A PUBLICATION BY

Cruising Through

the Gut

Gut Your HealthKeep your digestive system

in tip top condition Pg 10

Your Guide to Nutrient Absorption

Understand how food nutrients are digested and

absorbed by your body Pg 19

Foods That Hurt Food allergy and food

intolerance – recognise the difference to avoid the scare

Pg 21

Lies About Detox Here’s what detox

programmes don't tell you Pg 31

REGISTRATION No. 198901967K MICA (P) 091/11/2012 COMPLIMENTARY COPY ISSUE 03 / 2013

Scan here to see our videos for the latest healthcare tips!

'Ooomm' to Better Digestion

Yoga exercises that can help to improve your digestive health

Pg 33

Contact us to understand more about our services available at:Raffles Surgery Centre585 North Bridge Road | Raffles Hospital, Level 1 | Singapore 188770Tel: (65) 6311 1222 | Email: specialist@raffleshospital.com

Hospital

Opening Hours: Monday - Friday: 8.30am - 6.00pm Saturday: 8.30 am - 1.00 pm

* Terms and conditions apply.** For Singaporeans and Permanent Residents.

Scope forGood Health

Colonoscopy GastroscopyColonoscopy & Gastroscopy

Screening Packages@ Raffles Hospital

$1,250$642

$1,600

Package Prices*(Include GST)

Colonoscopy

Polyps in the colon and rectum show no symptoms and are common among individuals aged 50 and above. A screening colonoscopy can help detect polyps for removal before they develop into colorectal cancer, the leading cancer in Singapore.

You should go for a Screening Colonoscopy if you:• Are above 50 years old• Have a family history of colorectal cancer• Notice a change in bowel habits• Notice blood or mucus in stools or test positive for faecal occult blood test

Gastroscopy

A screening gastroscopy can diagnose conditions such as gastritis, stomach and esophagus cancers, as well as conditions associated with abdominal pain or bleeding.

You should go for a Screening Gastroscopy if you experience:• Upper abdominal pain or discomfort• Persistent indigestion• Heartburn after meal• Loss of appetite• Nausea and vomiting• Weight loss

Medisave** covers all

procedures in full.

Screening colonoscopy and gastroscopy is recommended for those above 50 years of age, with or without a family history of cancer. You may choose to do a colonoscopy or gastroscopy on its own, or together in a single session.

LIVEWELL EATSMART GETGORGEOUS SHAPEUP

10 Gut Your Health What goes in must come out. Do you understand how your digestive system works to support your daily function? We share with you tips on how to maintain it and keep it in tip top condition.

14 Scope for Good Health A common question asked when it comes to screening using colonoscopy and gastroscopy is: “What’s the difference between them”? In this article, find out what they exactly test for and who needs to be screened.

16 Do You Have a Gut

Problem? When do you know if you are running into trouble with your digestive system? Let experts share with you some disorders associated with it and tips to help you prevent them from affecting your life.

19 Your Guide to Nutrient Absorption Read on to get a clear picture on how nutrients from food are being digested and absorbed by your body.

21 Foods that Hurt Have you always thought that food allergy is the same as food intolerance? Let the experts clarify the difference.

23 Foods for a Healthy Gut Good foods not only help to ease digestion but also help to strengthen our immune system and ultimately protect the body from various diseases. There are six types of food you shouldn’t miss. Find out what they are.

25 A Healthy Porridge for the Soul Do you experience digestive issues manifested in the form of fatigue, poor appetite, indigestion, watery stools and diarrhoea? Here’s a recipe that might just be able to help your digestive health get back on track.

28 When Your Gut Gets in the Way Through recent research studies, it is more evident that certain bacteria in our gut system may be the cause of unwanted weight gain. Read more to find out.

31 Lies About Detox Have you believed in a lie about how effective detox diets are? This article serves to expose what most detox programmes don’t tell you.

33 ‘Ooomm’ to Better Digestion Try out these yoga exercises that can help to improve your digestive health.

5 Editor’s Note6 NewsroomNew Docs on the Block | Triple Joy | Health Seminar: Love Your Heart, Save Your Brain | Yummy Hospital Food | Opening of New Specialist Centres | Travel with Peace of Mind | A Special Delivery: Raffles Delivers First Baby in Ambulance | Double Mastectomy Surgery | Nurses’ Merit Award | Medical Advances in Lymphoma Cancer

26 UpClose Ever wonder what it is like to work in an operating theatre? Read on to find out as Ms Tan Kin Hong, a Nurse Clinician, shares on what keeps her adrenaline pumping.

37 Made Me Smile38 Ask The Experts39 Social Media

Contents26

21

33

23

6

4 HealthNews

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Hello !Eating these foods

can improve our digestive system

– page 23

Will the state of my

digestive health be a hindrance to my

weight management plan? – page 28

This porridge is

easy to prepare and could help to improve digestive health – page 25

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Editor's Note

5HealthNews

Digestive distress is hardly a topic for an after lunch or dinner conversation, but the truth is, it’s surprisingly common. About one in three Singaporeans suffers from gut problems of various sorts. And the number of visits to GP doctors for “functional bowel disorders” - such as reflux and irritable bowel syndrome (IBS) are increasing.

Many people think of their digestive systems as a series of tubes through which food is mechanically digested, broken down and extruded. It’s not as simple as that. Your gut’s health determines which nutrients are absorbed and which toxins, allergens and microbes are repelled. As a result, it is directly linked to the health of your entire body. Intestinal health could be defined as the optimal digestion, absorption and assimilation of food. But, that is also a big job that depends on many other factors.

Ever wonder how our digestive system works in our body and the common signs of digestive problems that one should know? Read on to find out more as we also share tips to having a healthy digestive system (page 10).

One consequence of poor diets, medications, infections and stress is the impairment of our ability to tolerate food. In other words, we become sensitive or allergic to certain foods we consume. Here, we find out how we can better determine whether one has a food allergy or food intolerance within our body (page 21).

People often think that eating more foods that has been claimed to detox our body will indirectly improve our skin and digestive health. We shall explore and find out if that is a truth or a myth (page 31).

Lastly, I would like to wish all readers a happy Hari Raya Puasa and National Day this August! As much as we are in our celebrative mood, do remember that we should still have a balanced diet, eat our meals regularly and exercise to improve and maintain our digestive health.

Dr Peter ChenGuest Editor

Deputy Physician LeaderRaffles HealthScreeners

6 HealthNews

Newsroom

Dr Ong Keh Oon Specialist in Diagnostic Radiology & Consultant, Raffles Radiology

Dr Ong has subspecialty interests in musculoskeletal, sports and body imaging including intervention and pain management. Prior to joining Raffles Hospital, Dr Ong was a consultant at the Singapore General Hospital.

Dr John Wan Mun Chin Specialist in Diagnostic Radiology & Consultant, Raffles Radiology

Dr Wan is trained in a broad spectrum of minimally invasive, imaging-guided diagnostic and therapeutic procedures including oncology, vascular, gastrointestinal, genitourinary and musculoskeletal interventions.

NewDocs on the Block

Raffles Hospital’s team of cardiology and neurology specialists came together on 18 May to share on how everyone should “Love Your Heart, Save Your Brain”. The Raffles Hospital – Channel NewsAsia seminar was held at Joyden Hall, Bugis+ with close to 600 attendees turning up that afternoon.

The first half of the seminar constitutes talks on stroke and vascular diseases by Dr Alvin Seah, Dr N V Ramani, and Dr Manish Taneja. While the specialists in cardiology, Dr Abdul Razakjr, Dr Alvin Ng Chee Keong, Dr Teo Swee Guan and Dr Ng Wai Lin took the stage in the second session to discuss arrhythmias, screening tests, advances in interventional cardiology and the latest treatments in cardiology.

For more information and updates on our upcoming seminar, stayed tuned to our Facebook and Twitter pages!

Love Your Heart, Save Your Brain

According to Prof Walter Tan, Specialist in General Surgery and Plastic Surgery, and the Medical Director of Raffles Hospital, double mastectomy is recommended after considering all other options of treatment, which includes close monitoring or chemoprophylaxis. “Breast cancer treatment requires detailed discussions between the patient and her doctors taking into consideration the characteristics of the cancer and its stage, existence of pre-cancerous lesions, and patient factors, including genetics. Every case is distinct and treatment has to be tailored accordingly,” shared Prof Tan.

For Angelina, however, this was a decision that she’s happy to make: “My chances of developing breast cancer have dropped from 87 percent to under 5 percent. I can tell my children that they don’t need to fear they will lose me to breast cancer.”

