What starts as 'just piles' can end as colorectal cancer | ft. Dr Parameshwara CM

What starts as 'just piles' can end as colorectal cancer | ft. Dr Parameshwara CM

Author Name:Dr. Parameshwara CM

Youtube Channel Url:https://www.youtube.com/@drparameshwaracm

Youtube Video URL:https://www.youtube.com/watch?v=y_0gfPZmfy4



Transcript:
(00:00) In India, the entire population would have used the word constipation at least once in the lifetime. >> So what is gut health and how is it related to diseases and logically? >> It's not about lifespan. Now it is about health span. >> Yes, >> these conditions points, [music] fissure and fistula they are called as below the belt.
(00:25) In India they feel it is a taboo. If suppose there's a delay in diagnosing a certain disease, what are the um repercussions of it? >> The only cancer which is diagnosed late in the country is colorophy cancers. >> What are the first stages of detecting something like >> about 73% of people think anything in the anal canal is spice only.
(00:48) The most dangerous thing is self medication. One in two mothers have got constipation [music] related to their child birth over a period of 9 months because of the weight of the baby. The pelvic floor comes down. So what is the price they pay for this? Whole life they have constipation. [music] 90% of the fistula start from small issues.
(01:12) >> Is the biggest myth around this? The biggest myth around twice, fissure, fistula, absis, constipation is >> uh s so you being a colctal surgeon. Yeah. >> Now I want to talk about the taboos that are in the society >> around the conditions like piles, fissures, fistulas. Now why are people like India being so literate now? so progressive now and many people are aware of many things and why are they >> still so conditioned to you know not talk about these kind of conditions or diseases >> yeah uh madam you said uh India is a
(01:52) progressive nation now >> right >> it's moving towards $5 trillion economy >> yes >> these conditions piles fissure and fistula they are called as below the belt In India it's just not about why >> even sex is not discussed in open >> right >> they feel shy >> right >> they feel it is a taboo >> they feel it is a sin >> they feel people make jokes out of spola they can't walk properly they can't sit properly and uh people bully this kind of pes fistula diseases is so even today in the US forget about India even in the US it is
(02:40) a taboo subject >> so you're saying that it's a taboo worldwide >> worldwide >> constipation taboo they say he's a constipated prof >> he's a constipated guy >> so this is the kind of language people use slang English slang >> they also tell pain in the ass. >> Pain in the ass. We used to tell in the college. P I T A pa.
(03:10) >> Oh >> pa means sitting place. Pain in the ass. It was the short form we used to tell in the so >> pain in the ass. He's constipated. He's walking as though he's got some pes for these kind of uh jokes people make fun of. >> Yeah. Yeah. True. I think for me as well like throughout my life I've seen >> or maybe if I talk about myself also I've always been a little hesitant talking about this even when it comes to >> a small problem like dentry for example you know >> uh and I feel like people are very embarrassed to kind of talk about these
(03:49) things but >> tell me one thing now because of this what is the impact that you know it's causing >> uh for example now If somebody is embarrassed to even talk about it. >> Yeah. >> How how like the diagnosis also gets delayed because of this, right? >> Yes. >> So, uh what do you think about this as in like uh patients don't come on time to doctors and they don't get diagnosed and then >> uh does it like cause any like if if suppose there's a delay in diagnosing diagnosing a certain disease, what are the um repercussions of it?
(04:27) >> Yes. Just because it is a taboo subject people doesn't discuss in open >> right >> the average age a person comes to your hospital in this country is 9 years >> right >> they suffer in silence people think every bleed is spice >> every pain is spice >> it can be as dangerous as colo rectal cancer okay It can be inflammatory diseases like ulcerative colitis and Crohn's disease.
(05:06) So the impact the repercussion of this is we miss colon cancer diagnosis early because of this colon cancer diagnosis in the country is delayed. The only cancer which is diagnosed late in the country is colal cancers. As per ICMR 78% of colurectal cancers are diagnosed in the late stage when people die. >> So this is the repercussion if people don't share if people don't go to a doctor because it is spice or pain in the ass or constipation or mucus.
(05:46) You mentioned decentry >> this is the repercussion. But now for example for a common person who does not know all of these terms and in fact I also don't know a lot of I don't have a lot of knowledge about all of this and I'm sure a lot of common people don't have it. So how do they know what are the first stages of detecting something like this because >> uh whether it's piles fissures fistulas like you said they can get dangerous eventually leading to cancer. Yes.
(06:16) So what are the things that they can do or you know how can awareness be spread on? >> Yes. Yes. Anything in the anal canal? >> Anything in the people colloquially called as us >> anything in the anal canal people think it is spice only. About 73% of people think anything in the anal canal is spice only. >> Okay.
(06:43) >> It's just not pies. When people come to clinic they come as spice. It can be piles, it can be fissure, it can be fistula, it can be absess, it can be anal polip, it can be rectile polyp, it can be a colctal cancer, it can be IBD, ulcerative colitis and Crohn's disease. But 73% of the people come as spies to us.
(07:07) Only when we go deep into their lives, we'll diagnose water. So this is what the common presentation when the patient comes to the hospital with only pies >> but >> they are not aware of any other diseases in the anal canal they're not supposed to be know it also but still yeah >> right so uh coming back to the question where what are the early symptoms that we can detect as a common person >> yeah as a common man >> if there is bleeding in the anal canal.
(07:40) >> If there is pain in the anal canal. >> If there is puss in the anal canal. If there is a mucus in the stools. If the stool is black in color. If the stool is pale white in color. If the consistency of stool is very hard, very soft. If there is puss around the anal canal, if there is pimple around the anal canal, anything which is disturbing the early morning activity of poop, >> people should come to us immediately.
(08:10) Otherwise, they will be landing up in problem. They'll be landing up in their graveyard. >> They miss we miss color cancers in case if it is colic cancer. >> Okay. And what do you think is the biggest myth around this? >> Yeah, the biggest myth around pies, fissure, fistula, absess, constipation is don't go to hospitals.
(08:38) >> Don't go to doctors. >> If they go to doctor, they will cut the muscles and people lose control of stools. If you go to doctor, they operate. It comes back again. Right. >> The biggest myth is losing control of stools and getting back piles again. So these are the two biggest myth myths when it comes to piles fissure and fistula.
