Severe Bloating from Fibroids

When fibroids become enlarged, they may press on the surrounding organs, including the bowel. This sometimes leads to constipation, resulting in slower bowel movements and blocked intestines. A woman may feel bloated or complain of a feeling of 'fullness'. If you do experience constipation as a result of fibroids, you may consider a stool softener.

Where a fibroids diagnosis has not be given, but you continue to experience abdominal bloating, constipation and weight gain, ask your doctor for a pelvic examination. These are also signs of ovarian cancer.

Some women may have uterus the size of a 4 to 5 month pregnancy with several large fibroids. The upper abdomen will get severely bloated and tight at times. You will feel like it is going to blowup when the pressure gets severe. Size of the fibroid can be very large fibroid making women's uterus the size of a full term pregnancy.

Some patients experience inconsistency in the sizes of fibroids. "I can put on a pair of pants in the morning, and they'll be too tight by the end of the afternoon if I'm on my feet too much. Yesterday, I scrubbed my bathtub and felt horrible for the rest of the day. One day constipation... the next diarrhea. Today I hurt all the way from my lower back all the way to my thighs... it's really gotten much worse in the last couple of weeks. And feeling like "something is going to drop out of me...." said one of the patients. 

I too feel really "full" at times. But I have found with moving or walking a bit it "moves" and the pain is easier. Not sure if this makes sense. My fibroids have my uterus about 4 months pregnant size. I also am finding I need to go to the bathroom more often, possibly pressing on my bladder now. And I too have had the diarrhea for "no reason". Mentioned another patient. 

Treatment 

Small fibroids do not usually require any treatment. If fibroids are small, they will be monitored regularly and treated only if they grow in size. If a fibroid causes a significant amount of pain, over-the-counter or prescription pain relievers may be used to reduce the severity of the pain. Low dose birth control pills may also be used to maintain hormonal balance and stop the growth of fibroids, according to Women's Health. A medication called a gonadotropin releasing hormone agonist may be given to decrease the size of fibroids. If medications are ineffective or the symptoms of fibroids interfere with daily life, surgery may be needed.

A myomectomy is used to remove only the fibroids from the affected area of the uterus. If there are a large number of fibroids present, a hysterectomy, which is the removal of the entire uterus, may be necessary.

Removal of the uterus renders the patient unable to bear children (as does removal of ovaries and fallopian tubes) and has surgical risks as well as long-term effects, so the surgery is normally recommended when other treatment options are not available or have failed. It is expected that the frequency of hysterectomies for non-malignant indications will fall as there are good alternatives in many cases. The video below shows how a large intramural fibroid was removed by Dr Vijayavel.

Women's cancer : Ovarian cancer

 

Overview 

Ovarian cancer accounts for approximately 3 percent of all women's cancer and is the fifth leading cause of cancer-related death among women in the United States. In 2014, it is estimated that nearly 22,000 women will be diagnosed with ovarian cancer in the United States, and approximately 14,000 will die of the disease. Ovarian cancer incidence rates declined by nearly 1 percent annually from 1987 to 2011; mortality rates fell an average of 1.6 percent each year from 2001 to 2010. White women have higher incidence and mortality rates than women of other racial/ethnic groups. To avoid these cancers, it's important to understand them.

The most common type of ovarian cancer is called ovarian epithelial cancer. It begins in the tissue that covers the ovaries. Cancer sometimes begins at the end of the fallopian tube near the ovary and spreads to the ovary. Cancer can also begin in the peritoneum and spread to the ovary. The stages and treatment are the same for ovarian epithelial, fallopian tube, and primary peritoneal cancers.

Another type of ovarian cancer is ovarian germ cell tumor, which is much less common. It begins in the germ (egg) cells in the ovary. Ovarian low malignant potential tumor (OLMPT) is a type of ovarian disease in which abnormal cells form in the tissue that covers the ovaries. OLMPT rarely becomes cancer.

Cancers of the ovaries, fallopian tubes, and primary peritoneum are the fifth leading cause of cancer death in women in the U.S. These cancers are often found at advanced stages. This is partly because they may not cause early signs or symptoms and there are no good screening tests for them.

This cancer usually occurs in women over age 50 but can affect younger women. It causes more deaths than any other women's cancer of the female reproductive system and is the leading cause of death from gynecologic cancer in the developed world. Its cause is unknown. 

Ovarian Cancer Symptoms 

Symptoms include:

• Bloating or pressure in the belly
• Pain in the abdomen or pelvis
• Feeling full too quickly during meals
• Urinating more frequently 

These symptoms can be caused by many conditions that are not cancer. If they occur persistently for more than a few weeks, report them to your health care professional.

  

Prevention

Each time you ovulate, your ovaries are damaged by the egg as it breaks through the surface of the ovary and is released into your reproductive system.

