pain
  • Loss of appetite
  • Nausea and vomiting
  • Weakness and fatigue
  • Yellowing of your skin and the whites of your eyes (jaundice)
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CHRONIC HEPATITIS C

Chronic hepatitis C infection is caused by the hepatitis C virus (HCV). As the virus enters the body, it causes an infection in the liver. Over time, the infection scars the liver and prevents it from working normally. This condition can be fatal if not treated.

Acute and chronic hepatitis C are caused by the same virus. Acute hepatitis C develops after initial infection. This stage can last up to six months. Many people have no symptoms during the acute stage and never find out that they’re infected.

Most symptoms of chronic hepatitis C don’t appear until cirrhosis develops and the liver begins to fail. Symptoms can include
  • weakness
  • weight loss
  • blood clotting problems
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Non-alcoholic fatty liver disease

Non-alcoholic fatty liver disease (NAFLD) is the build up of extra fat in liver cells that is not caused by alcohol. It is normal for the liver to contain some fat. However, if more than 5% – 10% percent of the liver’s weight is fat, then it is called a fatty liver (steatosis).

What are the symptoms?
  • Non-alcoholic fatty liver disease often has no symptoms.
  • When symptoms occur, they may include fatigue, weakness, weight loss, loss of appetite, nausea, abdominal pain, spider-like blood vessels, yellowing of the skin and eyes (jaundice), itching, fluid build up and swelling of the legs (edema) and abdomen (ascites), and mental confusion.
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Alcoholic Liver disease

The liver is a large organ with an important job in your body. It filters the blood of toxins, breaks down proteins, and creates bile to help the body absorb fats. When a person drinks alcohol heavily over the course of decades, the body starts to replace the liver’s healthy tissue with scar tissue. Doctors call this condition alcoholic liver disease.

There are 3 types of liver disease related to alcohol consumption: fatty liver, alcoholic hepatitis, or cirrhosis. Fatty liver disease occurs after acute alcohol ingestion and is generally reversible with abstinence. Fatty liver is not believed to predispose a patient to any chronic form of liver disease if abstinence or moderation is maintained. Alcoholic hepatitis is an acute form of alcohol-induced liver injury that occurs with the consumption of a large quantity of alcohol over a prolonged period. Alcoholic hepatitis can range in severity from asymptomatic derangement of biochemistries to liver failure and death. Cirrhosis involves replacement of the normal hepatic parenchyma with extensive thick bands of fibrous tissue and regenerative nodules, which results in the clinical manifestations of portal hypertension and liver failure.

Symptoms
  • jaundice
  • portal hypertension, which increases blood pressure in the vein that travels through the liver
  • skin itching (pruritus)
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ASCITES

Ascites is the accumulation of fluid (usually serous fluid which is a pale yellow and clear fluid) that accumulates in the abdominal (peritoneal) cavity. The abdominal cavity is located below the chest cavity, separated from it by the diaphragm. Ascitic fluid can have many sources such as liver disease, cancers, congestive heart failure, or kidney failure.

Types
  • Ascites related to portal hypertension (cirrhosis, congestive heart failure, Budd-Chiari) is generally greater than 1.1.
  • Ascites caused by other reasons (malignant, pancreatitis) is lower than 1.1.
Causes

There may be no symptoms associated with ascites especially if it is mild (usually less than about 100 – 400 ml in adults). As more fluid accumulates, increased abdominal girth and size are commonly seen.

  •  Abdominal pain
  • discomfort
  • bloating 
  • Shortness of breath can also happen with large ascites due to increased pressure on the diaphragm and the migration of the fluid across the diaphragm causing pleural effusions (fluid around the lungs). A cosmetically disfiguring large belly, due to ascites, is also a common concern of some patients.
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LIVER TUMOR

The liver is the body's largest solid organ. Lying next to the stomach on the right side of the abdomen, it has many jobs — like cleansing the blood of toxins, producing bile (which helps break down food during digestion), and storing energy in the form of a sugar called glycogen.

Tumors happen when abnormal cells form a mass or growth. If a tumor develops in the liver, the liver can't work as it should. 

Symptoms
  • A lump that can be felt in the abdomen, or a swollen abdomen
  • Pain on the right side of the abdomen, where the liver is (if the tumor is pressing on nerves or muscles, pain may extend upward and back)
  • Early puberty
  • Decreased appetite and weight loss
  • Vomiting
  • Jaundice (yellowing of the eyes and skin)