Classic list

You may have heard of ‘keyhole’ surgery, or your doctor may have discussed using a minimally invasive technique for your surgery. As technology advances this type of surgery is becoming more common. But what is minimally invasive surgery, when can it be used and what are the benefits?   What is minimally invasive surgery? Surgery is called minimally invasive when it is performed through very small incisions (cuts), or no cuts at all for some types of procedures. A flexible telescopic instrument, with a light and a video camera, is used to view the operation site on a monitor screen. Small instruments are then inserted through small openings to perform the surgery. This is different from traditional open surgery, where a larger incision or cut is required for surgeons to see the area being operated on directly.   What are the benefits of minimally invasive surgery? Minimally invasive procedures mean that less skin and muscle needs to be cut, with the following benefits compared to traditional open surgery: ● Less trauma and pain ● Less bleeding ● Lower risk of infection ● Reduced risk of complications ● Faster recovery ● Shorter hospital stay ● Less scarring   What types of minimally invasive surgery are there? Surgical techniques are continually advancing. Currently, the 3 main types of minimally invasive surgery are: ● Endoscopic surgery – uses a flexible tube with a small camera at the end is used (an endoscope) which may be inserted into the through a natural body opening, like the mouth, or a small incision. Tiny surgical instruments are manipulated through the endoscope to perform the operation. ● Laparoscopy – uses a modified endoscope (laparoscope), inserted through a small incision in the belly (abdomen) to guide the surgeon as he performs the surgery, looking at a monitor screen. ● Robot-assisted surgery (robotic surgery) – instead of manipulating surgical tools manually, the surgeon controls a high-definition camera and robotic arms while sitting at a nearby computer console.   Which surgeries can be done using minimally invasive techniques? Minimally invasive techniques can be used for many types of surgery, including: ● Gastrointestinal surgery ● Cancer surgery ● Some types of heart or lung surgery ● Hip or knee replacements ● Gynaecology or urology procedures ● Kidney transplant surgery   Is Minimally Invasive Surgery suitable for me? There are many benefits of minimally invasive surgery. However, it is not recommended for all types of operations. If you require surgery, discuss the options with your surgeon. They will be able to advise you about the benefits and possible risks of any procedure.

Pain or bleeding from your anus, or bottom opening, can cause problems sitting and going to the toilet. You may feel embarrassed and hesitate to consult your doctor. But how do you know if it is a common problem that will go away on its own, or if it could be something more serious?   Common causes of anal pain or bleeding Haemorrhoids or Piles Haemorrhoids are a common problem, affecting about half of adults by the age of 50. They occur when blood vessels in the anus swell up. Although they are most often relatively harmless, haemorrhoids can cause pain, itching and bleeding, made worse when straining going to the toilet.   Anal Abscess, Fistula or Fissure An abscess occurs when a space in or around the anus becomes infected and filled with pus. Fistulas may occur with repeated abscesses, when pus drains through a tunnel which opens to the skin. Anal fissures are small tears in the thin tissue which lines the anus. Fissures are common in young infants but can occur at any age. They may be caused by straining when going to the toilet.   Polyps Polyps are small clumps of cells that form on the lining of the colon (large intestine) or rectum (back passage). Most people with polyps don’t experience symptoms, but they may cause abdominal pain and rectal bleeding. Most polyps are harmless but over time, some colon polyps can develop into cancer.   Less common but more serious causes of anal pain or bleeding Cancer of the anus, colon or rectum Cancer of the anus is relatively rare. However, colorectal cancer – cancer of the large intestine or back passage – is the third most common and the second most deadly type of cancer.* Symptoms include bleeding or blood in stools (poop), constipation or diarrhoea, pain, itching, swelling or a lump, weakness or fatigue, unexplained weight loss. The best prevention for colon cancer is regular screening for and removal of polyps.   Inflammatory Bowel Diseases Ulcerative colitis is an inflammatory bowel disease (IBD) that causes inflammation and ulcers in the innermost lining of the large intestine (colon) and rectum. Crohn’s disease is a type of inflammatory bowel disease that affects any part of the small or large intestine and often spreads into the deeper layers of the digestive tract. Symptoms of inflammatory bowel diseases may include blood in stools, diarrhoea (often with blood or pus), abdominal pain and cramping, nausea and vomiting, weight loss, fatigue and fever.   What can I do at home to relieve symptoms? Some less serious causes of anal pain and bleeding can be helped by making lifestyle changes such as eating more fibre, drinking more water, being active and avoiding sitting for long periods.   Home treatments which may help include over-the-counter medications, such as topical ointments or creams for haemorrhoids or anal fissures, medications for pain relief or constipation. Soaking the area in a warm-water sitz bath, up to 3 times a day, can also help relieve anal pain. However, if you have severe pain or bleeding, or home remedies are not working then seek medical help.   When should I see a doctor? See your doctor if you have: ● Pain during bowel movements (pooping) ● Rectal bleeding, blood on stools (poop) or toilet paper ● Changes in bowel movements ● Haemorrhoids that don’t improve after a week of home care ● Persistent pain, especially if painkillers are not working.   If you have the following symptoms, you should seek immediate medical attention: ● A significant amount of rectal bleeding or rectal bleeding that won’t stop ● Anal pain that gets much worse or spreads ● You also have fever, chills, dizziness or anal discharge   When is treatment required? Your doctor will be able to advise you on how to manage your symptoms, as well as screen for more serious conditions. Some people with anal fissures may need medication or, occasionally, surgery. Surgery is usually needed to treat anal fistulas. Abscesses often need to be drained as well as antibiotics. Colorectal surgery may be required for more severe disorders, or those that haven’t responded to other treatments.