The cells that make up the surface of your ovaries divide and multiply rapidly to repair the damage caused by the egg. It's this rapid cell growth that can occasionally go wrong and result in ovarian cancer.

Anything that stops the process of ovulation can help to minimise your chances of developing ovarian cancer. This includes:

• pregnancy and breastfeeding
• the contraceptive pill
• hysterectomy surgery (removal of the ovaries)
• Tubal ligation is having the fallopian tubes tied surgically to prevent pregnancy.
• A salpingectomy, which is the removal of the fallopian tubes, is also sometimes recommended for women with a risk of ovarian cancer. 

You cannot control some things that put you at risk for ovarian cancer, such as your family history or inheriting gene changes. But you can make some personal choices that lower your risk of cancer and other diseases.

• Eat a healthy diet with plenty of fruits, vegetables, and whole grains.
• Be active. Talk with your doctor about what kinds of activity and how much activity would be good for you.

If you are at a very high risk because of your family history, you may want to have gene testing. Women at very high risk because of inherited genes may want to have surgery to remove their ovaries and fallopian tubes. This is usually done between the ages of 35 and 40, or when women are finished having children. Having this surgery greatly reduces a woman's risk for ovarian cancer, but it will cause a woman to start menopause early, which may have other risks.  

Angiogenesis

Researchers are working on therapies that target the way ovarian cancer grows. A process called angiogenesis involves the formation of new blood vessels to feed tumors. A drug called Avastin blocks this process, causing tumors to shrink or stop growing (seen in the illustration here). Avastin is approved for other cancers, but ovarian cancer researchers are still testing this therapy, which can have serious side effects. 

According to the American Cancer Society, eating right, being active, and maintaining a healthy weight are important ways to reduce your risk of cancer as well as other diseases. For the American Cancer Society's for diet and fitness, please visit www.cancer.org.

What is the difference between Kista Endometriosis and Ovarian Cysts?

KISTA ENDOMETRIOSIS

 

Kista Endometriosis is a condition in which tissue similar to the lining of the uterus is located outside the uterus. Usually there are implants of this tissue in the pelvis. When the lining of the uterus bleeds during the menstrual cycle, these implants also bleed. This causes pain and scarring in the pelvis. The other pelvic structures react to this bleeding by becoming adherent to each other so that tubes, ovaries and intestine are stuck together. If the endometrial tissue is within an ovary, that ovary will fill with blood. These are called endometriomas and are cysts in the ovary filled with old blood. This old blood has the appearance of thin chocolate or motor oil. They are also called chocolate cysts of the ovary. Endometriomas are frequently found at surgery for ovarian cysts. An elevated Ca-125 is often associated with endometriosis. (Source: William M. Rich, M.D. Clinical Professor of Obstetrics and Gynecology, University of California, San Francisco, Director of Gynecologic Oncology, University Medical Center, Fresno, California).

A video explanation on Kista endometriosis and its symptoms:

https://www.youtube.com/watch?v=yM88T1R8HD4

OVARIAN CYSTS

 

Ovarian cysts are fluid-filled sacs in the ovary. They are common and usually form during ovulation. Ovulation happens when the ovary releases an egg each month. Many women with ovarian cysts don't have symptoms. The cysts are usually harmless. (Source: Cheryl B. Iglesia, M.D., FACOG, Professor, Department of Obstetrics and Gynecology, Georgetown University School of Medicine; Director, Female Pelvic Medicine and Reconstructive Surgery, MedStar Washington Hospital Center; Food and Drug Administration Advisory Committee).

A video explanation on Ovarian Cysts and its symptoms:

https://www.youtube.com/watch?v=X8N4M_2dJh0 

Why are so few major gynaecologic procedures performed laparoscopically?

The answer is relatively simple. Major laparoscopic surgical procedures are difficult for most gynaecologic surgeons to master. The gynaecologist must perform many simple laparoscopic procedures to develop the skill necessary to perform the more complex surgeries. They must perform these procedures on a regular basis to develop and maintain expertise. As a result, unfortunately, most gynaecologic surgeries for benign disease are still performed abdominally, although experts throughout the world agree that the vast majority could safely and efficiently be performed laparoscopically. However, it is important that the patient understand that these procedures should be performed by a qualified gynaecologic oncologist who has experience in the proposed procedure either using traditional surgical methods or Laparoscopic surgery.

The surgeries shown in the video clips are entirely done by Dr Vijayavel and my experienced team at KPJ Klang Specialist Hospital.

Dr Vijayavel's laparoscopic surgery removing kista endometriosis:

https://www.youtube.com/watch?v=2GYdq72zwaY

Dr Vijayavel's laparoscopic surgery removing ovarian cyst (gangrenous):

https://www.youtube.com/watch?v=i2R61IuVHao

Further interesting viewing: 

World's largest ovarian cyst. https://www.youtube.com/watch?v=l8AvIJKBb1M

Giant ovarian cyst or pregnant? https://www.youtube.com/watch?v=rZLk0UQJVoI

Ovarian Cysts

Ovarian cysts: These growths can develop in a woman during her reproductive years. They can cause torsion (twisting), infection, rupture, and cancer. These dermoid cysts can be removed with either conventional surgery or laparoscopy (surgery that uses small incisions and specially designed instruments to enter the abdomen or pelvis).

