Tag Archives: Dr Saravana Kumar Karunanithi

Hepatitis C

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Dr Saravana.KDigestive Health

By Dr Saravana.K
Consultant Physician,
Gastroenterologist & Hepatologist

Hepatitis simply means “inflammation of the liver” (the suffix “itis” means inflammation and “hepa” means liver). Hepatitis C (HCV) is a specific type of hepatitis that is caused by a virus. There are many other hepatitis viruses such hepatitis A, B, D, E, etc. The only thing they have in common is that they all affect the liver. Most people infected with the HCV have no symptoms until liver damage shows up decades later, during routine medical tests.

It is spread when you come in contact with blood contaminated by the virus. Three per cent of the world’s population is chronically infected with HCV. In Malaysia the prevalence of HCV is about 1.5 per cent.

SYMPTOMS

  • Hepatitis C-1HCV infection usually produces no signs or symptoms during its earliest stages
  • Fatigue, fever, muscle and joint pains
  • Nausea or poor appetite
  • Yellowing of the skin and whites of the eyes (jaundice)
  • Leg swelling, abdominal distension
  • Passing foul smelling blackish stool
  • Vomiting blood

How do I become infected with HCV?

  • Hepatitis C-2Health care and emergency workers who have been exposed to infected blood or accidental needle stick injury
  • Have ever injected illicit drugs
  • People with HIV infection
  • Received a piercing or tattoo in an unclean environment using non sterile equipment
  • Received a blood transfusion, clotting factor concentrates or organ transplant before 1994
  • Received hemodialysis treatments for a long period of time
  • Was born to a mother with a HCV infection
  • Sexual partners of anyone diagnosed with HCV infection
  • People with hemophilia.

People with the above risks may want to talk to their doctors about screening for hepatitis C infection, to detect it early and prevent complications. HCV infection at the initial stages produces no symptoms and if detected early treatment could be administered to prevent complications such as:

  • Scarring of the liver tissue (cirrhosis). After 20 to 30 years of HCV, cirrhosis may occur. Scarring in your liver makes it difficult for your liver to function.
  • Liver failure. A liver that is severely damaged by HCV may be unable to function adequately.
  • Liver cancer.

HCV can be diagnosed by doing simple blood tests that include:

  • HCV antibody test: To determine whether you have the HCV virus.
  • Measure the quantity of the HCV virus in your blood (viral load) and the genetic makeup of the virus (genotyping), to determine your treatment options.

TREATMENT

Antiviral medications

HCV infection is treated with antiviral medications intended to clear the virus from your body. Your doctor will decide whether you are eligible for treatment and may recommend a combination of medications taken over several weeks. Throughout treatment your doctor will monitor your response to medications and for side effects.

Liver transplant

If your liver has been severely damaged; a liver transplant may be an option.

PREVENTION

Protect yourself from HCV infection by taking the following precautions: stop using illicit drugs, be cautious about body piercing and tattooing and practice safer sex.

Tips To Maintain a Healthy Liver

  • Vaccinations against the hepatitis A and B viruses. These viruses can also cause liver damage and complicate treatment of hepatitis C.
  • Stop drinking alcohol.
  • Avoid medications that may cause liver damage.

For more information call Saravana.K Gastroenterologist and Liver Specialist Clinic at Hospital Fatimah (05-5487181) or email gastrosara@gmail.com.

 

Gastroesophageal Reflux Disease (GERD)

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Dr Saravana.KDigestive Health

By Dr Saravana.K

Consultant Physician, Gastroenterologist & Hepatologist

 

GERD is a common chronic digestive condition that occurs when stomach acid or bile flows back into your food pipe. The backwash of acid irritates the lining of your oesophagus and causes GERD symptoms. These symptoms can interfere with your daily activities.

Symptoms:

  • A burning sensation in your chest (heartburn)GERD-1
  • Chest pain
  • Difficulty swallowing
  • Dry cough
  • Hoarseness or sore throat
  • Regurgitation of food or liquid

When you swallow, the lower esophageal sphincter – a circular band of muscle around the bottom part of your oesophagus – relaxes to allow food and liquid to flow down into your stomach. Then it closes again.

However, if this valve relaxes abnormally or weakens, stomach acid can flow back up into your esophagus, causing frequent heartburn. Carbonated drinks, spicy food and alcohol, fatty food can also cause the valve to relax abnormally thus producing symptoms of GERD.

GERD symptoms can also be aggravated by a number of medications – either through impaired valve function or by damaging the oesophageal surface.

This constant backwash of acid can irritate the lining of your oesophagus, causing it to become inflamed. Over time, the inflammation can erode the oesophagus, causing complications:

  • Narrowing of the oesophagus (stricture). The scar tissue narrows the food pathway, causing difficulty swallowing.
  • An open sore in the oesophagus (ulcer). Stomach acid can severely erode tissues in the oesophagus, causing an open sore to form. The esophageal ulcer may bleed, cause pain and make swallowing difficult.
  • Barrett’s oesophagus. Changes occur to the tissue lining the lower oesophagus which is associated with an increased risk of esophageal cancer.

GERD-2

Risk factors for GERD include:

  • Obesity
  • Pregnancy
  • Smoking
  • Asthma
  • Diabetes
  • Delayed stomach emptying.

