The need for information on medical issues is growing. Especially those affected who face medical questions and problems also look for answers to their individual questions on the internet. Unfortunately, the online information from the search engine results of Google and Co. is not always accurate and in many cases not sufficiently well-founded. As a result, many people move in a grey area between self-diagnosis with not always reliable information and the need for a profound and, above all, factually correct diagnosis by the respective medical specialists.
The experts at Swiss1Chirurgie have long recognised the need for comprehensive and, above all, professional information and offer comprehensive information options on specialist medical questions in the respective service areas on the websites of Swiss1Chirurgie, the Centre for Bariatric Surgery ZFBC, the Gastroenterology Group Practice GGP Bern and the Bern Clinic PZBE.
Swiss1Chirurgie Podcasts – Listening instead of reading
The podcasts, which are offered on the initiative and under the content supervision of Dr. Jörg Zehetner, are a relatively new information service for the medical layperson but also for specialist colleagues.
This means that there is also a professional information service for those affected, who can get an initial overview of diagnoses, medical interventions, surgical techniques and aftercare as well as accompanying services.
Podcasts on the following topics are currently available:
Medical knowledge – Obesity (Complex bariatric surgery)
Medical expertise and expert advice on Radio Bern1
Swiss1Chirurgie informs patients and endocrinologists (overweight surgery possible from BMI 30 with diabetes)
Gastric balloon only a “crutch” for overweight patients
Inguinal hernias and modern 3-D net care
Abdominal wall hernias, closure with net insertion
Further podcasts are in the works and are constantly expanding the range of information for patients but also for referring doctors.
With the podcasts, Swiss1Chirurgie, as an obesity expert centre and hernia centre, has created an extended information option that makes knowledge available and at the same time provides the appropriate recommendations.
It is important to note that those affected by a surgical problem can also contact the Swiss1Chirurgie clinics in Bern, Brig and Solothurn directly at any time. In this way, well-founded diagnoses can be made for individual “suspicious cases”, which enable professional further treatment.
Those in need of information about the services offered by Swiss1Chirurgie are invited to make use of the free Swiss1Chirurgie podcast offer. Knowing what is is always better than guessing what could be.
Welcome to the fifth part of our podcast series on hernias. In this podcast from the Hernia Centre at Swiss1Chirurgie, we look at the topic of rare hernias of the abdominal wall today.
The podcast was based on an idea and text by Prof. Dr. Jörg Zehetner. Jörg Zehetner is, among other things, the owner of Swiss1Chirurgie and attending physician at the Hirslanden clinic Beau-Site.
This podcast series is intended as patient information for those affected and all those who are concerned with the topic of hernias, here especially with rarely occurring hernias of the abdominal wall.
In previous podcasts we have looked at inguinal hernias, abdominal wall hernias and dwarf skin hernias. The fourth podcast in the series focused on the surgical treatment of hernias with nets. If you have already listened to these podcasts, you already know what is meant by a hernia. These are always ruptures in the tissue, which cause internal organs to move completely or partially out of their physiologically correct position. This can be associated with more or less severe pain. Depending on the specific fracture, the blood and oxygen supply to the affected organs may be impaired or completely interrupted, which under unfavourable circumstances can lead to the death of the organ parts in the hernia sac and endanger life.
In addition to the abdominal wall hernias already discussed, there are also rarer manifestations of abdominal wall hernias. Such rarer forms are often only detected by a computer tomography of the abdominal cavity. A gastric resonance examination can also provide information about the presence of an abdominal wall hernia, which cannot be detected with the conventional options of palpation after a corresponding pain pattern of the patients.
A targeted examination of the abdominal wall using ultrasound can also occasionally detect one of the rare forms of abdominal wall hernia. Especially in the lower abdomen, the rare form of a Spieghel hernia is often diagnosed. This special form of hernia is named after its special location.
The posterior fascial sheet of the abdominal muscles ends midway between the belly button and the pubic bone. There may be a gap in the posterior fascial sheet or a hernia sac may slip in between the posterior fascial sheet and the abdominal muscle. Parts of the small intestine can also be trapped in this hernia sac.