Many women have ovarian cysts at some time during their lives. Most ovarian cysts present little or no discomfort and are harmless. The majority of ovarian cysts disappear without treatment within a few months. 

What causes functional ovarian cysts? 

A functional ovarian cyst forms because of slight changes in the way the ovary makes or releases an egg. There are two types of these cysts: 

• A follicular cyst occurs when a sac on the ovary does not release an egg, and the sac swells up with fluid.

• A luteal cyst occurs when the sac releases an egg and then reseals and fills with fluid.

Further viewing: 

 
Complication Ovarian Cyst (Gangrenous)
Laparascopic Endometriotic Cyst Removal
Other videos : http://www.caringgynae.com/video.html

Women's Health - Pregnancy Care

Pregnancy care consists of prenatal (before birth) and postpartum (after birth) healthcare. 

It usually consists of regular prenatal visits to monitor the wellbeing of the mother and baby as the both of them go through the journey to birth and identify any complications before they become serious.

Some doctors also have a provision for clinics after office hours at no extra charge to facilitate visits by the working mother.

Pregnancy Care and supplements? 

"It will be beneficial to take folate three months prior to conception. This reduces the occurrence of neural tube defects like spina bifida significantly. Some women may also want to take calcium and DHA as part of their supplementation." says OB-GYN Dr. Vijayavel, at KPJ Klang Specialist Hospital in Klang, Selangor.

Neural tube defects develop in the first 28 days after conception, before many women know they are pregnant. Spina bifida is a type of neural tube defect (NTD) that affects the spine, or spinal cord. With this condition, the neural tube does not close completely.  

Myelomeningocele is the most serious type of spina bifida-a sac of fluid with part of the spinal cord comes through an opening in the baby’s spine damaging the nerves. Neural tube defects happen in the first month of pregnancy, often before a woman even knows that she is pregnant. (http://www.mothertobabyca.org/)

"The three most widely prescribed nutrients, are folic acid, iron and calcium," says Dr Vijayavel.

Folic acid is a water-soluble B vitamin. Folic acid helps prevent neural-tube defects; iron is important for the delivery of oxygen to the baby and prevents anemia in the mom; and calcium helps build your baby's bones and prevents bone loss in the mother.

It is recommended pregnant mothers shall take a 400 microgram folic acid tablet every day while trying to get pregnant until the twelfth week of pregnancy.

If you didn't take folic acid before you conceived, you should start as soon as you find out that you are pregnant.

Your diet shall contain folate (the natural form of folic acid), such as green leafy vegetables and brown rice. Foods that are naturally high in folic acid include leafy vegetables, fruits (such as bananas, melons, and lemons) beans, yeast, mushrooms, meat (such as beef), orange juice, and tomato juice.

It is difficult to get the amount of folate recommended for pregnancy from food alone, which is why it is important to take a folic acid supplement.

Your health care professional will prescribe a daily prenatal vitamin and or other vitamin and mineral supplements to help meet your additional needs.

Spina bifida?

(mater.org.au) 

The name spina bifida means split or divided spine and is used to describe a neural tube defect that affects the spine. If the neural tube fails to close in an area that goes on to develop into the spine the protective bones surrounding the spinal cord (vertebra) are unable to fuse together properly. As a result the spinal cord and its protective sac (meninges) may be pushed through the open part of the spine.

The symptoms associated with spina bifida vary depending on where in the spine the opening has occurred and how much of the spinal cord and/or protective sac are pushed through this opening. Generally the condition is more severe if the opening is above the base of the spine and if the spinal cord is pushed through the opening.

There are three different types of spina bifida which are defined according to the location and severity of the abnormality: 

Occulta is the mildest form and refers to when the outer vertebrae are not completely joined but the spinal cord and protective covering are unaffected. The only visible sign maybe a dimple, tuft of hair or small swelling at the site of the abnormality. There are usually no problems associated with this form of spina bifida. 

Meningocele is when the outer parts of the vertebrae fail to fuse and a cyst or fluid filled sac is pushed through the divide in the vertebrae. The sac contains the membranes that protect the spinal cord but no spinal nerves. The spinal cord itself is normal and not affected. The defect can be surgically closed after birth. 

Myelomeningocele is severest form of spina bifida. In these cases both the spinal cord and the protective covering are pushed through the opening in the vertebrae. Affected babies will have some degree of leg paralysis, after surgery, as well as bowel, bladder and other complications.  

Other related stories:

Baby with rare neaural-tube disease, has survived a year despite being born with Anencephaly