Dr Christian Jeske

GLP-1 Medications: Benefits, Risks and Safe Use

Christian Jeske — Mon, 27 Jul 2026 06:05:42 +0000

What are GLP-1 medications?

GLP-1 medications are prescription medicines that help regulate appetite, blood sugar and digestion. They are used to treat conditions such as:

Type 2 diabetes
Overweight and obesity (in appropriate patients)
To reduce the risk of heart disease in selected high-risk patients

Examples include semaglutide, liraglutide and tirzepatide.

What are the benefits?

When prescribed by a healthcare professional and combined with healthy eating and regular physical activity, GLP-1 medications may:

Help you lose weight by reducing hunger and helping you feel full sooner.
Improve blood sugar control in people with diabetes.
Lower the risk of developing type 2 diabetes in some people with prediabetes.
Reduce blood pressure.
Improve cholesterol levels.
Reduce fat in the liver.
Lower the risk of heart attack and stroke in some patients with diabetes or cardiovascular disease.
Improve overall health and quality of life.

What are the possible side effects?

The most common side effects are usually mild and improve over time, especially when the dose is increased gradually.

These may include:

Nausea
Vomiting
Diarrhoea
Constipation
Stomach pain or discomfort
Heartburn or indigestion
Feeling full quickly
Reduced appetite

Are there any serious risks?

Serious side effects are uncommon but can occur.

Seek medical attention immediately if you develop:

Severe or persistent abdominal pain, especially if it spreads to your back.
Persistent vomiting leading to dehydration.
Yellowing of the skin or eyes (jaundice).
Severe allergic reactions such as swelling of the face or difficulty breathing.

Your doctor may recommend stopping the medication temporarily before surgery because it slows stomach emptying.

Who should not use GLP-1 medications?

These medicines may not be suitable if you:

Have a personal or family history of medullary thyroid cancer.
Have Multiple Endocrine Neoplasia type 2 (MEN2).
Have had a serious allergic reaction to one of these medicines.

Always tell your healthcare provider about your medical history and any other medicines you are taking.

Can these medicines be addictive?

No.

GLP-1 medications are not addictive. They do not produce a “high,” do not cause dependence, and are not drugs of abuse.

However, some people misuse them by:

Using them without a medical need.
Taking someone else’s prescription.
Buying them online or through social media.
Using higher doses than prescribed.

Using these medicines without medical supervision can be dangerous.

Buying GLP-1 medications safely

Only obtain GLP-1 medications:

From a registered doctor or healthcare provider.
From a licensed pharmacy.
With a valid prescription.

Do not buy injectable medicines from:

Social media advertisements.
WhatsApp groups.
Online marketplaces.
Friends or family members.
Unlicensed weight-loss clinics.

Why is this important in South Africa?

South African health authorities have warned about fake and illegally imported GLP-1 medications being sold outside licensed pharmacies.

These products may:

Contain the wrong amount of medicine.
Contain harmful or unapproved ingredients.
Be contaminated during manufacture.
Not work as expected.
Cause serious health problems.

Because these medicines are injected, products made or stored incorrectly can pose additional risks.

Getting the best results

GLP-1 medications work best when combined with:

Healthy eating.
Regular physical activity.
Good sleep.
Ongoing medical follow-up.
Regular monitoring by your healthcare team.

These medicines are designed to support long-term health and should only be used under medical supervision.

Contact

Please contact our rooms for an appointment if you need any more information about GLP-1 medication at (012) 644 1327, or use any of the provided links on our website or facebook page to book or send us an e-mail at unitas@generalsurgery.co.za.

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Patient Orientation for surgery

Christian Jeske — Tue, 25 Nov 2025 21:31:55 +0000

Dr Jeske guides you through the process when going for surgery at Netcare Unitas hospital.

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Understanding Fatty Liver Disease: A Patient Guide

Christian Jeske — Wed, 25 Jun 2025 12:52:54 +0000

Fatty liver disease, or hepatic steatosis, occurs when an abnormal amount of fat accumulates in the liver. While the liver normally contains some fat, more than 5–10% of the liver’s weight in fat is considered unhealthy. This condition can lead to liver inflammation (steatohepatitis), scarring (fibrosis), and in severe cases, cirrhosis or liver failure. Fatty liver disease is broadly divided into two types: alcoholic fatty liver disease, caused by excessive alcohol intake, and non-alcoholic fatty liver disease (NAFLD), which is more common and not related to alcohol.