Diese Sonderform des Spieghelbruchs ist von außen nicht tastbar, verursacht aber die gleichen Probleme wie der klassische Bauchbruch. Accordingly, surgical treatment will also be necessary for this form of abdominal hernia.
Another special form of abdominal wall fractures can be lateral fractures. These are located in the flank or even further back in the lombar area. Such fractures occur more frequently after open kidney surgery. Such hernia gaps are more difficult to treat than hernias in the anterior abdominal wall due to their anatomical location. Due to the rotation in the movement of the upper body, strong forces occur, which makes the surgical treatment of such rare fractures with mesh insertion rather difficult. Although a net insert can be used to close the hernia gap, it can also noticeably restrict mobility.
The treatment of such rare fractures requires true specialists who have sufficient experience in the surgical technique and operation of such fractures.
Special forms of hernias also occur on the diaphragm. This already involves the correct diagnosis of deviations in the diaphragmatic gap. Abnormalities are often misjudged and not diagnosed as a diaphragmatic hernia. Even in the course of a computer tomography, these special diaphragmatic hernias are often overlooked. The result is that the patients’ suffering is sometimes prolonged by years. Sometimes it is only laparoscopic diagnosis that leads to the discovery of such diaphragmatic hernias.
The form of hernia known in medical parlance as rectus diastasis is also one of the special forms of hernia. Here the midline between the straight muscle strands of the abdominal muscles is clearly widened. This physiological phenomenon occurs especially in women during pregnancy. Such phenomena can also be observed in severely overweight patients.
Due to the increased pressure on the abdominal muscles, the abdominal muscles are overstretched and give way. A weakening of the muscles in the midline then leads to a separation of the muscle strands up to the width of the hand.
Such fractures can be recognised when the patient lies on his back and lifts his head. Then a tent-like structure appears in the area of the navel, which appears as a bulge. This bulge is called a rectus diastasis. The patients hardly complain about pain. The softening of the abdominal muscles can be felt by the experienced surgeon. Since this is not a classic hernia and those affected are mostly pain-free, there is also no need for surgical intervention. At best, cosmetic considerations may lead to rectus diastasis correction. If minor hernias occur on the abdomen in the midline together with rectus diastasis, both symptoms can be corrected surgically.
The Swiss1Chirurgie experts have also learned the latest methods and techniques of surgical intervention in the special forms of hernias and have tested them over many years. One possibility of surgical intervention is the placement of sutures that bring the abdominal muscles back into the correct position. A net insert stabilises the tissue and supports the healing process. Doubling the anterior fascia sheet at the midline also corrects the defect successfully and sustainably. By means of a net insert, any gaps that may exist are also closed here. Such an operation can be performed openly, minimally invasively or as a laparoscopic procedure.
Occasionally, the “DaVinci” surgical robot is also used for such interventions. Whether and how robot technology is used in surgery is always decided by the operating surgeon in a preliminary discussion with the patient.
In the case of very complex abdominal wall hernias or larger hernia gaps, the Swiss1Chirurgie experts always work together with plastic surgeons. In this way, an optimal result can be achieved for each patient.
Should you wish to obtain a second opinion in connection with particular forms of hernia, the experts at Swiss1Chirurgie in the Hernia Centre are recommended as your professional contacts. This also applies if you wish to work with a plastic surgeon for a hernia operation or have already spoken to a plastic surgeon about or planned a hernia operation.
Even if the results of an operation already performed are not satisfactory, we will be happy to talk to you and recommend the next steps to correct the surgical procedure.
In overweight patients or older patients with weak tissue structures or risk factors such as heart disease, as well as in smokers and diabetics, even the best surgical techniques are always associated with an increased risk. A generally healthy lifestyle reduces the risks. Sufficient sport and exercise, a healthy diet and a mindful approach to one’s own health are ways to significantly limit the risks regarding abdominal wall hernias and also to reduce the risks of surgery.
