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Gallstones in Growing Adults: A Rising Concern.
By Dr. Tapas Mishra | Senior Consultant – Advanced Laparoscopic GI & Bariatric Surgery

Gallstones were once considered a health issue mostly seen in older adults, especially women over 40. But today, gallstones are increasingly being diagnosed in younger adults, even those in their 20s and 30s, raising concern among health professionals.

So, why is this happening, and what can young adults do to protect their gallbladder health?

What Are Gallstones?

Gallstones are hardened deposits of bile that form in the liver and stored in Gallbladder when the person is fasting . They can be as small as a grain of sand or as large as 4 to 5 cm. Many people with gallstones experience no symptoms, but when a stone blocks cystic duct or bile duct, it can trigger a gallbladder infection and complications. A sudden, severe pain in the upper abdomen associates with Nausea, vomiting, fever or jaundice

Why Are Young Adults at Risk?

The rise in gallstones among younger adults can be linked to several lifestyle and health changes:

High-fat, processed diets

Rapid weight loss through crash diets

Obesity and sedentary habits

Hormonal imbalances, including those caused by birth control pills

Family history of gallbladder disease

These factors affect how bile is produced and stored, making it more likely for stones to form.

Common Symptoms to Watch For:

Pain in the upper right abdomen

Discomfort after eating fatty foods

Nausea or vomiting

Pain radiating to the back or right shoulder

These signs should never be ignored, especially if they occur frequently after meals.

What Can Be Done?

Lifestyle changes like healthy eating, regular physical activity, and maintaining a stable weight can help prevent gallstones. If you’re already experiencing symptoms, early diagnosis is key.

In many cases, ultrasound imaging can quickly identify the presence of gallstones. For those with recurrent pain, laparoscopic gallbladder removal is a safe, minimally invasive option that offers long-term relief.

Take Your Symptoms Seriously

Gallstones in young adults are on the rise but with timely lifestyle adjustments and medical support, they are completely manageable. Stay alert to the signs, and don’t hesitate to seek professional guidance when needed.
May 26, 2025

Gallstone Induced Problems Vs Acid Reflux – How to Know the Difference ?

By Dr. Tapas Mishra | Senior Consultant – Advanced Laparoscopic GI & Bariatric Surgery

If you’ve experienced a burning sensation in your chest or a sharp pain in your upper abdomen, you might wonder: Is this Acid Reflux or something more serious, like a Gallbladder infection

Though both affect the digestive system, they are very different in cause, symptoms, and treatment. Recognizing the signs early can help you take the right steps for relief.

What is a Gallbladder infection or cholecystitis

A Gallbladder infection occurs when gallstones block the normal passage of gall bladder to common bile duct , causing a buildup of pressure and inflammation. It often occurs spontaneously or after a heavy or fatty meal and can last for several hours.

Common Symptoms:

Sudden pain in the upper right abdomen
Pain that may radiate to the right shoulder or back
Nausea and vomiting
Pain lasting 30 minutes to several hours
No relief from over-the-counter antacids

The pain tends to come on quickly, is colicky and doesn’t improve with rest or changes in posture. In some cases, fever or chills may also develop, signaling a more serious issue.

What is Acid Reflux?

Acid reflux, or Gastro Esophageal Reflux Disease (GERD), occurs when stomach acid flows back into the Esophagus. This backward flow causes irritation, often after eating or when lying down.

Typical Symptoms:

Burning sensation in the chest (heartburn)
A sour or bitter taste in the mouth
Burping, bloating, and gas
Discomfort that worsens when bending over or lying flat
Relief with antacids or acid blockers

Unlike an attack of cholecystitis, acid reflux is usually chronic and recurrent and can occur daily or weekly, depending on diet and lifestyle.

Key Differences at a Glance:

Issue	Gallbladder infection	Acid Reflux
Pain Area	Upper right abdomen	Chest/upper abdomen
Trigger	Fatty/heavy meals	Spicy food, lying down
Duration	30 mins to hours	Short episodes, recurring
Antacids Help?	No	Often yes

What You Can Do ?

If you’re unsure which condition you’re experiencing, pay attention to the type, location, and timing of your symptoms. While acid reflux can often be managed with lifestyle changes and medications, gallbladder issues may require medical imaging or surgical intervention.

Persistent or intense symptoms should never be ignored. If pain worsens or is accompanied by fever, seek prompt surgeon attention to avoid complications.