NAFLD is closely linked with metabolic risk factors such as obesity, type 2 diabetes, insulin resistance, high blood pressure, and elevated cholesterol or triglycerides. Genetics, poor diet, rapid weight loss, or certain medications may also contribute. Most people with fatty liver do not experience symptoms in the early stages, making regular health screening important.

Diagnosis

Fatty liver is often discovered incidentally during routine blood tests or imaging done for other reasons. Elevated liver enzymes (ALT and AST) may suggest liver inflammation, although many people with fatty liver can have normal levels.

A liver ultrasound is usually the first imaging test used and may show a “bright” liver indicating fat accumulation. More advanced imaging like FibroScan (transient elastography) or MRI can measure the degree of liver stiffness or fat. In some cases, a liver biopsy is needed to confirm the extent of inflammation or fibrosis, especially if non-invasive tests are inconclusive or if liver disease is advanced.

When to Consult a Doctor

You should consult a healthcare provider if you have:

Unexplained fatigue, weakness, or weight loss
Discomfort in the upper right side of your abdomen
Yellowing of the skin or eyes (jaundice)
Persistently abnormal liver function tests
Risk factors such as obesity, diabetes, or high cholesterol

Early detection is crucial. If left untreated, fatty liver can progress silently over years.

Treatment and Lifestyle Changes

There is no specific medication to cure fatty liver, but it is often reversible with lifestyle changes. The main treatment goals are reducing liver fat, improving metabolic health, and preventing disease progression.

Dietary Changes

Adopting a healthy, balanced diet is essential. The Mediterranean diet—rich in vegetables, fruits, legumes, whole grains, lean protein (especially fish), olive oil, and nuts—has been shown to reduce liver fat. Avoid:

Processed foods and refined carbohydrates
Sugar-sweetened beverages and snacks
Saturated and trans fats
Alcohol, which can worsen liver damage

Smaller, more frequent meals and mindful eating can also support liver health and weight control.

Physical Activity

Regular exercise significantly reduces liver fat—even without major weight loss. Aim for:

150–300 minutes of moderate aerobic activity per week (e.g., brisk walking, cycling, swimming)
Or 75–150 minutes of vigorous activity (e.g., running, aerobics)
Plus 2 or more days of strength training

Exercise improves insulin sensitivity, reduces inflammation, and supports weight loss. Find an activity you enjoy and maintain consistency.

Weight Loss

A weight loss of 5–10% of body weight can reduce liver fat and improve liver enzyme levels. A slow, steady weight loss of 0.5–1 kg per week is safe and effective. Those who struggle with weight loss may benefit from:

Referral to a dietitian
Structured programs involving behavioral therapy
Medications for weight or diabetes control, if appropriate
Bariatric surgery in severe cases of obesity with related conditions

Ongoing Monitoring

Follow-up is essential. Your doctor will monitor liver enzymes, metabolic health, and possibly repeat imaging or blood tests to assess your progress. Early intervention can prevent irreversible liver damage.

Conclusion

Fatty liver disease is common, often silent, but potentially serious. The good news is that with timely diagnosis and lifestyle changes—focusing on diet, exercise, and weight loss—it can often be reversed or halted. If you have risk factors or symptoms, do not delay in seeking medical advice. Protecting your liver today safeguards your health for the future.

Contact

Please contact our rooms for an appointment if you have experienced or are experiencing any of the above mentioned symptoms at (012) 644 1327, or use any of the provided links on our website or facebook page to book or send us an e-mail at unitas@generalsurgery.co.za.

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Gastroesophageal Reflux Disease (GERD) – Making lifestyle changes to manage GERD

Christian Jeske — Mon, 02 Sep 2024 20:25:50 +0000

GERD

Gastroesophageal reflux disease is a condition in which stomach acid repeatedly flows back up the esophagus. This backwash is known as acid reflux, and it can irritate the lining of the esophagus. GERD is caused by frequent acid reflux or reflux of nonacidic content from the stomach.

When you swallow, a circular band of muscle around the bottom of the esophagus, called the lower esophageal sphincter, relaxes to allow food and liquid to flow into the stomach. Then the sphincter closes again.

If the sphincter does not relax as is typical or it weakens, stomach acid can flow back into the esophagus. This constant backwash of acid irritates the lining of the esophagus, often causing it to become inflamed.

Most people can manage the discomfort of GERD with lifestyle changes and medicines. And though it’s uncommon, some may need surgery to help with symptoms.