Most people can manage the discomfort of heartburn with lifestyle modifications:

  • taking  frequent small meals
  • avoid food that can aggravate the condition including alcohol
  • avoid tight fitting clothes
  • elevate the head of the  bed by 30 degrees
  • to have an interval of 3 hours between meals and bedtime
  • weight loss.

 

When to see a doctor

  • If you take over-the-counter medications for heartburn more than twice per week.
  • Chest pain.
  • Difficulty swallowing.
  • Loss of weight and appetite.
  • Persistent vomiting.

GERD can be diagnosed by doing an endoscopy which involves inserting a scope through the mouth down to the stomach to assess the internal surfaces of the stomach, oesophagus and duodenum. The scope will show any inflammation and enable a biopsy to be done to determine the presence of cancer.

Alimentary Checks Now Elementary

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By See Foon Chan-Koppen

ipoh echo issue 140, Dr Saravana Kumar Karunanithi, Gastroenterologist & Hepatologist, Hospital Fatimah
Dr Saravana Kumar Karunanithi, Resident Consultant Physician, Gastroenterologist & Hepatologist, Hospital Fatimah

Dr Saravana Kumar Karunanithi who is the new Resident Consultant Physician, Gastroenterologist & Hepatologist at Hospital Fatimah is all set to make people of Ipoh aware of liver diseases.

Dr Saravana, a local Ipoh Boy and ex Michaelian, obtained his medical degree from the University of Sheffield, UK, in 2000 and subsequently returned to Malaysia where he did his housemanship at Hospital Universiti Kebangsaan Malaysia. Subsequent stints as medical officer in Hospital Sungai Siput and Ipoh General Hospital, gaining experience in managing acute and chronic medical conditions, saw him receiving his Membership of the Royal College of Physicians (MRCP) in 2006 after which he served as a specialist at Taiping Hospital for a year.

A move to Selayang Hospital which is a liver transplant centre in 2008, to do his sub-speciality in Hepatology (diseases of the liver) and Gastroenterology (diseases of the digestive tract), gave him first-hand experience in managing liver-related disorders including Hepatitis B and C.

Normal liver functions include breaking down harmful substances, removing waste products from the blood, storing nutrients and vitamins and moderating chemical levels in the body.

“There are several possible risk factors for developing liver disease, such as alcohol; bacterial or viral hepatitis (especially Hepatitis B and C); drug-induced liver disease (e.g., Paracetamol overdose and some herbal remedies); congenital birth defects or abnormalities at birth; metabolic disorders or basic body processes with defects. Then, there is non-alcoholic fatty liver disease (NAFLD) which can be caused by several issues such as obesity, diabetes, elevated cholesterol and elevated triglyceride levels,” said Dr Saravana.

“Hepatitis is the most common form of liver disease. It occurs when the liver is inflamed and is linked to the spread of various viruses, but can also be developed because of poisons entering the body, an autoimmunity or hereditary condition,” he added.

“The Chinese in particular are very susceptible to Hepatitis B and a lot of them are carriers without knowing it,” he said.  “As Hepatitis B and C are often asymptomatic, it is advisable for most people to have a routine screening through a simple blood test. This way, those who don’t have hepatitis B can be vaccinated against it while those found to have Hepatitis B/C can be treated early on as untreated hepatitis can often lead to liver cirrhosis and cancer.”

Cirrhosis of the liver, also known as chronic liver disease, is a very serious and deadly form of liver disease. “The symptoms that one could experience with liver disorders include jaundice or yellowing of the skin; loss of appetite, nausea, unusual weight loss; darkened urine; vomiting; diarrhoea, light-coloured stools; abdominal pain in upper right part of stomach; vague feelings of illness, fatigue; low-grade fever; generalised itching; susceptibility to bleeding; enlarged and tender liver, enlarged spleen; edema or under-the-skin swelling,” he elaborated.

Certain tests may be needed to ensure an accurate diagnosis. These may include blood tests, Liver function tests, imaging tests such as X-rays, computed tomography (CT), magnetic resonance imaging (MRI) and Ultrasound.

According to Dr Saravana, anyone showing signs of jaundice (yellowing of the complexion) should see a hepatologist immediately. With his specialist training in hepatology, Dr Saravana is ideally positioned to help patients with any problems of the liver.

Another area of concern for Dr Saravana is in the digestive tract. With stomach and colon cancers being high on the list of cancers in Ipoh and Malaysia, he urges all people over 50 to have a gastroscopy and colonoscopy by the time they reach that watershed year. Given that stomach and  colon cancers have a very high success rate of cure when caught early,  he also stresses that other issues when detected early, such as polyps, inflammatory bowel disease, and even tuberculosis in the colon, which surprisingly is not uncommon, can be treated and the dangers minimised if not removed.

For someone who has done many Oesophageal Duodenoscope and colonoscopies, Dr Saravana looks set to introduce some well needed diagnostic and treatment options for Ipohites and Perakeans.

Dr Saravana’s clinic is situated on the Ground Floor, Block D, Medical Suite No. 34 at Hospital Fatimah,
Tel.:
05-545 5777 ext. 472/473.
Monday-Friday: 8.30 a.m. – 5.00 p.m.  Saturday: 8.30 a.m. – 1.00 p.m.