Ladies at risk of breast cancer considering double mastectomy need not worry about the procedure. “Advances in immediate breast reconstruction techniques ensure that women who undergo prophylactic mastectomies will still have aesthetically satisfactory breasts after the prophylactic mastectomy,” said Prof Tan.

Actress and director, Angelina Jolie shocked many when she wrote about her double mastectomy experience. In her article, she shared that she carries the BRCA1 gene which sharply increases her risk of developing breast cancer and ovarian cancer. “Once I knew that this was my reality, I decided to be proactive and to minimise the risk as much I could.” Angelina’s mother passed away at age 56 after battling cancer for 10 years.

Double Mastectomy Surgery

7HealthNews

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7

Raffles Hospital opened a new Specialist Outpatient Clinic, Raffles Diabetes & Endocrine Centre in July 2013. The centre would benefit patients with diabetes, thyroid, parathyroid, adrenal problems and other conditions leading to hormonal imbalance. The new clinic at level 2 will be staffed by Endocrinologists Dr Stanley Liew and Dr Abel Soh. The centre also provides dietetics and weight management services tailored by Senior Dietitian Ms Sarah Sinaram.

Following its success, Raffles Neuroscience Centre was expanded and relocated to level 2 of Raffles Hospital. Our two Neurologists, Dr N V Ramani and Dr Alvin Seah, will be joined by Neurosurgeon Dr David Choy and Interventional Neuro-Radiologist Dr Manish Taneja. The new centre will have these specialists help patients with diseases and conditions affecting the nervous system.

In line with the revamp of the hospital’s in-house menu, bloggers were invited for a food tasting session on 12 April.

A total of four dishes were served, including some of chef’s signature dishes like Penang Fried Kway Teow and Steamed Herbal Fish Set. Chef Richard, together with Senior Dietitian Ms Sarah Sinaram, explained the menu and also expounded on the nutritional value of the meals.

The bloggers were suitably impressed by the experience. “We’re obviously not advocating you get warded to try out these meals at Raffles Hospital, but if you are, rest assured you’ll be well-fed,” said Blogger Esther.

Andy, a parent blogger from Sengkang Babies, was pleasantly surprised: “Not many people will find hospital food delectable (gulp), but thanks to Raffles, Daddy’s perception has changed.” The session definitely corrected the misconception that hospital food is bland and tasteless.

Yummy Hospital Food

New Centres

With globalisation, the rise of budget airlines and affluence, we are travelling more frequently than in the past. So if you are preparing for your next holiday: flights and hotels booked, planning travel itinerary ready, luggage packed. But did you remember to book your doctor’s appointment to ensure that you are fit enough for the trip? How about getting your vaccinations up-to-date? And do you have a travel medicine kit at hand in case you do fall sick?

Be it a holiday or a business trip, nobody wants to be sick overseas. It’s miserable to pass on all the exotic foods or to be holed up in the hotel room when others are enjoying the beautiful sights.

The new Raffles Travel Clinic is designed specifically to meet the needs of travellers. According to Dr Raymond Choy, General Practitioner at Raffles Medical Changi Airport Terminal 3 Medical Centre: “We would advise you which are the necessary vaccinations and medications you would need for your trip. Depending on the country you are visiting, the clinic would provide you with the necessary information to keep you in good health. For persons with health concerns, you can get certified for travel by aviation medicine trained doctors.”

Travel with Peace of Mind

Raffles Travel Clinic is now available at the Raffles Medical clinic in Raffles Hospital as well as in our Changi Airport Terminal 3 medical centre. Please call 6311 2222 for more details.

8 HealthNews

Newsroom

We congratulate Ms Ong Suat Kien, Manager, 24 Hour Emergency Department, Raffles Medical on being awarded the Singapore Ministry of Health (MOH) Merit Award 2013. The award recognises outstanding performance and dedication to the profession.

Ms Ong attributed her win to her care philosophy: “I always treat my patients as if they are my closest kin so as to give them the assurance that they are under proper care and treatment.”

“Suat Kien has great passion in Trauma Medicine and has been instrumental in the development of the Emergency Department’s Clinical Proficiency and Quality Standards,” said Ms Tan Siew Hoon, Deputy Director, Raffles Medical.

Specialist in Haematology & Consultant, Raffles Cancer Centre’s Dr Daryl Tan, shares about the recent therapeutic advances in the treatment of Lymphoma, the commonest blood cancer.

Although there are now more than 40 entities of lymphoma, clinically, they can still essentially be classified into two broad variants; an indolent variant where the aim of treatment is to palliate the symptoms as cure is rarely possible, and an aggressive variant, which is potentially curable and intensive therapy is usually prescribed.

Up until a decade ago, lymphoma could only be treated with conventional chemotherapy and radiotherapy. Common to both modalities of treatment is the collateral damage to normal healthy tissues seen as complications of treatment. In addition to killing cancerous cells, chemotherapy could result in indiscriminate killing of normal proliferating cells in the bone marrow, gastrointestinal tract and hair follicles, while radiotherapy could scar and cause inflammation to healthy tissues adjacent to the cancer.

With the exception of Hodgkin lymphoma, a rare subtype of aggressive lymphoma where cure rate is now over 80 percent with conventional chemotherapy, the overall survival of most non-Hodgkin lymphomas has not improved significantly from 1960s to 1990s despite remarkable progress in the development of many chemotherapeutic agents.

Consequently, scientists started looking for novel approaches, and it became clear that antibodies, proteins made by the immune system, might provide the clues needed to treat lymphoma. Antibodies are one way the immune system recognises and destroys foreign invaders. Cancer cells are not foreign, since they are part of our own body, but they often exhibit alien features that can make them appear foreign. The use of anti-lymphoma monoclonal antibodies has now dramatically changed the treatment strategy in lymphoma

Advances in Lymphoma Cancer

Nurses’ Merit Award

therapy and we are beginning to see dramatic improvements in the outcomes of patients diagnosed with lymphoma.

In addition, we are beginning to understand what makes a lymphoma cell tick and drugs designed to disrupt the internal machinery that keeps the lymphoma cell alive and growing are now complementing lymphoma treatments. Overall, this is an exciting time for the field of lymphoma as we are seeing clinical improvements by leaps and bounds.

There are very few things in this world that you can honestly say you can’t live without: food, glorious food. However, besides feasting on food, what goes in, has to come out. Our digestive system is therefore uniquely constructed to perform its specialised function of turning food into the energy you need to survive. Through the same system, it also rids all the waste that the body does not need. Thus, maintaining a good digestive system is the basis for good health.

Your HealthGutHow does your digestive system works?The digestive tract is a series of hollow organs - the mouth, esophagus (e-SAW-fuh-guhss), stomach, small intestine, large intestine (colon), rectum and anus - through which food and liquid pass and are absorbed or eliminated. These organs are aided by a couple of friends: the liver, pancreas and added digestive juices. These juices help break down food into nutrients that can be absorbed by the body. Another organ, the gallbladder,

stores bile between meals. Bile is the digestive juice produced by the liver that helps digest fats. At mealtime, the gallbladder empties bile into the small intestine. Most nutrients in digested food are absorbed through the walls of the small intestine and travel through the bloodstream to other parts of the body. There, they are used to build and nourish cells and provide energy. Waste products, including the undigested parts of food such as fibre, leave the body through a bowel movement.

MouthThe brain tells the mouth to produce saliva, making food easier to swallow. Amylase in saliva begins to break down carbohydrates in food before it enters the throat. Food enters the esophagus through the upper esophageal sphincter and muscle contractions in the esophagus push the food along. At the end of the esophagus, the lower esophageal sphincter opens quickly to let food into the stomach.

Large IntestineIndigestible parts of food enter the large intestine and leave through the rectum. Muscles move the waste through the colon where salts, fluids and other substances are absorbed by bacteria until only faeces remain. Dysfunction of the large intestine may result in abdominal pain, loose stools or constipation.

10 HealthNews

CoverStory

StomachThe stomach is the main receiver of the food we consume and is in-charge of receiving and breaking down food and liquids for further absorption. Glands in the stomach secrete acid, enzymes and a mucous that protects the stomach lining. Muscle contractions stir up the acid and enzymes, liquefying most of the food. If this function is disturbed, loss of appetite, nausea and vomiting may occur.