Symptoms:

A burning sensation in the chest, often called heartburn that usually happens after eating and might be worse at night or while lying down.
Backwash of food or sour liquid in the throat.
Upper belly or chest pain.
Trouble swallowing, called dysphagia.
Sensation of a lump in the throat.
If you have nighttime acid reflux, you also might experience:
- An ongoing cough
- Inflammation of the vocal cords known as laryngitis
- New or worsening asthma

Lifestyle factors that reduce risk of Gerd:

Drink more water – 2Lt per day
no more than two cups of coffee/tea/soda daily
a healthy diet (comparatively higher intake of fruits, vegetables, whole grains, legumes, poultry, and fish)
Moderate or vigorous exercise for at least 30 minutes daily – if your heartburn gets worse after exercise, time your meals and wait 2h after eating
Avoid alcohol
Avoiding eating meals at least 3 hours before going to bed
Eating smaller portions and avoiding overeating, eat slowly and chew food properly
Quitting smoking
Obtaining/maintaining a healthy body weight (body mass index between 18.5 and 25)
Not lying down for at least two hours after a meal
Avoiding heartburn triggers such as certain foods and drinks for example:
- Onions, peppermint, chocolate, caffeinated beverages, citrus fruit or juice, tomatoes or high fat and spicy foods.
Sleeping in an inclined position
Keep a heart burn diary is a good way for you to figure out which foods cause your symptoms. Jot down when your heartburn hits and the specific things you’re doing when it comes.

Conditions that can increase the risk of GERD include:

Obesity
Bulging of the top of the stomach up above the diaphragm, known as a hiatal hernia.
Pregnancy
Connective tissue disorders, such as scleroderma
Delayed stomach emptying

Factors that can aggravate acid reflux include:

Smoking
Eating large meals or eating late at night
Eating certain foods, such as fatty or fried foods
Drinking certain beverages, such as alcohol or coffee
Taking certain medicines, such as aspirin.

Possible complications:

Over time, long-lasting inflammation in the esophagus can cause:

Inflammation of the tissue in the esophagus, known as esophagitis. Stomach acid can break down tissue in the esophagus. This can cause inflammation, bleeding and sometimes an open sore, called an ulcer. Esophagitis can cause pain and make swallowing difficult.
Narrowing of the esophagus, called an esophageal stricture. Damage to the lower esophagus from stomach acid causes scar tissue to form. The scar tissue narrows the food pathway, leading to problems with swallowing.
Precancerous changes to the esophagus, known as Barrett esophagus. Damage from acid can cause changes in the tissue lining the lower esophagus. These changes are associated with an increased risk of esophageal cancer.

When to see a doctor:

If you have have severe or frequent GERD symptoms.
Take non-prescription medicines for heartburn more than twice a week.
Have chest pain, especially if you also have shortness of breath, or jaw or arm pain. These may be symptoms of a heart attack.

Contact

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Jaundice

Christian Jeske — Fri, 31 Mar 2023 10:49:31 +0000

Jaundice

Jaundice is a sign of an underlying disease; it occurs when there’s too much bilirubin in your blood. Bilirubin comes from the break down of old red blood cells, which the liver filters from the bloodstream.

Jaundice may develop if there is either an increased breakdown of red blood cells, the liver’s functional capacity decreases or there is a blockage in the excretion of bile. Bilirubin builds up and can cause your skin to look yellow.

What is Bilirubin?

Bilirubin is a yellowish pigment that is made during the normal breakdown of red blood cells. Higher than normal levels of bilirubin may indicate an underlying liver or bile duct problem. Eventually, most of it leaves the body in the faeces.

Causes

Jaundice is divided into 3 groups: according to the different causes.

Pre-hepatic (before bile is made in the liver).

- Haemolysis (rupture or destruction of red blood cells), the most common cause of prehepatic jaundice, this involves increased production of bilirubin.
- Less common cause of pre-hepatic jaundice includes Gilbert’s disease and Grigler-Najjar syndrome

Hepatic (problems arising within the liver).

Jaundice in these cases is caused by the liver’s inability to properly metabolize and excrete bilirubin. Examples include:

- Certain medicines: Drugs like acetaminophen, penicillin, birth control pills, and steroids have been linked to liver disease.
- Alcohol-related liver disease: If you drink too much over a long period of time — typically 8 to 10 years — you could seriously damage your liver. Two diseases in particular, alcoholic hepatitis and alcoholic cirrhosis, harm the liver.
- Hepatitis: Most of the time, this infection is caused by a virus. It may be short-lived (acute) or chronic, which means it lasts for at least 6 months. Drugs or autoimmune disorders can cause hepatitis. Over time, it can damage the liver and lead to jaundice.

