Successfully treat oesophageal cancer

If we analyse the cases of oesophageal cancer in Switzerland, we find that around 600 people suffer from this serious disease every year. The main risk for the development of oesophageal cancer are reflux diseases, which clearly favour the development of cancer in the oesophagus due to the pathological acid regurgitation. About three quarters of those affected are men. One of the promising therapies for oesophageal cancer is oesophagectomy, which will be explained in more detail in this article.

More information and interesting insights directly from Prof. Dr. med. Jörg Zehetner can be experienced in a Zoom Online lecture. Date: 10 March 2021, 6:30 pm to 7:30 pm.

Let’s start by explaining the technical terms that are important for this topic

The medical term reflux refers to the backflow of gastric acid from the stomach into the oesophagus. In layman’s terms, this is described as acid reflux. The cause of the backflow of stomach acid into the oesophagus is a weakening of the muscle at the end of the oesophagus (cardia). In addition to the actual acid regurgitation, patients describe such things as frequent heartburn, burning in the chest area or also stomach burning.

The oesophagus is called the oesophagus in medical vocabulary. Functionally, the oesophagus is a kind of muscular tube that transports food into the stomach through contractions. In the stomach, stomach acid, among other things, is responsible for breaking down the food as part of the digestion process. To protect the oesophagus from the constant acid attack, there is a muscle at the bottom of the oesophagus that closes it when it is functioning normally. If the function of this muscle is impaired, the reflux described above occurs.

In medicine, resection is the surgical removal of an organ or part of an organ. With reference to our topic, oesophagectomy is accordingly the surgical removal of the largest part of the oesophagus.

The risk factors for the development of oesophageal cancer

Over the years, the main risk factors for developing oesophageal cancer have changed somewhat. Whereas in the past it was smoking and excessive alcohol consumption, today it is persistent (pathological) acid regurgitation and obesity that significantly increase the risk of oesophageal cancer. If you follow the relevant advice books, acid blockers and diets are often recommended to get the problem of reflux under control. However, this only addresses the individually noticeable phenomena, but not the cause. Therefore, the risk of developing oesophageal cancer remains in the medium and long term unless the causes of acid regurgitation are consistently addressed. What remains is the no longer correctly functioning “valve” at the end of the oesophagus, i.e. the muscle that prevents the stomach acid from rising into the oesophagus. If no improvement can be achieved here, then the constant acid attack on the oesophagus ultimately threatens oesophageal cancer. Surgery on the reflux muscle at the right time can significantly reduce the risk.

From complaints to diagnosis

One of the most common complaints that bring patients to the doctor is difficulty swallowing. After anamnesis and a more detailed description of the symptoms, a gastroscopy is often performed. If malignant tissue is discovered or suspected in the oesophagus or at the transition to the stomach, it can be removed under a short anaesthetic using a type of mini forceps. A laboratory examination will confirm whether or not this is malignant tissue. In the former case, it must then be assumed that there is oesophageal cancer, which must be treated surgically as a matter of urgency. Once the diagnosis of oesophageal cancer has been made, the decision for a suitable therapy must be made.

Recommendation: Combined therapy

Before therapeutic steps are taken, the severity of the disease and the spatial spread of the oesophageal cancer must first be examined more closely and determined in detail. Computer tomography (CT) of the chest and abdomen is the method of choice for this. In this way, it is also possible to assess whether there are deposits in the lungs and liver. An ultrasound scan of the oesophagus can also assess deposits in the lymph glands.

A common feature of the work of the medical specialists at Swiss1Chirurgie and at the Beau-Site Clinic is an interdisciplinary tumour board, where specialists from all the disciplines involved carry out a precise assessment of the symptoms, risks and treatment options. In addition to recommending therapeutic measures, this also includes timely clarification of follow-up treatment.

In most of the cases, a combined therapy is considered by the tumour board. This combination consists of an upstream chemotherapy, which is to be understood as a preparation for the actual surgical intervention within the scope of the oesophageal resection. If necessary, radiotherapy can also be part of the treatment. The surgical intervention takes place a few weeks after the start of chemotherapy or radiotherapy.