Small IntestineThe small intestine receives food from the stomach to carry out further absorption of essential nutrients needed by the intestinal wall and into blood vessels. This is where food is mixed with enzymes from the pancreas and bile from the liver. The digestion in this small intestine can help reduce the heatiness of the body.

11HealthNews

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TCM PerspectiveCommon digestive complaints such as nausea, vomiting, bloating, gas, heartburn, diarrhoea, and constipation can be temporary. They can be caused by certain food, food contaminated with harmful bacteria, flu, even normal physological changes such as short-term illness, and menstruation and pregnancy. But sometimes these symptoms are signs of a more serious digestive disease or other health problem such as colon or ovarian cancer.

According to Consultant TCM Physician Miao Meng, Raffles Chinese Medicine, our digestive system includes the functions of the stomach, spleen and liver.

Ms Miao said: “The spleen is the key organ of digestion in TCM as it transforms the nutritive essence from food and liquids in the stomach into qi, blood and body fluids.” The spleen is also responsible for water metabolism. When the spleen is in disharmony, symptoms like abdominal dissention, poor appetite or loose stools may follow. If the transformation and transportation functions of the spleen are harmonious, there will be abundant nutritive essence for energy and blood. However if the spleen is in disharmony, its digestive powers will be affected. As a result, fatigue, abdominal discomfort, pain, flatulence and diarrhoea can occur.

Ms Miao also said: “in TCM, the organ most affected by emotional stress is the liver. The primary function of the liver is to ensure the free-flow of energy throughout the body. As stress tends to impede energy flow, the effect on the liver in this condition becomes evident.” The liver’s flowing and spreading functions also adjust the digestive functions of the spleen. If the liver is not functioning properly, the movement of the spleen energy will also be affected. Eventually, the stomach and spleen would be weakened, resulting in digestive disorders.

Generally treatment of stress aims to harmonise the liver and restore the free-flow of energy and blood in the affected organs and meridians. Treatments will be tailored to suit patient’s particular conditions according to the unique ‘patterns of disharmony’. Often combinations of acupuncture, herbal medicine and massage therapy are used to restore the body to emotional and physical harmony. Patients taking western medication can be prescribed herbal medicine and/or acupuncture concurrently to strengthen and boost the digestive system.

1. Invasion of Liver Energy

Syndrome（肺郁气滞）–

Excessive liver energy invades

into the weaker stomach and

spleen, causing abdominal pain,

belching, sensation of fullness,

acid regurgitation and a bitter

taste in the mouth.

2. Deficiency of Stomach Energy Syndrome（脾胃虚弱）– Symptoms include poor appetite, chronic fatigue, heavy limbs, indigestion or diarrhoea, white coating on tongue and slippery or weak pulse.

12 HealthNews

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1 Incorporate healthy gut bacteria in your diet

Factors such as stress, lack of sleep, antibiotics, illness, ageing and poor diet choices can often lead to an imbalance of your digestive tract bacteria. Certain probiotics, mostly found in dairy products and some fortified cereals, can help to maintain the balance of “good” bacteria in the digestive tract. Try a daily helping of yoghurt.

2Keep the fibre on deck

Consistently eating the right amount of fibre can help promote bowel function. High-fibre foods such as fruit, vegetables and whole grains also help you feel full, which can help lower your chance of overeating throughout the day. Keeping a running tab on the fibre you consume can help give you more energy.

3HydrateWater is one of those essential

elements for a healthy digestive system. Adequate hydration gives your digestive system the moisture it needs to properly function. Insufficient water intake can cause constipation. Also, sometimes our bodies mistake thirst for hunger, so stay hydrated to prevent unnecessary overeating. Try keeping bottles of water with lemon slices around to help boost your intake.

Here’s 10 tips to having a healthy digestive system

4Become a frequent flyer

Eat small, frequent meals throughout the day to keep your metabolism revved up, your blood sugar balanced and your energy up. This can also help you avoid feeling ravenous at your next meal, which in turn can lead to eating larger portions of high-fat foods that can slow your digestion. Try to curb your appetite before going to a party or out to dinner with a nutrient-dense snack like a handful of nuts or a plain yoghurt.

5Work it outExercise can help create a healthy

digestive environment by allowing food to move through the large intestine much quicker. Daily physical activities help keep the GI tract active. This will reduce bowel problems such as constipation. Intestinal muscles that contract during exercise also contribute to more efficient movement of stools.

6Chew, chew, chewSome researchers claim that the

more you chew your food, the less you eat. Chewing foods slowly also increases the digestive enzymes in your mouth, which allow for better overall digestion as the food moves through your digestive tract. So, the next time you decide to gobble down your food, think again!

7Don’t pull the trigger!Holiday festive foods, such as

red wine, holiday citrus punch, spicy shrimp appetisers or tomato bisque soup, are all examples of foods that may irritate the digestive system. By avoiding “trigger” foods such as these, your digestive system will operate more smoothly.

8Think of the saucer sizeHaving a smaller plate means

that a smaller amount of food can fit on it. With less food, of course, the less you will end up eating. Portion control is important not only for weight management but for reducing the stress on the digestive system that comes from overeating.

9 If it’s fried and preserved, lay it to

the sideHeavy, wintry foods, such as duck confit, eggnog and apple pie not only stay in the digestive system longer, but they cause more stomach acid to be produced, which can also lead to gastric reflux. Processed comfort foods such as instant mashed potatoes, canned gravy and cranberry sauce may be challenging for your digestive system; avoid these and your stomach will thank you!

10 Indulge consciously

For those who must have dishes that just cannot be trimmed of fat and calories, go ahead and go for it -- but in a conscious manner. Avoid the post-meal sluggish feeling by cutting the portion in half and feel empowered having a controlled portion. Always try to have a cup of tea on hand -- try mint or cinnamon tea. This will help slow down your eating, allow you to listen to your body and be more mindful. HN

13HealthNews

CoverStory

The process of food digestion begins from the moment food enters our mouth. In fact, the surface area of the digestive tract is estimated to be equivalent to that of a football field. To protect such a large area, our body needs to work extra hard.

Gastroscopy and colonoscopy can help detect problems before they arise. Find out from our specialists on how these scopes can keep you in good health.

ScreeningColon

Colorectal cancer account for 1,300

new cases and 600 deaths in Singapore

each year.

If you experience upper abdominal pain or

discomfort, persistent indigestion, heartburn

after meal, loss of appetite, nausea and

vomiting, and weight loss, gastroscopy is

recommended.

The colon is the last part of the

digestive tract, a hollow tube about 1.5 metres long.

The colon has more than 36

different species of bacteria to

digest unabsorbed fibre and starch.

You should screen earlier if you have a family history

of colorectal, breast, gynaecological, prostate, kidney, stomach cancers; noticed a change in bowel habits; noticed blood or mucus in stools; present

with a positive faecal occult blood test.

The colon reabsorbs liquid

so that only 100 to 200 milliliters are present in the

faeces.

Colonoscopy is recommended for those above 50 years of age

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LiveWell

Scoping the Digestive Tract!

Gastr

oscopy

Information provided by:Dr Law Ngai Moh, Specialist in Gastroenterology & Consultant, Raffles Internal Medicine CentreDr Wong Kutt Sing, Specialist in General Surgery & Consultant, Raffles Surgery CentreDr Yang Ching Yu, Specialist in General Surgery & Consultant, Raffles Surgery Centre

Gastro- IntestinalPost-scope

Polyps are common among individuals above 40 years of age.

Our stomach’s gastric juice is

primarily a mix of hydrochloric acid and digestive enzyme, pepsin

and strong enoughto dissolve razor

blades!

Our GI Tract from small to large intestine is about

30 feet long!

Colonoscopy detect polyps for removal before

they develop into colorectal

cancer.

Gastroscopy uses a thin flexible fibre-optic instrument to examine the lining of the oesophagus, stomach and duodenum for issues such as ulcers or growths. It is used to remove samples,

stop bleeding from an ulcer, remove non-cancerous

growths or early cancers, and dilate the oesophagus,

stomach or duodenum.

Gastroscopy is Generally SAFE in trained hands. Serious complications

are extremely rare. Some may experience mild

complications, such as a sore throat or bloating which usually disappear

within 24 hours.

After colonoscopy, you may experience bloating, gas, and

mild cramping.

Gastroscopy Facts: FAST at least 6 hours before

Procedure time: 10 to 20 minutes

Potential complications

of colonoscopy include excessive

bleeding, and perforation or

puncture of the colon wall.

You may be offered a light

snack about one hour after you are

awake.

Usually, you can go home after

about 2 to 4 hours.