(09:02) >> So just summarizing what you said. So I think detecting it at an early state is very important >> so that you know it does not get to the cancerous phase. >> Yes. And also if uh and talking about it in general talking about it, asking questions is something that is a mandate. Right. >> Yeah. >> Um now I want to get into constipation as well.
(09:26) >> Correct. >> Um what exactly is constipation from a medical perspective? >> Yeah. Constipation. 148 billion people in this country at least once in their lifetime use the word constipation. >> 15% of India's population have constipation which has to be treated. >> Right? >> 44% of India's population got constipation which is lifestyle.
(09:58) >> In treatable constipation there are four types. One type is When people pass tools, >> they're supposed to contract the abdominal muscles. Push it down. They're supposed to open this. >> Contract this. Open this. >> Contract this. Open this. Here we contract. We push down. This does not open. It closes very tight.
(10:25) So this is called as paradoxical pubo rectto contraction. Simple common man term. The brain gut axis is not working. The muscles are not in synergy. There is disenergy. So this is one type of constipation. >> This type of constipation can be treated completely completely completely 100% by simple physiootherapy 10 weeks 10 session one hour each session >> they're done with constipation.
(10:59) Sir, so I just want to know like what I mean see a lot of people experience constipation depending on our lifestyles today. I feel the kind of food we consume >> or various other factors lead to constipation. Right. >> So even in my family I've heard people talk about constipation or like you said every other person talks about it.
(11:20) >> And how do we know that like okay in our Indian culture there are like homemade remedies that you know people say or suggest that you know eat this do that and you won't be constipated the next day. Certain times what happens is that kind of actually helps. It helps but certain times it doesn't and I think over a period of time people just tend to like dismiss it.
(11:44) >> Yes. >> So how do you know at what stage you should you should visit a doctor? >> Yeah. Uh unfortunately for constipation people try home remedies first. >> Right. Right. >> Very bad. >> Right. Number two, people listen to ads on FM. >> People watch ads on TV. People watch ads on print. >> You have constipation. You take this.
(12:12) >> Correct. >> Ao. >> Correct. >> Correct. >> Correct. Correct. >> So the most dangerous thing is self- medication. >> The most dangerous thing is home remedies. >> Gone are those days of ancient India where people were trying home home remedies. Today we living in an advanced technology where even an AI can constipation.
(12:36) So if people are constipated they have to consult the doctor immediately. >> Okay. Just within one or two days of detection or immediately. >> The second variety of constipation is irritable ball syndrome constipation. >> IBS is of four types. IBS diarrhea, IBS constipation, IBS bloating, IBS pain. It can be separate all the four or it can come in combination.
(13:11) >> In IBS constipation, the stools are very hard like pellets. >> In IBS constipation, the person doesn't pass tools every day. They pass through only twice a week, sometimes only once a week. >> Okay? >> They may have pain abdomen. They may have bloating. So this is IBS constipation. IBS constipation.
(13:39) When we do a colonoscopy, it'll be normal. When we do an endoscopy, it'll it'll be normal. It can be treated with simple plain medications. for IBS constipation. Now we have gone into gut microbata analysis to see why IBS constipation. >> Why IBS for this particular person. So this is second type of constipation. Another type of constipation is constipation which is sudden onset.
(14:10) >> Everything is fine with him. Suddenly he faces constipation issues. This guy goes to home remedies, goes to self medication, find one day he will come with severe abdominal pain. >> Then we see cancer >> causing constipation which is obstructing the large intestine. >> The large intestine is 1.5 m long.
(14:39) M >> anywhere blockage in the large intestine suddenly the patient lands up in constipation. >> Got it. >> A CEO of a GCC facility in India. He had constipation and he went to a detox center. They did a colon hydrotherapy. After colon hydrotherapy he started bleeding very badly. After a week he came to us. Detailed history was taken.
(15:12) We did a colonoscopy. He had a colon cancer in the transverse column. So this can be as dangerous as this. So constipation should not be neglected. Number three, constipation. A mother who has delivered one in two mothers. Underline this. One in two mothers >> have constipation which are related to pelvic floor dysfunction, >> pelvic floor descent, >> pelvic floor relaxation which is a consequence of a normal delivery which is a consequence of a big baby.
(15:54) So this constipation in mothers is called as obstructive defecation syndrome. Obstruction means blocking, defecation means passing stool. Syndrome is the problem what they have. So this is number three. Another type of constipation is people take some medications, >> for depression, for anxiety, for epilepsy, iron supplements.
(16:21) So there is one type of constipation related to this kind of medications and supplements. Another type of constipation is when there are when there are injury to the nose supplying the anal canals. >> This can happen in spinal cord disorders. >> Another type of constipation is hormonal where thyroid gland is not functioning properly.
(16:52) Another time type of constipation what what we have strangely observed another type of constipation which patients present with this families of constipation and this is >> so you're saying that genetics >> yes >> okay >> we have identified 90 lakh genes in the world now >> oh my god >> so genetics is also playing a role in constipation Oh, so to summarize >> one constipation mother's not working.
(17:26) One constipation is irritable ball syndrome. >> Another constipation is mothers. >> Another constipation is cancers. Another constipation is nerve disorders, medications, hormonal impances. So these are the concept of these are the causes of constipation and these people are to be treated without fail. >> So I think it's equivalent to any other big disease >> right whether you are a heart patient or a diabetic or anything I think >> taking care of your gut health is one of the most important factors.
(18:04) >> Yeah. Yeah. >> Because uh this can slowly lead to cancer. >> Exactly. >> Yeah. If somebody is constipated, >> it is a signal sending from the gut. Dude, watch out. >> Got it. >> Go to your colarctal surgeon. >> Go to your gastroenterologist. Go to smiles. Meet people and get diagnosed.
(18:28) Why is this happening to you? >> That's the most important thing. >> So you said one out of two mothers experience constipation. >> Yeah. >> Why is that? uh during pregnancy when the mother is uh carrying the fetus in the womb >> there is a demand for iron >> so the oxidation gives iron supplements >> the stool becomes harder during pregnancy the progesterone hormone is released >> so because of that the blood vessels get swollen during pregnancy because of the fetus because of the uterus putting pressure on the veins during pregnancy
(19:14) mother develops constipation. >> Okay. >> So this is one type of constipation lady experiences during pregnancy. >> Okay. So it's common that that you're saying that mostly every everyone >> every mother a childbearing mother who takes this kind of iron supplements >> should ensure that >> they take good amount of water, >> fruits, >> vegetables, fiber, sleep, anti-natal exercises which the obstitrician says should be done religiously so that she will prevent us to becoming heart >> she will prevent prevent the fissures
(20:00) pice and fistulas and absis. So this is during pregnancy mother experiences hard stool >> that is not constipation understood. >> So there is a difference between hard stool and constipation >> during pregnancy it is hard stools. Sometimes it so happens that this mother she would have had constipation for life.
