Patient Comes First!
At Mid Illini Surgical Associates, we provide evaluations and treatment of a full range of complex general surgery problems that are common today. We work closely with colleagues to form a multi-disciplinary medical plan that gives our patients the best care possible!
At MISA we are disciplined, knowledgeable and familiar with general diseases that may require surgical treatment.
- IBS
- Constipation
- Gallbladder
- Hernia
- Anal conditions such as: hemorrhoids, PPH and hemorrhoid rubber band ligation, fistulas and fissures, and abscesses
- Cysts, lumps and bumps
- Skin moles and tags
Irritable Bowel Syndrome
IBS is a disorder most commonly characterized by a combination of symptoms:
- abdominal pain
- bloating
- constipation
- diarrhea
- infrequent bowel movement
Although IBS causes great discomfort and distress, it does NOT cause permanent damage to the intestines, does NOT lead to serious diseases, such as cancer, and NO link to inflammatory diseases (Crohn's or ulcerative colitis).
Yet the pain and discomfort can be disabling to some people as it can interfere with traveling and attending social events. Symptoms can vary person to person and sometimes symptoms will subside for a few months yet return. Patients have reported a "constant worsening" of symptoms over time.
Improved diet, stress management and prescribed medications, or over the counter, for most people can control symptoms.
Ways to Managing IBS
Medications can be used to relieve symptoms, but affect people differently. Remember too that no one medication or combinations of medications will work for everyone with IBS.
Working with your doctor to find the best combination of:
- prescribed medication, or over the counter medications as suggested by your physician
- seek dietary counseling to establish a diet plan that is high fiber and increased water intake
- increase good bacteria (enzymes needed to digest lactose), try yogurt or probiotics
- avoid larger meals, eat smaller meals/portion sizes more often
- decrease caffeine and alcohol consumption
- establish stress management tools, or counseling to overcome stressors
IBS Screening & Procedures
IBS is generally diagnosed after completion of a medical history, which may include detailed description of symptoms and physical examination. There are no specific tests for IBS, although diagnostic testing may be performed to rule out other intestinal problems.
Our physician will then determine the best treatment plan for your particular symptoms and encourage you to manage stress and make dietary changes to manage symptoms.
*This information is not intended to substitute professional medical care, diagnosis or treatment. It is for informational purposes only. All procedures have risk of complications. Please contact your healthcare provider for better guidance regarding your individual situation.
Constipation
Constipation occurs when bowel movements become difficult, or less frequent. Almost everyone gets constipated at some point in time of his/her life. Bowel movements vary from person to person. However going longer than 3 days without a bowel movement is way too long! After 3 days, the stools, or feces, will become harder and more difficult to pass which will also cause swelling of the abdomen and abdominal pain.
What causes Constipation?
Constipation is a bowel function disorder rather than a structural problem.
There are several common causes of constipation which include:
- inadequate water intake
inadequate fiber and whole-grain intake
- poor diet
- eating large amounts of dairy products (i.e cheese)
- overuse of laxatives (over time can weaken the bowel muscles)
- eating disorders
- depression and medications for depression
- overly stressed & worried
- medications (i.e. narcotics and iron pills)
- pregnancy
Ways to Managing Constipation
- drink plenty of water
- decrease caffeine intake (i.e. soda pop, tea & coffee)
- try warm drinking warm liquids (i.e de-caf tea)
- increase fruits and vegetables in diet
- consume high fiber and whole-grains in your diet (i.e. oatmeal)
- may use a very mild stool softener, or laxative (i.e. Mira lax)
* Do NOT use laxatives for more than 2 weeks - call your physician
Constipation Screening & Procedures
Constipation is generally diagnosed after completion of a medical history, which may include a detailed description of symptoms and physical examination. Most people do not need extensive testing to diagnose constipation. Our physician will make the best determination based on your symptoms and medical history.