Colonoscopy

15HealthNews

LiveWell

LiveWell

16 HealthNews

Have a Gut ProBlem?From time to time, we may experience an upset stomach, some heartburn, bothersome constipation, bad diarrhoea and maybe bloated-ness. Many digestive problems may be uncomfortable and embarrassing, but the good news is that these can be controlled with simple changes in your lifestyle. Nonetheless, these common digestive symptoms can be tell-tale signs of a more serious problem. Let’s delve deeper to investigate if you truly have a gut problem.

1Irritable Bowel Syndrome (IBS)

Sometimes called ‘spastic colon’, IBS is not a disease but a common bowel disorder consisting of a set of bowel symptoms explained Dr Law Ngai Moh, Specialist in Gastroenterology & Consultant, Raffles Internal Medicine Centre. People with IBS most often have abdominal pain, bloating and change in stool consistency. Some experience constipation (i.e. infrequent bowel movements with hard, dry or difficult-to-pass stools) and others diarrhoea (i.e. frequent loose, watery stools). This disorder can go undetected easily as the symptoms range from mild to severe in nature. Dr Law said: “While IBS does not damage the intestines, it affects the way the digestive tract

YouDo

burning sensation on

chest

sudden

and rapid

intensifying pa

in

Inflammatory Bowel Disease

abdomen pains

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(Fangfeng, 防风), White Peony Root (Baishao, 白芍), Licorice Root (Gancao, 甘草), Chinese Yam (Huaishan, 淮山) and Dried Ginger (Ganjiang, 干姜).

• Acupuncture helps by alleviating the pain, regulating bowel movements and preventing abdominal pains or cramps associated with this condition. It also regulates the gastrointestinal functions, which may in turn treat the root of the problem.

2GallstonesGallstones form when elements

in bile harden into small, pebble-like pieces in the gallbladder. Most gallstones are pigment (break down of red blood cells) or cholesterol stones. If liquid bile contains too much cholesterol, or the gallbladder does not empty completely or often enough, gallstones can form. People suffering from gallstones experience sudden and rapid intensifying pain in the right upper portion of the abdomen.

People who are more likely to have gallstones if they:• are female; women are twice as

likely as men to have gallstones

• have a family history of gallstones;

• are overweight;

• eat a high-fat diet;

• have lost a lot of weight quickly;

• are older than 60;

• have diabetes.

TIPS!a. Maintain a healthy weight; don’t skip

meals.

b. If you need to lose weight, lose it gradually.

c. Eat a low-fat diet.

3 Gastro Esophageal Reflux Disease (GERD)

If you ever felt food or regurgitation from your stomach to your throat, then you know what GERD feels like. According to Dr Baladas H.G, Specialist in General Surgery and Consultant,

GERD is a chronic digestive disease caused by frequent acid reflux. This ring of muscles, called the lower esophageal sphincter opens when you swallow to let food pass into the stomach, then closes again. However, if this valve relaxes abnormally, stomach acid can flow back up into the esophagus, causing frequent heartburn and disrupting your daily life.

The main symptom of GERD is frequent heartburn, i.e. a burning sensation in your chest or throat. Ms Poh shared: “In TCM, heartburn is regarded as a manifestation of disharmonies in the stomach and liver functions”. There are occasions where some adults and most children with GERD do not experience heartburn, they, instead, experience a dry cough, asthma symptoms or trouble swallowing. Making changes in your lifestyle may ease the symptoms of GERD.

TIPS!a. If you smoke, stop.

a. Avoid foods and drinks that trigger heartburn especially caffeinated drinks and citrus food.

a. Maintain a healthy weight.

a. Wear loose-fitting clothes.

a. Avoid lying down for three hours after a meal.

a. Raise the head of your bed six to eight inches by using extra pillows.

Alternative Medicine• Common herbs used to relieve

heartburn symptoms are Processed Pinellia (Zhibanxia, 制半夏), Chinese Dates (Dazao, 大枣), Licorice Root (Gancao, 甘草), White Poeny Root (Baishao, 白芍), White Atractylodes (Baizhu, 白术), Peppermint (Bohe, 薄荷), Thorowax Root (Chaihu, 柴胡), Chinese Angelica (Danggui, 当归), Poria (Fuling, 茯苓) and Fresh Ginger (Shengjiang, 生姜), Calcined Concha Arcae Praeparata (Duanwalengzi, 段瓦楞子) and Sepiae Endoconcha (Haipiaoxia, 海螵蛸)

• Ban Xia Xie Xin Wan (半夏瀉心丸) and Xiao Yao Wan (逍遥丸) are two examples of herbal formulae commonly used to reduce acid reflux and relieve heartburn symptoms.

functions; impairing quality of life with major disability.”

According to Dr Kelvin Thia, Specialist in Gastroenterology & Consultant, Raffles Internal Medicine Centre, the exact cause is unknown. People with IBS may suffer from some form of anxiety, depression or stress and many researchers believe that IBS is a result of heightened sensitivity in the bowel to normal sensations such as passage of air and food. People with IBS may also experience worse symptoms if they eat certain types of food, i.e. spicy and greasy food.

Having IBS can be quite disruptive as the pain comes on without warning and you may be embarrassed by the frequent need to visit the bathroom. It could potentially get in the way of social activities and work. Ms Poh Yu Min, TCM Physician, Raffles Chinese Medicine added: “IBS may also cause problems in your sex life such as painful intercourse or loss of interest in sex.”

TIPS!Learning to cope with IBS can help you live a normal productive life. Try these steps recommended to manage your IBS problems.

a. Learn your triggers. Eat smaller meals and avoid problem foods and drinks such as chocolate, dairy products, caffeinated beverages and alcohol.

b. Medications for example anti-diarrhoea pills do not cure IBS but can provide much relief for IBS sufferers.

c. Drink plenty of water every day.

d. Try to reduce stress through regular physical activity, relaxation techniques such as meditation.

e. For enhancement of general well-being and bowel care, regular exercise and getting a good night’s rest are also important.

Alternative Medicine• For symptoms of IBS, TCM

prescriptions use herbs such as White Atractylodes (Baizhu, 白术), Tangerine Peel (Chenpi, 陈皮), Poria (Fuling, 茯苓), Ladebouriella Root

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Gluten-free grains and starches

• Amaranth• Arrowroot• Buckwheat• Cassava• Corn

• Flax• Indian rice grass• Job’s tears• Legumes• Millet

• Nuts• Potatoes• Quinoa• Rice • Sago

• Seeds• Soy• Sorghum• Tapioca• Wild Rice• Yucca

Foods to avoid

• Barley• Rye• Wheat; durum,

semolina• Triticale• Cereal filler, cereal

binder, cereal protein• Farian

• Flour; wholemeal, wheat flour, wheat starch,white, enriched, graham

• Bran; wheat bran, wheat germ, wheat gluten

• Rusk

• Starch; modified starch, hydrolyzed starch, edible food starch

• Vegetable protein; vegetable starch, vegetable gum

• Cracked wheat• Hydrolyzed wheat protein

Other food sources of gluten

• Bagels• Biscuits• Bread• Breakfast cereal• Crackers• Croissant• crumpets• donuts• sausage rolls• wraps• waffles

• cakes• gravies• mayonnaise• MSG• salad dressings• Sauces including

soy sauce• Soups• non-dairy creamer

i.e. 3 in 1 or 2 in1 beverages

• sweet chilli sauce• vegemite• vinegar• ice cream & cones• macaroons• marshmellows• potato crips• trail mixes• Sausage/hot dogs• meat patties

Digestive problems can range from mild to severe and it can overcome many problems by making simple lifestyle changes: watch what you eat, maintain a healthy weight, learn to deal with stress and if you smoke, quit. Other serious digestive problems may require medication or even surgery. HN

Gluten-Free Diet

4 Inflammatory Bowel Disease (IBD)

IBD is chronic inflammation of the digestive tract and consist mainly of two subtypes: Crohn’s diseases and ulcerative colitis. Crohn’s disease can affect any part of the digestive tract, causing inflammation that extends deep into the lining of the affected organ. Ulcerative colitis affects mainly the colon or rectum, where sores called ulcers form on the top layer of the intestinal lining. “While most people with IBD have abdominal pain and diarrhoea, which may be bloody, some others present with anaemia, fever or weight loss,” Dr Thia said. Symptoms outside the gut such as eye inflammation, arthritis, liver disease and skin rash can also occur in IBD.