The esophagectomy procedure

Thanks to modern surgical techniques, the removal of the oesophagus (oesophagectomy) can be performed as a minimally invasive procedure (also called keyhole surgery). The operation itself takes about three to four hours and is performed under anaesthesia. Through small incisions in the abdominal wall, the connections of the oesophagus to the stomach and at the diaphragm are loosened. The lymph glands in the abdomen are then removed, followed by removal of the oesophagus itself either through the abdomen or through the chest. The adjacent tissue, which may also be affected by tumour cells, is also removed.

In a further step, the stomach is formed into a tube. This stomach tube is finally connected to the upper remaining end of the oesophagus in the neck area. Afterwards, the success of the surgical procedure is checked using a method specially developed by Dr. Jörg Zehetner. For this purpose, a fluorescent substance is injected into the patient’s bloodstream. Within five to ten seconds, a laser camera can be used to determine whether the result of the operation is satisfactory.

Rapid mobilisation and recovery of patients

A clear advantage of modern surgical techniques in the context of oesophageal resection is the short time patients spend in hospital. With independent breathing, the operated patients wake up from the anaesthesia and remain in the intensive care unit for one to two days, depending on their condition, to monitor their bodily functions. In the normal ward, a swallowing X-ray is taken as early as five days after the operation to check whether the connection between the stomach tube and the beginning of the oesophagus has healed well. If this can be confirmed, the diet can be slowly built up.

Depending on the individual development, the clinic stay itself lasts about one week to ten days. This is followed by a two-week rehabilitation measure, which helps the patient to heal quickly. After just three months, the patient experiences his or her original quality of life, now without oesophageal cancer and the unpleasant accompanying symptoms. In principle, everything can now be eaten again, perhaps in smaller portions, but spread over several meals a day.

More information and interesting insights directly from Prof. Dr. med. Jörg Zehetner can be experienced in a Zoom Online lecture. Date: 10 March 2021, 6:30 pm to 7:30 pm.

Knowing what’s what – The Swiss1Chirurgie podcasts enlighten you

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.

Latest post:

[podigee-player url=”https://nachsorge-swiss1chirurgie.podigee.io/5-neue-episode”]

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.

You can find the Swiss1Chirurgie podcasts directly at https://www.swiss1chirurgie.ch/podcast-uebersicht but also at

  • Spotify
  • Deezer
  • Apple Podcasts
  • Google Podcasts
  • amazon music and
  • Podimo

or click on the link:

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

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.

Focus on bowel cancer screening

In the USA, the US Preventive Services Task Force has come out with a recommendation for earlier bowel cancer screening from the age of 45. According to the study, the risk of severe to fatal colorectal cancer increases significantly, which clearly underlines the sense of screening for colorectal cancer before the age of 50. Accordingly, not only patients at risk, for example those with obesity, but also other groups are affected.

In the wake of the COVID19 pandemic, the problem of unnoticed regular screening is intensifying, which is likely to develop as a time bomb with a fuse of up to ten years.

The specialists of Swiss1Chirurgie and the Gastroenterological Group Practice GGP Bern point out the importance and great benefit of regular preventive examinations. In view of the developments in the USA and beyond, this should not only become more of a focus for people over 50, but also open up the discussion for universal pension provision from the age of 45 in Switzerland. The counselling service offered by Swiss1Chirurgie and the Gastroenterology Group Practice GGP takes this topic extremely seriously and provides important information on bowel cancer screening.

Read more about the recommendation of the US Preventive Services Task Force and the position of Swiss1Chirurgie and the Gastroenterological Group Practice GGP in the detailed article.

“This is a time bomb with a ten-year fuse”.

The US Preventive Services Task Force recommends colorectal cancer screening starting at 45

When the US news channel CNN reports in detail, it is on issues with implications. This is also the case in a report dated 18 May 2021, which deals in detail with the recommendation of bowel cancer screening from the age of 45.

Until now, at least in the USA, screening for colorectal cancer was recommended from the age of 50. If one follows the research results and the statements of renowned medical specialists on the subject, then bowel cancer diseases are reaching more and more people, including younger people. Accordingly, the lowering of the recommended age was only a question of common sense and forward-looking care.

The US Preventive Services Task Force is the leading advisory body on medical issues in the US and had already presented the draft of this recommendation in October 2020. The final version now available suggests that all people aged 45 to 75 years should be screened for colorectal cancer.

The reasoning

In a detailed justification, the makers of the recommendation explain that with colorectal cancer screening from the age of 50, about 50 cases in a number of 1,000 persons could be detected and avoided and, in addition, 25 deaths could be prevented.

