Brief Answer:
Ovaries are palpated bimanually - vaginal and abdominal palpation

Detailed Answer:
Dear XXXX,

Please do not be so anxious. Medical fraternity is there to help you out.

Ovaries are not abdominal organs. Therefore they cannot be palpated from the abdomen. To feel the ovaries, bimanual examination has to be performed; i.e. two fingers in the vagina and a hand on the abdomen. They are located by the sides of the uterus on both the sides.

Whenever there is any tumour in the ovaries and they increase in size, they can be felt from abdomen, not otherwise.

Why are you so much worried about ovarian tumour? Is there any family history of ovarian tumour?

I would have preferred to know your age, marital history, family history and number of children if any.

Please revert back with the relevant information and if there are any further queries you have got. I will definitely try to resolve them.

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Brief Answer:
Get rid of cancer phobia

Detailed Answer:
Dear XXXX,

I definitely would not blame you for the fear that you are carrying in your mind. Your aunty had breast cancer - that too recently! Naturally, you are going to carry the phobia for cancer with you.

However, please understand, you are very young. The age for ovarian cancer is at the later stage of life. The frequent egg formation trauma is supposed to be one of the triggering cause for ovarian cancer. Therefore, those who had fair number of pregnancies and those who take birth control pills to suppress egg formation get fair protection against ovarian cancer.

To remove the ovarian cancer phobia from your mind, you may undergo ultrasonography to find out the size of your ovaries. If they are normal sized, you need not nurture the ovarian cancer phobia.

Keeping in mind the history of cancer breast to your aunty, you may practise self palpation of the breasts. That is sufficient at this age. Please palpate the breasts by the flat of the hand and not by holding the breasts in fingers. After the age of 40 years, you may consider mammography to keep watch on your breasts.

There is a dictum which says, 'The breasts who do not do their function are more vulnerable for breast cancers'. So please breast feed your children fairly to protect your breasts.

Regarding the pain in your iliac region radiating to your hips, the doctors have explained to you constipation as the cause of it. Have faith in your doctor. To get rid of it, you may have less meat in the diet, more vegetables, fruits and green leafy vegetables in your diet. Drink at least 500 ml milk (with honey and ghee if possible) daily. If needed, you may occasionally take stool softeners. With your doctors consultation, a course of antiamoebic medicines will give you relief since the symptoms are suggestive of amoebiasis.

If you decide to get your ultrasonography done, you may upload the images and the report for my review.

If you want any more information, I am always available for you on Health Care Magic forum. Even later also you may ask me a direct question also.

Please get rid of the cancer phobia and enjoy your normal life.

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Brief Answer:
Utrasonography is a good decision to sort out many problems

Detailed Answer:
Bravo XXXX for your efforts to develop positive approach!

It is a good decision to go for ultrasonography and get rid of the stress of cancer of ovary that is hanging in your mind. In your next message after ultrasonography, I would love to see :) in place of :(. I am sure you will do that from the heart of your heart.

For monitoring your breasts, I have suggested you about self palpation and later in your life, mammography. If you contact me directly or send me a direct question, I can share with you some good presentations I have gathered about self palpation of breasts.

Now this problem of scanty menses. You have mentioned it for the first time. Are you having such scanty menses for the whole year or in the last year you had it only once? Will you please clarify? If it is for complete year, we will look into the problem more in depth; if it is only for once, you can ignore it keeping a watch for any future such incidences. In your ultrasonography, please ask the doctor to look for the thickening of the uterine lining (endometrium). This will give us some clue. Then later I may suggest you estimation of certain hormones in your blood. Meanwhile, please get T3, T4 and TSH values in your blood estimated from the laboratory. Considering your worries and menstrual problem I feel this investigation is necessary.

The stomach is situated in the left upper part of the abdomen. The colon is from right side to the left side; i.e. the flow of the digested food is from right to left. Naturally in a constipated person, the left side is fuller. The position of the stomach adds to that. My suspicion of amoebiasis is further strengthened by your heaviness and tenderness in the left side. Please ask your doctor whether you need antiamoebic treatment. Secnidazole two tablets should give you much relief from this. Also during ultrasonography, your gastrointestinal tract too will be viewed completely and will enlighten about the fullness in the right side. Please get ultrasonography of full abdomen with kidney, ureters and bladder along with complete pelvis done.