TIPS!a. Seek correct medical advice early if

you have symptoms of IBD.

b. Avoid dairy products if you have lactose intolerance problem.

c. Avoid problem foods such as caffeinated and carbonated beverages.

d. Drink plenty of liquids.

e. Consider multivitamins; it helps to supply the missing nutrients, however it is not a substitute for meals.

f. Low fibre diet may be necessary if the intestine is narrowed from disease.

Alternative Medicine• Acupuncture; it stimulates the

release of the body’s natural painkillers.

5Celiac Disease“People who have celiac disease

cannot tolerate gluten, a protein found in wheat, rye, and barley” said Ms Sarah Sinaram, Senior Dietitian, Raffles Diabetes & Endocrine Centre. When people with celiac disease eat foods or use products that have gluten in them, the immune system responds by damaging the lining of the small intestine. This damage interferes with the body’s ability to absorb nutrients from food. This is found more commonly in Caucasians. As a result, a person with celiac disease becomes malnourished, no matter how much

food is eaten. Symptoms may occur in digestive systems or in other parts of the body. For example, one person might have diarrhoea and abdominal pain, whereas another person maybe irritable or depressed and it is possible that some people have no symptoms at all. Management of celiac disease involves the complete avoidance of all foods containing gluten, the protein in wheat, rye, barley and certain other grains.

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Our small intestine has three sections - duodenum (first section), jejunum (second section) and ileum (last section). Duodenum and jejunum are where nutrient absorption usually takes place. The duodenum mainly absorbs carbohydrates, proteins and minerals while the jejunum absorbs any remains from the duodenum as well as water-soluble vitamins B and C. As for the ileum, it absorbs amino acids (broken down from proteins), fats and fat-soluble vitamins A, D, E and K.

Any undigested particles such as indigestible fibre will then be passed on to the large intestine or colon. In the colon, its main function is to absorb water for the body and in so doing, produces formed stools which are discharged out of our body.With this understanding in mind, we will now unravel the mystery on how

Good nutrition is the key to good health. We all need nutrients from our food to keep us in tip-top condition. But do you know that these foods when consume are not in the right form for nourishing our body?

It is only through the process of digestion that our food is broken down into smaller molecules of nutrients before nutrient absorption can take place.

In this article, we will help you understand how these nutrients are being digested and absorbed into our body.

Your Guide to Nutrient Absorption

How do we digest and absorb nutrients?

Food begins its journey of digestion in our mouth. When swallowed, food passes through a tube called esophagus where it is then pushed to the stomach. In the stomach, food is further broken down into smaller bits and mixed with digestive juices.

The small intestine is where the process of digestion and absorption mostly occurs. The intestinal wall of our small intestine is covered with minute, fingerlike projections called villi. Each villus is in turn covered with microscopic finger-like projections called microvilli . When taken together, these structures create a vast surface area through which nutrients can be absorbed. Specialised cells allow the nutrients to cross the mucosa (the inner lining of the organs which contains tiny glands that produce juices for digesting food) and be carried off in the bloodstream to other parts of the body either for storage or for further chemical change.

QUICK FACTSWhat are Nutrients?Nutrients provide our body with its basic needs, including energy and the raw materials to all cell membranes. There are six major categories of nutrients- lipids/fats, carbohydrates, proteins, vitamins, minerals and water.

What is Nutrient Absorption? Absorption is defined as the movement of molecules across the GI tract into the circulatory system. Hence, nutrient absorption simply means that nutrients from digested molecules of food are absorbed into the blood and are carried off to other parts of the body.

each digested nutrient is absorbed and transported throughout the body. This process varies with different types of nutrients and is achieved either with the aid of enzymes and/or digestive secretions from three sources: the liver, the pancreas and the cells of the small intestine.

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the maltose into glucose molecules, allowing it to be absorbed into the blood. These glucose molecules are then carried through the bloodstream to the liver where it is stored or used to provide energy for our body.

Dr Thia shared that unlike starch, sugars, another form of carbohydrates, are digested in one single step. An enzyme secreted by the lining of the small intestine digests sucrose (also known as table sugar) into glucose and fructose which are absorbed through the intestine into the blood. Similarly, lactose (a type of sugar found in dairy products) is changed into absorbable molecules by another enzyme in the intestinal lining.

• ProteinsThe digestion of proteins begins in the stomach with the aid of an enzyme found in the juice of the stomach. Subsequently in the small intestine, several enzymes from the pancreatic juice and the lining of the intestine complete the breakdown of large protein molecules into small molecules called amino acids. “The small molecules can then be absorbed through the intestinal cells into the blood and used to support the cell function within our body,” said Dr Thia.

• VitaminsThe small intestine is where vitamin absorption occurs. There are two types of vitamins and they are classified by the fluid in which they can be dissolved: fat-soluble vitamins (vitamins A, D, E and K) and water-soluble vitamins (all the B vitamins and vitamin C).

Digestion and Absorption of Nutrients

• Lipids or Fats According to Dr Kelvin Thia, Specialist in Gastroenterology & Consultant, Raffles Internal Medicine Centre, fat is important as a major source of energy for our body. The first step in digesting fat is to dissolve it into the watery content of the intestine.

Dr Thia said: “The bile acids, which are produced by the liver, help to dissolve fat into tiny droplets and allow the pancreatic and intestinal enzymes in the small intestine to break the large fat molecules into smaller ones.” Some of these small molecules are fatty acids and cholesterol. When combined with bile acids, these molecules are absorbed into the cells of the mucosa. “In these cells, the small molecules are formed back into large ones and most of which are passed into vessels called lymphatics near the intestine,” he added. He also shared that the reformed fats are then carried by these small vessels to the veins of the chest and the blood carries the fat to storage depots in our body.

• CarbohydratesCarbohydrates begin breaking down in the mouth. Digestible carbohydrates - starch and sugar - are broken into simpler molecules by enzymes in the saliva, in juice produced by the pancreas and in the lining of the small intestine.

Digestion of starch requires two steps. First of all, the salivary enzyme and pancreatic juice help to break the starch into simpler molecules called maltose. Next, an enzyme in the lining of the small intestine will then split

For fat-soluble nutrients, bile acids from the liver are required to break down the fat so that the vitamins can move along with it through the intestinal wall and into the body. The ileum absorbs the fat-soluble nutrients and the excess usually ends up in the liver and stored as body fat.

Water-soluble vitamins are absorbed in the jejunum. The vitamin molecules are transported through the intestine’s cell wall and deposited in our blood. Unlike fat-soluble nutrients, water-soluble vitamins are not easily stored and any excess amount will be flushed out in the urine.

• MineralsMost minerals often compete for absorption. This is because all minerals are absorbed through the same pores in the small intestine, thus reducing the chances of absorption. When the body is lacking a particular mineral, it will increase intestinal absorption of minerals or vice versa. Minerals are crucial for the functioning of our body. For instance, sodium, calcium and potassium are vital for muscle contraction and the conduction of nerve impulses while iron is a central component of haemoglobin in blood.

• Water and Salt

Our small intestine mostly absorbs water in which salt is dissolved. The salt and water come from the food and liquid we swallow and the juices secreted by the many digestive glands. Water is essential as it is involved in hydrolysis reactions that break down nutrients such as protein, carbohydrates and fats into simpler molecules. HN

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Foods that

Rash, nausea, vomiting, diarrhoea, tingling sensation in the mouth - all these are common reactions when your body rejects a certain type of food that you eat. But do you know whether your body is allergic or just intolerant towards a certain food? Well, know the difference to avoid the scare.

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Food Allergy vs Food IntoleranceHow can you determine whether one has an allergy or intolerance towards certain foods? Dr Stephen Lee, Specialist in ENT Surgery & Consultant, Raffles ENT Centre, clarified the difference between these rather similar yet different conditions.

Causes of Food IntoleranceDr Chong Yong Yeow, Specialist in Internal Medicine and Rheumatology & Consultant, Raffles Internal Medicine Centre shared with us five causes of food intolerance.

• Food poisoning - when spoiled food is consumed, the bacteria can cause severe digestive symptoms.

• Celiac disease - celiac disease has some features of a true food allergy because it does involve the immune system. However, symptoms are mostly gastrointestinal, and people with celiac disease are not at risk of anaphylaxis - a severe and potentially life threatening allergic reaction that can occur within seconds or minutes when exposed to something that one is allergic to. This chronic digestive condition is triggered by eating gluten, a protein found in wheat and other grains.

• Absence of an enzyme required to fully digest a food - a common example is lactose intolerance.