Post-hepatic (after bile has been made in the liver)

- Blocked bile ducts: These are thin tubes that carry a fluid called bile from the liver and gallbladder to the small intestine. Sometimes, they get blocked by gallstones, cancer, or rare liver diseases. If they do, you could get jaundice.
- Pancreatic cancer: This is the 10th most common cancer in men and the ninth in women. It can block the bile duct, causing jaundice.
- Cancer is also an overlapping cause of post-hepatic jaundice.

Symptoms

Yellow discolouration of the skin and mucous membranes
Light-coloured stools
Dark-coloured urine
Itching of the skin
Nausea and vomiting
Abdominal pain or discomfort
Fever
Loss of appetite
Headache

Tests

Liver function tests.

Blood tests that measure certain enzymes or proteins in your blood as well as your bilirubin levels

Albumin and total protein.

Levels of albumin — a protein made by the liver — and total protein show how well your liver is making proteins that your body needs to fight infections and perform other functions.

Complete blood count.

This test measures several components and features of your blood

Prothrombin time.

This test measures the clotting time of your blood

Treatment

The treatment of jaundice depends on what is causing it. All cases of jaundice require a detailed physical examination and work-up to ensure optimal treatment.

Contact

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Pancreatitis

Christian Jeske — Tue, 14 Mar 2023 08:50:06 +0000

Pancreatitis

Pancreatitis is a common nonbacterial inflammatory disease caused by activation and autodigestion; a process whereby pancreatic enzymes destroy its own tissue leading to inflammation. This may or may not be accompanied by permanent anatomical and functional changes in the pancreas.

Pancreatitis is mostly caused by gallstone disease or alcoholism, a few cases result from trauma, hypercalcemia, hyperlipidemia with the remainder cases being of no identifiable cause.

There are two different types of pancreatitis namely, acute, and chronic pancreatitis.

Acute Pancreatitis

Acute pancreatitis is a syndrome resulting from acute inflammation, it is the 3^rd most common indication for hospital admissions among gastrointestinal diseases. It is associated with significant morbidity and mortality.

Acute pancreatitis has many causes but biliary tract disease and alcohol consumption accounts for most cases, with drug reactions, metabolic causes, and traumatic injuries accounting for almost all the remaining cases. In patients who do not drink alcohol, the most common cause of acute pancreatitis is biliary tract disease. Acute pancreatitis associated with biliary tract disease is more common in women, because gallstones are more common in women.

Symptoms of acute pancreatitis

Abdominal pain

The pain of acute pancreatitis is characteristic, often described as an intense, deep, searing pain that radiates to the back. The acute attack frequently begins following a large meal and consists of severe epigastric pain, this is usually accompanied by vomiting and retching.

Fever

Almost two-thirds of patients develop fever, this is due to tissue injury, inflammation, and necrosis.

Dehydration and increased heart rate (tachycardia)

Depending on the severity of the disease, dehydration and tachycardia may be profound.

Treating acute pancreatitis

Fluid replacement in patients with acute pancreatitis are necessary to maintain circulation of blood and renal function.
Antibiotics, prophylactic broad-spectrum antibiotics are often used in patients with severe pancreatitis since the likelihood of infections are high.
Oxygen therapy is used in more than 30% of all patients who develop hypoxemia.
Calcium and magnesium replacements are used in severe attacks of acute pancreatitis.
Surgical treatment is generally contraindicated in uncomplicated acute pancreatitis.

Chronic Pancreatitis

Chronic alcoholism causes the most cases and accounts for 70-80% of the cases. Patients with chronic pancreatitis resulting from alcohol abuse usually have a long history (6-12 years) of heavy alcohol consumption (150-175 ml of pure alcohol a day). Other causes include bile duct obstruction due to gallstones, hypercalcemia (calcium level in your blood is above normal), hyperlipidemia (your blood has too many lipids (or fats), such as cholesterol).

Chronic pancreatitis causes irreversible damage towards the pancreas, whereas the damage in acute pancreatitis is reversable. In patients with chronic pancreatitis diabetes mellitus is commonly present.

Symptoms of chronic pancreatitis

Abdominal pain

Chronic pancreatitis may be asymptomatic, or it may produce abdominal pain. The pain is usually felt deep in the upper abdomen and radiates through the back. Early in the disease, the pain may be episodic lasting for days to weeks and then vanishing for several months before returning.