Lowering the recommended age for colorectal cancer screening from 50 to 45 could effectively achieve two to three more cases of colorectal cancer and at least one death over and above the numbers achieved so far, he said.

This is the assumption of Dr Michael Barry, who, as vice-chairman of the US Preventive Services Task Force, has spoken to CNN on the subject.

Bowel cancer is the third most common cause of cancer deaths

This is true at least for the USA, but is also likely to be the case internationally. If you follow the figures in the USA, it is predicted that around 53,000 people will die of colorectal cancer in 2021, and the trend is rising. It is noteworthy that about 10.5 percent of newly diagnosed colorectal cancers occur in people under the age of 50. In the first 15 years since the turn of the millennium, cases have increased by a worrying 15 percent among adults aged 40-49. This, too, puts the US Preventive Services Task Force on alert to focus carefully on colorectal cancer at an earlier age.

Whereas colorectal cancer was previously mainly observed as a result of the risk factor obesity, the intestinal disease is increasingly affecting people who do not have such risk factors. Dr Benjamin Lebwohl, a gastroenterologist at NewYork-Presbyterian and Columbia University Medical Center, confirms this when he tells CNN: “To some degree, it can be driven in part by obesity, but there are many people younger than 50 who are not obese who develop colorectal cancer without any identifiable risk factors.”

American scientists and doctors have not yet been able to clearly define why cases of colorectal cancer are now also increasing in the age groups under 50. What is certain, however, is that cases can also be detected much earlier and treated more effectively through earlier screening.

The time bomb is ticking

What comes across here as an ominous scenario is justified when one takes a closer look at the figures. In 2018 alone, about 31 percent of eligible people in the US were not up to date on their colorectal cancer screening.

This number is likely to increase even further in the context of the Corona pandemic, as many adults are skipping the necessary screening examinations out of uncertainty, especially in the current phase. This is just as true in the USA as it is in Europe and Switzerland.

If one follows the opinion of Dr Michael Zinner, CEO and senior medical director of Baptist Health’s Miami Cancer Institute, it could be that “delayed screening due to Covid is a ticking time bomb with a ten-year fuse”.

Accordingly, doctors are increasingly urging their patients to catch up on bowel cancer screening examinations that they have not attended. The emphasis is that any test that has been done is always better than a test that has not been done.

Conclusions from the perspective of Swiss1Chirurgie and the GGP Bern

From the point of view of Swiss1Chirurgie and the Gastroenterology Group Practice GGP, bowel cancer screening has been the best and safest means of detecting and treating bowel cancer in good time for decades. Accordingly, attention should be paid to preventive examinations.

In Switzerland, too, this affects not only older women and men, not only people with certain risk factors such as obesity or a genetic predisposition, but practically every adult. From middle age at the latest, people should actively address this issue and talk about it with their family doctor or a specialist.

Although many developments from the USA only arrive in Europe and Switzerland with a certain delay, great vigilance must be maintained, especially in the case of colorectal cancer. To continue to wait here would allow the aforementioned time bomb to continue ticking and lay the extended fuse in this country as well.

The clear call is therefore to take advantage of the opportunities for bowel cancer screening in any case. And they do so regularly and even when there are individual concerns, such as during the COVID19 pandemic.

Jörg Zehetner, MD
Professor (USC) MMM, FACS, FEBS (hon.)

In Switzerland, the recommendation is still to have a colonoscopy as a preventive examination from the age of 50. However, this does not apply to patients with stool irregularities, blood in the stool, chronic abdominal pain, or alternating diarrhoea and constipation, or relatives who have already had bowel cancer. If necessary, these patients should have a colonoscopy at an earlier stage so that changes can be diagnosed and treated in time.

The original CNN article on the subject can be found at Colorectal cancer: US task force lowers recommended age to start cancer screening to 45 – CNN

What is LINX, what can LINX do?

Swiss1Chirurgie informs – The LINX System

Constant acid regurgitation is not only annoying, but can also cause serious secondary diseases. What is summarised in technical language as reflux is an extremely unpleasant restriction of the quality of life for those affected.

The LINX system has been available for years for reflux therapy and has led to extremely positive results. You can find out what LINX is, what LINX can do and how it works in the detailed article, in the video or on the Swiss1Chirurgie website.