May 23, 2025

Is Surgery Always Required for Hernia?
Not all hernias require immediate surgery. Small, asymptomatic hernias may be monitored. However, hernias do not resolve on their own and tend to enlarge over time. Surgical repair is the only definitive treatment.
Indications for Surgery:
Persistent pain or discomfort
Increasing size of the hernia
Complications like incarceration or strangulation
Types of Hernia Surgery
As a GI surgeon, I offer both open and minimally invasive (laparoscopic or robotic) options depending on the case.
1. Open Hernia Repair:
The traditional approach involving a single incision over the hernia site. The protruding tissue is pushed back, and the weak area is reinforced with stitches and a mesh.
2. Laparoscopic Hernia Repair:
A minimally invasive approach using small incisions, a camera, and instruments. Recovery is quicker, and there is less post-operative pain and scarring.
3. Robotic-Assisted Surgery:
An advanced form of minimally invasive surgery offering more precision, especially for complex or recurrent hernias.

Post-Surgery Recovery
Most patients can go home the same or next day
Return to normal activities within 1-2 weeks (depending on the type of surgery)
Avoid heavy lifting or strenuous activity for a few weeks
Follow-up is essential to monitor healing and prevent recurrence

Can a Hernia Be Prevented?
While not all hernias can be prevented, you can reduce your risk with the following:
Maintain a healthy weight
Exercise to strengthen abdominal muscles
Avoid straining during bowel movements
Stop smoking (chronic cough weakens the abdominal wall)
Use proper lifting techniques

Conclusion
A hernia might seem like a minor inconvenience at first, but neglecting it can lead to complications. Early diagnosis and timely surgical management offer excellent outcomes and help restore your quality of life.
If you suspect a hernia or have been diagnosed with one, consult a nearest GI or laparoscopic surgeon for proper evaluation and guidance on treatment options.
May 21, 2025
All That You Need to Know About Hernia
By Dr. Tapas Mishra, Senior Consultant Advanced Laparoscopic GI Surgeon & Bariatric Surgeon

A Hernia is one of the most common conditions that affects people of all ages and backgrounds. Though it may sound minor initially, if left untreated, a hernia can lead to severe complications and even become life-threatening. As a GI and Advanced Laparoscopic Surgeon, I believe it’s important to spread awareness about hernias — what they are, why they occur, how to recognize them, and the treatment options available.

What Is a Hernia?
A hernia occurs when an internal organ or tissue pushes through a weak spot in the surrounding muscle or connective tissue. The most common hernias occur in the abdominal area, but they can also develop in other parts of the body.

Common Types of Hernias:

Inguinal Hernia: Found in the groin area. Most common, especially in men.

Umbilical Hernia: Occurs near the belly button. Seen in infants and adults.

Incisional Hernia: Develops at the site of a previous surgical incision.

Hiatal Hernia: Part of the stomach pushes through the diaphragm into the chest cavity.

Femoral Hernia: Less common, seen more in women, occurring near the thigh.

Epigastric Hernia: Found between the chest and belly button, due to a weakness in the abdominal wall.

What Causes a Hernia?

Hernias are generally caused by a combination of pressure and weakness in the muscle or connective tissue. Common causes include:

Heavy lifting

Chronic coughing or sneezing

Obesity

Pregnancy

Previous surgeries

Aging

Congenital defects (present at birth)

What Are the Symptoms?

While some hernias are painless and asymptomatic, many present noticeable symptoms:

A visible bulge or lump in the abdomen or groin
Pain or discomfort, especially when bending, coughing, or lifting
A feeling of heaviness or pressure
Weakness or burning sensation at the site
In severe cases (strangulated hernia): nausea, vomiting, fever, and inability to pass stools or gas — this is a medical emergency

How Is a Hernia Diagnosed?

Most hernias can be diagnosed with a physical examination. However, in some cases, imaging tests such as:

Ultrasound
CT scan
MRI may be recommended to confirm the type, size, and extent of the hernia.
April 28, 2025
Gallstone Emergencies: Symptoms, Diagnosis & The Need for Surgery
Gallstones are formed in the gallbladder due to hardened deposits of normal liver bile fluid secretions either due to defective Gall bladder function or other conditions
While many people with gallstones may not experience symptoms, in some cases, these stones lead to severe pain and life-threatening complications. Understanding the symptoms, diagnostic methods, and urgency of surgical intervention can help manage gallstone emergencies effectively.
What Are Gallstones?
Gallstones are formed when substances in bile—such as cholesterol, bilirubin, and bile salts—crystallize and harden. They can vary in size, from tiny grains to larger stones. They may develop due to factors such as obesity, rapid weight loss, pregnancy, diabetes, sickle cell disease, defective Gall bladder function, or a high-cholesterol diet.
Symptoms of a Gallstone Emergency
Gallstones may remain asymptomatic for years, but when they obstruct the gallbladder bladder passage or bile ducts, they can trigger intense symptoms that require immediate medical attention.
Severe Abdominal Pain (Biliary Colic)
Sudden, sharp pain in the upper right abdomen or just below the rib cage.
Pain may radiate to the right shoulder or back.
Often occurs after fatty meals and can last for several hours.
Jaundice
Yellowing of the skin and eyes due to bile flow blockage in the biliary tract.
Indicates obstruction of the bile duct, possibly leading to cholangitis, severe pruritus and liver damage.
Nausea and Vomiting
Persistent nausea, sometimes accompanied by vomiting, especially after eating.
May be a sign of gallstone-induced inflammation or infection.
Fever and Chills
High fever with chills may indicate an infection such as acute cholecystitis (inflammation of the gallbladder) or cholangitis (blood infection due to blockage of the bile duct).
Requires immediate medical intervention to prevent sepsis.
Dark yellow Urine and Pale Stools
Dark-coloured urine suggests excess bilirubin in the bloodstream.
Clay-coloured stools result from blocked bile flow, affecting digestion.
Rapid Heart Rate and Low Blood Pressure
In severe cases, gallstone complications can lead to shock, especially if infection spreads to the bloodstream (septicemia).
Diagnosis of Gallstone Emergencies
If gallstone complications are suspected, a series of tests are conducted to confirm the diagnosis and assess the severity of the condition.
Ultrasound
The most common and non-invasive imaging test to detect gallstones.
Helps determine the presence of stones and signs of inflammation.
Blood Tests
Elevated white blood cell count suggests infection or inflammation.
Liver function tests check for bile duct obstruction.
CT Scan or MRI (MRCP – Magnetic Resonance Cholangiopancreatography)
Used to detect stones in bile ducts and assess complications.
MRCP
Endoscopic Retrograde Cholangiopancreatography (ERCP)
A procedure that combines endoscopy and X-ray to detect and remove stones in bile ducts.
Can also place a stent to relieve blockages.
The Need for Surgery in Gallstone Emergencies
When gallstones cause severe pain, infection, or complications, surgery is often the best treatment option.
Laparoscopic Cholecystectomy (Gallbladder Removal Surgery)
The most common and preferred treatment for recurrent gallstone attacks.
A minimally invasive procedure with small incisions, less pain, and quicker recovery.
Open Cholecystectomy
Performed in complicated cases where laparoscopic surgery is not suitable.
Requires a larger incision and a longer recovery period.
ERCP for Stone Removal
If stones are blocking the bile duct, ERCP can remove them without gallbladder removal.
Often used for patients who are not candidates for surgery.
Post Lap Chole ERCP stone clearance of CBD
When to Seek Emergency Medical Care?
If you experience any of the following symptoms, seek immediate medical attention:
Intense and persistent abdominal pain.
High fever, chills, or jaundice.
Signs of sepsis, such as confusion, rapid heartbeat, or low blood pressure.
Key Notes for Readers
Gallstone emergencies can lead to serious complications if not treated promptly. Recognizing symptoms early and seeking timely medical care can prevent life-threatening conditions. In most cases, surgical removal of the gallbladder is the most effective long-term solution to prevent future attacks and complications.
February 7, 2025
Acid Reflux: A Modern Life Style Disease – Causes, Symptoms & the Importance of Surgical Intervention
Acid reflux, also known as gastroesophageal reflux disease (GERD), is a common digestive disorder that occurs when stomach acid flows back into the esophagus. While occasional acid reflux is normal, frequent and severe refluxes can lead to chronic GERD, causing discomfort and complications. If left untreated, GERD can lead to serious health issues, including esophagitis, chronic cough, dysphagia, Barrett’s esophagus, and even esophageal cancer. While medications and lifestyle changes can help manage symptoms, surgical intervention becomes necessary in severe cases to provide long-term relief.

