Category Archives: EZ 36

Regenerative medicines offer new lifeline for many

By Shane Fonseca
M-Tech Chiropractic (RSA)

With the average life expectancy climbing ever higher due to advancements in medical technology, it has become increasingly important to move into a preventative health paradigm, especially with regards to the musculoskeletal system of the human body. 

Advancements in the field of cosmetic surgery have proverbially opened a Pandora’s Box for all those capable of enjoying the benefits. However, these external enhancements cannot replace the long term damage of tired spinal joints, osteoarthritic knees, untreated idiopathic scoliosis, and the “silent killer” – pinched nerves resulting from Spinal Disc Degeneration.

Slipped Disc and Inter-Vertebral Disc degeneration is one of the most common causes of back pain today, affecting more than 30 percent of adults over the age of 20 years. Unfortunately, its prevalence is further increased exponentially with advancing age. It is currently the single largest reason (65 percent of sick cases) besides the common cold resulting in absenteeism and loss of productivity at the work place.

This epidemic is dramatically affecting the quality of lives by ruthlessly condemning its sufferers to either severe pain or surgery. However surgery is still a poorly developed treatment protocol, with more than 40 percent of patients having an unsatisfactory outcome for primary disc surgery, with more than 75 percent of those patients suffering from recurrent back pain within a year of the surgery itself.

At present, the primary non-surgical treatment protocol for disc bulges and spinal nerve pathology is Spinal Decompression Therapy. With a success rate of over 83 percent, it is fast proving to be the treatment of choice for both patients and doctors alike. Spinal Decompression Therapy is a computerized, machine based protocol designed to unload the tired, bulging dehydrated lower back and neck discs by cycling through distraction and relaxation phases. This allows for the accurate repositioning of the discs, while creating a negative pressure within the disc material. This facilitates the resorption and hydration of any bulging disc material, restoring disc health and reducing the associated nerve compression causing relentless back, leg or arm pain.

Children, like adults, also have degenerative health concerns. Over 67 percent of our children are affected with Idiopathic Scoliosis a manageable but devastating condition. It is the most common spinal deformity confronting orthopedic surgeons today with Asia currently having the highest incidence of idiopathic scoliosis in the world. Described as ‘progressively relentless, deadly at its end result’, early detection and treatment is critical. A Dynamic Scoliosis Bracing System offers the first and only Dynamic Corrective Brace for the treatment of idiopathic scoliosis in the world. Together with physiotherapy it provides an 89 percent efficacy rate.

Other medical advancements in joint-muscle healthcare include Cold Laser for accelerated regenerative repair, Extra Corporeal Shockwave Therapy to break down scar tissue and remodel living bone, and Whole Body Vibration Therapy for advanced acceleration, balance and strength training.

If you think aches and pains are part of growing old and is something you just have to “ live with it”, THINK AGAIN! You deserve a life that is free of pain, a life that is full of vigour. At TAGS, our team is here to help you get well and most importantly, stay well.

Screening For Bowel Cancer Today

by Mr Buvanesvaran Tachina Moorthi
MBBS (Mal), MS (UKM), MRCS (Ire)
Fellowship in Colorectal Surgery (Hull, Eng)

Better understanding of anatomy and bowel physiology coupled with technological advancement has propelled new concepts, techniques and ever evolving trends in the management of colorectal disorders in the present era.

Historically, the Ebers Medical Papyrus 1700BC described 33 prescriptions for anorectal disease. Hippocrates (460-377 BC) had documented dissertations on Fistulae and Haemorrhoidal diseases. Such is the influence of history in the development of Colorectal Surgery into a subspeciality as it stands today.

Screening for bowel cancers are routine practice in many Western countries. The United Kingdom has a well-established bowel cancer screening program where anyone turning 60 years old are offered a ‘Fecal Occult Blood’ test kit which tests to identify microscopic bleeding in the stools of asymptomatic persons.

Those with positive results are invited to undergo a screening colonoscopy to exclude presence of polyps or cancers and are followed up with regular colonoscopy (as per protocol) depending on the findings of the first screening colonoscopy. However, these are meant for asymptomatic persons with no obvious family history of bowel cancer. Individuals with strong family history of bowel cancer or symptoms of it should be investigated much earlier.

Though Colorectal Disorders encompass a wide range of conditions ranging from benign perianal diseases to functional disorders, none gets more importance that Colorectal Cancers as it rightly deserves. The morbidity and mortality associated with bowel cancers has pushed researchers to innovate new investigative tools, surgical techniques and treatment options that promises better outcomes for patients.

Successfully treating a clinical condition vastly depends on the understanding of the pathophysiology of the disease. However, the multifactorial origin of cancers on the whole is the stumbling block towards its treatment.

The “Adenoma-Carcinoma Sequence” best describes the formation of bowel cancers through a series of gene mutations whereby the normal bowel mucosa undergoes changes leading to the formation of small polyps that grow and eventually risk becoming cancerous lesions. Hence, early detection of these precancerous polyps through screening techniques offers hope in preventing overt cancers and its grave sequelae.

This brings us to the most important question on what exactly are the symptoms of bowel cancer? Unfortunately, bowel cancers may have vague symptoms and unless one is aware it may be missed. Blood in the stool or during defecation are the most obvious signs. Early bleeding from small tumours or polyps may go unnoticed to the naked eye and as such requires stool testing. In addition passage of mucus with the stools are often noticed.

Another important feature is the change of bowel pattern. Every individual develops their own routine normal bowel pattern. Common pattern among Asians is moving the bowel once or twice a day or even once in two days.

However, what matters most is a deviation from the normal pattern of bowel movement in a person. Thus, if one notices change in their habits of visiting the toilet, either in frequency of visits or in the nature of their stool then it should be investigated. The risks of cancer in persons with such changes are multiplied in the background history of bowel cancers among family members.

Screening colonoscopy is conducted using a fiber-optic video-endoscope inserted through the anus to directly visualize the entire colon and rectum. The procedure performed under sedation on a cleansed bowel can be done as a daycare procedure.

In addition to direct visualization, the video-endoscope allows biopsy and removal of polyps (Polypectomy). Advanced endoscopic techniques through the use of ‘narrow band imaging’ also allows earlier detection and removal of suspicious lesions through the ‘Endoscopic Mucosal Resection’ (EMR) techniques.

Bowel Cancer Screening in Malaysia is still in its infancy and lack of awareness is yet a stumbling block. Successful detection of early cancers and pre-cancerous polyps would enable early multi-modality treatment that promises good outcome for patients.

Hence visiting a Colorectal Surgeon, who would risk stratify and advise the most appropriate investigation for each individual is the first step to a successful bowel cancer screening programme.