We recommend that you take our online health check on our website at www.swiss1chirurgie.ch. This will give you valuable information about your current state of health.
For patients with a body mass index above 35, targeted weight loss is always recommended before surgery. Ideally, a weight below body mass index 30 is achieved before surgical correction of a large abdominal wall hernia is performed.
The specialists at the Centre for Bariatric Surgery ZfbC in Berne will be happy to make recommendations for any bariatric surgery that may be required. All services offered are subject to the strict criteria of the Swiss Working Group for Overweight Surgery SMOB. The results of any bariatric surgery are recorded and documented.
If you have any further questions about surgical intervention options, surgical techniques and methods or general 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 for your attention!
This podcast is part of the Helvetius.Life podcast series.
Helvetius.Life is the in-house newspaper of Helvetius Holding AG.This is where Swiss1Chirurgie, the Centre for Bariatric Surgery ZFBC, the Gastroenterology Group Practice GGP and the Bern Clinic PZBE 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.
Anyone who has ever taken a closer look at the topic of “losing weight” will sooner or later have come across the recommendation of a high-protein diet. Supermarkets are full of modern and mostly expensive high-protein products aimed at both athletes and people who want to lose weight. But can these products really help, is a high-protein diet good for weight loss at all and isn’t there something better? This medical article by Helvetius Holding AG, which is also available as a podcast in several languages on Deezer and Spotify, explains this.
Why a high protein diet?
From a scientific point of view, a higher protein diet can indeed be useful for losing body weight. If the diet contains more protein, however, the proportion of carbohydrates and possibly fats must decrease at the same time. Otherwise, the calorie content would be too high and the body would gain even more weight. A high-protein diet is suitable for weight loss, as proteins are very filling. Secondly, it leads to weight loss really coming from a lower body fat percentage. If the calorie intake is only reduced by eating less of all nutrients, the body will mainly lose muscle mass. The body also needs protein to build muscle, which is also part of a comprehensive weight loss strategy.
Are high-protein products from the supermarket a good idea?
Many of the high-protein products contain little or no more protein than simple dairy products such as low-fat curd cheese, cream cheese or natural yoghurt. For some of the products, the main difference is only the higher price for the high-protein marketing. Other products are loaded with other ingredients such as sweeteners or flavourings that are solely for taste and are often unhealthy. High-protein products are therefore not always worthwhile as a high-quality source of protein; the price-performance ratio in particular is often not right here.
Which foods provide enough protein?
Ideal sources of protein in a healthy diet are dairy products, fish, eggs and pulses. Nutrition experts advise that 1.2 grams of protein per kilogram of body weight should be consumed daily through food. Overweight people should base the amount of protein on their target normal weight and not on their current weight. Otherwise the calorie content is too high and losing weight does not work, because proteins also provide energy. It is also important to eat three meals a day and not all the time. Then the body has time in between to break down fat. Without these breaks, the insulin level in the blood does not drop and a high insulin level suppresses fat burning.
Protein-rich nutrition with taste
A sensible change of diet does not mean going hungry. Quite the opposite. Those who want to eat healthily can certainly do so with taste. For example, a gourmet cheese (such as Le Gruyère) is excellent as a tasty source of protein. Add a colourful salad with tuna or a vegetable mix with some lean meat and you have a healthy and delicious meal on the table.
If protein shakes, then the right ones!
In contrast to the high-protein products from the supermarket, some protein shakes can support weight loss as a so-called formula diet over a set period of time. In order for the weight reduction to be successful in the long term, a doctor should accompany the project. A nutritionist can make sure that a formulary diet really makes sense in the individual case and that suitable formulary products are used. Not every protein shake has an appropriate composition of the macronutrients protein, fat, carbohydrates and micronutrients such as vitamins and minerals. If other illnesses are already present or if medication is being taken, a doctor will also take this into account when planning the weight loss programme. He can also measure blood values and body fat percentage during the diet and optimise the formula diet plan if necessary. For example, in some cases, switching to a meal replacement strategy, where one protein shake replaces only up to two main meals per day, could help. In addition, a doctor makes sure that a formula diet does not last too long or too short and that the amount of energy taken in is suitable. If the dosage is too high, weight loss will fail, while if it is too low, hunger will not be satisfied sufficiently and the diet will not be followed through or the body will instead lose muscle mass.