(20:30) >> This mother as a child would not share with anyone. >> As an adolescent girl would not share with anyone. She gets married, she will not share with anyone. Then she conceives. Then the problem she had constipation since childhood >> added to this progesterone fetus iron. >> So it compounds the problem and they land up in our clinic.
(20:56) >> So this is >> pregnancy and constipation. >> Now I understood uh why mothers experience constipation in pregnancy. But why do they come in after pregnancy, post pregnancy? Why are there so many patients coming up? >> Yes. One in two mothers have got constipation related to their child birth. >> So during child birth it may be a C-section or it may be a normal delivery.
(21:26) >> Most commonly seen in normal deliveries every two mothers who have delivered normally one mother has this. Why they have and what kind of constipation they have? There is urinary bladder in the front. There is uterus in the center. >> There is rectum behind back. So that's there in the pelvis.
(21:50) There is a pelvic floor supporting all these things. >> Over a period of 9 months because of the weight of the baby, the pelvic floor comes down. This is called as pelvic floor descent or relaxation. And then what happens? She goes to a normal delivery. During normal delivery because of the because the baby is big during child birth during normal delivery because baby's weight is more than 3 kgs or 3.
(22:26) 5 kgs mother is very short >> and there is a narrow pelvis. Even if the mother is tall sometimes they are narrower than this but a very big baby like 4 plus kgs 4.5 kgs I have seen as big as 4.8 8 kg mother coming to my hospital. So during normal delivery what happens is they told they tell the mother to push >> push and push. When the delivery doesn't happen during pushing they cut it is called as aottomy.
(23:02) I'm sure most of the mothers know this. Number two if it is difficult they take a vacuum and pull it out. Number three, they take a forceps and pull the baby out. Birth can channel is so narrow and 3.5 kg coming out, a big baby coming out. During that time, the urinary bladder also comes down. >> The uterus also comes down and the rectum also comes down.
(23:31) So what is the price they pay for this? Whole life they have constipation. What type of constipation? It is called as obstructed defecation syndrome. Obstructive defication syndrome. Defication is passing stools. Obstructing while passing stools is obstructive defecation syndrome. >> When this happen what do women do? They resort to home remedies.
(24:02) diet, curds, buttermilk, ghee, fruits, vegetables, fibers, >> whatever they do, they're not happy passing stools. While passing stools, the stool will get stuck in the rectum. That time what the mother does is she goes forward like this, she goes backward like this, she goes right like this, she goes left like this.
(24:31) Some others put finger and remove it. Some others keep health faucet that European faucet >> they call it as gun. They keep it and it acts as a stimulant for the stools to come out. They visit multiple doctors. They don't get diagnosed properly. They just given powders, syrups, different laxidos and modification in the diet. Despite doing all those things, the constipation is not good because it is abstracting.
(25:02) The obstruction has to be really not powder syrup but clear. So this is the biggest cause of constipation in women in this country and the world. >> So sir what is the solution to this then? Yeah. Solution is it has to be diagnosed first. >> What is the type of constipation? >> Whenever a patient comes to a doctor with constipation related issue, the most important is the why of constipation.
(25:42) The why of the disease which is missing in India. Why constipation and then treat accordingly. clear. So why of constipation is very very important. >> Okay. So you're saying why >> why constipation? >> Why constipation? >> Is it because of child birth? >> Is it because of mus not functioning well? Got it. >> Is it because of IBS? Is it because of depression? Postpartum psychosis multiffactorial lot of factors.
(26:13) So the why of constipation is very very very important. So for that in that case only a doctor visit can help >> according to me >> any small ailment in the body >> it may be as common as a common cold >> little burning >> little stomach upset little bloating little pain little distension little discomfort your gut is signaling something your gut is interacting with you.
(26:52) Gut is called as the second brain. Listen to your second brain >> and go to a specialist doctor. >> Um now there is chronic constipation and there's occasional constipation. >> Yeah. >> How do you differentiate? In India, the entire population would have used the word constipation at least once in the lifetime. >> Right? >> For people in India, passing a heart stool is constipation.
(27:25) >> It is not constipation. It is an episode of hard stool. Why that? What it means? Lack of fiber, lack of fruits, lack of vegetables, lack of sleep, lack of physical activity, lack of lack of water intake. Lack of water intake >> will cause stools hard. This is hard stools due to lifestyle and this is not called as constipations.
(27:56) So I am making it very clear there is something called as lifestyle constipation which is not constipation which is just episode of heart strokes. There is constipation where 15% of India's population have this and this has to be treated either medication or surgery or physotherapy or any other cause. 44% of India's population have constipation related to their lifestyle.
(28:32) >> So, so talking about lifestyle, how has modern lifestyle make constipation more common? >> Yeah, modern lifestyle and constipation >> very common in India and the world. Every day we get at least five jenzies coming to this hospital, >> right? What is that? These jenzes have got pressure to perform. >> The whole country's future is on jenzes.
(29:02) The responsible people at the same time these jenzes are obsessed with their fitness, >> obsessed with their muscle mass. So these tenzis they don't take food on time irregular food habits junk food processed food ultrarocessed food packed food and they go to gym in the gym protein shakes whey protein protein bars bers and then 25 eggs and then two wings four wings of chicken to build their muscle mass.
(29:38) So this type of people are increasing every day in this country especially among jenzes. So this is the one of the common cause of lifestyle constipation. >> Okay. And what do you think is a sustainable lifestyle to avoid constipation? >> Yeah. To avoid heart stool. >> To avoid heart stool. >> Heart stool. >> Yes. Yes.
(30:03) >> Constipation is something which has to be treated. >> Right. Hot stool is not constipation. Got it? >> It is an episode of hard stool because of lifestyle. >> So how do you prevent this? >> Sleep 8 hours complete happily >> so that next day you perform well. >> Have physical activity at least 1 hour of physical activity for yourself. Love your body.
