Podcast: Abdominal wall hernias, closure with net insertion

Welcome to the new Swiss1Chirurgie podcast. In this podcast from the Hernia Centre at Swiss1Chirurgie, we look today at the topic of abdominal wall hernias and their closure using a net insert.

My name is Jörg Zehetner. This podcast series is intended as patient information for patients and all those who are interested in the topic of hernias, especially abdominal wall hernias and their treatment with net inserts.

First of all, we would like to clarify at this point what abdominal wall hernias actually are.

Abdominal wall hernias are caused by a weakness of the connective tissue in the abdominal wall. Such abdominal wall hernias often occur as a result of surgical procedures in the corresponding area. Such abdominal wall hernias must be distinguished from those caused by a congenital tissue weakness in the abdominal wall or by regenerative processes in old age. Small gaps in the tissue structure of the abdominal wall approximately above and below the navel are conspicuous in any case.

The most common form of abdominal wall hernia is the umbilical hernia. In medical Latin, the umbilical hernia is called hernia umbilicalis et paraumbilicalis. Generally, there is a weakness in the abdominal wall around the navel in all people at birth. This is due to the physiological structure of the umbilical cord, which enables the placenta to supply the unborn child. After the actual birth, the umbilical cord is cut and the belly button is formed. It is precisely at this point that weaker tissue repeatedly develops, which makes an umbilical hernia possible in the later course of development.

Women in advanced pregnancy are particularly affected, and it is not uncommon for a large hernia to form due to the pressure from inside on the abdominal wall.

Abdominal wall hernias also occur more frequently after operations in the abdominal area, especially after open operations, because the abdominal wall that is separated during the operation causes a weakening of the tissue at these points.

In addition, abdominal wall hernias can occur in different places, for example on the left or right upper abdomen or in the area of the lower abdomen.

Manifestations of abdominal wall hernias

Smaller gaps in the tissue in these areas can cause the fat below the abdominal wall to protrude. Through somewhat larger gaps of about two to four centimetres, there is then already the danger that, for example, parts of the small intestine can be pressed through the abdominal wall.

Even larger hernias with a size of five to seven centimetres already cause more severe pain for those affected and therefore hardly go unnoticed. This is also because with such a size of hernia, the hernia sac, also known as the hernia sac, can already take on the size of a medium-sized apple.

A hernia of the abdominal wall is already very unpleasant due to the entrapment of organ parts and causes, above all, pulling pain.

This is always associated with the increased risk of small intestinal loops becoming trapped, as already mentioned. This means that the blood supply to these parts of the intestine is at least significantly restricted, if not interrupted, which can ultimately lead to the death of the affected organ parts. There is always the risk of peritonitis with the corresponding complications and even danger of death.

Treatment of abdominal wall hernias in the Swiss1Chirurgie clinics

The hernia experts at the Hernia Centre of Swiss1Chirurgie have been dealing with the treatment of abdominal wall hernias for many years. Very small abdominal wall gaps are treated here in a minimally invasive way. For this, only a small incision is made, which is then directly sutured again and provides sufficient strength in the abdominal wall tissue even without a net insert.

Larger abdominal wall hernias are treated more intensively. It always depends on the specific formation of the fracture, the age of the patients, the general state of health and existing previous findings of the patients. In many cases, laporoscopic surgery using small incisions is possible. Laporoscopic surgery using a net insert is a very gentle method that can be performed quickly, is not very stressful for the patient and usually has very good results.

Laporoscopic surgery

In laporoscopic surgery, a camera is inserted under the side of the abdominal wall through a small incision and allows a view of the existing tissue defect from the inside. The affected area of the abdominal cavity is filled with CO2 gas so that a sufficiently large surgical area is created. Minimally invasive surgical techniques are used to insert, position and fix the hernia net. These are two cuts about half a centimetre long.

The net serves to reinforce the abdominal wall from the inside. This means that further abdominal wall hernias in the corresponding areas can be ruled out very reliably for the future. This net is uncoated on one side so that it can bond and grow together well with the abdominal wall. The net is coated on the inside to reliably exclude the possibility of it growing together with the small intestine tissue.

In the treatment of abdominal wall hernias, Swiss1Chirurgie has relied for years on the hernia meshes of the Bard company, which have already proven themselves thousands of times in therapeutic treatment. Another advantage of these nets is that they are already equipped with a special fixation system, which makes it much easier to fix the nets to the abdominal wall and makes the minimally invasive operation even more bearable for patients.

The main advantage of these nets is that they can be placed very easily and precisely due to their special shape. The net itself is placed on a balloon structure and then positioned centred on the break. Inflating the balloon stretches the net open and ensures that it lies flat on the abdominal wall. This gives the hernia net a perfect position without major surgical effort. The net is then fixed to the abdominal wall at the edges. Afterwards, the balloon structure can be removed again. This positioning system described here is used exclusively by Swiss1Chirurgie in Bern. In this way, we were able to achieve consistently very good results with little postoperative pain for the patients.