Formula diet only with medical supervision
If the BMI is over 30 kg/m2, then no independent attempts at weight loss should be made: An appointment with a doctor is necessary. For a BMI over 35 kg/m2, the best option, after a detailed assessment, is bariatric surgery (obesity surgery). For patients in between, there is the possibility of conservative methods:Unfortunately, it is not easy to do all this on your own. Equally important is the long-term change in diet after the formula diet and more exercise. If both are missing, the yo-yo effect is already pre-programmed. Therefore, a doctor should also accompany the phase afterwards. So don’t just stock up on the next best protein shakes when you go shopping, but rather make an appointment with a doctor who specialises in obesity treatments. However, if you only want to lose a few kilos, you should focus on a healthier, somewhat calorie-reduced diet and more exercise. Formula diets are aimed more at people who are more overweight or have a fatty liver.
The protein shakes from Bodymed with weight loss programme
A good example of a weight loss programme with a formula diet is the Bodymed nutrition concept developed by doctors. It offers a medically guided course programme and matching protein shakes that have been put together according to scientific findings. The professional associations German Obesity Society (DAG), German Diabetes Society (DDG), German Nutrition Society (DGE) and the German Society for Nutritional Medicine (DGE). (DGE) and the German Society for Nutritional Medicine e. V. (DGEM) recognise Bodymed as an appropriate weight loss programme in their guidelines. (DGEM) recognise Bodymed as an appropriate weight reduction programme in their guidelines.
Nutrition is part of the aftercare for obesity surgery
Under certain conditions, it is hardly possible to bring the body mass index (BMI) into the normal range under one’s own efforts. Especially with a BMI over 35, an overweight operation such as a gastric bypass or the formation of a tube stomach may be advisable. However, this also means that patients have to be actively involved for the rest of their lives. So a healthier lifestyle and dietary changes are also crucial after obesity surgery. On the one hand, this is the only way to achieve sustainable weight loss. Secondly, there must not be any nutrient deficiencies, which can occur after obesity surgery due to the reduced food intake and the changes in digestion. Depending on the type of surgery, a deficiency of protein, calcium, zinc or vitamin B12, for example, is relatively common. Therefore, after such an operation, patients should compensate for a deficiency with appropriate dietary supplements and consume at least 60 grams of protein per day or 1.5 grams per kilogram of normal weight.
Professional support after obesity surgery
However, patients should not be left alone with this, because the changes in lifestyle and diet are very individual and have to be adjusted every now and then in the course of life. That is why professional aftercare is a high priority at the Centre for Bariatric Surgery ZfbC in Bern. In addition, complications can arise at any time and further interventions or other medical measures may be necessary. With good follow-up care, this is noticed early on and the treating doctors can react quickly.
The following also applies to a fatty liver: less carbohydrates and more protein
Many people associate fatty liver with excessive alcohol consumption. However, there is also the clinical picture of a non-alcoholic fatty liver, for which a wrong eating pattern and too little exercise are usually responsible. The body stores excess energy in the form of fat not visibly under the skin layers, but in the internal organs such as the liver. Therefore, although non-alcoholic fatty liver often occurs together with obesity, it does not always occur. In addition, a fatty liver can be the reason why weight loss attempts fail. A fatty liver leads to insulin resistance, which on the one hand promotes the storage of fat and thus weight gain. On the other hand, it can block the burning of fat. In order to successfully treat a fatty liver, first and foremost, those affected must do something themselves. Since, in addition to a lack of exercise, a diet too rich in carbohydrates and sugar in particular causes non-alcoholic fatty liver, the diet should contain fewer carbohydrates, more proteins and fewer calories overall. The principle is similar to losing weight. Here, too, those affected should seek professional help.
