The title is full of medical jargon but it basically means the removal of anus, rectum and colon and creation of a new opening for excreting the waste products. The procedure of abdominal perineal resection is done to treat cancer of the anus, near the sphincter muscles which control the bowel movements.

The new opening created for discharging the waste is called the stoma. The opening is made from the large intestine to the surface of the abdomen skin. As it includes colon and stoma, it may also be called as colostomy. As the stoma is created and not natural like the anus, it does not have sphincter muscles to control the bowel movements. This requires wearing a pouch all the time to collect the discharged waste. There is also another alternative to this procedure, known as anterior perineal resection.

The abdominal perineal resection procedure includes administering anesthesia to the patient and making two incisions – in the abdomen and between the anus and genitals. The area is then cleaned with an antibiotic solution and a drainage tube is attached to the bladder for drainage of the urine. An incision is also made from the abdomen to the pubis to check the spread of the tumor. The abdominal cavity is checked and it is examined if the tumor is attached to the pelvic organs. The operation may be carried out from the abdominal incision, gradually proceeding towards the posterior end or it may be carried out at both regions simultaneously.

The rectum and the bowel are freed from the surrounding tissues and removed. The open end of the colon is connected to tissues of the skin surface in such a manner that all excretory material is directed towards the outside of the body. This is called end-colostomy. Once the surgeon has removed the anus, he will medically seal the region and prevent loss of blood. Incase pelvic bleeding is suspected, the region can be packed up. Tubing and a drainage bag are placed in the colostomy as the operation is completed.

The colon surgery is done for the treatment of colon cancer. The standard procedure for colon surgery is called surgical resection. The colon resection procedure includes making an incision in the abdomen and removing the tumor. Then the colon is reconnected without the diseased parts.

The recovery from abdominoperineal-resection-of-rectum takes almost a week and the pouch is attached since the operation for waste disposal. The digestive system is mostly inactive for a few days. The major support post operation is that of an enterostomal therapist ET nurse, who is specially trained for it. But with today’s technology, new medical products have made the task easier and are a great support too. Post surgery, every patient goes through many psychological and physical adjustments and it takes time to cope with the changes

The presence of stuffy nose for more than a week or two may signal the occurrence of a more serious medical condition than a simple cold such as sinusitis, which is the inflammation or infection of the sinuses, the hollow spaces in the bones near the nose.

Normally, sinuses have among other duties, the function of warming and humidifying the air on its way from the nostrils to the lungs. A lining of mucus keeps the sinuses moist, and tiny hairs called cilia sweep mucus from the sinuses down into the nose.

When a person gets a cold or an allergy attack the passages connecting the nose and the sinuses get congested; as a result, the sinuses may fail to drain. Bacteria and/or fungi multiply in the trapped mucus, causing infection.

Sinusitis can lead to persistent cough or bronchitis – and can exacerbate existing cases of asthma. In rare cases, it can result in a life threatening infection of the eyes or brain.

SYMPTOMS AND CAUSES

The symptoms of Sinusitis can vary from person to person depending on severity and pre-existent conditions and factors like asthma, smoking, etc. the most common presentation is marked by severe congestion, headache, mild fever, pain in the face or teeth and a thick yellowish-green nasal discharge that continues all day and night. Some sinusitis sufferers are sensitive to shifts in barometric pressure – for example, on plane flights or during changes in the weather.

The common cold, in contrast, is characterized by watery white or yellow mucus that clears up as the day goes on. Allergies are often accompanied by itching and watering eyes. Keep in mind that a simple cold when not properly managed can turn into sinusitis.

Most cases of sinusitis occur during or shortly after a cold. Other cases are caused by allergies, tobacco smoke or other respiratory irritants, mouth infections, or anatomical problems, such as nasal polyps or a deviated septum, that obstruct sinus drainage.

Forty percent of cold-related sinus attacks heal spontaneously without treatment as sinuses begin to drain again. But sinusitis often becomes chronic, creating long-term changes in the delicate lining of the sinus (the mucosa).

Chronic sinusitis may damage the cilia or acidify the mucus, leading to further irritation and inflammation. Over time, repeated bouts of sinusitis can permanently narrow the opening of the sinuses into the nose.

TREATING ACUTE SINUSITIS

The standard treatment for acute sinusitis is a course of antibiotics lasting 10 to 14 days, plus oral decongestants and nasal spray. Very important to complete the full course of antibiotics even though you start feeling much better; otherwise, you can promote drug-resistant bacteria. Antihistamines are not recommended because they can be too drying making the mucus too thick and therefore more difficult to drain.

Caution: Using over-the-counter decongestant nasal sprays for more than five days can produce a “rebound” effect, in which the sprays themselves cause the nose to clog up.

Another good treatment for acute sinusitis is saline irrigation. When done under a doctor’s supervision, it can be highly effective at reducing nasal and sinus congestion.

What to do: Each morning, fill a clean, narrow-tipped plastic squeeze bottle with a mixture comprised of one teaspoon salt to one pint lukewarm water. As you lean over a sink, squirt the solution into your nose until it’s all gone. The solution will drain out. Be sure to clean the container and tip after each use. You can also find a “nasal irrigation kit” over the counter, with premixed solution packets.

THREATING CHRONIC SINUSITIS

Chronic sinusitis is the result of recurrent sinusitis attacks (poorly managed) or when there is subjacent anatomical obstruction such as nasal polyps. It is harder to treat and In addition to decongestant sprays and pills, needs at least three-week course of antibiotics. If there’s still no improvement at that point, see an allergist or otolaryngologist.

To pinpoint the source of your sinus trouble, this doctor may recommend an X ray or CT scan or perform endoscopy. Via this simple procedure – done in the doctor’s office – the doctor can determine whether you have nasal polyps or another anatomical obstruction. If so, surgery to remove polyps or to widen the sinus opening slightly may be helpful.

If your sinusitis is diagnosed as allergy-related, it may be necessary to avoid, animal dander and other allergens. Nasal medications such as steroid inhalers may also provide some relief.