As well as being an important spiritual practice for Muslims, Ramadan fasting in healthy individuals has been shown to have potential health benefits, such as reduced blood sugar and cholesterol levels, and weight loss.

However, it is still possible to put on weight during Ramadan if you don’t control your diet during Suhoor and Iftar. Changes to your normal patterns of eating, sleeping and taking medication, as well as dehydration, can lead to digestive system problems such as heartburn, indigestion or constipation.

Follow these 7 tips to stay healthy while fasting

1. Have a healthy Iftar

• Break your fast with dates and water before your main meal
• Don’t binge eat – keep portions small to help avoid indigestion and prevent weight gain
• Avoid heavy, fried foods as much as possible
• Cut down on salty and sugary foods
• Opt instead for lean fish and meat, beans and pulses
• Choose whole grain brown rice, bread or pasta
• Include lots of fresh fruits and vegetables
• Take your time, don’t rush to eat dessert if you are already full

2. Stay hydrated

• Drink enough water to avoid dehydration and aid digestion
• Drink at least 10 glasses of water or other non-sweetened drinks between Iftar and Suhoor
• Eat fluid-rich foods such as soup, salads and fresh fruits
• Limit coffee and other caffeinated drinks

3. Don’t skip Suhoor

• A balanced Suhoor will help you keep going until Iftar
• Eat Suhoor as close to dawn as possible
• Choose nutrient-rich foods like oatmeal, cheese, labneh, fruits and vegetables
• Opt for foods which release energy slowly throughout the day such as oats, quinoa, or multigrain and whole grain breads

4. Exercise, but don’t overdo it

• Remain active, but limit exercise during the day to avoid dehydration
• The best times to do light to moderate exercise are just before Suhoor or a few hours after Iftar

5. Don’t go to sleep on a full stomach

• Try to stop eating at least 2 hours before you go to bed, especially if you experience indigestion or gastric acid reflux

6. Drop unhealthy habits

• Ramadan is the ideal time to give up unhealthy habits such as smoking or eating sugary snacks, as you learn to avoid habit triggers during the day you can continue to avoid them after fasting hours

7. Talk to your doctor if you have any concerns

• If you have health issues or take regular medication it is important to discuss with your doctor before fasting
• You should also consult your doctor if you experience any changes to your health or new symptoms while fasting

Wishing you a healthy Ramadan and all the blessings of the Holy Month!

Fasting during the holy month of Ramadan by abstaining from food, drink and medication from sunrise to sunset, is one of the pillars of Islam. Some Muslims may be exempt from fasting due to medical conditions. It is important to consult your doctor if you take regular medication or have any concerns.

But how does fasting affect your pancreas? How can you look after your pancreas while fasting? What should you do if you are diabetic?

What does my pancreas do?

Your pancreas, a long, flat gland located behind your stomach, plays a big role in digesting the food you eat. The pancreas produces enzymes that help break down fats, starches and proteins. It also makes hormones (chemical messengers) that play important roles, such as insulin and glucagon, which help to regulate your blood sugar levels.

What happens in my pancreas when I fast?

When you eat, your digestive system breaks down the food into glucose (a type of sugar) and the nutrients your body needs. When glucose is detected in your bloodstream, the pancreas secretes insulin, which signals cells throughout your body to absorb the sugar to use for energy. Leftover glucose is stored in your liver in the form of glycogen.
Between meals or in longer periods of fasting, insulin levels drop and your pancreas secretes the hormone glucagon which signals the liver to use its glycogen stores to provide the body with energy and keep blood sugar levels steady. When glycogen stores are used up, your body will start to break down fats to get the energy it needs.

Can I fast if I am diabetic?