The number of places where the net is attached to the abdominal wall varies depending on the size of the hernia. Experience shows that fewer fixation points also mean less pain for the patient. While permanent suture material was used in the past, the experts at Swiss1Chirurgie now use absorbable material that dissolves completely and without residue after eight to twelve weeks. If, for example, a nerve is hit during the operation, any pain that may occur will usually disappear after the absorbable staples are dissolved.

If abdominal wall hernias are treated in a large open operation, this often leads to very complicated healing processes with correspondingly difficult tissue adhesions. With minimally invasive procedures such as those we perform in the Swiss1Chirurgie clinics, such complications are ruled out from the outset, which significantly simplifies and shortens the healing process for patients.

Performance and follow-up of open surgery for abdominal wall hernia

If major open operations with corresponding adhesions have already been performed, we recommend a follow-up operation in which these complicated adhesions can be removed and further stabilisation of the abdominal wall can be achieved. The primary concern here is the closure of the affected abdominal muscles, where the posterior fascial sheet is usually affected. This can be closed well again with an appropriate follow-up operation and reinforced with a net. The remaining abdominal muscles are then precisely placed again.

With such an operation, which takes a little longer, the tissue adhesions can be removed and the function of the abdominal wall can be fully restored. It should not be concealed that such a major operation also involves certain risks due to its length of two to three hours. Depending on age, health condition and possible previous findings, inflammatory processes may occur in the area of the operated tissue, for example.

It is certain that such an open operation is associated with significantly more pain than the minimally invasive procedures. A stay of five to seven days in observation in hospital must be planned. The healing processes themselves also take longer than with minimally invasive surgery.

Depending on the surgical field, drains may also need to be placed to allow drainage of wound secretions as the tissue heals. In the case of major open surgery, an abdominal belt must always be worn afterwards to support the tissue. Together with the orthopaedic specialists, the surgeons at Swiss1Chirurgie have developed a belt with a special abdominal calotte. In complicated cases, it is even possible to produce an individual calotte using 3D printing. This allows the abdominal wall to be excellently supported, which is not always the case with prefabricated products.

Wearing such an abdominal belt will be necessary for about three to six weeks after the operation. Our recommendation is to wear the abdominal belt day and night for the first three weeks. For the following three weeks, the belt must only be worn during the day. Continuous monitoring and follow-up care takes place in the Swiss1Chirurgie clinics.

For further questions about abdominal wall hernias in general and the therapeutic options, please feel free to contact the specialists at Swiss1Chirurgie. In addition, we provide further information material on our website www.swiss1chirurgie.ch. You can also use the contact options at www.swiss1chirurgie.ch or call one of our clinics.

Thank you for your interest and attention!

This podcast is part of the Helvetius.Life podcast series.

Helvetius.Life is the in-house newspaper of Helvetius Holding AG. Here, Swiss1Chirurgie, the Centre for Bariatric Surgery ZFBC, the Gastroenterology Group Practice GGP and the Bern Clinic PZB combine their expertise and services in the interests of our patients’ health.

With Helvetius.Life we inform you about exciting topics from the specialist areas of the clinics and practices, provide insights into the work of specialists, show you what we can do in patients’ testimonials and present new findings, therapies and scientific research results.

Our podcast series:

  • hernien-podcast.ch
  • adipositas-podcast.ch
  • ggp-podcast.ch

We would also like to recommend our website

www.swiss1chirurgie.ch or our app, which you can also find at www.swiss1chirurgie.ch.

You can also find more topics and information at: hernien-podcast.ch, nachsorge.ch and in our in-house newspaper www.helvetius.life.

We introduce: Anita Scheiwiller, MD

The new member of the Swiss1Chirurgie team

Always on the lookout for the best surgeons and specialists in the Swiss1Chirurgie service areas, we have found one again. From 01 July 2021, our surgical team will be supported by Anita Scheiwiller, MD. We would like to take this opportunity to introduce you to our new expert in visceral surgery.

Anita Scheiwiller was born in Zurich in 1971, from where she moved with her family to Bern after only a short time. The mother, two sisters and the father, who was the director of a school, naturally went along.

Anita Scheiwiller finished school by starting a commercial apprenticeship, which she successfully completed. But it soon became clear that an office job would probably not be the right thing for the versatile young woman. During a trip through South America, the decision matured to go back to school and take the Matura. After three years, that was also successfully done and Anita Scheiwiller had long since made the decision to become a doctor.

At the University in Bern, this developmental step was also successfully completed, although it was only towards the end of her studies that it became clear that Anita Scheiwiller would choose the field of surgery. An internship in cardiovascular surgery at the Inselspital Bern turned a decision into something like love at first sight. From then on, it was clear that the newly trained medical doctor would dedicate herself to the field of surgery. What began as “love at first sight” has remained a deep passion to this day.

After her first residency at the regional hospital in Langenthal, she returned to Bern two years later, this time to the Tiefenau City Hospital. During her work there, Anita Scheiwiller became more and more intensively involved in abdominal surgery, thus setting a clear signal for specialisation.

At the University Hospital Zurich, the now quite accomplished surgeon was able to complete her training as a specialist in the Clinic for Visceral Surgery in 2008 and obtain the FMH title for surgery. In the same year she took up her first position as senior physician at the Bürgerspital Solothurn. After only a short time, Anita Scheiwiller followed an offer from Eastern Switzerland and was then engaged for several years in Frauenfeld and Zurich respectively. With the acquisition of extensive surgical experience, the specialist title for visceral surgery and the European specialist title for colorectal surgery and proctology followed.