*This information is not intended to substitute professional medical care, diagnosis or treatment. It is for informational purposes only. All procedures have risk of complications. Please contact your healthcare provider for better guidance regarding your individual situation.
Gallbladder
Gallbladder disease is a very common problem, especially when consuming foods that are fried, fatty, greasy and high fat processed foods. If you've had a painful gallbladder attack, you are not alone! Treatment is available, which will eliminate pain and prevent future attacks. Best of all, you can live a full happy healthy life!
Painful attacks often occur after meal consumption. Some people are known to experience one attack, while others have many.
Most common symptoms may include:
- nausea
- upset stomach
- heartburn
- vomiting
- severe pain and/or aching in upper right side of the abdomen
- pain can radiate to shoulder blade and/or back pain
- dull ache beneath the ribs, or breastbone
Understanding the Gallbladder
The gallbladder is a small pear-shaped organ (under the liver) in the abdomen. The job of a gallbladder is to store and release bile, which helps break down fats in the foods you eat. Bile then moves smoothly through the digestive system, but if gallstones form this will cause blockage. This too can be painful and lead to more serious complications.
What are Gallstones?
Most gallbladder problems are caused by gallstones, which is bile that is crystallized and become solid. Stones usually don't cause problems, however they can irritate the wall of the gallbladder and more serious problems can occur with those nearby ducts getting blocked. Bile is passed through two duct systems: cystic duct and common bile duct.
The common bile duct is formed by the junction of ducts leading from the liver and gallbladder. It is also a very common place for blockage to occur.
Symptoms of common bile duct may include:
- pain
- nausea
- infection
- inflammation
- Jaundice (buildup of bile chemicals in the blood). Symptoms may include: yellowing of the skin, eyes, dark urine, and itching.
If gallstones block within the pancreatic duct, it can lead to inflammation of the pancreas causing, pancreatitis. This is a serious medical problem that will need immediate treatment!
Ways to Managing Your Gallbladder Condition
- sparingly consume fried fatty greasy foods
- drink plenty of water (i.e. 64 oz per day)
- decrease caffeine intake (i.e. soda pop, tea & coffee) and alcohol. This can cause an irritable stomach with pain, gas, and bloating.
- try warm drinking warm liquids (i.e de-caf tea) to soothe stomach
- increase fruits and vegetables in diet
- consume high fiber and whole-grains (i.e. oatmeal, wheat bread)
Gallbladder Screening & Procedure
A medical evaluation before any treatment will be conducted that will consist of your health history and symptoms.
You will then have a series of blood tests and physical examinations that may include:
1. Ultrasound Scan is a painless test that produces sound waves to check for gallstones.
2. CT scan (CAT scan) a detailed x-ray image of the abdominal to help rule out other causes of abdominal pain.
3. HIDA (Hepatobiliary scan) radioactive fluid injected to check for gallbladder function and show whether bile ducts are blocked. The fluid will safely pass from the body.
What are my Gallbladder Surgical Options?
Having gallbladder surgery is quit common. The most common procedure known as, laparoscopic cholecystectomy, which is done using a laparoscope (long, thin device with a small light and camera). It will send images to a video monitor to allow your surgeon to view inside the abdomen. Only small tiny incisions will be needed to insert the scope and other instruments during surgery.
However depending on certain situations, an open procedure may be conducted. This entails performing a single, larger incision to reach the gallbladder. Incision may be made in the upper right side (solid line), or middle (dashed line), of the abdomen.
Unless the gallbladder is removed, the possibility of stones forming is likely. The gallbladder may also need to be removed for reasons other than gallstones.
See Pre-Op and Post-Op for more details!
Want more? Check out "In the News" to read article by Dr. Brian Heywood
*This information is not intended to substitute professional medical care, diagnosis or treatment. It is for informational purposes only. All procedures have risk of complications. Please contact your healthcare provider for better guidance regarding your individual situation.
What is an Exploratory Laparotomy Procedure?