Learn more about the reflux therapy procedure

There are probably around 20 percent of the population who regularly or chronically complain of reflux of stomach acid into the oesophagus. However, acid regurgitation is not only extremely unpleasant, but can also cause serious health problems, including oesophageal cancer.

With LINX, a system is available that can effectively prevent the backflow of gastric juice into the oesophagus. This system is used as part of a minimally invasive surgical operation. After placement of the LINX system, the symptoms subside and patients can return to a normal life in most cases.

What is LINX?

In principle, the LINX system is a magnetic ring chain. At first glance, the system can be compared to an elastic pearl necklace, whereby here the pearls are on magnets that are titanium-coated and thus completely harmless to the organism. Due to the attractive forces acting on the magnetic beads, they are repeatedly attracted to each other in the absence of counterpressure, which leads to a narrowing of the chain. When mechanical tension is applied to the system, the chain expands and widens the passage.

What can LINX do?

The LINX system is placed around the lower end of the oesophagus in a minor surgical procedure. The attraction of the titanium-coated magnetic beads creates a reliable closure of the oesophageal outlet without compressing the oesophagus. Only when, for example, a certain internal pressure is exerted on the oesophagus by the intake of food, does the magnetic ring open so that the food pulp or even liquids can enter the stomach unhindered. In this way, the normal function of the oesophagus is efficiently supported and the reflux of gastric juice into the oesophagus can be prevented. The bottom line is that LINX is strong enough to close the oesophageal junction into the stomach, but weak enough to allow air to escape from the stomach or vomiting to occur.

Practical experience

The LINX system has been known and proven for years. In the Swiss1Chirurgie clinics, this system is preferably used for reflux therapy whenever possible. The experience is extremely good, which includes that there are hardly any complications with the system during and after the surgical procedure. Since 2015, Prof. Dr. Jörg Zehetner has already treated over 250 patients with the LINX system. For most people with reflux symptoms, this system is the first choice, provided there is otherwise normal oesophageal function.

In order to assess this condition, a preliminary assessment of oesophageal function and reflux symptoms is essential. This preliminary examination includes a gastroscopy and a functional test of the oesophagus. Ideally, these examinations are supplemented by manometry, which means measuring the pressure in the oesophagus.

Would you like more information? Do you yourself have complaints due to acid reflux? Then watch the video with Prof. Dr. Jörg Zehetner, visit the Swiss1Chirurgie website or make an appointment at one of the Swiss1Chirurgie clinics in Bern, Brig or Solothurn.

https://v.calameo.com/?bkcode=0061151993dbd1bbf97d6&mode=mini&showsharemenu=false&clickto=embed&autoflip=4

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.

The thyroid gland – a small organ with a big impact

Dr. med. Anita Scheiwiller Specialist in Surgery FMH Focus Visceral Surgery

The thyroid gland is a very small but all the more important organ. Thyroid function disorders lead to many secondary diseases and should be treated in any case. You can read about how different thyroid diseases manifest themselves and how they can be treated in the detailed article, watch the video or follow along with the PowerPoint presentation. Click here to go directly to the topic.

Recognise and treat thyroid diseases

The Swiss1Chirurgie recommends

Overall, thyroid disease affects about six percent of the total population. Hypothyroidism, hyperthyroidism, a benign or malignant growth of the thyroid gland are forms of thyroid disease that can all be treated well. As the thyroid gland is a small but very important organ, professional advice and help should always be sought if thyroid disease is suspected. In a detailed article, Swiss1Chirurgie shows how thyroid diseases are to be assessed and how they can be treated. Read the detailed technical article on thyroid diseases and treatment options here.

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

The thyroid gland – a small organ with a big impact

The thyroid gland is a relatively small organ located below the larynx in the throat. Despite its small size, the organ and its thyroid hormones have a very far-reaching effect on almost all organs in our body. If the thyroid gland functions normally, we don’t notice anything about it in principle. Only when disorders of the thyroid gland are present do we become aware of their importance. Known forms of thyroid disease are, for example, hypothyroidism and hyperthyroidism.

Anita Scheiwiller, MD, deals with the function and disorders of the thyroid gland. Among other things, it shows in interesting series of lectures how to evaluate the normal function of the thyroid gland, which disorders and diseases can occur and how they can be treated.

Anita Scheiwiller, MD, is a practising visceral surgeon in the Swiss1Chirurgie clinic in Bern, where she is very committed to working in the specialist areas of intestinal and rectal disorders, obesity surgery and thyroid disorders. With 20 years of professional experience as a surgeon, Anita Scheiwiller, MD, advises and treats her patients with great empathy, experience and professional competence.