After 20 years of working in public hospitals, Anita Scheiwiller is now returning to her roots. As an affiliated doctor, she will be a member of the Swiss1Chirurgie team of experts and will be a valuable asset with her work in the Solothurn, Brig and Bern clinics. Her interests in colon and rectal surgery, obesity surgery and thyroid surgery fit perfectly with the profile of Swiss1Chirurgie.

In addition to the new professional challenges, Anita Scheiwiller, MD, is also pleased to be joining the Swiss1Chirurgie team of experts for very personal reasons. For her, returning to Bern and her work in the Swiss1Chirurgie clinics in Bern, Brig and Solothurn is also a return to her home country, where a wonderful natural environment with the mountains and unique natural landscapes offers plenty of space for relaxation, recreation and activity.

Dr. Jörg Zehetner on Anita Scheiwiller

It is a particular pleasure for me to welcome Anita Scheiwiller, MD, to our Swiss1Chirurgie team as of 01 July 2021. With her, we are gaining an expert for a large part of our service areas who has proven herself as a surgeon over many years. For Swiss1Chirurgie, the addition of an experienced surgeon not only means a further expansion of our efficiency in the interests of our patients.

As the first woman in our team of surgeons, Anita Scheiwiller is a real enrichment for our team, both personally and professionally. Our patients in particular will be pleased to be able to turn to an empathetic and extremely qualified specialist colleague with their sometimes very shameful problems.

Moreover, I am sure that we can all benefit from the experience of an outstanding surgeon and thus do an even better job for the benefit of our patients.

Welcome to the team, Dr. med. Anita Scheiwiller!

Stigmatisation Obesity. What does that mean?

Dr. med. Jörg Zehetner on the problem of obesity and what it means for those affected.

As part of the lecture series of Helvetius Holding AG, Dr. med. Jörg Zehetner, Professor USC, took a stand on the stigmatisation of overweight people and the resulting consequences for those affected. In his lecture in the Saaser-Stube Saas-Fee, the experienced physician, who also deals intensively with obesity problems, described the circumstances that obesity patients have to live with practically every day.

They are among us

At the beginning of the lecture, Dr Zehetner made it clear that practically everyone knows the overweight. In one’s own family, in one’s circle of friends or in the circle of colleagues, they exist everywhere and the number of those affected is constantly increasing. And the lives of patients with obesity are not easy.

Where stigmatisation begins

Look at the fat guy! Oh, she’s fat. The fat man should exercise more. Look what he’s got in his shopping basket, and he’s already fat enough.

This is how the stigmatisation of overweight people begins. Without asking why or wherefore, without taking into account how people are personally affected, they are consciously or unconsciously pigeonholed into a category in which they neither belong nor can free themselves from it. Besides the flippant remarks, there are also those that really hurt and don’t help the people concerned at all.

Reduce prejudices

Anyone who has studied the problems of obesity and adiposity in depth knows that those affected suffer greatly from their current life situation. A first step towards at least reducing this unfortunate situation would be to dismantle popular prejudices. It’s always the best moment for that.

The fight against obesity requires a professional network

Hardly any overweight person with a serious problem will be able to successfully face the disease alone in the long term. Even though overweight surgery is now a proven and successful means of fighting the extra pounds, it requires targeted networking before, during and after the medical intervention. For this purpose, a professional network has been established under the umbrella of Helvetius Holding AG, which provides advice, support and assistance to patients in all phases.

Large social alliance against stigmatisation necessary

The topic of obesity is present everywhere. Not only in everyday life, but also in the media, people are encountering this topic more and more frequently and intensively, in addition to the commonly known jokes and remarks about being overweight. From stigmatisation, the path to discrimination is usually a very short one. Obese people are associated with a conceptual world that is anything but pleasant or appreciative. Especially when you don’t know these people personally. This stigmatisation extends far into the personal and social lives of those affected. Even professional life is not excluded. To change this, a large social consensus is needed.

Steps out of stigmatisation

If the spiral of stigmatisation and discrimination against overweight people is to be broken, a clear line is needed. And this begins precisely where obesity is understood as a disease and thus also as treatable and curable. Only then can an active approach be made to these people, who can then actively face their problems themselves without having to continue to hide.

A further step would be to significantly rethink the approach to these patients. And in every area of life and in every encounter with overweight people. Only when the stigma is taken away from these people will they themselves be able to actively enter into the process of their recovery. Dignity, respect and tolerance are exactly the right keywords here.

It is important to also perceive overweight people as valuable members of our society and to recognise that they are not lazy, sedentary, unpleasant and low performers, but sick. And something can be done about diseases, including morbid obesity.

Define obesity as a disease

Anyone who takes a closer look at overweight and obesity will quickly be able to understand them as actual diseases. As with any organic disease, there are clear definitions and developments, but also therapeutic interventions that clearly speak for a clinical picture. A first indication of this is the division into different classifications of overweight, starting from the Body Mass Index, BMI.