Diabetes is a condition in which your body cannot absorb blood sugar properly, either because your pancreas doesn’t produce enough insulin, or cells respond poorly to insulin and take in less sugar (type 2 diabetes). You may need insulin, other medications, or dietary adjustments to help regulate your blood sugar levels.
If you are diabetic, you are at risk of your blood sugar levels becoming too high (hyperglycemia) or too low (hypoglycemia), with potentially dangerous effects on your body. It is essential that you discuss with your doctor whether you can fast safely. This will depend on the type and severity of your diabetes. It is important to follow your doctor’s advice regarding diet, medication, and checking your blood sugar levels regularly.

Is fasting good or bad for my pancreas?

Research has shown that intermittent fasting, as occurs during Ramadan, may provide some general health benefits such as improved metabolism, lowered blood sugar levels and decreased inflammation. Combined with a healthy lifestyle and balanced diet, these effects may potentially help weight loss and reduce the risk of some diseases, such as obesity and cancer.
However, some research has shown that there is a higher rate of acute pancreatitis (short-term inflammation of the pancreas) during Ramadan fasting. The risk of pancreatitis is thought to be increased due to binge eating during the night, eating fatty foods, and not drinking enough water.

How can I keep my pancreas healthy during Ramadan?

Maintaining a healthy weight and lifestyle can reduce your risk of pancreatic disease:
● When breaking your fast, try not to over eat.
● Stick to a healthy balanced diet including fruits and vegetables, whole grains, and lean protein.
● Avoid fatty, salty or highly processed foods.
● Drink enough water to stay hydrated.
● While daytime exercise can be challenging during Ramadan, you can do light exercise such as going for a walk in the evening.
● Smoking increases your risk of pancreatitis and pancreatic cancer. If you do smoke, Ramadan can be a good time to stop. Your doctor can help if you are struggling to quit.
● If you are diabetic, discuss with your doctor how to keep your blood sugar under control.

Fasting during the holy month of Ramadan by abstaining from food, drink and medication from sunrise to sunset, is an important religious practice for muslims. If you are ill or have underlying health conditions, such as kidney disease, high blood pressure or diabetes, discuss with your doctor whether you can fast safely or how fasting may affect your medical treatment. How can I keep my kidneys healthy while fasting? If you are healthy and are not taking medication that affects your hydration, your kidneys should not be affected by fasting. However, you can avoid problems by following the following tips: Eat Healthy It can be tempting to overdo it when breaking your fast. But sticking to a healthy balanced diet as much as possible can help control weight gain, blood pressure and blood sugar – all risk factors for developing kidney disease. Dates and other dried fruits are a great way to break the fast as they provide natural sugars and minerals and are a source of fibre. Include plenty of fresh fruits and vegetables and wholegrain foods during your Iftar and Suhoor meals. Avoid too much fatty, salty or highly processed foods. Avoid dehydration Dehydration can impact your kidneys as well as your general health. You need to drink enough fluids, including water and other non-sweetened drinks, during non-fasting hours to replace fluids lost during the day and to start the next day of fasting well hydrated. Try drinking one or two glasses of water: ● when you break your fast before you eat ● after your iftar meal ● during nightly prayers ● with your suhoor meal Keep moving Regular exercise can help reduce your blood pressure, boost your heart health and maintain a healthy weight – all of which can help prevent kidney damage. While exercise can be challenging during the day, you can do light exercise such as going for a walk in the evening.   Don’t smoke Smoking, whether cigarettes, shisha or medwakh, increases the risk of kidney function problems, as well as kidney cancer. If you do smoke, Ramadan can be a good time to stop as during fasting hours you can learn how to go through your regular daily routine and to avoid the triggers that make you smoke. Your doctor can help if you are struggling to quit.   Get enough rest Changes to your sleep routine during Ramadan can impact your kidneys and general health. You can counteract this by building in rest periods during the day, even if you can’t get your normal number of hours at night.

A lump or boil near or between your buttocks can be painful and cause problems sitting. You may be embarrassed to see your doctor about it. Maybe you hope it will go away on its own. But how can you tell if it could be more than a simple boil and when you need to see a doctor?