Understanding Acid Reflux and Its Causes
Acid reflux occurs due to a weak or dysfunctional lower esophageal sphincter (LES)—the muscle that acts as a valve between the esophagus and stomach. When this valve fails to close properly, stomach acid and digestive juices flow back into the esophagus, causing symptoms.

Common Causes of Acid Reflux
Hiatal Hernia – A condition where part of the stomach pushes through normal diaphragmatic opening, weakening the LES.
Obesity – Excess weight puts pressure on the abdomen, increasing the likelihood of reflux.
Dietary Habits – Spicy, fatty, or acidic foods, caffeine, alcohol, and carbonated drinks can trigger reflux.
Smoking and Alcohol – These substances weaken the LES and increase acid production.
Lying Down After Eating – Eating large meals and lying down immediately can worsen reflux.
Pregnancy – Hormonal changes and increased abdominal pressure contribute to reflux.
Certain Medications – Painkillers (NSAIDs), muscle relaxants, and certain blood pressure medications can aggravate reflux.

Symptoms of Acid Reflux

The most common symptom of acid reflux is heartburn, a burning sensation in the chest. Other symptoms include:
Regurgitation – Sour or bitter liquid rising in the throat and occasionally teeth.
Chronic Cough – Due to acid irritating the throat and airways.
Hoarseness or Sore Throat – Caused by acid exposure.
Difficulty Swallowing (Dysphagia) – Due to narrowing of the esophagus.
Chest Pain – Can mimic heart-related pain.
Excessive Burping and Bloating – Resulting from trapped gas.
Bad Breath – Due to acid and undigested food in the esophagus.
If these symptoms persist despite lifestyle changes and medications, it may indicate severe GERD requiring advanced treatment or surgery.

When Is Surgical Intervention Necessary?

Following are the scenarios for Surgical Intervention:
Failure of medical management – If proton pump inhibitors (PPIs) or antacids do not provide relief.
Complications Develop – Such as esophageal strictures, Barrett’s esophagus, or chronic esophagitis.
Quality of Life Is Affected – When daily activities are restricted due to severe symptoms.
Hiatal Hernia Is Present – Large hernias often require surgical correction.
Benefits of Surgical Intervention
Long-Term Relief from acid reflux symptoms.
Reduced Dependence on Medications, especially PPIs, which may have long-term side effects.
Prevention of Complications, such as Barrett’s esophagus or esophageal cancer.
Improved Quality of Life, allowing patients to eat and sleep comfortably.
February 3, 2025
Signs That You Are Experiencing the Onset of Obesity
Obesity is a concern that can cause troublesome health issues at any given point of your life. Be it congenital or due to any allied medical conditions, the risks attached to obesity are multifold. If you have been gaining weight drastically, or have been noticing considerable changes in your body fat, here are a few notable signs of obesity you must consider before seeking expert help from a doctor of your choice!
1. Your BMI: Your Body Mass Index is always a clear indicator of your body weight. If you have been noticing the extra weight gain in the past couple of weeks, make sure you’re keeping tabs on your BMI. Once you calculate your BMI, ensure that it doesn’t exceed 27.5. A BMI that stands above 30 is a clear indication of obesity.
2. Irregular Periods Among Women: Being overweight can increase the risk of having irregular or heavy periods among women. In some cases, obesity might also trigger missed cycles and delays in ovulation. These could be the most prominent signs of obesity in women.
3. Heartburn and Acid Reflux: if you have been noticing frequent occurrences of heartburns or acid refluxes lately, it is wise to keep tabs on your weight. People who have gained a few extra Kilograms lately might experience symptoms such as a burning sensation near the chest and pain and pressure around the chest and throat. This occurs due to an accumulation of excess fat that pressurises the digestive system and leads the food in the stomach to be pushed towards the oesophagus, causing discomfort and acid reflux in the digestive system.
4. Anxiety and depression: An increase in stress levels and weight can both trigger a certain amount of anxiety and depression into our minds. If you feel that you might have been feeling anxious or depressed the past few days, try checking your weight or a possible increase in it. If the fact that you might have gained a few kgs in the past few months is making you socially reserved or depressed, make sure your BMI is not on the offside.
5. Increased Snoring: The tendency to snore increases exponentially as and when you gain weight. As your weight increases, the risk of obstructive sleep apnea due to too much bulk around the neck increases, leading you to snore more than usual.
Apart from these symptoms, if you have been witnessing excessive fat deposits around certain areas of your body, make sure you check your weight and visit a weight loss specialist if you seem to find yourself becoming obese.
June 8, 2020