(30:31) >> Invest in your body cell. Number three, there is fiber shortage in every Indian meal. We need about 25 grams of fiber. >> 10 g shortage we have. So add enough fruits, salad, vegetables in the diet. Number four, do not sit in the washroom for a long time with mobile phone, >> iPad, laptop, WhatsApp, >> email, Instagram.
(31:01) Stop this bathroom camping forever, >> right? >> Avoid the screen time. >> Avoid eating outside. Once in a while you can go on, chill out, >> but not too much of chilling, >> right? [snorts] >> So, water, fiber, >> sleep, >> physical activity can prevent heart stones. Will prevent heart stones. >> Okay.
(31:26) And what do you think about you were talking about uh Jenz's consuming a lot of packaged food for example protein bars and I think a lot of people want to maintain their muscle so they they have a lot of like especially vegetarians have a lot of protein powder and all of that you think that is healthy >> I totally agree muscle mass is very very important for longevity >> right >> if people wants to live longer muscle mass is one of the important in peace.
(31:56) >> That doesn't mean that this Jenz they are just going to build a muzzle mass. They're not going to an Olympic games where they have to win a gold medal. >> Right? >> So because of this Jenz's lifestyle very commonly we see people coming with constipation especially in the people who are born between 1997 and 2012.
(32:23) So we can coin the term jenzee constipation. >> Okay. >> Not constipated. Jenz is jenzee constipation. >> Right. Right. >> Right. >> Right. >> Yeah. >> So you're saying simple home food >> and eating on time, sleeping, drinking enough water >> is the simplest remedy to hard stools. >> These are the basic principles of life.
(32:47) >> Like we have principles of surgery, >> right? Your principles of production, >> your principles of editing, >> there are principles for everybody including our school principal. This is different. >> Right. >> Right. >> So, uh basic principles are water, fiber, fruits, vegetables, sleep, good physical activity and having a balanced diet of carbohydrates, proteins, fats, vitamins and minerals.
(33:18) >> Right. And what do you think about consuming supplements? Do they affect your gut? >> Yeah, supplements. Consuming is supplements. The word itself is telling it is a supplement. >> It is not the core core core >> correct >> core food what we should consume. >> It is only a supplement. So whenever in different age groups when we do analysis of this supplements there are vitamin D deficiencies, vitamin B12 deficiencies, magnesium, calcium, >> zinc and many other minerals deficiencies there.
(34:01) So during this time we give supplements. >> Supplements are not required always if they are present enough in the body. So before taking supplements ensure that you will get your blood analysis very deep. >> So blood work is very important. >> Very very important to do a complete blood workup and then take supplements >> just not pop supplements like food.
(34:29) >> Got it. Got it. And can stress and mental health nowadays like you mentioned a lot of stress is there like in general like because of the social media because the digital age coming in I think everyone wants to just everyone's become anxious in general >> unknowingly >> somewhere >> so because of that there's a lot of stress that is you know >> uh developing even in like young kids.
(34:53) >> Yeah. >> So >> does that impact your gut as well? stress and mental health I think is is something that is talked about now at least you know like earlier people never spoke about mental health and all of that >> but now I think a lot of people are >> talking about it which is a good thing >> but do you think that directly impacts your gut >> yeah mental health >> before few years it was a taboo >> people would not tell that I have a mental illness.
(35:27) >> Correct. Correct. >> Especially girl child they would not want anybody to know because tomorrow the girl child should get married. >> Correct. Correct. >> So mental health and gut are connected directly. >> That's the brain gut axis. >> We see our gut as the we treat our gut as second brain because of the neural networks between the brain and the gut.
(35:52) M >> so mental health, stress, anxiety, gut, constipation, all are connected. >> All are correlated. So if one thing gets affected then it's going to. >> Yes. Okay. >> Uh so what happens to bowel habits as we age? >> Bowel habits as we age. As we age the muscles become weak >> in the gut also we have some muscles.
(36:25) So this muscles also become weaker. >> These muscles also become weak. When this when these muscles become weak the intestine will not contract properly. So during that time in old age people put pressure by passing stools >> and this will lead to constipation. Added to this motility, the contraction which comes off in India, old age people have diabetes, hypertension, mobility is less, they take lot of tablets, they consume lot of tablets,
(37:09) they get dehydrated, they don't drink enough water. And as age progress, as the age progresses, constipation increases. When the constipation increases in old age, they'll end up in fissures, pies, absess and fist. >> Right. So tell me what are the common symptoms for a common man >> to know if they're constipated? Uh if somebody is not passing stools comfortably every morning >> when they spend more than 7 to 10 minutes in the washroom number one.
(37:56) >> Number two ideally at least they should pass tools every alternate day. >> If they pass twice in a week. Number three, if they try finger to bring out the ball, >> the stools, >> the poop. >> Number four, if they try to manipulate like going forward, coming back, going left, going right.
(38:23) Number five, sudden onset of constipation. Young man about 45 years suddenly notices constipation one day and that day they should meet the doctor immediately because this sudden onset of constipation can be due to coloerectyl cancer. >> Okay. Okay. And what about children? Do children notice I mean do you see constipation in children as well? >> Yeah.
(38:55) So these days children have got hard stools. >> Once again I tell it is not constipation. 20% of children in India have constipation from 5 to 15 years age group. In that only 5% have got real constipation which has to be treated. >> The remaining are simply lifestyle constipation. Children these days very demanding. There is no physical activity.
(39:27) There is always on a screen. They they're always on a mobile. In fact, the screen usage happens as early as 2 months, 3 months. Young little babies, the culprits are the mothers. >> Why they tell that? They have to feed the child. The child doesn't eat if skill is not shown. So it becomes an habit.
(39:58) This habit goes on will go throughout the life and they're always with mobile and using mobile for a long time. Screen time very disastrous it is. So children why constipation? Why hard students? >> Children don't do physical activity. >> Children have got irregular sleep habits. Children eat pizzas, >> burgers, KFC, fries, piri, lace, kur, chips.
(40:30) Even for the lunch box, you see these kinds of stuff going into the children. So these children have heart stones. They land up in fissures, piles and fistulas. If they're not handled in early stage, >> they may end up in ulcerative colitis and chron disease which is a very bad disease. This can lead to colurectal cancers.