A healthy liver promotes a healthy life
Liver fasting with advice from the ZfbC
Liver fasting according to Dr. Worm with the Hepafast products from Bodymed is a good companion on the way to a defatted liver and, like the Bodymed programme mentioned above, is based on scientifically sound findings. The Hepafast products are specially formulated for liver fasting, which is why weight loss can certainly be a welcome side effect, but is not the primary goal. Individual medical advice on liver fasting according to Dr. Worm is very happily provided by every clinic within Helvetius Holding AG, of which ZfbC is one.
Where can I find more information about dietary changes and losing weight?
If you would like to find out more about a suitable diet for losing weight, after obesity surgery or for fatty liver, listen to our podcast and read the Helvetius.life newspaper. There, leading experts share their knowledge and explain, among other things, how you can successfully fight obesity and why this is so important in the first place. New scientific findings on the topics also have a firm place in it.
Conclusion: Cover your protein needs with pleasure and be accompanied by experts
When losing weight, it is helpful to pay attention to the protein content of the diet. High-protein products from the supermarket are not recommended, however. Instead, people who want to lose weight should get the amount of protein they need from simple dairy products, fish and pulses. For example, the daily consumption of a La Gruyère in combination with vegetables or salad can already make a good contribution to a protein-rich and healthy diet. In certain cases, protein shakes can also be useful. But then they should be products that are approved by doctors. These include the protein shakes from Bodymed. Regardless of whether the Bodymed programme is to lead to a BMI in the normal range, an overweight operation is necessary or the liver needs to be defatted, the doctors at the ZfbC provide individual advice and accompany you on your way to a permanent normal weight.
Information www.helvetius.events
Information events with live streams Medical expertise at first hand
Zermatt Zermatt: Backstage Hotel 18 June 2021 Colon infection: Prevent with diet(?)! J. Zehetner, MD 18 June 2021 Bowel cancer screening: who, when, how, where? MD I. Linas 18 June 2021 Follow-up after obesity surgery: Yes, but at the centre Dr med R. Steffen 18 June 2021 Integrative Medicine: Burn-out Treatment in the Mountain World Dr med. Th. Russmann
03 December 2021
Saas-Fee Saas-Fee: Saaserhof 16 July 2021 03 September 2021 10 December 2021
Kreuzlingen KREUZLINGEN: Talent-Campus Bodensee 22 October 2021
Helvetius Holding AG offers interesting specialist lectures on various topics at selected locations in Switzerland for referring physicians, medical laypersons and those affected. Conducted by Prof. Dr. Jörg Zehetner, these lectures not only offer in-depth knowledge from different focus areas, but also opportunities for further information. Disease patterns, diagnostic procedures and surgical techniques are presented as well as the forms of professional aftercare following surgical interventions. For those affected, such specialist lectures offer an increased degree of security before the planned intervention, and for those interested in medicine and doctors, the information events hold a plus in knowledge and experience.
Sources 1. https://www.aerztezeitung.de/Medizin/Daenische-Forscher-finden-die-optimale-Diaet-fuer-Uebergewichtige-216004.html (accessed 01.06.2021) 2. https://www.youtube.com/watch?v=5VRxhlfylTk (accessed 01.06.2021) 3. https://www.bodymed.com/gesundheitsprogramme/ernaehrung/ (accessed 01.06.2021) 4. https://www.ndr.de/ratgeber/gesundheit/Eiweiss-Shake-zum-Abnehmen-Worauf-kommt-es-an,formula100.html (accessed 01.06.2021) 5. https://www.nachsorge.ch/patientenzeitung-2021-helfetius-life/ (accessed 01.06.2021) 6. S3-Leitlinie “Prävention und Therapie der Adipositas”. German Obesity Society (DAG), German Diabetes Society (DDG), German Nutrition Society (DGE). (DGE), German Society for Nutritional Medicine e. V. (DGEM). Version 2.0 April 2014. 7. S3-Leitlinie “Chirurgie der Adipositas und metabolischer Erkrankungen”. German Obesity Society e.V. (DAG), German Diabetes Society e.V. (DDG), German Society for Nutritional Medicine e.V. (DGEM), German Society for Endoscopy and Imaging Procedures e.V. (DGE-BV), German Society for Psychosomatic Medicine and Medical Psychotherapy e.V. (DGPM), German Society of Plastic, Reconstructive and Aesthetic Surgeons e.V. (DGPRÄC), German College of Psychosomatic Medicine (DKPM), Association of Diabetes Counselling and Training Professions In Germany e.V. (VDBD), BerufsVerband Oecotrophologie e.V. (VDOE), Adipositaschirurgie-Selbsthilfe-Deutschland e.V. 8. https://www.aerztezeitung.de/Medizin/Eiweiss-laesst-das-Leberfett-schmelzen-301389.html (accessed 01.06.2021)
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.