The thyroid gland – position and shape

The thyroid gland is a very small organ that is not normally visible from the outside. Embedded in structures of the neck, the thyroid gland lies directly on the trachea below the larynx. The spatial proximity to the vocal cord nerve and the carotid artery as well as to the parathyroid glands is also interesting here. This circumstance is also particularly important when surgical interventions in the area of the thyroid gland become necessary. Here it is important to work very precisely, accurately and carefully to avoid injury, especially to the vocal cord nerve or the parathyroid glands. Because of its shape, the thyroid gland is often called the butterfly organ.

The function of the thyroid gland

As the title of this article suggests, the thyroid gland is a very small organ that nevertheless has a big impact. The thyroid gland continuously produces hormones that are referred to in medical parlance as T3 (triiodothyronine) and T4 (tetraiodothyronine). In order for this hormone release to function, the thyroid gland is stimulated by a precursor hormone from the pituitary gland. This results in a control loop from the pituitary gland to the thyroid gland. This means that disorders in the function of the pituitary gland can also lead to disorders in the function of the thyroid gland.

It is important to know that iodine, among other things, is necessary for the production of thyroid hormones. Without an adequate supply of iodine, thyroid function will also be disturbed.

What effects do thyroid hormones have on the organism?

The thyroid hormones have clear effects on almost all organs of the human body. Colloquially, we rate the thyroid hormones as the “accelerator pedal of the body”, which make essential functions of other organs possible in the first place. For example, the metabolism as a whole can be accelerated but also slowed down. Thyroid hormones also have a significant effect on the activity of the heart. In addition, these hormones affect blood pressure, energy and fat metabolism and thus also body weight, bone metabolism and even brain function. The effects of the thyroid hormones extend to the function of the muscles. These facts alone show how important the well-functioning thyroid gland is for human health.

Thyroid hormone production disorders

Hypothyroidism

If too few hormones are produced and secreted by the thyroid gland, then we are talking about an underactive thyroid gland. An underactive thyroid gland has a wide range of effects on well-being and health. The most common symptoms are tiredness, fatigue and weight gain. More rarely, enlargement of the thyroid gland is observed, which can occur in connection with hypothyroidism.

We observe hypothyroidism as a very common condition. After all, about five percent of the total population suffer from hypothyroidism. That is a lot, especially since many of those affected do not notice anything directly at first. Even the patients who show corresponding symptoms cannot classify them correctly in the first step. Accordingly, many affected people do not even think that a disturbed function of the thyroid gland could be the cause of the individual complaints and symptoms.

The causes of hypothyroidism are often infections of the thyroid gland or the consequences of surgical procedures, such as thyroidectomy. Hypothyroidism can also be observed as a result of certain therapies or in connection with taking various medications.

What very often played a role in earlier times, but only marginally today, is iodine deficiency. Images of huge goiters, medically known as goiters, are well known. This was very common in iodine deficient areas, often in mountain valleys. Due to the enrichment of various foodstuffs with iodine, this problem is hardly seen today. Just think of the well-known iodised salt.

For the treatment of hypothyroidism, the focus is on relatively easy-to-use options. Thus, missing or insufficiently produced thyroid hormones can simply be replaced by corresponding preparations in tablet form. These medicines are quite easy to adjust and well tolerated. Checking the correct setting can be done at the GP.

If enlargement of the thyroid is diagnosed at the same time as hypothyroidism, surgery is advisable. This usually involves removing the entire thyroid gland. For the operation itself, read the special section.

Hyperthyroidism

The opposite of hypothyroidism is known as hyperthyroidism. In this case, the thyroid gland produces excessive amounts of hormones. This also has a noticeable impact on the entire body, as these hormones affect so many functions.

The symptoms are opposite to those of hypothyroidism. Weight loss, abnormal nervousness, sweating, undifferentiated trembling, rapid heartbeat and other unpleasant symptoms can be observed. Often the so-called “googly eyes” can be seen, which are typical for a special form of hyperthyroidism.

Hyperthyroidism is also often accompanied by enlargement of the thyroid gland. Overall, we observe hyperthyroidism somewhat less frequently than hypothyroidism. Nevertheless, over one percent of the total population is affected by hyperthyroidism. We often see younger patients in the process. Women are affected five times more often.