(40:57) Got it? >> Yeah. Yeah. >> Children they start screen time then after that junk food, packed food, processed food, it goes on whole life then they'll end up in IBD then colurectal cancer. So this is constipation in children because of lifestyle >> right >> second thing is 5% >> I told they have to be treated >> in that the most common thing is the synergy is not there between abdominal muscles and the rectal muscles >> number one number two children in their born they've got absence of some nerves in the gut because of this their
(41:41) Constipation early first day there is something called as imperforate anus. The anal canal is closed. It is not open. On the very first day we operate on this little one day infant. Okay. So children with constipation for a long time. Parents blame children that he doesn't come out of the washroom. parents blame children he or [snorts] she child doesn't take water fiber fruits vegetables parents complain they watch lot of screen time there are a lot of screen time actually this child will be suffering from
(42:25) constipation the child will tell mama I got constipation mother says you don't drink water you don't drink fruits that is why you have constipation. When any child says that my stool is s, I've got constipation, please take it seriously and bring them to a doctor. >> Just don't brush it away by telling you're not playing, you're not drinking water, you're not drinking, eating fruits, you're not taking fiber, you're not sleeping on time.
(42:56) Yes, we do agree these are there. But beyond that, does the child have constipation or not? It has to be evaluated [clears throat] here. One bureaucrat came to me and told >> I have constipation since childhood. Yes. As early as 5 years, 6 years, 7 years. He is 41 now. >> And he comes and says this is what my life is. And after we do a series of investigation, we found out why it is.
(43:31) The next day this mother comes >> sir is there anything else my son has got because if you can't tell that in front of my son please tell me oh he does not have a colon cancer >> okay >> understood >> and the mother >> cries my child was telling I have heart stones my child was telling I sit for a long We thought that child is not taking vegetables, fruits, fiber, water in adequate quantity.
(44:11) We met many gastroenterologists across the country. It was not diagnosed. It was diagnosed. It was diagnosed here. He asked me why it was not diagnosed anywhere else. >> Understood? >> So whenever the take-home message is what? Whenever child struggles with past stools, when a child spends lot of time in the washroom, when the stool is hard, instead of blaming the child, be accountable, be responsible for your child.
(44:45) Be responsible for your child and bring them to a specialist immediately without delay. I think that's a very important message because I think anything related to the gut whether it's constipation or any other uh diseases >> we just have that mindset like you said it's it's a taboo that you know it's still a taboo where we kind of neglect it >> and neglecting it from a young age can cause >> cancer and and it can actually like >> uh you know be such a danger like I think People are not aware of this.
(45:19) >> Yes. >> People are not at all aware of what you know they're doing to themselves or their children. >> Yeah. >> So yeah. And um they also say that a lot of women are more constipated. Like percentage of women being constipated is higher. Is that true? >> Yes. Women suffering from constipation is more when compared to men.
(45:44) >> But why is that? There's a book called men are from Mars, women are from Venus, >> right? >> Because of the hormones they have. Clear. Number two, women after normal delivery, she develops obstructive defecation syndrome. Women after normal delivery or a C-section with a big baby develop obstructive defecation syndrome which is a different type of constipation.
(46:20) It has to be corrected. >> So women are more because they deliver a child. >> Got it? >> They gift a child to planet. >> Is there any link between cancer and constipation? Cancer and constipation, >> sudden onset of constipation. A person who leading a comfortable life without any problem, one day suddenly there is constipation.
(46:51) He's not able to pass the stools. >> So what happens here is we have large intestine which is 1.5 m in length. M >> anywhere in the large intestine if there is a colon cancer or a rectal cancer when the cancer becomes so big you completely close the lumen of the intestine >> the tube >> the coils. So when that happens they develop sudden constipation.
(47:21) So any sudden onset of constipation people should not neglect they should visit a colctal surgeon immediately. Constipation means what? The whole fecal matter the poop is blocked somewhere in the intestine >> right? >> It is stuck in the large intestine. When this happens because of chronic irritation, the layman terms people can develop leaky gut syndrome.
(47:54) Constipation may be one of the causes of coloctile cancer. >> Constipation is one of the causes of diverticulosis in the sigmoid colon. >> Some kind of pits. So constipation should not be neglected. Constipation can be very fatal if not treated on time especially colctal cancer. >> Right. So do you have any message for the common man uh which you know can make them more aware or anything related to constipation that you want to address the common man? uh for a anybody it may be child it may be
(48:44) adolescent child it may be jenzi it may be millennial it may be baby boo any age groups >> if they don't poop properly in the morning the day is gone so if they have repeated symptoms like this it is ongoing for a certain period of time say about 2 to 6 weeks >> they should consult a colurectic surgeon immediately.
(49:16) >> Got it. >> Right. That too if constipation is associated with weight loss along with constipation if there is a loose stool diarrhea along with constipation if there is a bleeding in the stools along with constipation if there is a pain abdomen along with constipation is if there is a distension >> or bloating not two weeks sir even two days sir even two hours sir even 2 minutes sir they should not waste they should consult doctor immediately if it is associated with all these things.
(49:59) So constipation and loose stools, constipation and pain abdomen, constipation and bloating, constipation and bleeding in the stones. All these are red flag signs. >> The gut is communicating to the brain that red flag traffic is there now. >> Traffic is jammed now. Please go to med surgeon immediately. >> Uh so sa how should constipation ideally be treated? Yeah, constipation uh should not be treated by powders, syrups, diet, lifestyle >> and all these things.
(50:41) Basically, constipation treatment depends on type of constipation. As I said the first type of constipation where the muscle incoordination is not there >> where the synergy between the abdominal muscles and the rectal musles are not there. This type of constipation should be diagnosed first >> what type of constipation it is and then for this particular type of constipation we do a bof feedback feed to the brain. So bio feedback.
(51:15) So we train the particular patient suffering from constipation 10 weeks sir. >> Okay. >> One week 1 hour we do physiootherapy for these people. In 5 weeks 70% is done. >> Okay. >> In about uh 8 weeks 90% is done. In 10 weeks time the decad's problem is completely relieved. What we see is people don't know what is the type of constipation this particular person has.
(51:46) So if they have constipation the only thing what people do is powder, use syrup, lifestyle modification, sleep, physical activity. >> So majority of the people who come to us say sir I do all but I still have constipation. >> So these are the kind of people where you have to diagnose what type of constipation it is.