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!
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.
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.
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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.
The focus of the 4th Helvetius Holding AG symposium at the Talent Campus Bodensee in Kreuzlingen on 22 October 2021 was the topic of liver health. All speakers agreed that fatty liver is a major cause of many diseases of civilisation in modern society. What could be more natural than to invite the co-founder of liver fasting with HEPAFAST® to the event? In his impressive and scientifically supported lecture, the nutritional physician and internist Dr. med. Hardy Walle not only established the connection between non-alcoholic fatty liver and diabetes, but at the same time proved the previously unattained effectiveness of the BODYMED HEPAFAST® concept for liver fasting. In the detailed report you will learn a lot about the topic and receive further information about liver fasting with HEPAFAST®.
Lecture:
Interview:
Liver Fasting with HEPAFAST® – The Effective Way to Liver Health
A healthy liver has extensive effects on a person’s state of health and has a lasting impact on many functions, especially metabolism. Hardy Walle, MD, was a very special guest at the 4th Helvetius Holding AG symposium at the Talent Campus Bodensee in Kreuzlingen.
Hardy Walle, MD, together with Prof. Nicolai Worm, is known as the founder of liver fasting with HEPAFAST®. The system, specially developed by both nutritional physicians, has been proven to have a positive effect on liver health and offers excellent opportunities for keeping the liver healthy. Even after severe liver diseases, but also used preventively, liver fasting according to Dr. Walle brings about the full functionality of the liver and thus contributes decisively to a healthy lifestyle. In his lecture, the internist and nutritionist and founder of BODYMED AG will present liver fasting with all its effects on liver detoxification and interactions on a healthy life.
Why liver fasting and what is special about it?
The core of the considerations here are the differences of liver fasting compared to other diet programmes. The starting point is provided by data on the development of overweight and the spread of obesity in Germany. It is clear that obesity with a BMI over 25 has spread significantly in the last 20 years or so. This applies especially to obesity with a BMI of 30 and above. In Germany, it is currently assumed that more than half of the total population is overweight. This leads to the logical conclusion that being overweight is now considered the normal thing to be. At the same time, almost a quarter of the population with a BMI of over 30 can be classified as obese. When we talk about obesity, we clearly mean obesity. This also makes it clear that in the case of overweight we are essentially looking at the ratio of fat to total weight. Last but not least, it is also about body fat distribution, i.e. where the fat is located on the body.
It is also interesting to note in the assessment of obesity that with the increase in overweight people, the proportion of people with type 2 diabetes is also increasing at more or less the same rate. It is interesting to note that diabetes mellitus type 2 has nothing to do with people’s age, as was once assumed. People of any age can be affected by type 2 diabetes, with obesity playing a particularly decisive role. Also among young people. So there is a clear correlation between obesity and secondary diseases.
It is all the more astonishing that light overweight is repeatedly communicated as not being so bad and that there are specialist journalists who believe that people “with light to medium overweight live the longest and get the fewest diseases …”. What is often meant is that the connection between BMI and mortality is not so significant.