I am sure this should take away most of your stress. Please revert back with the requested information and reports of investigations. Even if this string of communication closes, you can any time ask me direct question.

I hope you are happily convinced about the guidance you have received; if so, I would appreciate a good review and 5 stars rating from you. If you need any further information, I am always available for you XXXX

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Brief Answer:
You may skip all these investigations and be happy

Detailed Answer:
Dear XXXX,

Let me clarify that there is no such urgency of ultrasound for you. I suggested you only to remove your stress of probable ovarian tumour.

If now your periods are normal, forget about any investigations for it. The pain you are getting on the first day is seen in most of the women, a little severer in unmarried girls. This pain lasts for 14 hours and then goes away. It is good to have this pain as it denotes that the girl is forming and releasing her eggs. Only if such pain is intolerable, it may require some intervention. When I say intolerable, it means the pain which does not allow the woman to carry out her daily routine work. From your narration, your pain does not seem to be of such severity. If sometimes it bothers you quite a lot, you may take pain killer like Tylenol or so.

Gurgling in the colon suggests gaseous distension. I would like to treat you with antiamoebic medicines (secnidazole) and then deworm you by albendazole. You may seek for your doctors opinion on this.

I can read from your response that majority of your stress about ovarian cancer has subsided. Keep it up XXXX.

And keep in your mind forever that for any more advice, I am always available for you XXXX.

If you are happy with this, please post a good review on the Health Care Magic and rate me by 5 stars.

Please be in touch about the progress.

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Brief Answer:
Keep your bowels empty and stools soft

Detailed Answer:
Hi XXXX,

It was so nice to notice :) in your latest message!:)

From your description that the anal tags are just hanging - not bleeding nor painful suggests that it is a prolapse of the anal mucous membrane; i.e. the lining of the anal canal. This is a very delicate coat. Such prolapse results due to straining due to constipation - you have it! To combat it:

1. Get rid of the cause of constipation - amoebiasis and/or worms. I had suggested this in my previous messages also. Commonly it is amoebiasis.
2. For some period, take stool softener regularly till your bowels are really empty. They should indeed make the stools soft by retaining more water in it and/or lubricating it. Eno's fruit salt or Milk of Magnasia are good products for retaining water in stools. Liquid paraffin can smoothen the stools. You get a combination of water retainer and lubricator in Cremaffin liquid. It is a good product.
3. Every night before you go to bed, take a glassful of hot whole milk with a teaspoonful each of cow's ghee and honey in it.
4. Consume plenty of fruits, particularly citrus fruits like orange, also banana, custard apple, watermelon, figs, dates, etc.
5. Drink plenty of water.
6. Have green leafy vegetables in your every meal. Celery like salads are very good.
7. If needed, initially you may try Dulcolax suppository on first day.
Develop a habit of everyday bowel motion.

With softening and lubricated stools, your prolapsed mucous membrane will reform since from your doctors description it appears to be a minor one. For major really long prolapse, sometimes, surgical removal/ligation is indicated.

And XXXX, please do not feel sorry for asking me questions. I would welcome any number of your questions any times; you are most welcome, it's your right over me.

Happy, XXXX?

Keep me informed about the progress and improvement of your health, please! I am indeed keen to know.

Wishing you best of the health for your rest of very long life!

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Brief Answer:
Take antiamoebic and deworming treatment.

Detailed Answer:
Dear XXXX,

I am using your name as XXXX. I hope I am correct. If not, please correct me.

I still maintain that you need treatment for amoebiasis and worms. Amoebiasis is known to cause these lesions and does not allow healing properly. Also I insist that you work up on your constipation, initially by medicines and simultaneously and continued by modifications is diet as I have suggested you.

Locally you may have to apply some antibiotic cream with some anti-inflammatory and smoothening agent. Practosedyl ointment is good for that. The tube comes with applicator, however, I insist on application by finger so that some local massage is done while applying the ointment.

You should be fine with this treatment.

If any other information is needed, please do not hesitate to ask me.

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