(52:07) The next type of constipation as I said it is because of irritable bowel syndrome. >> Here we generally practice a deep dive into their gut health >> and see the link between brain gut access and then treat this with some good bacteria >> which is a prebiotic okay and then treat them with tablets. this IBS constipation will settle down.
(52:36) While treating IBS constipation, we tell patients to be mindful >> in what they're eating, meditation, physical activity to just calm down. Clear? >> Right? >> Second type, the third thing what I said is obstructive constipation in case of cancers. Here cancer has to be treated. Another type of constipation where people take lot of medications for depression, anxiety, epilepsy.
(53:05) These people get constipation. This is linked to lifestyle constipation because of the tablets. This side effect of tablet is constipation. >> Along with these tablet, we tell them to have a good fiber, good sleep and good physical activity. Another type of constipation where mothers have >> pregnant mothers >> here a pregnant mother throughout 9 months of her pregnancy she should take more water because the demand is more more fiber more fruits more vegetables sleep and physical activity.
(53:44) The post pregnancy constipation. The post pregnancy constipation. First we should assess what is the degree of ecto that is the rectum coming down. If it is mild we do physiootherapy and fix it. >> If it is moderate moderate means then the mother has got symptoms. >> Symptoms means what? putting finger in taking it out >> right >> going forward coming backward going right going left some kind of manipulation if the mother does then this is the ideal case to correct through a simple minimally invasive procedure
(54:28) and then uh we have people with old age with constipation for that particular old age we give tablets so that gut motility the gut will contract relax, contract, relax and they pass to comfortability. >> Right? >> Another variety is constipation related to the nerves >> where the nerves supplying the rectum are damaged in various conditions.
(54:53) For them also we do physiootherapy. We for them we do something called as nerve stimulation by physio. So this is the way constipation is treated. So in one word when people come with constipation >> we have to find out what type of constipation it is >> right >> the treatment depends on the type of constipation. Constipation cannot be treated by powders, syrups, home remedies and quax.
(55:25) Constipation is a serious concern. It has to be treated. It can be treated completely by specialist in gastroenterology or colorectile disorders. Constipation is one thing the gut is giving signal to your brain. Do go to your consultant and get checked why constipation. So the why of constipation is important for you.
(55:50) >> So what is gut health and how is it related to diseases and longevity? >> Yes, gut health. the gut of the human being. Generally the gut is the large intestine is what people talk >> and it is large intestine. >> Uh in the human gastrointestinal system >> we have bacteria >> they are called as gut microbiota.
(56:23) 99 99% of gut bacteria are there in large intestine. >> Remaining 1% remaining 1% are from mouth to anus anal canal entry to exit >> it is 30 ft. So in that in this 30 ft highway >> from entry to exit >> various gut bacteria present >> right >> so they are present in large intestine 98 to 99% and there about 100 trillion bacteria in the gut 100 trillion means what
(57:08) >> one followed by 14 zeros >> as Brian Johnson stated as everyone knows that uh he's working on his longevity and I want to know if longevity is connected to gut health. Uh yes sir. All these days in India or in the world >> we were talking about lifespan >> right >> today in India average age of men >> 70 years daily >> women is 73 years >> okay >> it's not about lifespan now it is about health span >> right >> it is not important how long you live is very important how healthy you
(57:56) Right? >> So longevity is connected to gut bacteria. >> Right? So now at the genomics level, >> advanced genomic levels, we sequencing all the genes >> and predicting what kind of disease this person will get and we do intervention. >> This is done at smile instead of gastroenterology. >> Okay.
(58:22) So what we do there we go very deep dive into the genetics. We will figure out all the risk factors for modern diseases like diabetes, hypertension, certain cancers, malabsorption, gut issues, anxiety, depression, mental health, stress. All these things are connected to gut bacteria. It is because of this bacteria in the gut which are living beings who will take care of us.
(58:57) >> The gut bacteria is not taken care of properly then they will not take care of us properly. They give different diseases >> right? >> So longevity is linked to gut bacteria. What kind of bacteria we have? Longevity is linked to genes. In some people they are more prone for certain genetic diseases.
(59:19) Then we do intervention and ensure that the disease is not transmitted to the next generation. So longevity and gut health, lifespan and gut health, health span and gut health are connected. So it's very very important to keep the gut health clean, neat. And how do we improve that as in what is the kind of lifestyle that we need to follow to maintain that gut bacteria? >> Yeah.
(59:49) >> And improve your gut health. >> Yeah. Uh very simple. People have made it complicated >> regarding what to eat. The most important thing is what not to eat. >> Okay. >> How does it what not to eat define? Once again we are doing a genetic analysis. Some people come to us and say I can't eat chapati. >> Some say I can't eat rice.
(1:00:19) >> Some say I can't eat certain types of dals. I get bloating. I get allergies. We do endoscopy colonoscopy and find out it's normal. Then we went to genetic analysis. Certain genes can tell that why certain people are preferring certain types of food habits. >> For example, if it is me, >> my genetic analysis done such a strong correlation. I don't like knowledge.
(1:00:51) >> I don't like safe food. So in my genes, it says this person doesn't like knowledge. This person's gut will not fit. So all the while before doing uh analysis I was in different kind of world today I know what to eat what not to eat. >> So you're saying that once you test when you do these tests is when you [clears throat] actually get to know what your body rejects >> exactly and what it accepts.
(1:01:18) >> Exactly. >> For example >> is somebody is allergic to gluten. >> Gluten is a protein which is present in the wheat. M >> so this gluten allergy people have >> the moment they eat any wheat products they get bloated the moment they stop wheat products they're comfortable so what type of foods to eat what type of foods not to eat it's a complex thing >> right >> the basic thing is not everybody in India can can afford this genetic analysis >> this genomic sequencing >> and identify which genes is responsible for that M
(1:01:57) >> it's very common if somebody who cannot do this >> steeple diet in the country in India >> as you travel every 100 kilometer >> the food changes >> correct correct correct >> so I have a different staple diet gujaratis have a different staple diet >> tamilians have a different staple diet >> so let's stick on to a staple diet and not make it complex >> so what our ancestors have been eating is what to follow.