Accordingly, there is a study in which, for once, not the BMI but the body shape, here specifically the waist circumference, was taken as a yardstick for the assessment among high-risk patients. Surprisingly, in the test group of around 15,000 volunteers, the group that turned out to be more mortal when measured within five years was the one that only had a BMI of 22. However, a closer look revealed that this group showed exactly the same waist circumference as the group of obese volunteers with a BMI 30. The waist circumference was 101 centimetres in each case. However, while the BMI 22 volunteer only had a belly, the BMI 30 volunteer also had a lot of fat distributed over his body.
The volunteers with the highest mortality were quite thin except in the abdominal area and had hardly any muscles. This also explains the relatively low weight despite a 101 abdominal girth. If we know that muscles also have a protective factor, then the increased mortality in this comparison group can also be explained by the lack of a protective function of the muscles. If one follows this thought, then it becomes clear that the ratio of muscle mass to fat mass is of great importance.
Conversely, this also means that BMI alone does not indicate how muscle and fat are distributed. So looking at BMI alone distorts reality, although it can provide initial signals. So it is not the BMI alone that is decisive. It definitely depends on the abdominal girth. Nevertheless, most people may know approximately their weight, but hardly anyone can quantify their abdominal circumference relatively clearly. An increased abdominal girth (women over 88 cm, men over 102 cm) is a clear risk factor for heart attacks, for example. Here, the risk increases by a factor of 4.5.
While there are tablets against high blood pressure, you can only influence your abdominal girth with your own activity. And this is exactly where liver fasting comes in. It is not one-sidedly about weight reduction, but quite clearly about belly reduction. In conclusion, this means getting rid of belly fat. But not only the fat around the organs, but especially the fat in the organs. This refers to the liver, pancreas, kidneys and, more broadly, the heart and bone structure.
Belly fat is the dangerous fat
It must be clear that the liver, for example, is not made to store fat. For that, there is rather the subcutaneous fat tissue. Belly fat has clear potential dangers. These show up as risk factors for
Diabetes type 2
High blood pressure
Heart attack
Stroke
Potency disorders
Circulatory disorders
Dementia
All these can be consequences of too much belly fat. In principle, this is also where bariatric surgery comes in, which can certainly also ensure rapid defatting of the liver with obesity surgery.
A renowned German researcher puts the basic statement in a nutshell: “Without a fatty liver, there is no diabetes”. (Professor Norbert Stefan, Tübingen)
In most cases, it is the fatty liver that is the trigger and cause of many secondary diseases. Knowing this is important, because only then can cause, symptom, effect be clearly determined, which ultimately has clear implications for the right therapy.
Non-alcoholic fatty liver (NAFLD) can be considered the cause of many manifestations of pathological processes. For example, for infections caused by free radicals, for gout caused by increased uric acid, increased blood sugar levels, lipid metabolism disorders, high blood pressure or for thrombosis and finally the metabolic syndrome. Liver cancer is not negligible here and is increasing explosively, especially in the USA with the large proportion of obese people.
Generally speaking, 30 to 40 percent of the total population in Germany is affected by a fatty liver. In the overweight group, this proportion is already 70 percent. If we take only type 2 diabetics, around 90 percent of those affected are “equipped” with a fatty liver. From this, the connections between fatty liver, obesity and diabetes become even clearer. This makes non-alcoholic fatty liver one of the most common liver diseases. But even 15 percent of outwardly slim people are affected by a fatty liver.
How can non-alcoholic fatty liver be diagnosed?
Basically, a non-alcoholic fatty liver is a fatty liver that is not caused by alcohol or other causes. In industrialised nations, it is considered the most frequently diagnosed liver disease. Just as no typical complaints can be detected, pure laboratory values alone hardly provide a meaningful basis.
We speak of a non-alcoholic fatty liver when more than 5.5 to 6 percent of the liver cells are fatty. This portion cannot be detected on ultrasound alone. Here, something can only be seen from a fatty degeneration of about 20 percent. The most accurate diagnosis can be made with a liver biopsy, but this is unlikely to be the first step in the diagnosis.