Although obesity surgery is a helpful intervention, it does not by itself solve the problem. Being morbidly overweight is and remains a chronic disease that requires lifelong attention, but not disparaging stigmatisation.

More in-depth information on the topic is available in the video recording of the lecture (LINK) and directly on the Swiss1Chirurgie website.

4th Symposium of Helvetius Holding AG at the Talent Campus Bodensee in Kreuzlingen

The 4th Helvetius Holding AG symposium will take place on 22 October 2021 from 18:00. Core topics of the public event are diabetes and obesity as well as liver diseases with the effects on personal health. The subject area will be expanded by interesting lectures on motivation in recreational sports and on liver fasting with Hepafast.

In addition to Dr. med. Jörg Zehetner, nutritional physicians Dr. med. Hardy Walle and Dr. med. Tilmann Schmitz as well as football and coaching legend Martin Andermatt will lead through the exciting topics.

We expect your registration for the free event under Registration Kreuzlingen – Helvetius Holding AG.

More information is available in the article and under Streaming – Live Events Kreuzlingen – Die Helvetius Holding AG.

Symposium of Helvetius Holding AG at the Talent Campus Bodensee Kreuzlingen

An event full of specialist medical and social topics with networking opportunities

With its 4th symposium at the Talent Campus Bodensee in Kreuzlingen, Helvetius Holding AG is heading for the highlight of this year’s lecture series.

With Dr. med. Jörg Zehetner (Professor USC), Dr. med. Hardy Walle (nutritional physician), Martin Andermatt (trainer and football legend) as well as Dr. med. Tilmann Schmitz (nutritional physician), nationally and internationally recognised personalities will be on stage and will speak on focal points of medical research, healthy nutrition, motivation and sport.

The core topics of the medical specialist subjects are

  • “Belching, obesity and diabetes – recognising connections” and
  • “Fatty liver and obesity – liver fasting with Hepafast”.

In addition, the highly interesting event deals with topics on motivation and healthy lifestyles in everyday life, but also answers questions that arise for every concerned and interested participant.

In addition to specialists from the various fields, well-known and successful entrepreneurs and personalities of public interest also meet here to exchange opinions and network.

This will provide interesting opportunities for participants in the event to expand knowledge, build skills and make valuable contacts.

The 4th Helvetius Holding AG symposium is open to all interested and registered participants free of charge.

Date: 22 October 2021, 6:00 p.m. at the Talent Campus Bodensee in Kreuzlingen.

Please note that participation in the symposium is only possible after prior registration.

You can easily register at Registration Kreuzlingen – Die Helvetius Holding AG.

Please feel free to consider this information as a personal invitation and register to participate in the event. We look forward to meeting you or seeing you again at the 4th Helvetius Holding AG symposium at the Talent Campus Bodensee in Kreuzlingen.

Beer belly – men and the trivialisation of overweight

Whether at the football pitch or in the bar, men don’t hide their beer belly, but the 10-15kg overweight is proudly carried in front of them. No one should make fun of it, but the topic must be addressed and discussed with sensitivity. People like to keep quiet about their supposed beer belly, even at the doctor’s, even at physiotherapy or during sports.

“Male obesity”. This cannot simply be categorised as “gluttony” or “self-indulgence”. Male obesity has as many causes as it has manifestations. It primarily affects men from middle age onwards, who (like women) are undergoing a particular type of metabolic change.

Recording from 3.9.2021 ” Saaserhof” in Saas-Fee Overweight: Beer Belly & Love Dumbbells as a Danger? by J. Zehetner, MD

Chapter selection : Start video Select menu bar at the bottom right or the dots!

More on upcoming events & recordings: https://www.helvetiusholding.ch/helvetius-life-streaming-2021/

Particularly with increasing age, the body strives for developmental reasons to store food reserves as fat reserves, so to speak, in order to provide for possible shortages. Especially for men who consume fewer calories than they take in due to their occupation or limited exercise, this quickly leads to unwanted excess weight. Organic processes in particular play an important role here, which cannot be “switched off” so easily.

While there is often talk of dieting and smaller portions, the topic of alcohol and alcohol consumption is talked down, ridiculed and negated, especially among men. However, liquid foods such as beer and wine contain many hidden calories that are not readily counted. The energy drinks that have become fashionable, various shakes and also protein shakes (although healthy) are also energy suppliers and usually high in calories. Fruit juices and smoothies in particular are easily consumed on the side without thinking about how much sugar is being consumed.

Obesity is now more common than malnutrition worldwide. The real problem is predominantly to be observed in the western industrialised countries, since it is precisely here that there is an ever-increasing oversupply of food at all times. The obesity rate in the USA, for example, is around 35-40 percent of the population, which is a fact that should not be underestimated. This means an overweight of at least 20 kilograms, or a BMI of 30 or more. This is also the case despite the surgical intervention options, although these methods in particular can now be classified as very safe and successful. Nevertheless, the rate of surgical interventions needed in this particular area is far too low.

The topic of beer bellies – as the starting point of the discussion – is not only about informing the population and professional colleagues accordingly. Rather, I see it as important to educate about the modern treatment options of bariatric treatment methods up to surgery. The primary aim is always to help patients according to their individual starting situation.