(1:02:27) >> Yeah. >> And that's going to impact your body. >> Yes. >> Uh we are what we eat, >> right? >> Yeah. >> Right. >> Yeah. >> Our body is the biggest real estate. >> Our ran for says this, our body is biggest real estate. >> So we are we we are what we eat. So when we eat, people are eating like a gutter. M >> so they dump everything they want in their gut instead of becoming gut it be it becomes gutter if guts are not taken care of properly we have to treat their butts >> so I mean I feel like a lot of people are following western diets now a lot of
(1:03:12) Indian people are following western diets >> coming in from the west uh where where it's like micili uh you know a lot of oats package stuff I mean I feel like Indian diets in any region didn't have any of this like here we in the south we have idli >> sambar dosa all of that in the north there's something else >> so I'm just saying that um will that also impact you know like your gut in in in the sense like can we adapt to diets from different regions the so-called healthy diets or is it is it best to adapt to what your
(1:03:49) ancestors did coming back to what you said >> yeah Whichever part of the world you live, >> what we eat, >> we eat proteins, >> we eat carbs, >> we eat fats, >> right? >> We eat minerals, >> right? >> We eat multivitamins. >> Okay, >> this is the basic. >> Whatever we eat, what are the pilot taste? That's different story.
(1:04:11) [clears throat] >> Every part look in the entire globe, >> what we eat is only that, >> right? >> Correct. Correct. >> Okay. Number two, >> every 100 kilometers in the globe only the type of food and the taste changes. >> Clear? So now uh as I said we are what we eat, >> right? Instead of making it very complex, the staple diet, the balanced diet what we did in school, >> the balanced diet, uh if you go to say for example uh uh some regions across India, they have a very balanced diet.
(1:04:52) They have fiber, they have vitamins, they have minerals, they have probiotic, they have prebiotic, there is curd, there is buttermilk, there is uh ghee, >> there is um butter. So all these stuff. >> So basically it should be inclusive. >> Yeah. >> And have balance. >> Yes. Whichever part of the world people live, whichever part of the country people live, the most important is the balanced diet.
(1:05:23) >> Carbohydrates, proteins, fats, minerals, vitamins, all in good proportion. >> Right. >> Right. [snorts] >> So this is one. >> So, so some people they have a great lifestyle. They eat like balanced diets and you know even work out and all of that. Then why do they have a poor gut? >> Yeah. Uh we are what we eat as I said >> the most important thing is the food what we eat it should be absorbed properly >> right >> so in India what is the practice somebody's weak somebody's lethargic somebody is tired they come to a doctor
(1:06:07) and they give a blood sample doctor sees vitamin D deficiency vitamin B12 deficiency calcium deficiency. >> So India is a deficiency capital of the world. >> Really? >> India is a protein deficient country. >> The amount of protein what we take in our diet is very very less. >> Yes. >> So when this happens a doctor does vitamin D deficiency take vitamin D.
(1:06:37) Vitamin B12 take injection shots. Calcium deficient take calcium. This is not a way to treat a disease. This is not the way to treat gut health. We should see why vitamin D deficiency, >> why B12 deficiency, why mineral deficiency, why multivitamin deficiency. Again the way of disease is very very important.
(1:07:07) People come and tell us I take balanced diet, I have a great sleep, I do physical activity but still I'm feel lethargic. diet and they're deficient. >> That's because your gut is simply not absorbing what we eat. Why is that? Because the gut lining is already damaged. When we do a genetical analysis and go deep dive into it, we will come to know which specific vitamin is deficiency in that. It is vitamin B12.
(1:07:36) They give B12 shots. >> Actually, it is not. So there are different types of vitamin B's. We analyze at the genetic level. We go very deep and do only that particular vitamin supplement. This is called as precision medicine. So we are moving from a reactive health care >> to a proactive health care.
(1:08:05) What is a reactive healthare? Reactive health care is going to a doctor when somebody has got constipation. >> Going to a doctor when somebody's bleeding. Waiting for a long time when the until the disease progresses. This is reactive health care. You react only when something happens. Here proactive health care >> is more on the prevention side.
(1:08:31) It is always said that prevention is better than cure. So proactive is what? Right from childhood you should be responsible for your body. >> You should be accountable for your body. Right from childhood till they go to the tomb from zero to 100 years. >> We have to be proactive in taking care of our health.
(1:09:00) So this body as I said a very rich real estate invest on this. The returns are very high from our body >> compared to any other investments like gold, silver, stock market, mutual funds, real estate, bitcoins, blockchain. Body is the biggest real estate. Invest on the body. >> Means what? Be proactive in your health. >> Means what? every year go for a proper deep dive into entire system >> because I preferably say that don't wait until 40 30 20 no adolescent chits kids are to be addressed because there multiple issues
(1:09:46) some have got ADHD >> some some have got great cognitive skills until I did my genetic analysis I did not know I was wondering how can how much how how come I have so much of cognitive skills then I realized when I did my genetic analysis because of one particular hormone I've got that so gut bacteria is linked to longevity gut bacteria is linked to cognition >> gut bacteria is linked to anxiety depression and psychosis so gut bacteria will predict what kind of disease the person will Right.
(1:10:26) >> Putin the president of Russia >> wherever he goes when he poops esteemed will collect all the poop and go after washing clean clean because they don't want the world to know what kind of disease Putin will get in the future. >> They don't want to know what kind of bacteria Putin has got. So poop is a valuable asset in our real estate of the body, >> right? >> So poop is like a prime commercial location.
(1:11:02) >> Your poop decides value of your body. >> Your poop decides the value of real estate, >> right? Uh and so what happens if constipation is not treated? >> Yeah. Constipation is mother of all diseases in the colon. >> Okay. Constipation is mother of all diseases in the large intestine. All the diseases in the large intestine.
(1:11:28) What will happen if it is not treated? They develop fissures. >> Fissures may get infected and form an absess. This absis will open and form a fistula. >> And this chronic constipation will disturb the life every day. It is not life-threatening. It is life disturbing. If not addressed on time, it may be life-threatening also.
(1:11:56) So constipation is the mother of all diseases. If it is not treated, piles, fissures, absess, fistula, polyp, devoticula, IBD, leaking, leaky gut syndrome and colic cancers. Plus it will suppress human being. They lose solid prime working hours. >> They spend in the washroom only early morning. We say make or break before 8:00 a.m. in the morning.
(1:12:28) Before 8:00 a.m. they're only breaking their head to move the bowel. So if the bowel is not cleared properly, nobody can perform their disturbed their agitated and real constipated. We can make out whether this person has got constipation not by behavior in the office. We ask are you constipated? So let's talk about piles, fissure, fistula, absis, polyp, colon cancer and IBD.