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What is a boil? Boils occur when bacteria gets inside the skin, such as through hair follicles. They commonly occur in areas of the body with skin folds where sweat pools, and the buttock area is one of these.   What do boils on the buttocks look and feel like? You may notice a red, tender, and painful bump or lump on the skin, on or near the crease of the buttocks. Over time this may swell and fill with pus.   What can I do to ease the pain? You can apply moist, warm compresses to the boil area, 3 or 4 times a day. You can take painkillers that you would usually use at home. If it is a simple boil, it may clear up without treatment. Do not try to pop or puncture the boil yourself as this can make the problem worse and cause the infection to spread to other parts of the body.   When do I need to see a doctor? You need to see a doctor if you have had a boil for more than 2 weeks, or if the boil is large, increasing in size, very painful or keeps recurring. Ignoring the problem will not make it go away and could lead to complications. See a doctor if you also have a fever, as this could be a sign of spreading infection. In these cases you may need antibiotics, or your doctor may need to drain the boil to remove the pus.   How do I know if it is more than a normal boil? Sometimes an infection can occur in an abnormal pocket of skin near the tailbone at the top of the cleft of the buttocks, or inside the buttock crease. This is called a pilonidal cyst or pilonidal sinus. If not treated, a pilonidal cyst can lead to an extremely painful abscess when pus builds up under the skin. This type of infection can get worse quickly and does not usually clear up on its own. Therefore it is important to seek medical help if you have a painful lump in this area, especially if it is getting worse or if you have other symptoms such as nausea or fever   What is the treatment for a pilonidal cyst? Treatment depends on the size of the cyst and your symptoms. Where an abcess has developed antibiotics are usually required. Your doctor may need to drain the pus through a small incision (cut) after numbing the area. If the cyst is large or repeatedly infected, surgery may be performed to clean or remove the cyst. Wound care is extremely important after surgery, to keep the area clean.   Can pilonidal cysts be prevented? It’s not clear what causes pilonidal cysts. It is thought that a skin problem, pressure or friction may cause loose hair between the buttocks to be pushed inwards. This leads to the creation of a cyst or pocket around the hair which can become infected. Pilonidal cysts are more common in men and in people who sit for long periods of time, such as long distance truck drivers. You can reduce your risk of pilonidal cysts by keeping the buttock area clean, maintaining an active lifestyle and avoiding prolonged sitting whenever possible.   Remember: Don’t put off seeing a doctor if you have had a painful lump in your buttock area for more than 2 weeks, espe

Hope for pancreatic cancer: advances in treatment 

 

Pancreatic cancer is known for being a difficult cancer to detect and treat. It is the seventh leading cause of global cancer deaths in industrialized countries and the third most common in the USA, despite accounting for only about 3% of diagnosed cancers.

 

The cause of pancreatic cancer is not clear and research is ongoing. Some factors such as smoking, diabetes, obesity, and some genetic mutations have been shown to increase the risk of developing pancreatic cancer.

 

Why is pancreatic cancer difficult to treat? 

 

Pancreatic cancer is difficult to detect in the early stages of the disease. The most commonly found type of pancreatic cancer has a tendency to spread (metastasize) to other parts of the body quickly, and recur after surgical removal. Currently, the majority of pancreatic cancers are diagnosed at an advanced stage when they have  already spread, making treatment challenging.

However, there is cause for hope. Research is enabling earlier detection and advances in the treatment of pancreatic cancer, with the potential to improve survival rates.

How is the treatment of pancreatic cancer improving?

Treatment options depend on the type, location and stage of the cancer. In general, the earlier a cancer is detected, the better the prognosis. Treatments for pancreatic cancer are becoming safer and more precise. Studies have found that survival rates are improving for cancers found in the early stages. Clinical trials are being conducted to find more effective ways to treat pancreatic cancer.

 

Advances in chemotherapy

 

Chemotherapy drugs may be either injected or taken by mouth to help kill cancer cells, relieve symptoms and prolong survival. New types of chemotherapy and new ways to combine chemotherapy drugs are currently undergoing clinical trials in order to find more effective treatments.

 

Advances in radiotherapy

Radiation therapy uses high-energy beams to destroy cancer cells. Technology is continually advancing to enable more precise delivery of radiotherapy to tumours while minimizing any unwanted radiation to the rest of the body.

 

Improved surgical techniques

New surgical techniques and improved post-operative care, alongside advances in chemotherapy and radiotherapy to shrink tumours pre-operatively, mean that more pancreatic cancers can be treated surgically. For suitable cases, tumours can be removed more safely with smaller incisions using minimally invasive procedures, and sometimes even robotic-assisted surgery. Minimally invasive laparoscopic surgery is performed through tiny abdominal incisions using a thin, lighted tube with a camera on its tip (a laparoscope).

 

New immunotherapy drugs

 

Immunotherapy interferes with proteins produced by cancer cells which prevent them from being attacked by the body’s immune system. This enables the body’s own immune system to fight the cancer in cases where surgery is not an option. There are currently many clinical trials for new immunotherapy drugs.

Targeted drug therapies

Targeted drug therapies target specific weaknesses present within cancer cells, causing the cancer cells to die. Some clinical trials have focused on certain genetic mutations associated with a higher risk of developing pancreatic cancer.

Improved palliative care

Medical advances in supportive, or palliative, care are enabling better management of symptoms and improved quality of life for cancer patients. Palliative care is beneficial at all stages from diagnosis to during and after treatment, and can help improve outcomes and well-being.

 

Remember:

 

Early detection can improve treatment outcomes. Consult your doctor if you experience unexplained symptoms, develop diabetes over the age of 50, or have a family history of pancreatic cancer.