Information on the topic of obesity

It is important to understand that obesity is always associated with concomitant diseases. Diabetes, high blood pressure, sleep apnoea, high cholesterol – all these manifest themselves in the environment of obesity. But there is also another aspect that has emerged, especially in recent years. The point is that people who are overweight are simply stigmatised. At school, at work and even in private life, overweight people are described as lazy, fat, greedy, careless and lazy about exercise. This puts additional stress on those affected and does not help to tackle the problem in a targeted and conscious way. Significant overweight has been defined as a disease since 2013 at the latest. This puts morbid obesity in the same category as diseases such as diabetes, high blood pressure and many other chronic diseases.

The stigmatisation of obesity is extremely dangerous for patients, as they then withdraw and cannot address their actual problem in a targeted and active way. Professional treatment, counselling and support is the surest way out of obesity.

Everyone is challenged to exercise some restraint in their contact with morbidly obese people, both in their choice of words and in their behaviour. Even if it’s “only” about the supposed beer belly.

Why specifically “men who are overweight”?

Yes, women also suffer from morbid obesity. But men do it in a special way. There are now “curvy models” for women, but not for men. And men by nature already tend to eat the slightly larger portions, even if that seems to be gradually declining. The world view was and still is such that a belly is always subconsciously associated with prosperity. Also in modern industrial societies. The dangers are mostly conscious, but are only realised when they are actually there, visible and sometimes already tangible.

In addition, after a certain stage of life at the latest, men do not have this special view of their appearance that many women have. The actual problem is not recognised, or is recognised only very late, and is then gladly accepted as natural. This means that they don’t have to go to the doctor, and the obesity surgeon is an unknown quantity for many of those affected. Therefore, men in particular must be sensitised to actively face this problem.

What starts with a beer belly that is not taken seriously often ends in an overweight catastrophe, unless the right steps are taken in time, for example to a Swiss1Chirurgie clinic.

Next event:

Fatty liver and diabetes – the connections

Dr. med. Michaela Neagu FMH Gastroenterology and Internal Medicine GGP Bern

In a lecture by the gastroenterological group practice GGP Bern AG (a company of Helvetius Holding AG), the gastroenterologist Dr. med. Michaela Neagu illustrates the connections between fatty liver and diabetes. Following the lecture, it becomes clear that fatty liver and diabetes form a vicious circle in which both diseases trigger and drive each other. In addition to diagnostics and the effects on overall health, the lecture also opens up a clear picture of how the course of the disease can be successfully influenced and, in the best case, reversed. We have made the lecture by Dr Michaela Neagu available in text form, but also as a video lecture and as a PowerPoint presentation. You can find out more here.

Chapter selection : Start video Select menu bar at the bottom right or dots !
Full screen : Start video Select menu bar bottom right and !

Fatty liver disease and diabetes mellitus – are there correlations?

The experts at Helvetius Holding AG clarify

In a lecture by GGP Bern AG, Dr. med. Michaela Neagu presented the connections between fatty liver disease and diabetes mellitus. This is less about medical jargon and more about educating people about what a fatty liver is, what it means for people’s lives and whether there is a connection to diabetes mellitus.

Dr Michaela Neagu is a specialist in gastroenterology (gastrointestinal diseases) and general internal medicine in the Gastroenterology Group Practice Bern, a partner of Helvetius Holding AG, and has extensive experience and expertise in her specialist field.

In her lecture, Michaela Neagu, MD, highlights the clear connections between fatty liver and diabetes mellitus.

The fatty liver disease

Basically, a distinction is made between alcoholic fatty liver disease and non-alcoholic (metabolic) fatty liver disease. As the different names suggest, one form of fatty liver disease is related to excessive alcohol consumption, the other has nothing to do with alcohol consumption. In addition, there are manifestations such as viral liver diseases, autoimmune diseases, iron storage disorders and other conditions that promote fatty liver disease or make it possible in the first place.

Worldwide, about 25 percent of the population is affected by fatty liver disease. This makes fatty liver the most common liver disease of all. Among diabetics themselves, about 30 to 40 percent have a fatty liver. Also, about half of patients with severe dyslipidemia suffer from fatty liver disease.

How does a fatty liver develop?

A fatty liver occurs when the capacity of the liver cells to absorb fat is exceeded. This causes fat to be deposited in the liver itself, which can no longer be broken down by the liver. The accumulation of fat in the liver cells causes these cells to become inflamed and then send out messenger substances that inhibit the supply of insulin to the liver. Eventually, a kind of insulin resistance develops, so that insulin cannot work in the body as nature intended.

As a result, hyperglycaemia occurs in the body. This sends out a stimulus that causes even more insulin to be produced. The increased insulin level then further leads to increased fat absorption, fat synthesis and fat storage as well. This creates a cycle of action that deposits more and more fat in the liver, but also generally increases fat storage in the body far beyond normal levels.

What do people affected by fatty liver notice?

It is sobering to note that about half of all those affected live practically asymptomatic and accordingly do not worry at all about their liver health, for example. On the one hand, this may have a calming effect, but on the other hand, it is an alarm signal that effective therapeutic interventions only start late, usually very late.