Continued alcohol intake may increase the frequency of painful episodes

Nausea and vomiting
Weight loss and malabsorption
Jaundice and diabetes mellitus

Treating chronic pancreatitis

The treatment for chronic pancreatitis is mainly symptomatic and directed toward relieving pain.
Discontinue the use of alcohol. Abstention from alcohol will reduce chronic pain in more than half of cases even though damage to the pancreas is irreversible.
Diabetes in these patients usually require insulin therapy.
Fluid replacement with calcium and magnesium replacements is also advisable in patients with chronic pancreatitis.

Medical tests

Endoscopic pancreatography (ERCP) – is helpful in establishing the diagnosis of chronic pancreatitis, and in the ruling out of pancreatic cancer.

Imaging studies – CT scans with contrast. MRI if suspected cause is bile duct obstruction.

Blood tests – Pancreatic function tests, Liver function tests (LFT’s), CRP (C-reactive protein), Kidney function tests

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Disease of endocrine pancreas

Christian Jeske — Mon, 27 Feb 2023 09:48:16 +0000

Disease of endocrine pancreas

About the pancreas

The pancreas lies behind your stomach, extending laterally from the duodenum toward the spleen. The pancreas is an elongated, pinkish grey organ with a length of about 15cm and weight of about 80g. The broad head of the pancreas lies within the loop formed by the duodenum. The slender body of the pancreas extends toward the spleen, and the tail is short and bluntly rounded. The surface of the pancreas has a lobular texture.

Arterial blood supply includes the branches of the splenic, superior mesenteric and common hepatic arteries. The pancreatic arteries and pancreaticoduodenal arteries are the major branches from these vessels. The splenic vein and its branches drain the pancreas.

The pancreas is primarily an exocrine organ, producing digestive enzymes and buffers. The large pancreatic ducti (Duct of Wirsung) deliver theses secretions to the duodenum. A small accessory pancreatic duct or duct of Santorini may branch from the pancreatic duct. This pancreatic duct extends within the attached mesentery to reach the duodenum, where it meets the common bile duct from the liver and gallbladder. These two ducts empty into the duodenal ampulla, a chamber located roughly halfway along the length of the duodenum.

Functions of the pancreas

The pancreas has digestive and hormonal functions and is known as the only organ in the body to have both endocrine and exocrine secretions. Each day your pancreas secretes abut 1000ml of pancreatic juice. The secretory activities are controlled primarily by hormones from the duodenum. Furthermore, some enzymes are secreted as inactive proenzymes that are activated only after they reach the small intestine. The release of proenzymes rather than active enzymes in the pancreas protects the secretory cells from the destructive effects of their own products.

Carcinoma of the pancreas (Cancer)

Pancreatic carcinoma has become the third leading cause of death in the United States and is known to be the eight most common cancer in women and tenth in men respectively. Pancreatic cancer usually occurs after the age of 50 years and increases in incidence with age, with most patients diagnosed between the ages of 60 and 80 years of age.

Carcinomas occur more often in the head of the pancreas (70%) and body (20%) than in the tail which accounts for 10% of the cases. Carcinoma of the head of the pancreas tend to obstruct the common bile duct early in their course, with resulting jaundice, and can extend into the uncinate processes to involve the superior mesenteric artery and vein, thus compromising surgical respectability. Tumours of the body and tail tend to present later in their course, as they cause few symptoms until they become quite large. Patients with carcinoma of the body or tail of the pancreas typically present with epigastric abdominal pain, profound weight loss, abdominal mass, and early satiety. Due to the vague nature of the symptoms, patients tend to present at later stages, often with distant metastases, particularly in the liver. Microscopically, 90% of pancreatic cancers are adenocarcinomas; the remainder are adenosquamous, anaplastic, or acinar cell carcinomas.

Risk factors of pancreatic cancer includes

Cigarette smoking has the strongest overall association and is thought to account for one-quarter of cases diagnosed.
High dietary intake of saturated fat (cream, butter, cheese, pastries, cured meats, chocolate etc.)
The role of other dietary factors such as coffee, high fat intake and the use of alcohol are still much debated.
Diabetes mellitus has also recently been identified as a risk factor for the disease.
Chronic pancreatitis increases the risk of developing pancreatic adenocarcinoma by 10 – 20-fold.

Whipple Procedure (Pancreaticoduodenectomy)

A Whipple procedure is the removal of the head of the pancreas, the entire duodenum, a portion of the jejunum, the distal third of the stomach, and the lower half of the common bile duct, with reestablishment of continuity of the biliary, pancreatic, and GI tract systems. Gastrointestinal continuity is re-established by connecting a portion of the intestine to the bile duct, remaining pancreatic body/tail, and the stomach or duodenum. The procedure may take anything from 6-12 hours, with post operative High care for 7-10 days if no complications arise.