• Sensitive to food additives - for example, sulfites used to preserve dried fruit (or wine) can trigger asthma attacks in people who are sensitive to it.

• Irritable bowel syndrome - this chronic condition can cause myriad of symptoms such as constipation, diarrhoea and cramps.

Is There a Remedy Afterall?“Mainstay of treatment of IgE-mediated food allergy is still avoidance. You are advised to read food labels carefully and have an action plan, such as being equipped with an emergency epinephrine shot (e.g. EpiPen and Twinject) for emergency self-treatment, in the event of accidental ingestion,” said Dr Chong.

For children, Dr Chu Hui Ping, Specialist in Paediatrics & Consultant, Raffles Children’s Centre advised concern parents to keep a food diary on the foods that their children are eating. Use it to also keep track of the symptoms that the child may be having due to food allergy, including the type of symptoms (i.e. skin, respiratory or gut) and how soon after the ingestion of food does the symptoms occur. More notably, always seek medical advice from a doctor. HN

You Ask Allergy IntoleranceWhat is it?

• Food allergy refers to the classical immunological mediated response to food ingested which triggers an immune system reaction that affects numerous organs in the body.

• This is well established through an antibody, called IgE, to the specific offending food.

• Food intolerance, also known as delayed or masked onset type, generally occurs gradually and does not involve an immune system reaction.

• It is due to immunological mediated responses but it does not involve the IgE antibody. Instead, studies have shown it to be linked to the presence of an antibody called IgG.

What are the signs?

• The reactions usually occur within minutes and up to two hours after ingestion.

• It can be triggered by ingesting even miniscule amounts of food that is usually eaten infrequently.

• The reactions tend to be persistent each time the offending food is ingested.

• The reaction occurs from two to 72 hours after ingesting the offending food.

• It’s triggered by food eaten frequently and often in larger quantities.

• It frequently involves four, five or even more types of food. As such, one is usually unable to establish a relationship between the offending food and reaction. Therefore, it is often thought to be a food allergy.

• Although the symptoms tend to be low grade, the problem is that they are often chronic, recurrent and associated with inflammation in multiple organ systems.

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Foods for a Healthy Gut

As the saying goes, you are what you eat. This is especially true when it comes to eating the right food to boost your digestion. Good foods not only help to ease digestion but also help to strengthen our immune system and ultimately protect the body from various diseases.

Keeping our guts happy and healthy is more than just an instinct. Start by incorporating the following healthy foods to help your digestive system stay on track!

ProbioticsProbiotics are live micro-organisms that help with digestion. According to Ms Sarah Sinaram, Senior Dietitian, Raffles Diabetes & Endocrine Centre, probiotics-containing foods like yoghurt are good for the digestive system because they contain good bacteria.

Research has shown that consuming yoghurt reduces the symptoms of lactose intolerance due to the process of fermentation. In addition, the probiotics in yoghurt also help to boost the immune system, promote digestion and prevent digestive problems such as diarrhoea and Irritable Bowel Syndrome (IBS).

Ms Sinaram said: “Consumers should check the food packaging for words such as “live active cultures” to ensure that good bacteria are included.”

Tip: Try making a smoothie thickened with yoghurt or add fresh fruits to a bowl of yoghurt for breakfast or an afternoon treat. For a healthier choice, choose plain, unsweetened low-fat or non-fat yogurt to give your digestive system a healthy boost.

PrebioticsPrebiotics are basically non-digestible carbohydrates that act as food for probiotics and thus help to stimulate their growth in our gut. The most common prebiotics are fructooligosaccharide, galactosaccharide and inulin. Inulin, for instance, was reported in a study for being able to increase healthy bacterial colonies in the digestive tract and reduce the severity of inflammation in intestines. Probiotics are also known to treat digestive problems related to diarrhoea and IBS.

Prebiotics are natural components found in many foods. Prebiotics-containing foods range from certain vegetables such as artichokes, garlic and onions to some whole grain foods such as oatmeal, flax and barley.

Tip: Avoid adding too much prebiotics in our diet as it can cause a temporary increase in gas, bloating or bowel movement.

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VeggiesVegetables are packed with nutrients such as dietary fibre, vitamins, minerals and antioxidants. These nutrients are essential for protecting our body against digestive diseases and infections and are helpful remedies for occasional or chronic constipation. Veggies like celery and onions contain a plant-based nutrient known as flavonoids that helps to block Helicobacter pylori (H. pylori) bacteria from growing in your digestive tract. This is important as H. pylori bacteria affect our digestive tract and result in conditions such as indigestion and gastritis, which is characterised by stomach ulcers and inflammation.

Tip: As suggested by the Health Promotion Board (HPB), the recommended intake of vegetables for individuals is two servings or about 200g daily. A quick guide: For those pre-packaged raw leafy vegetables available at local supermarkets, each pack would provide about two servings of vegetables.

FruitsFruits are packed with essential fibres, vitamins and minerals. They are definitely a must-have food for a healthy digestive system. The Centers for Disease Control and Prevention recommends eating a wide variety of fruits so as to reap the benefits they offer for our digestive system.

Fruits like apples and bananas are rich in fibre and such fibre-rich foods have many digestive benefits. For instance, bananas can help in restoring the function of bowel movement after diarrhoea. Eating them can also help in replacing the electrolytes and potassium lost due to runny stools. Besides this, bananas are also rich in pectin. Thus, it helps in removing toxins and heavy metals from the body.

Tip: Ensure you have two servings of fruits daily as proposed by HPB. Also, consider snacking on fruits instead of chips when those hunger pangs strike!

GingerGinger is a plant commonly used as a spice in cooking. However, it also has medicinal properties which make it the perfect home remedy to treat various stomach problems such as nausea, gas, diarrhoea, intestinal spasms, IBS and indigestion. It contains special constituent - gingerol and shogaol which helps to stimulate our body’s flow of digestive juices such as saliva, bile and gastric secretions.

Side effects of ginger are rare but it’s best to consume them in moderation as too much consumption will lead to heartburn. Mr Liu Qiaode, TCM Physician, Raffles Chinese Medicine, said: “Even though ginger is a good food, we must understand the nature of ginger. It is heaty and therefore, people with gastrointestinal inflammation or hemorrhoids should consume ginger with caution.” He also added that decayed and rotten ginger should not to be consumed as it contains dangerous ingredients which may lead to cancer.

Tip: As ginger should be consumed in small amounts, one may do this by adding grated ginger to main dishes. Another alternative is to drink ginger extract after boiling it in water.

WaterWater is by far the most essential “food” of all. It not only helps sustain our body but also plays a significant role in digestion. Without water, digestion can’t take place. We need water to help break foods down into smaller components so as to maintain the normal functioning of our digestive system.

Besides this, enzymes and good bacteria also need water to maintain optimum digestion and allow the absorption and transportation of nutrients. In addition, water also helps to hydrate our digestive system, preventing constipation. HN

Tip: Start the day with two glasses of warm water so as to flush away all the toxins within our body. You may also want to add lemon juice to your water to help kick start your digestive system. A good guide to a healthy digestive system would be to drink six to eight glasses of water a day as recommended by HPB.

Ease of preparation:

Nutritional level:

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Serves: 1 to 2

From the aspects of Traditional Chinese Medicine (TCM), our digestive system transforms food into blood and ‘Qi’ which are the essential substances that are necessary for our well-being. Therefore, maintaining a good digestive system is the basis for good health.

Our digestive system includes the functions of the small and large intestines, spleen and stomach. For instance, the spleen is the vital organ for digestion in TCM’s point of view. It transforms nutritional essence from food and liquids in our stomach into ‘Qi’, blood and body fluids. When the spleen is in disharmony, symptoms like poor appetite, loose stools, abdominal distention or indigestion problems may follow. The small intestine on the other hand absorbs food from the stomach to carry out further absorption of key nutrients required by our body. Disharmony in the small intestine may give rise to bowel disorders or urinary problems.

This recipe is especially beneficial for those having stomach problems with symptoms such as fatigue, poor appetite, indigestion, watery stools and diarrhoea.

Ingredients• Raw peanuts (花生)– 20 grams• Fresh Chinese yam (山药) – 100 grams• Red dates (红枣) – 10 grams• Rice (白米) – 50 grams• Cut Ginger (生姜) – 3 slices

Preparation1. Wash the rice, raw peanuts and red dates (seeds removed) with

water till clean. Soak all these ingredients in the water for 30 minutes.