Sometimes people may have an unexplained stomach, abdominal or intestinal pain that other tests have not revealed the cause of the problem, or pain. In emergency situations, an exploratory laparatomy operation can be performed. The surgeon will make an incision in the abdomen and visually investigate organs within the abdominal cavity to determine the cause of your problem.
*This information is not intended to substitute professional medical care, diagnosis or treatment. It is for informational purposes only. All procedures have risk of complications. Please contact your healthcare provider for better guidance regarding your individual situation.
Hernia
The abdominal wall is composed of layers of tissue, such as muscle and connective tissue that helps protect and enclose the intestines and other vital organs. Most hernias aren't life threatening but proper treatment can help prevent future complications and discomfort. A hernia can grow larger when more pressure inside the body presses on the intestines, or other surrounding tissue that is weak.
Understanding Hernias
A hernia, also known as a rupture, is a weakness or defect in the abdominal wall. This weakness can be present at birth too. "What makes an area weak?" Good question!
Weakness can occur from:
- wear and tear we put on our bodies from daily activity
- intense physical activity (i.e. sports, weight lifting, hard labor jobs)
- even being overweight with excess abdominal skin
- previous opening that was closed from a surgical incision
- injury
- aging
A weakness, or breakdown, in the abdominal wall will allow the contents of the abdomen to push outward, which causes a bulge under the skin. This can set off pain/discomfort depending on the size and location of the hernia. Although a hernia bulge may appear sudden to you, often most hernias take years to develop!
Common symptoms may include:
- bulge of groin, abdomen, thigh, genitals, labia
- bugle may get bigger upon standing, or go away upon laying down
- discomfort/pain worsening at the end of the day, or after standing for long periods of time
- pain during lifting, coughing, sneezing or physical activity
- weakness or pressure in groin
- discomfort/pain during bowel movement, or urination
Understanding the Abdomen and Groin
Most often hernias happen when tissue in the abdomen bulge through an opening into the groin. Normally the abdomen and groin are kept separate by walls of muscle and tissue. There are natural openings in the wall, known as canals, which allow nerves, blood vessels and other structures to pass through.
The abdominal wall helps protect, enclose the intestines and other surrounding organs. Over time the abdominal wall can become weaker from physical stress allowing the intestines, or other tissue, to bulge outward through an opening. The contents of the abdomen will act very similar to a bicycle tire from wear and tear. For example,if a spot on the rubber of a bicycle tire frays and weakens, the inner tube will bulge out causing damage that needs repaired.
If the intestine becomes strangulated (tightly trapped) it loses its blood supply and dies. This can cause severe pain and emergency surgery is required to relieve the blockage yet repair hernia.
A hernia will not heal on its own! Surgery is needed to repair the defect in the abdominal wall, yet if not treated, a hernia can get bigger.
Hernias are more likely to occur in men at or near the inguinal area at any age!
Weak area for MEN include:
- umbilical (where the umbilical cord once passed through the abdomen wall)
- inguinal (around the inguinal canal) and most common in men especially after the age of 40
- femoral (in the femoral canal)
- scrotum (male genitalia)
Women are more likely to have femoral hernias then men!
Weak area for WOMEN include:
- umbilical (where the umbilical cord once passed through the abdomen wall)
- inguinal (around the inguinal canal)
- femoral (in the femoral canal)
- labia (female genitalia)
Locations of Hernias
Abdominal hernias are most often formed around the naval, or a previous surgery site.
- Incisional Hernia - occur at the site of a previous surgical incision and can be on both sides of the body, known as bilateral hernias.
- Epigastric Hernia - occur in the upper abdomen at the midline.
- Umbilical Hernia - occur at the naval.
Groin hernias are the most common types of hernias.
- Indirect Inguinal Hernia - occur in the groin at the opening of the inguinal canal.
- Direct Inguinal Hernia - occur in the groin next to the opening of the inguinal canal. Less common than indirect inguinal hernias.
- Femoral Hernia - occur in the femoral canal.