References

Martini, F. and Ober, W.C. (2001). Fundamentals of anatomy & physiology: [main volume]. Upper Saddle River, N.J.: Prentice Hall.
Mcphee, S.J. and Hammer, G.D. (2019). Pathophysiology of disease: an introduction to clinical medicine. 8th ed. New York: Mcgraw-Hill Education Medical.
Lowe, J.S., Anderson, P.G., Anderson, S.I. and Stevens, A. (2020). Stevens & Lowe’s human histology. Amsterdam: Elsevier.
www.bartleby.com. (n.d.). Illustrations. Fig. 1062. Gray, Henry. 1918. Anatomy of the Human Body. [Online – Accessed 11 Aug. 2022].
Edythe Louise Alexander, Rothrock, J.C. and Mcewen, D.R. (2015). Alexander’s care of the patient in surgery. St. Louis, Missouri: Elsevier/Mosby.

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Liver health

Christian Jeske — Mon, 13 Feb 2023 10:59:14 +0000

Liver Health

The liver

The liver is located in the right upper quadrant of the abdomen, just below the diaphragm and the rib cage. It is anatomically divided into a left and right lobe. The liver weighs approximately 1400g and is the second largest organ in the human body. It receives nearly 25% of the cardiac output (The amount of blood your heart pumps in one minute) approximately 1500ml of blood flow per minute. This is achieved by the portal vein and hepatic artery.

Since the liver has such a rich and systemic blood supply, the liver is a prime site for the metastatic spread of cancer, especially from the GI tract, breast, and lung. It performs over 500 functions, this includes protein, lipid, carbohydrate metabolism as well as drug metabolism and excretion. Iron is also stored in the liver/bone marrow to make red blood cells which carries oxygen in our bodies. The liver adjusts cholesterol levels, builds proteins, and makes bile, which helps you absorb fats, stores sugar for when you really need it and regulates hormone levels

Liver health and diseases

Many health problems can keep your liver from functioning properly and cause disease.

Alcoholic Liver Disease. Alcoholic liver disease is a result of alcohol abuse. Repeated episodes of acute injury ultimately cause necrosis, fibrosis, and regeneration, leading to cirrhosis.

Cholestasis. This happens when the flow of bile from your liver is limited or blocked. Cholestasis can be caused by certain drugs, genetic factors or even pregnancy. It can also occur from a blockage caused by a tumour, or a gallstone stuck in the body’s digestive system.

Cirrhosis. An irreversible alteration of normal liver architecture, characterized by hepatic injury, fibrosis, and nodular regeneration. Heavy alcohol use and viruses like hepatitis are common causes of cirrhosis. Not all patients will Cirrhosis develop life-threatening complications.

Hepatitis. This is the name for any condition involving inflammation of your liver. There are many different types, acute, viral, toxic, chronic, and alcoholic hepatitis. Hepatitis can lead to liver failure, liver cancer and other life- threatening conditions.

Non-alcoholic Fatty Liver Disease (NAFLD). A form of chronic liver disease associated with the metabolic syndrome. This is an umbrella term for a wide range of liver diseases. NAFLD is diagnosed when there are no other causes of secondary hepatic fat accumulation (e.g., heavy alcohol consumption)

Lifestyle

Get vaccinated for hepatitis. Hepatitis A and B are viral diseases of the liver. While many children have now been immunized, many adults have not. Ask your doctor if you are at risk.
Avoid contaminated needles while tattoos and piercing.
Avoid toxins like drugs and some medicines that can harm your liver.
Practice safe sex because there is no vaccine for hepatitis C. Hepatitis B and C can develop into chronic conditions that may eventually destroy your liver. They are transmitted by blood and other bodily fluids.
Wash your hands: Hepatitis A is spread through contact with contaminated food or water.
Avoid smoking and the use of tabaco products.
Pesticides and other toxins can damage your liver. Read warning labels on the chemicals you use.

Diet

Don’t eat foods high in fat, sugar, and salt.
Stay away from a lot of fried foods including fast food restaurant meals.
Raw or undercooked shellfish such as oysters and clams are a definite no-no.
Try to limit alcohol consumption to no more than one drink a day if you’re a woman and two drinks a day if you’re a man.
Eat a balanced diet: Select foods from all food groups: Grains, fruits, vegetables, meat and beans, milk, and oil.
Eat food with fibre: Fibre helps your liver work at an optimal level. Fruits, vegetables, whole grain breads, rice and cereals can take care of your body’s fibre needs.
Drink lots of water: It prevents dehydration, and it helps your liver to function better.