One value has become established in Europe. We are talking about the Fatty Liver Index (FLI). This results in a validated algorithmic numerical value that is also well suited for progress monitoring. With the FLI, a fatty liver can be diagnosed quite well and reliably.
Statistics show that mortality is significantly increased in fatty liver patients. Fatty liver is therefore not a cosmetic problem or characterised solely by increased blood fat levels etc., it is a real high-risk factor in terms of life expectancy and mortality.
Main causes for the development of a fatty liver
In the past, the causes of fatty liver were simply summarised by saying that people eat too much fat. The real cause, however, is an excess of ingested carbohydrates. Another cause may be the intake of a lot of fructose, i.e. fruit sugar. The main fatsifier of the liver is even found here.
Carbohydrates are broken down into sugar in the body. At the same time, the pancreas produces insulin. However, insulin has two effects: On the one hand, insulin ensures that the sugar reaches the muscles, and on the other hand, some of the sugar reaches the liver to regulate the blood sugar level there. If the liver releases too much sugar, insulin slows down this release. In addition, insulin ensures that excess sugar is stored in fat tissue.
Under certain conditions, organs begin to no longer respond adequately to insulin. A kind of insulin resistance develops. Then the liver is also no longer properly regulated by insulin. In the prediabetic course, the blood glucose level then rises even in fasting volunteers. Such a process develops slowly, so that in individual cases diabetes only develops after ten to twelve years. This process can even take up to 20 years. During this time, the liver is less and less regulated by insulin and becomes increasingly fatty. This process is accelerated when the subcutaneous fat tissue cannot form any more fat cells because it is literally flooded with fat. More and more fat and sugar move in the blood. Out of a natural reaction, the organism then builds up additional fat stores in the liver.
In the long term, however, it is not only the liver that becomes fatty, but also the pancreas, the kidneys, the muscles, the heart and even the hypothalamus in the brain.
The basics of liver fasting
The basic idea behind liver fasting is to simply go backwards from the rather unhealthy path taken so far. The most important step is the defatting of the liver. This usually requires a strict diet.
This means:
less than 1’000 kcal per day
few carbohydrates
Absorption of high quality protein
Only “good” fats if possible
special liver-active agents and dietary fibres
All this is combined in HEPAFAST® in a well-tolerated and easy-to-use formula. The programme is easy to implement in everyday life. It is easy to digest, fills you up and meets all the requirements of a good liver-healthy diet.
HEPAFAST® is taken three times a day, prepared with a milk product. In addition, twice daily vegetable preparations with a total of maximum 200 kcal per day. This means one HEPAFAST® preparation for breakfast, one HEPAFAST® and one vegetable preparation for lunch and one HEPAFAST® and one vegetable preparation for dinner. No more, but also no less.
Due to this suitability for everyday use, there are hardly any dropouts in the HEPAFAST® liver detoxification programme, which significantly increases the success rate.
The reset for the metabolism causes:
Normalisation of the function of the pancreas and the insulin sensitivity of the liver
Promotion of insulin secretion
Normalisation of glucagon regulation
reduces the uncontrolled release of glucose from the liver into the blood
improves metabolism and facilitates weight loss
For whom is liver fasting useful?
In principle, liver fasting with HEPAFAST® is useful for all patients with the following constellation:
Fatty liver (NAFDL, NASH)
metabolic syndrome
Type 2 diabetes
Overweight and obesity
Lipometabolic disorders
High blood pressure
preventive as a “metabolic cure” for the prevention of diseases
prior to bariatric surgery
It makes no sense to wait until you have a BMI of 30 or an abdominal circumference of well over 100 centimetres. You can always start a liver fast with HEPAFAST® even without such symptoms.
Further information
You can watch the entire live video stream with Hardy Walle, MD, with additional research results, statistics and a concrete case study here.
In addition, you will also find further contributions from Helvetius Holding AG’s specialist conferences here.
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