Hernia Surgical Options
Our surgeons will provide you with the best method to repair your type of hernia. A laparoscopic surgery is done with tiny small incisions. Traditional repair is used and more often, a mesh device is used to make a tension-free repair. The mesh acts just like a patch would on a bicycle tire. This will help strengthen and repair the weakened site yet help prevent the hernia from recurring.
An incision is made to reach the weakened area of the hernia. The hernia then will be pushed back into the proper place in order to be repaired properly. A thin mesh patch may be placed in front, behind or combined (front and back) of the defect area. It will then be secured to nearby tissue. Once the mesh is safely in place, the skin is closed with stitches, staples, surgical tape, or special glue. Over time, new tissue will begin to grow into the mesh. This will help strengthen the repair and help prevent future hernia occurences. A mesh plug may also be used in conjunction with a patch to fill a hole in the abdominal wall to secure the defect yet provide strength. Again, this will all depend on the "type" of surgery you will be receiving.
See Pre-Op and Post-Op for more details!
*This information is not intended to substitute professional medical care, diagnosis or treatment. It is for informational purposes only. All procedures have risk of complications. Please contact your healthcare provider for better guidance regarding your individual situation.
Hemorrhoids
Hemorrhoids are natural...yes that is correct! Everyone has them and you won't notice them as long as they are doing their job. Hemorrhoids are cushions of tissue and veins located both inside and outside the anal canal.
Foods high in fiber and good hydration (water) will aid in digestion, which will allow waste to collect appropriately in the rectum as a "soft stool" to be passed. Internal hemorrhoids will swell just a bit to cushion the stool being passed from the body. They are located in the upper area of the anal canal and they sense pressure of gas and stool but cannot sense pain - even when they become swollen. Internal hemorrhoids can protrude from the anus when you strain too much yet disappear upon relaxation. Bright red or dull maroon in color, they can bleed or discharge mucus.
External hemorrhoids lie outside the anus that are soft pads (same color as your skin), which rarely cause pain but when blood clot is formed, known as thrombose (they turn blue in color), this will be sudden and very painful.
Again, hemorrhoids will swell upon eliminating waste from your body (bowel movement),that is normal. However a poor diet can form hard stools and will remain there long after you begin to feel ready to pass it. Hard stools will scrap the the anal walls while passing through and will cause hemorrhoids to swell too much, this can be painful!
Other anal problems can occur and cause discomfort. A fissure is a crack in the anal canal's skin, which may bleed and be very painful. A fistula is an infected pathway that may develop an abscess working its way from inside the anal canal to the outside of the skin. Pain may vary with noticeable drainage.
Other common hemorrhoid symptoms are itching, irritation, burning and sometimes bleeding.
What causes Hemorrhoids to Swell?
- straining on the toilet during bowel movement
- constipation
- low-fiber diet
- inadequate water intake
- sedentary lifestyle (no structured exercise routine most day per week)
- strenuous exercise, or intense physical activity (i.e. heavy lifting)
- pressure on the rectum from pregnancy
- standing a lot most days of the week
- medications that may cause diarrhea or constipation (i.e. narcotics)
- family history of hemorrhoids
Ways to Manage Your Hemorrhoids
- Maintaining a healthy high-fiber diet (whole grains, fruit & vegetables) can relieve constipation and ease the digestion process in order to prevent swollen hemorrhoids that can also lead to bleeding.
- Developing a consistent exercise routine (i.e. walking daily >20 mins.) can develop better bowel habits.
- A sitz bath (soaking in warm tub water of 3 inches) for a few minutes can help alleviate pain for immediate relief.
- Don't push yourself to have a bowel movement every day. Yet don't put off the urge to go either. Sit on toilet only as long as necessary.
- Wipe gently with soft, white, unscented toilet paper.
- Use ice packs to thrombosed external hemorrhoids soon after you notice them. This can reduce pain and clotting within a few days. Ice no more than a few minutes at a time and stop the icing cycle after a few hours.