Exercise

Maintain your body mass index in the normal range (18 to 25) by eating healthy and exercising on a regular basis to decrease your risk of developing non-alcoholic fatty liver disease (NAFLD).

Screening

Blood Test – several blood tests are commonly used to assess liver function, these range from measuring the enzymes (AST and ALT) of the liver as well as levels of albumin, clotting factors and bilirubin.
Imaging Tests – Ultrasound, CT scan, MRI gives a detailed picture of the liver and abdominal part.
Biopsy – A small part of the tissue is removed to diagnose the type of liver disease by means of inserting a needle through the skin and aspirating liver cells. Most biopsies are performed as day-case procedures.

References

Mohan, Y., 2022. Liver – Anatomy, Functions, Diseases, Diagnosis, Tips – LeoGenic Healthcare Pvt Ltd. [online] LeoGenic Healthcare Pvt Ltd. [Accessed 19 August 2022].
Mcphee, S.J. and Hammer, G.D. (2019). Pathophysiology of disease: an introduction to clinical medicine. 8th ed. New York: Mcgraw-Hill Education Medical.
American Liver Foundation. 2022. Liver Disease Diets – American Liver Foundation. [online] [Accessed 19 August 2022].
Hopkinsmedicine.org. 2022. 5 Ways to Be Kind to Your Liver. [online] [Accessed 19 August 2022].

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In Room Procedures

Christian Jeske — Mon, 30 Jan 2023 11:58:24 +0000

In Room Procedures

The following procedures are done in the rooms by Dr C Jeske with the help of an Anaesthesiologist and clinical assistant. Anaesthesia is given in the form of sedation; sedation is used in small and minimal invasive procedures whereby the patient is still able to breath on their own with no loss if cardiac function. The patient is unconscious.

Gastroscopy

Procedure

A gastroscopy is best described as a minimal invasive procedure where Dr Jeske inserts a long, thin tube with a small camera through the mouth to reach the stomach via the path of the esophagus. During the procedure Dr Jeske may perform other small procedures such as taking specimens of the esophagus and stomach with a small biopsy forceps which he inserts through the scope.

Indications

Indications for a gastroscopy range from different digestive problems and complaints such as.

Difficulty or pain when swallowing (dysphagia)
Heartburn and Chest pain
Stomach or abdominal pain
Continues vomiting and nausea
Family history of esophageal/stomach cancer

Side effects of a gastroscopy

Slight pain in the throat
Feeling bloated
Belching

Preparing for a gastroscopy

Do not eat/drink after 22h00, the night before the procedure.
You should be fasting for at least 6 hours before the procedure for solids, but you are allowed to take clear liquids up to two hours before your procedure.

Colonoscopy

Procedure

The procedure colonoscopy provides visualization of the colon from the rectum to the ileocecal valve. During the procedure Dr Jeske will insert a long, flexible tube inside the rectum through the anus to reach the end of the large bowel (colon). During the procedure Dr Jeske may perform other small procedures such as taking specimens of the colon with a small biopsy forceps which he inserts through the scope.

Indications

Indications for which a colonoscopy will be performed are as follow.

Difficulty or pain when passing stool
Bleeding when passing stool or blood in stool
Abdominal pain
Acute and chronic diarrhoea
Family history of colon/rectal cancer

Side effects of a colonoscopy

Slight blood in stool
Passing a lot of gas
Minor discomfort in abdomen
Diarrhoea from residual effects of bowel preparation

Bowel preparation before the procedure

You will be provided with all the necessary information in the rooms as well as a script for Picoprep.
Picoprep is a laxative used in preparation for the colonoscopy to ensure the bowel is empty for optimal vision.

Patients using medication

Diabetes patients – please check your sugar levels the evening and morning; omit medication the morning of the procedure.

Warfarin – Stop 4 days prior to the procedure. If unsure whether you are allowed to stop medication, please check with your physician or cardiologist, and have an INR check the morning of your procedure.

Iron tablets – must be stopped one week prior to the procedure

Specimens

Specimens are taken with both the above-mentioned procedures. They are then sent to pathology labs (Lancet) to be tested; this is advantageous in making or confirming a diagnosis. The sizes of these specimens vary between 2 and 3mm, with no obvious side effects afterwards, Dr can take up to 6 specimens in the colon and up to 4 in the gastroscopy.