Some patients experience general but rather non-specific fatigue. A certain faintness and perhaps once undifferentiated slight pain in the upper abdomen indicate that a serious condition could be present here. Mostly, however, this is not taken seriously by the patients themselves.

As a result, in most cases the fatty liver remains an incidental finding that only comes to light during the treatment of other diseases. This could be, for example, elevated liver values during a health check or visible changes in the liver during a standard ultrasound examination.

In general, there is a risk that untreated fatty liver can progress to cirrhosis. At the latest then, those affected realise that their liver is sick. Typical signs are then the well-known large water belly, certain bypass circuits in the organism and other signs come very late, however. In practice, everything is possible with the clinical picture of fatty liver, from no symptoms to severe and dangerous courses of the disease.

Between 50 and 90 percent of people with fatty liver are obese, i.e. clearly overweight. Signs of a metabolic syndrome are recognisable.

How can a fatty liver be diagnosed with certainty?

A few years ago, biopsy was the method of choice when the condition of the liver cells needed to be determined more precisely. To do this, a needle is inserted directly into the organ and a small tissue sample is taken. This tissue sample can then be further examined for fatty liver cells.

Thanks to advances in medical technology, we can now diagnose fatty liver without a biopsy in 90 percent of cases. With different imaging methods such as ultrasound or computer tomography, absolutely painless examinations can be carried out today without interfering with the body. Thanks to the excellent presentation, the fat content in the liver can be determined comparatively well with reliable values.

The basis for the evaluation of the ultrasound examinations is, for example, a comparison of liver and kidney tissue. If both organs are healthy, they have approximately the same structure and colour in the image. If the kidney tissue appears darker than that of the liver, then the lighter parts in the liver indicate fat deposits. In this way, a fatty liver can already be recognised with a fairly high degree of certainty.

If the specialists then decide to take a tissue sample, usually to exclude or detect additional liver diseases, the differences become even clearer. A healthy liver consists of neatly arranged and clearly differentiated cells. In fatty liver, the disturbance of the cell architecture due to the fatty deposits is clearly visible. This becomes even more obvious in the case of a pronounced fatty liver with infected cells.

What is the path to fatty liver

From a healthy liver to a fatty liver always takes time and certain circumstances. Various unfavourable factors cause fat storage in the liver cells, which can then further lead to infection in the liver itself. It doesn’t have to be, but it can be. However, when such an infection takes place, a certain remodelling in the connective tissue is driven forward, which can lead to complete scarring of the liver if left untreated. Then the stage of liver cirrhosis has already been reached. Liver cirrhosis, in turn, is a favourable factor for the development of liver cancer. This applies to about two percent of those affected. But even when liver cirrhosis has not yet been diagnosed, more and more cases of liver cancer in fatty liver are becoming known. And in the USA, fatty liver is now considered the most common reason for liver transplantation.

A look at diabetes mellitus

Usually we are talking about diabetes here. This is diagnosed when chronically elevated sugar levels are found in the blood. The body is over-sugared, so to speak. The factors that cause high blood glucose levels are a reduction in the effect of insulin and, in the course of time, often an insulin deficiency.

Currently, about six percent of the world’s population, including children, are affected by diabetes. In children, type 1 diabetes is mostly observed. With the increase in morbid obesity, also in children, type 2 is also becoming more common. Diabetes can be diagnosed in a very reliable and uncomplicated way in various test procedures.

What does diabetes mellitus mean for people’s lives?

The presence of diabetes mellitus is actually associated with serious risks and consequences for the health and life of those affected. One problem is the damage to the small veins. This mainly affects the kidneys, the retina of the eye and the nervous system. The range extends from relatively mild kidney problems to complete kidney failure requiring dialysis. In the case of retinal diseases, such disorders can lead to blindness due to diabetes mellitus. In terms of damage to the nervous system, there is a loss of certain sensory impressions, which can manifest itself, for example, in patients no longer being able to feel the ground beneath their feet. Problems with coordination and spatial position change are also observed. Gastrointestinal disorders with diarrhoea and other symptoms are also reported. Cardiac arrhythmias can complete the picture.

In addition to damage to the small veins, damage to the large veins is also a consequence of diabetes mellitus. Particularly worth mentioning here are coronary heart diseases. At least here, the risk of diabetes patients is significantly higher compared to the normal population. For diabetics, this risk can be assessed as about twice as high. A full 75 percent of diabetics die from a cardiovascular event.

The risk of suffering a stroke is also about 2.5 times higher than in the comparison group of people without diabetes. A circulatory disorder, especially in the legs, has a risk of 4.5 times more than in the comparison group. The diabetic foot is well known, which is caused by precisely these circulatory disorders and can even lead to the necessary amputation.

Diabetes mellitus also generally increases the risk of infection in relation to practically all infectious diseases.

The relationship of fatty liver and diabetes mellitus

What is special about the relationship between fatty liver disease and diabetes mellitus is the fact that both diseases can be mutual and reciprocal triggers as well as consequences of the other disease. This means: fatty liver patients are or often become diabetics and diabetics often suffer from fatty liver. So there is a causal relationship between fatty liver and diabetes.