- Laxatives and enemas can ease symptoms, but overuse can make constipation worsen.
- Follow up with your doctor when hemorrhoids are swollen and painful, you will want to be sure nothing else may be wrong.
*Rectal bleeding, change in bowel patterns, or if irritation persists are other good reasons a trip to the doctor is advisable.
Hemorrhoid Screening and Procedures
In oder for our physician to provide a proper diagnosis and recommendation, he/she will ask questions regarding your symptoms to ensure the best care for you.
It may be helpful for you to journal daily by recording:
- length of symptoms
- daily food consumption and types of beverages
- how often and what kind of bowel movements you have
- your current activity level
- bring a list of medications/dosage currently taking
- note any family history of cancer, or polyps of the colon
During your visit with our physician, a visual examination of your outer anal skin comes first. A digital rectal exam will be conducted, which is when the doctor will use a well-lubricated gloved finger to feel for the hemorrhoids in the anal canal. Next an anoscopic exam (tube) may be inserted to view your lower anorectal canal. This brief exam causes little discomfort. If blood is present in stools, a sample of your stool may be sent off for more testing.
Additional tests may be done to rule out other problems, such as rectal cancer.
They may include the following:
1. Diagnostic Testing may be used to help diagnose the problem and/or rule out other colon disorders to ensure the best treatment possible for faster relief.
2. Barium study liquid barium that highlights your colon to show any abnormalities.
3. Colonoscopy is a thin long flexible lighted tube inserted into rectum to view higher up in the colon.
Will I need Hemorrhoid Surgery?
After attempts of home treatments provided by our physician, at times this may not be enough. If your symptoms are severe and persistent despite changes in your diet and various remedies, you may need an outpatient procedure performed in our office, which may include:
Thrombosed External Hemorrhoids - a local anesthetic will be injected to the area and a small incision will be made to remove the thrombosed hemorrhoid. The incision will be left open and heal within a few days.
Internal Hemorrhoids can be treated with Rubber Band Liagation which is a very effective way to treat prolapsed hemorrhoids. This is achieved by placing one or two elastic bands around the base of the hemorrhoid. This cause it to fall off in about 7-10 days, tissue will heal few days later.
A more serious approach may be necessary where surgery will be conducted at a hospital for a PPH or Hemorrhoidectomy.
What is a PPH?
The Procedure for Prolapse and Hemorrhoids (PPH) is a surgical procedure that will help reduce the prolapsed mucosa and restores the anal tissue to its original anatomical position. Using a hemorrhoidal circular stapler device, the surgical procedure for prolapse and hemorrhoids procedure essentially will "lift up", or reposition the mucosa and/or anal tissue while reducing blood flow to the internal hemorrhoids. Patients may experience less pain by effecting fewer nerve endings and possible faster recovery by returning to normal activities, such as work.
What is a Hemorrhoidectomy?
A surgical removal is sometimes needed when hemorrhoids haven't responded to all previous treatments. Hemorrhoidectomy is performed at a hospital as a surgery procedure. You'll be admitted and may go home soon after surgery, or one to two days later depending on how you may feel. During this surgery a spoon like instrument (retractor) will be inserted into the anal canal, which will help remove the swollen hemorrhoid. The incision will either be left open to provide drainage for fluid and mucus, or may be stitched partially closed. It may be necessary to remove several hemorrhoids during surgery depending on the severity.
After surgery you may experience gas cramps, nausea, or light bleeding for a short time, yet this will disappear. You may experience muscle spasms with your first bowel movements, but will be encouraged to pass stools to ensure good flow. Know you are in good hands and we want you to recover quickly to enjoy life again!
See Pre-Op and Post-Op for more details!
*This information is not intended to substitute professional medical care, diagnosis or treatment. It is for informational purposes only. All procedures have risk of complications. Please contact your healthcare provider for better guidance regarding your individual situation.
Cysts, lumps and bumps - details coming soon!
Skin moles and tags - details coming soon!