The treatment of hyperthyroidism proves to be somewhat more difficult than that of hypothyroidism. There are medicines that can suppress excessive hormone production. However, these drugs are not so well suited for long-term therapy. Both side effects and the diminishing effect of the medication must be taken into account.

Another solution, which is often used, is surgery to remove the entire thyroid gland. Destruction of the thyroid gland from within can also be used. Radioactive iodine is used, which is stored in the thyroid gland and destroys the cells there.

Other thyroid diseases

In addition to hypothyroidism and hyperthyroidism, we also know other diseases of the thyroid gland. This includes, for example, an enlarged thyroid gland that nevertheless shows normal hormone production. Iodine deficiency may be the cause of benign enlargement of the thyroid gland (goiter). Other underlying diseases or side effects of certain medicines are also possible.

If there is no danger of cancer, for example, in the case of an enlarged thyroid gland, it is possible to wait and observe at first. If the thyroid gland continues to grow, surgery should be performed. In some cases, the growth is only unilateral, so that only one side needs to be operated on. If both sides are affected, the entire organ is removed. It is also possible to destroy the thyroid gland from the inside. However, this radioiodine therapy is only used relatively rarely for benign enlargements.

When the thyroid gland reaches a certain size, it can also cause mechanical damage to the affected area. Often the oesophagus or trachea are then pushed to the side and compressed, leading to corresponding symptoms such as shortness of breath, difficulty swallowing. voice changes and sleep apnoea. Often there is both a visual and functional disturbance, which is distressing for the patient. Surgery is always the treatment of choice for mechanical impairments.

Surgery is always indicated for malignant thyroid enlargements associated with the rather rare thyroid cancer. Overall, thyroid cancer has a much better prognosis compared to other cancers.

Examinations of the thyroid gland

One method of examining the function of the thyroid gland is the laboratory chemical assessment of hormone production. In imaging diagnostics, ultrasound examination has proven its worth. In the simple, painless examination without radiation exposure, pathological processes in the area of the thyroid gland can be easily detected.

Further examinations are possible depending on the clinical picture. Scintigraphy can be used in cases of hypothyroidism or hyperthyroidism. The function of the thyroid gland is assessed and proven. Sometimes tissue examinations are also necessary to classify whether the process is benign or malignant. This involves puncturing the organ with a fine needle and removing a small amount of thyroid tissue. This can then be examined more closely under the microscope.

Molecular and genetic tests are also used today, although rarely, to confirm or classify a finding.

The operation of the thyroid gland

The first step in thyroid surgery is always a four to five centimetre incision in the lower neck, made transversely. Through the resulting opening, the neck muscles can first be pushed to the side. This clears the way directly to the thyroid gland. Depending on whether the operation is unilateral or bilateral, the surgical procedure takes two to three hours.

After the procedure, patients stay in hospital for about two to three days. The healing and recovery process is generally very fast.

As with any operation, complications are possible but very rare. The vocal cord nerve, for example, which is located in the direct vicinity of the thyroid gland, is at risk. The consequences of an injury to the vocal cord nerve would be hoarseness, voice changes or shortness of breath. Secondary bleeding is also possible. Monitoring in the recovery room during the first hours is therefore necessary. It is also important to protect the parathyroid glands, which are located next to the thyroid gland. These also produce hormones and should not be injured or removed.

What remains visible after the operation is a fine scar on the neck, but this usually heals very well and is hardly noticeable after some time.

Postoperative treatment

If the thyroid gland is completely removed, the missing hormone production must be replaced. Thyroid hormones are administered as medication for this. In most cases, patients go home well adjusted and only need to have their hormones checked by their family doctor or metabolic specialist every few months.

Conclusion

Overall, we observe thyroid diseases quite frequently, even if they are not always recognised immediately. Here, it is important to have a good diagnosis by the general practitioners, who should always refer possibly affected patients to a specialist for thyroid diseases. Hypothyroidism, hyperthyroidism or a benign or malignant thyroid growth can then be diagnosed.

If the thyroid gland has to be removed, hormone replacement is very simple. In this way, full organic and physical performance can be restored. The surgical procedure can be assessed as safe and with few complications.

You can experience the whole article here as a video recording of a lecture by Dr. med. Anita Scheiwiller or watch a supporting presentation.

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.