Let us imagine a possible course of events: An initially physically completely healthy and normal person begins to gain weight for various reasons. Fat tissue increases and at some point the ability to store fat is exhausted. This then leads to a veritable flooding of the entire organism with free fatty acids. At some point, the organism becomes resistant to the effect of insulin and hyperglycaemia occurs. Now the question arises: Where to put the sugar?

Some of the free fatty acids are deposited in the liver cells, where they lead to the fatty liver already described. This significantly limits the liver’s ability to metabolise healthy fats. In addition, there is an increasingly pronounced insulin residual tendency, which in turn affects blood sugar in the interaction and ultimately leads to type 2 diabetes. Other effects are always included here, such as high blood pressure, disorders of the function of the pancreas, etc.

The mutual condition of fatty liver and diabetes creates a vicious circle that is difficult to break, and then only with radical methodology.

What can be done?

At least up to a body mass index BMI of 30, maximum 35, it is still possible to take countermeasures and something should be done actively. It is worth noting that the fatty liver is reversible, i.e. it can also be regressed. Even if liver infection has already occurred, the process can still be reversed. Timely action is crucial. If cirrhosis of the liver has already occurred, it can hardly be stopped. Nevertheless, even then, consistent lifestyle adjustments and regular check-ups should be aimed at preventing further liver damage.

The way back to a healthy liver is always through a reduction in body weight and a corresponding reduction in the over-fatness of the organism. Even a five percent reduction in body weight leads to a relevant defatting of the liver.

With seven to ten percent weight loss, infections in the liver or incipient scarring of the liver tissue can also be reversed. These are encouraging facts that have been sufficiently tested and researched.

Several factors are crucial for weight loss. This starts with a significant reduction in calorie intake and continues with healthy and regular exercise. A period of at least eight weeks, but usually considerably more, is to be set. The closest possible consultation and care by specialists is highly advisable, as other risk factors must also be observed and ruled out. This applies especially to cardiovascular risks.

Toxic foods such as alcohol, drinks with a high fructose content and nicotine should be avoided at all costs.

You can watch the entire lecture by Dr. med. Michaela Neagu with a lot of additional interesting information and further questions and answers here in the video lecture.

A PowerPoint presentation on the topic illustrates and complements the lecture.

Belching, obesity and diabetes – recognising connections

Only those who recognise the connection between reflux, obesity and diabetes can find the right therapeutic approach. This is what emerges from the expert lecture by Dr. Med. Jörg Zehetner, Professor (USC), about which you can read the full article here.

Continue reading

Martin Andermatt with his experiences on liver fasting

When Martin Andermatt talks about his experiences with liver fasting, the football legend and FC Schaffhausen coach is mainly talking about experiences with himself. The core of his presentations is that something only changes if you change yourself. This is just as true in active sports as it is in maintaining the health of one’s own body. The well-known Swiss also shares this experience at the 4th Helvetius Holding AG symposium at the Talent Campus Bodensee in Kreuzlingen. Read the report here and find out where you can watch the live stream.

A field report on liver fasting with HEPAFAST® by Martin Andermatt

Dr. med. Jörg Zehetner, Professor (USC), and Dr. med. Hardy Walle spoke on the topic of liver health and fatty liver at the 4th specialist conference of Helvetius Holding AG at the Talent Campus Bodensee Kreuzlingen. The highlight of the evening was undoubtedly the lecture by Dr. Hardy Walle, MD, who not only used the latest scientific approaches to shed light on non-alcoholic fatty liver from a somewhat different perspective, but was also able to present an effective concept for liver fasting in the form of HEPAFAST®.

In the following, football legend Martin Andermatt reported on his own experiences of liver fasting with HEPAFAST®. As a successful professional footballer and now coach of FC Schaffhausen, Martin Andermatt knows very well how important stable health is and what effects a healthy liver has on the entire organism.

As a football coach, Martin Andermatt likes to talk about his own practical experiences. With his own experience, Martin Andermatt was the first Swiss coach of a German Bundesliga team and also knows the German league business from the perspective of a supervisory board member at the Hannover 96 club.

In line with his own sporting career, also as an active player, Martin Andermatt has always been interested in how a good, balanced and healthy diet can be designed. As he got older, the question of how to continue in life after active football also came into focus. The main interest was in the physical and psychological effects of no longer exercising so intensively and practically losing a previously accustomed amount of exercise.

As a coach, Martin Andermatt also sees his responsibility in conveying information to adolescent and also adult players that is also correct and underpinned. Conjecture, hearsay and supposed knowledge are not really strong arguments. That is why Martin Andermatt knows very well that only one’s own experience is a good basis for passing on knowledge. He also sees this fundamental approach as important when he gives his very own experience report on liver fasting with HEPAFAST® at the 4th Helvetius Holding AG symposium.

Even though Martin Andermatt, as a non-medical doctor, does not know the formulas for liver health, he was able to follow every step in the lectures by Dr. med. Jörg Zehetner, Professor(USC), and Dr. med. Hardy Walle, founder of BODYMED and co-developer of liver fasting with HEPAFAST®. Especially from his own experience.