(1:13:03) >> Doctor, can long-term constipation lead to serious problems like piles or cancer? >> Yes, very much. Long-term complications of constipation or piles, fissures, fistulas, absess, colon polyp and later colon cancers. If someone sees blood while passing stools, is it something serious or is it is it piles? >> When someone sees blood in the stools, it's like a traffic signal.
(1:13:33) Red light, stop. Go to the gastroenterologist. It can be piles, it can be fissure, it can be IBD, it can be coloerectile cancers also. >> A simple bleed should not be neglected. Doctor, if someone sees blood in their stool, is it piles or is it something serious? >> If somebody notices blood in the stools, it can be as dangerous as a colal cancer, just not pile, fissure and fistula.
(1:14:01) >> Doctor, why do people feel that sharp pain during stool? Is it fissure? Sharp pain during stools can be fissure can be absess inside can be a track inside can be due to fibractalis syndrome. >> Doctor what happens if piles are ignored for wrong. >> If piles are ignored for a long time they lose blood and in some cases it has bled to death.
(1:14:32) So don't neglect piles get treated immediately. >> Dr. How does a fistula start from small issues? >> 90% of the fistula start from small issues. 10% are different. This 90% it is as simple as sitting in a most cleanest washroom in the world >> has got bacterial colonies. When you sit in the European commode infection can from come from below.
(1:14:56) People who are constipated when they strain when they put pressure bacteria goes inside the anal glands and forms synapsis absesses related to a fistula. >> Uh doctor can symptoms like piles or bleeding uh can they be mistaken for colon cancer? >> Yes. The myth is piles will lead to cancer. No, piles will not lead to cancer.
(1:15:28) If colon cancer is there, it may be mistaken for piles. >> Dr. Young people with bad eating habits prone to piles. >> The younger generation, the Gen Z generation, they are having regularly irregular food. >> They're having regularly irregular sleeping habits. They're having regularly irregular in their physical activity.
(1:15:53) For Gen Z, everything has become regularly irregular. So they are more prone to fissures. Piles absess fistulas. >> And does that lead to colon cancer as well? >> Pile fissure does not lead to colon cancer. A fistula if not treated for a long time 2% will go to cancer. It is not a colon cancer. It is a different type of cancer which is seen in fistula.
(1:16:22) >> Doctor, the younger generation are they prone to colon cancer? Yeah, >> the younger generation it's just not colon cancer. They are prone to many different types of cancer but the commonest is colon cancer. In America by 2030 there'll be a 30% increase in colon cancers in 30 years age group. in India we will see 30 years from today.
(1:16:48) >> So doc uh people of the younger generation with bad eating habits are they at a high risk of colon cancer? >> Uh it's just not colurectal cancers the younger generations are coming with many different types of cancer. One among them is colurectal cancer. In that two colonal cancer, the rectal cancer the younger generation are coming.
(1:17:18) So the cancer is not sparing anybody because of the lifestyle and beating habits. >> Doctor, can uh home remedies cure piles of fissures? >> The most disastrous, dangerous, fatal, grave mistake is to go for home remedies. Home remedies will not cure any disease. Forget about piles, fissure and fistula. Home remedy is having a good homemade complete diet.
(1:17:48) That is a home remedy for your real estate body. >> So doctor, when should someone with constipation, pain or bleeding see a specialist? So whenever there is constipation, whenever there is pain, bleeding, burning, puss, diarrhea, mucus in the stools, blood in the stools, immediately they should consult a doctor. >> What is the biggest mistake that people make with piles, fissures or fistulas? >> Biggest mistake what people make is they feel embarrassed.
(1:18:21) >> They feel it is a taboo. they feel they'll be stigmatized. So biggest mistake is not sharing with family. Biggest mistake is not going to a doctor which can be fatal if they don't go early. >> Uh so doc a quick question. Uh they say that once piles are operated it comes back again. >> It's false if piles is treated with a root cause by piles it will not come back again.
(1:18:52) We do laser procedure for pies. It will not come back again. >> So doc, I've heard this a lot that even after multiple surgeries, it fistulas come back again. Why is that? >> Yes, true. We have seen a person getting operated by 14 times. Fistula comes back again because it should be removed from the root. The root cause has to be analyzed. A colonoscopy has to be done.
(1:19:16) Any scan has to be done. So if fistula is operated by an expert surgeon, it will not come back again. >> So doc uh does piles run in the family or is it a genetic disorder? >> No, piles does not run in families. It's not a genetic disord disorder. It's not a genetic disorder. People in the family they have a same lifestyle.
(1:19:42) They have same eating habits. They have same sleeping habits. Because lifestyle is same people get piles fure absin fistulas. It doesn't run in families. >> Doctor, what are the different kinds of diseases that run in families because of gut health? >> Yes. If somebody has a colal cancer in the family, there is more chance of the next generation getting colonal cancer.
(1:20:07) IBD, inflammatory bowel disease, inflammatory bowel disease, leaky gut syndrome, ulceric colitis and CRS disease can be genetically transmitted. Polypips can be genetically transmitted but not by fusion fula. >> So doc today globally a lot of people are they having like seated jobs they like for example software engineers.
(1:20:32) >> Yeah. >> What are the remedies for this? tech >> uh it's very clear every professionals who will sit for a long time and work they should take break every 1 hour just a 2 minutes break getting up from the chair relaxing and coming back and sitting can prevent piles physone absess >> so doctor is pile sexually transmitted >> no pile is not sexually transmitted it's a myth even today many people think that It is sexually transmitted and they don't seek a doctor's help or advice.
(1:21:11) It is purely lifestyle. This purely constipation but not sexually related. >> Doctor does piles impact sexual life. >> The sexual activity happens in the pelvis felt in the brain. So somebody's got a fissure fistula absis pice either men or women it'll impact very badly they should fix pice fur and fistula absess immediately so that it doesn't impact their personal life or life of intimacy >> doctor do bisexuals which means the LGBTQ community do they get piles fissures or fistulas easily the bisexuals,
(1:21:59) the LGBTQs, their way of intercoses through the anal canal. So while they use the anal canal for intercourse, if there is no proper lubrication, they get fissures, they get twice, they get absess, they get fistulas. Human being has explored 14 different types of intercourse methods including animals.