Duration of gastroscopy and colonoscopy

Gastroscopy – You will be in the procedure room for about 25-30 minutes. The scope itself will take 10-15 minutes (this is dependent on whether a procedure is done with/-out biopsies). You will need a few minutes to recover from the sedation afterwards in the recovery area.
Colonoscopy – You will be in the procedure room for about 30-40 minutes. The scope itself will take 15-20 minutes (this is dependent on whether a polypectomy or biopsy is being done). You will need a few minutes to recover from the sedation in the recovery area.

Important information

Please contact the rooms to schedule an appointment to follow-up scope and biopsy results, at least 7 days after your procedure.
You can return to work the day after your procedure. A sick note will be provided for the day of the procedure. Please discuss with our rooms if you need a longer sick leave note.
It is advised to bring a family member or friend who will be able to take you home, as you will not be able to drive due to the anaesthetic drugs administered during the procedure.

We are dedicated to helping you. Please note that this information is not exclusive

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Laparoscopic Surgery

Christian Jeske — Mon, 16 Jan 2023 06:12:33 +0000

Laparoscopic surgery

Laparoscopic surgery is a minimally invasive surgical technique used in the abdominal and pelvic areas. It uses the aid of a laparoscope — a thin, telescopic rod with a camera at the end — to see inside your body without opening it all the way up. Instead of the 15-30cm cut necessary for open abdominal surgery, laparoscopic surgery uses two to four small incisions of half a centimetre or less. One is for the camera, and the others are for the surgical instruments. Minimally invasive surgery may also be called “keyhole surgery,” referring to these small incisions.

History and Pioneers of Laparoscopic procedures

Endoscopy is derived from Greek and means “viewing the inner spaces of the human body” (“endo” and “skopein”)
Georg Kelling was the first to describe the basic principles of endoscopy of the abdomen. Kelling performed the procedure in a dog. Almost exactly a hundred years ago, Jacobaeus performed the first endoscopy in humans. Major advancements in endoscopy were accomplished from the 1960s to the 1980s, accompanied by a transition from diagnostic to surgical laparoscopy. These developments are inseparably linked with the names of Raoul Palmer in Paris and Kurt Semm in Kiel.
The first laparoscopic appendectomy was performed by Semm on 13 September 1980 at the department of obstetrics and gynaecology, University of Kiel.

Advantages of laparoscopic surgery

Smaller incisions and smaller scars
Less pain than open procedures
The chances of infection after the procedure are lower than with open procedures
Faster recovery for the patient
Shorter hospital stays
Due to the increase in intra-abdominal pressure, patients bleed less than with open procedures.

Disadvantages of laparoscopic surgery

Sometimes the procedure must be converted to an open procedure due to bleeding or other complications
Limited degree of motion
Increased operation time
Increased technical difficulty

Procedures done laparoscopically by Dr Jeske

Laparoscopic incisional hernia repair – This is a bulge or area of weakness in the muscles which form the lower front of the stomach in the groin region.
Laparoscopic drainage of abscess in the liver, pancreas, and abdomen
Laparoscopic liver resections and liver biopsies – The reason for removing part of the liver is likely due to one or more growths, cancerous or non-cancerous. Trauma to the liver is also a possible indication for this operation. A liver biopsy may be done to look for the cause of liver abnormalities, to assess if, and how much, the liver is damaged and/or to help in planning treatment.
Laparoscopic cholecystectomy – Removal of the gallbladder due to gallstones, both the gallbladder and stones are removed.
Laparoscopic appendicectomy – Removal of the appendix due to infection which causes pain and can ultimately rupture.
Laparoscopy for diagnostic purposes
Laparoscopic hemicolectomies – Removal of part of the large intestine due to cancer or other obstructions.
Laparoscopic splenectomy – Removal of the spleen may be due to Splenic cysts, abscesses, or tumours. Spleen damaged because of certain auto-immune diseases or traumatic trauma may also be an indication to remove the spleen.

Myths and facts about laparoscopic surgeries

Myth – Laparoscopic surgery is more costly than open surgery
Fact – Since patients have a shorter hospital stay and can return to work quicker the costs of laparoscopic procedures are less than that of open surgeries.
Myth – Visualization of the abdomen is limited using lapscopes
Fact – Laparoscopy provides better visualization of the abdomen when compared to the open approach.
Myth – Patients with multiple previous abdominal surgeries cannot have a laparoscopic procedure.
Fact – Laparoscopy can be safely performed in patients with multiple prior surgeries regardless of the size or location of the prior skin incisions.

We are dedicated to helping you. Please note that this information is not exclusive

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