Personal experience is what really counts

Martin Andermatt also knows from his experience with liver fasting that this is not simply a matter of doing things quickly for a short time. It is always important to look at the development. Martin Andermatt sees this in his sporting commitment as well as in his personal attitude to health. However, even here beautiful and melodious words are always worth less than one’s own experience. And this is exactly how Martin Andermatt reports on his own experience with liver fasting with HEPAFAST®.

His first observation is about the dream world. For example, he reports that he dreamed much more intensely than usual during the periods of liver fasting. In addition, he felt extremely vital and efficient in every phase of the liver fast.

With now already 60 years of life experience, Martin Andermatt still feels very well today and knows that he has already tried a lot of things regarding health maintenance. Be it juice cures or various diet programmes. Martin Andermatt knows what he is talking about when he passes on information to his athletes.

Especially with regard to older people, nutrition is very important. Too little exercise, a lack of good proteins and the loss of muscle mass all impact on health. Overall, the quality of life can suffer a lot, which is an important issue for Martin Andermatt. After all, quality of life is an important issue for all people. Especially when they get older. Then you also need a good measure of discipline if you want to stay physically and mentally fit over a long period of time.

Just thinking that maybe you should lose some weight is not enough to really achieve that. Only then, when one becomes active in the process, will success be achieved. So it’s about real action, which is always crucial for change.

A first step for Martin Andermatt in his encounter with liver fasting was to pick up the HEPAFAST® preparation himself in Bern and not simply have it sent to him. In the Swiss1Chirurgie clinic, he had his measurements taken, so to speak. What really counts are actual and current values. Martin Andermatt already knows this from his sporting career.

Motivation counts

As in many other areas, the right motivation is the best starting point for good results in liver fasting. If one’s own motivation can then be supported in a discussion with a medical specialist, this is a good prerequisite for active action.

What counts then is the real doing. Not tomorrow or perhaps the day after tomorrow, but ideally right away, one should start with what one has recognised as good and right for oneself.

From Martin Andermatt’s point of view, it is sometimes the small vanities that can be an impetus for liver fasting. Who doesn’t want to please their partner even at an older age? Who doesn’t want to be active and fit even as they get older? You also want to be a role model for the children and if you are a coach, it all has something to do with a positive aura on the people you are training. Only if you like yourself can you radiate that positively, says Martin Andermatt.

In addition, of course, there are the thoughts about one’s own health. Even if you have paid absolute attention to a healthy diet and lifestyle for many years, sometimes this changes as you gain experience in life. However, personal health always remains the most important asset. You have to decide what is good and what is right. Those who decide for themselves do not have to let others decide for them. And health should always be a very important factor in these decisions as well.

What advice should you give to active athletes at the end of their career?

In general, active athletes eat a diet very rich in carbohydrates, as they need this energy for their physical exertion. Often, at the end of their career, it can be observed that many athletes quickly gain weight and even tend to become obese. Then it is important to get back to normal life as well. A deeply human factor also plays an important role here. As an athlete, you are suddenly no longer in demand. This can quickly lead to letting oneself go. In every respect. It is then all the more important to recognise one’s own human value. You have to see what you still want to achieve in life and what you can accomplish and with what charisma you want to meet your fellow human beings. The short-lived lucky charms like good food, Coke or a bag of crisps are then not really what you need. The short happiness is a fallacy that in the end only makes people dissatisfied and unhappy.

The recommendation for active athletes at the end of their career

In any case, those who are at the end of their career have to train off slowly. It is not the end from one day to the next that counts, but the gradual change to a normal status. Just as you then gradually say goodbye to high athletic performance, you naturally also have to change your diet. The mental load also changes, which must also be considered.

Martin Andermatt is convinced that what counts now are good conversations, even beyond one’s own horizon of experience. Good medical supervision can be useful. This is not about fear of any diagnosis, but about developing visions for one’s own future. At the same time, it is also important for Martin Andermatt to simply live in a more relaxed and happy way.

As a coach, he follows a very clear philosophy, which he likes to sum up in three words: Laugh, learn, sweat. When he passes this on to his players, Martin Andermatt himself also likes to think about whether he has already laughed, learned and maybe even sweated today. The most beautiful thing is when you can give the players something beyond pure sport that is still of value for life after active sport.

Your own experiences with liver fasting

From his own experience, Martin Andermatt can only associate liver fasting with pleasant perceptions. This includes above all the real feeling of well-being and the new energy he felt for himself.

Especially in times when one wants to recognise oneself anew, liver fasting is an additionally exciting experience. Martin Andermatt has already completed a liver fasting cure with HEPAFAST® three times and is sure that he will do it again and again. If only because of all the positive energy it has given him. He is also happy to recommend liver fasting to others. He stands behind it with all his personality and experience.

Of course, it can be difficult for individuals to face their issues. People often prefer to make fun of themselves instead of tackling important changes. Certainly also because change can be uncomfortable. But those who listen to themselves know that only change brings change. And that is exactly what applies to liver fasting.

The question is not why you fell into the water, but how you get out of it. It’s about making decisions and then following through with them consistently. And if you need support to do that, you have to get that support.