2. Wash the Chinese yam clean, remove its skin and cut them into thin slices.

3. Boil a pot of water (about two litres). Once the water starts to boil, add in the rice, raw peanuts and ginger slices to be cooked altogether.

4. When the water boils for another five minutes, turn the fire smaller to let it continue boiling to allow the rice to be cooked thoroughly into porridge.

5. Thereafter, put in the red dates and Chinese yam. Allow it to cook for another 10 minutes before turning off the fire.

6. Add a pinch of salt or some soya sauce for taste before serving.

“We are what we eat; therefore the maintenance of our digestive health has to begin from the mouth. Apart from medications and treatments, good dietary choices are crucial to prevent digestive problems. Peanuts are natural ingredients that contain the essential vitamins in helping us to nourish our blood and ‘Qi’ within the body. Chinese yam is one of the best ingredients (in TCM aspects) which contains protein, amino acids, Vitamin C and other key nutrients that help in nourishing the blood as well.

Additionally, frequent eating of Chinese yam and red dates help in protecting our liver. They are also natural anti-ageing ingredients that can be included in our daily diet. This is a very simple dish that any one can prepare it for their family, friends and loved ones especially if they have indigestion problems, irritable bowel syndrome or heartburn condition.”

– Miss Ou Cuiliu, Consultant TCM Physician Raffles Chinese Medicine

A Healthy Porridge for the SoulRed Dates & Chinese Yam Porridge

Nutritional informationCalories: 370calTotal Fats: 10gTotal Carbohydrates: 63gDietary Fibre: 6.5gProtein: 9g

Tip:Add some dried ‘longans’ while cooking for a tinge of sweet after taste.

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UpClose with Ms Tan Kin Hong

Nurse Clinician | Inpatient - Operating Theatre

Nurse Clinician Tan Kin Hong, 46, has been working in Raffles since 1998, with a short break in between. Find out what keeps her adrenaline pumping and what her work in the operating theatre is like.

PHOTO BY EDD CHUA

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Hi Kin Hong, so when did you join Raffles and why? I started work in Raffles SurgiCentre in the year 1998, before it changed its name to Raffles Hospital. ln mid-2001, I stopped work to go to Saudi Arabia for one and a half years before returning to work with Raffles Hospital in the year 2003.

Working in Raffles Hospital is a dream come true for me as all my colleagues, superiors and doctors are all like close friends and family to me. I also see lots of opportunities available for career growth as the hospital is expanding.

What training and character traits do you need to have to be an operating theatre (OT) nurse? To be an OT nurse, you would need to have a General Nursing qualification and operating theatre experience. You would be required to have the Peri-operative Nursing Course Certificate as the course will equip you with in depth knowledge to be applied in your skills as an OT nurse.

You should be passionate about what you do. As an operating theatre nurse, you would need to be conscientious and meticulous plus be able to think quickly on your feet. As with any other surgical-related jobs, you would need to be prepared for any emergency that may arise during operations.

What’s a typical day for you like? As a nurse clinician, I need to ensure the operating theatre list goes smoothly for the day and deal with emergencies that arise. If I am not the coordinator for the day, I would be assisting, scrubbing and circulating for surgeries. This helps me to keep in touch with my peri-operative nursing skills.

During working hours, I have to manage my time and activities well. Prioritising what I need to do is very important so that I won’t struggle at the last moment to try to get things done.

Kin Hong in the Endoscopy

Reprocessing Room cleaning

the scopes.

What do you enjoy most about your work?Everyday, I see miracles happening. Patients come in with fractures and leave with their fractures mended. Eye sight restored after cataract surgery, tumours taken out, and even conjoined twins separated to live their own lives.

The most fulfilling moment in my work would be when we were operating on the Korean conjoined twins, Ji Hye and Sa Rang. An amazing team effort was put in to make the surgery a success. Everyone, from the doctors, nurses, laboratory staffs, radiology staff, and even marketing staff, were working together towards the same goal.

We are discussing about digestive health for this issue of HealthNews. As an OT nurse, do you have a memorable case that you could share with us?There was an 81-year-old patient that came for medical checkup in 2011 and was found to have a small polyp in his colon. He underwent a colonoscopy with Endoscopic Mucosa Resection Surgery. The polyp was removed and he was advised to come back for scope one year later. More polyps were found and resected. The polyps turned out to be cancerous. Then he underwent a major surgery to remove part of his colon in the year 2012. Six months post-surgery, he came back looking very healthy and

good except for a small abscess on the back. For cases like this, I feel very happy and glad that As an OT nurse, we could make a difference with our work.

As an OT nurse, do you have any tips on how to keep fit and stay healthy?Eat healthily and always have enough sleep. Go for a walk or exercise in the gym at least once a week. But above all, I recommend that if you are above 40 years of age to go for a regular medical checkup. Nowadays, you will never know what sickness you have and prevention is always better than cure.

Eat more fibrous foods and drink lots of plain water (at least two litres) a day as it is good to have regular bowel movements. It is advisable to have your stomach and colon checked once you reached 50 years old. According to the Singapore Cancer Registry, colorectal cancer ranks in the top two position for cancers diagnosed in Singapore.

Can you share one little known fact about the lives of an operating theatre nurse?As operating theatre nurses, we have to be alert at all times as you can be assigned to any emergency case that arises. You can say that we strive on adrenaline rush. To maintain a healthy body and mind, we really need to take good care of ourselves. HN

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GetGorgeous

When Your Gut Gets in the Way

Have you tried methods to shed some pounds but somehow it doesn’t seem to be able to achieve effective results? Did it ever cross your mind that the state of your digestive health

could be a hindrance to your weight management plan? In this feature, we explore the possibilities of it.

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A Bacterial Filled EnvironmentJust within your gut alone, imagine that there are between 500 to 1,000 species of bacteria making your gut their home. Sounds disgusting? However, our lives depend on them and they have the ability to affect the quality too.

Among these species of bacteria, there are good and bad ones that have different roles to play. It’s interesting to note that activity in the gut has a direct impact on where the calories go in our body. From various medical studies, there is growing evidence showing that the microbes in our gut have an influence on our metabolism. These studies shed light that certain bacteria in the gut can cause it to extract more calories from the food that we consumed, hence leading to weight gain.

to extract energy and nutrients from food. But if the gut contains too much of it, it can lead to unwanted weight gain.

Researchers suggest that M.Smithii does not do so directly. Instead, it affects its neighbouring bacteria by feeding on hydrogen from other micr-organisms. This in turn gives hydrogen a boost, making them more efficient in extracting more nutrients and calories from food. Thus, resulting in eventual weight gain.

What’s the Remedy?The calories that you consume in your diet are meant to either build your body’s tissues such as muscles and bone mass, or to be expended for energy. In order for either of these to take place, it is important to ensure that sufficient nutrients are absorbed into your system.

Paying more attention to foods that aid in your digestive health is one way to get it back into functioning at its peak. Besides this, maintaining a regular exercise regime and adjusting it appropriately to counter the imbalance of a gradual lowering in metabolic rate, due to ageing, goes hand in hand with a healthy diet to overcome unwanted weight gain.

We understand that our metabolism tend to slow down with age.

“Therefore, people who are overweight should be aware of this. They would have to compensate the drop in metabolic rate with healthier diet and more exercise,” explained Dr Stanley Liew, Specialist in Endocrinology & Consultant, Raffles Diabetes & Endocrine Centre.

In addition, when your body is unable to eliminate waste properly due to poor digestion, it will suffer from toxic build-up. Many toxins can cause your body to retain body fat and excess water. The result is sluggishness and difficulty in losing weight.

Don’t forget, sufficient sleep is needed for your body to do its necessary repair works. And, try to steer clear of stress, which can disrupt the hormones in your body leading to excess eating and finally an increased in unwanted body fat.

According to Dr Abel Soh, Specialist in Endocrinology & Consultant, Raffles Diabetes & Endocrine Centre, a US study showed evidence that higher levels of methane and hydrogen were found in people who had higher BMI and higher proportion of body fat.

A gut bacterium called Methanobrevibacter Smithii (M. Smithii) is responsible for the production of methane in the gut. This bacterium is beneficial as it helps

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GetGorgeous

Have you believed in a lie? Here are some common myths about how your stomach works.

MYTH. When you enter into adulthood, the size of your stomach will not be naturally altered and will remain the same size for the rest of your life. Eating less will not cause your stomach to shrink but it can help to reset your appetite. Therefore, you might find that you don’t feel hungry as frequently as before. This could help you to stick to a diet plan more easily.

MYTH. Although this claim sounds logically true, we understand that the amount of weight gain is determined by comparing the amount of food eaten over a period of time, and how much body fat you burn.

There is an intelligent ‘brain’ in our gut that ensures food is moved through the digestive system via contractions. During the night, our body becomes naturally tired too, and this could cause the gut’s function to be compromised, thus leading to digestion difficulty that can cause you to experience bloatedness, gas or heartburn.

MYTH. There is absolutely no exercise that can change the size of an organ. However, abdominal exercises can help burn the layers of fat that so easily accumulate on the outside of your body. Not only that, it can help to firm up the muscles in the abdominal area that houses the stomach and many other internal organs.

Interestingly, the part of your “belly fat” that can do you the most harm may in fact be the fat you don’t see. It resides in the ‘omentum’, a kind of internal sheet that lies over and around your internal organs.

More often than not, it’s what you don’t see that usually poses as a more dangerous health threat to us. People who are very overweight often have a lot of fats between their organs internally. However, the good news is that a healthy eating plan not only helps you shed the weight you can see, but also the internal fat layers that you don’t see. HN

You can control your hunger better if you cut down on your food intake, as your stomach will eventually shrink over time.

Having supper or eating before bed can make you gain weight faster than if you were to eat the same type of foods during the day.

Exercises like abdominal crunches and sit-ups can reduce the size of your stomach.

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GetGorgeous

Dr Stanley Liew, Specialist in Endocrinology & Consultant, Raffles Diabetes & Endocrine Centre, shared: “Detox is an appealing concept. It gives the impression that anyone can follow a straightforward recipe for a short period of time, and amazingly become healthier, with improvements or cures from various medical conditions. People like the idea of a do-it-yourself remedy, free from side-effects, instead of taking pills.”

Detox diets can help me lose weightThe benefits from a detox diet may actually come from avoiding highly processed foods that have unhealthy fats and sugar. “Such a diet change can benefit many, even without resorting to detox diets,” said Dr Kelvin Thia, Specialist in Gastroenterology & Consultant, Raffles Internal Medicine Centre.

Additionally, detox diets may involve supplements which are actually laxatives, designed to make you go to the bathroom more often. These can cause dehydration, mineral imbalances, and problems with your digestive system.

If you fast for several days, you might drop some pounds but most of it will be water and some of it might be from

loss of muscle mass, which will make you look thin and flabby, rather than tight and toned. Fasting for longer periods can also slow down your metabolism, making it harder to keep the weight off or to lose weight later.

“Regular exercise, coupled with healthy diet plans (avoiding processed foods, taking more fruits and vegetables, lean sources of protein) will promote health,” said Dr Thia, “Avoiding smoking and excessive alcohol intake are even more relevant in the quest for better health a special diets.”

Detoxification is important for well-being due to the toxins that remain in our body

According to Dr Thia, the health benefits of detox diets are unproven as there’s little evidence that detox diet can remove toxins from the body.

“Individuals should be able to eliminate toxins or waste from a healthy liver and kidneys. The human body is well equipped to deal with such toxins, and they are effectively neutralised, processed and removed by the body in the form of sweat, urine and faeces within hours of consumption,” said Dr Thia.

Detox diets are popular as they lead us to believe that following such as diet plan will help the body to become

healthier or aid in weight loss by “getting rid” of unwanted substances e.g. flavour enhancers, food colourings, pesticides,

and preservatives. The focus of most detox diets is to eat natural foods and drink lots of water - all the stuff we know are good for us. However, just like many fad diets, detox diets can have harmful side effects. This article will expose the lies about

detox diets and teach you how to eat for good health.

What’s the evidence behind Detox Diets?Harvard Health Publications reported that there are no data on detox diets in the medical literature. But many studies have shown that fast and extremely low-calorie diets invariably lower the body’s basal metabolic rate as it struggles to conserve energy. Once the dieter resumes normal eating, rapid weight gain follows.

Detox

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GetGorgeous

ConclusionA healthy diet is not one without food that has a ‘bad reputation’. A healthy diet includes eating in the right amounts. Food plays an important part in our social life and managing it in a healthy way, both emotionally and physically, is key to our good health.

When choosing a diet, you should always put your health as the top priority. Secondly, think about sustainability. Exercise should always play an integral role in weight loss. Finally, don’t forget to scrutinise the writers. Are they qualified medical or nutritional professionals with recognised training? Many diets are based on personal experience or ‘testimonies’, few are well researched and medically approved. HN

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Ms Sarah Sinaram, Senior Dietitian, Raffles Diabetes & Endocrine Centre, shared that the basic misconception of detox diets is that certain foods help to cleanse the body but science tells us that this is not true. By consuming more fruits, vegetables and wholegrains, you increase your fibre intake and this helps in bowel movement – there is no one specific food that has unique properties that does it. Drinking more water helps in urine production and bowel movement. Your body is designed to purify itself. Your liver and kidneys will do the job that they’re supposed to do if you eat healthily. People who create fad diets seem to exaggerate the truth in order to gain either monetary benefit or limelight. Readers should learn to be discerning when reading such news, consider whether it comes from credible sources and has scientific research to substantiate the claims. There is a ton of nutrition information available online that is simply misleading.

If you’re feeling tired or run down, or if you’re concerned that you’re overweight, speak to your doctor who can help you determine the cause and recommend ways to address the problem.

Detox diets are safe for all

The health benefits of a detox diet are not proven. And more importantly, detox diets are not for everyone. Dr Liew explained: “People with serious diseases, vitamin and mineral deficiency, and children and elderly should not undergo any detox diet.”

Depending on your health condition, the prescribed diets may do more harm than good to you. For example, individuals with sensitive stomach may not be able to handle acidic drinks. And

eating large amounts of apples may be a problem for diabetic patients who are on a restricted sugar diet.

“Teenagers need lots of good nutrition, with high calories and protein to support the teenage growth and development period. Diets that involve fasting and severe restriction of food are not a good idea, especially for teens who are involved in sports and physical activities,” added Ms Sinaram.

In addition, those who have chronic diseases such as heart, liver and kidney disease are vulnerable and should not start a detox diet without consulting their doctors. It’s also not recommended for people with diabetes, low blood sugar, or eating disorders. “However, if you have started and encountered unusual symptoms, for example, feeling unwell, breathlessness, dizziness, nausea, diarrhoea and/or leg swelling, you should stop immediately,” said Dr Liew.

I would feel better, with more energy to stay focused and clear-headed

After a week with a minimal and limited diet, many people report feeling lighter and less lethargic. According to Ms Sinaram, these are symptoms of a lack of calories and an increase nutrient intake from fruits and vegetables rather than the elimination of toxins from the body. Headaches are a common side effect of caffeine withdrawal along with tiredness and irritability in some people.

Dr Thia added that the use of herbs and extracts may put individuals at risk of developing an adverse reaction or may even be potentially injurious to the liver. Too rapid a weight loss can pose health risks such as fatty liver.

Detoxification works for me, and that’s all that matters

Anyone who goes on a low-fat, high-fibre diet is probably going to feel healthier. Not because of the elimination of toxins, but because you are carrying around less excess weight or having a healthier heart. However, there’s no scientific proof that these diets help get rid the toxins in your body faster or that the elimination of toxins will make you a healthier and more energetic person. “In fact, long term usage of such detox diets can lead to nutritional deficiencies (minerals and vitamins) and affect your energy levels and metabolism,” added Dr Thia.

Detox diets can be addictive - some people really like purging. That’s because there’s a certain feeling that comes from going without food or having an enema. This can become a dangerous addiction that leads to health problems, including serious eating disorders and even death.

We are not going to tell you that eating lots of vegetables and fibre, and drinking lots of water is a bad idea. But you need to ensure that you’re getting all the nutrients you need, including protein from lean meats, eggs, beans, or peas and calcium from low-fat or fat-free milk or yoghurt. Before you start on a detox diet or stop eating from any major food group, talk to your doctor or a registered dietitian to make sure it is right for you.

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to better digestionooO mm

Have you ever felt a “choke” in a pressure-filled situation or felt nervous “butterflies” before speaking in front of a large group? If so, then you may have first-hand experience of some of the effects that a short bout of stress can have on your digestive system. In this issue, we would like to share with you how practising yoga can help to improve your digestive health.

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According to research, good digestion is key to radiant health and sought to understand the mind-body connection. Yoga therapists tend to view the digestive system as a very ‘sensitive mirror’ of the mind and will encourage one with digestive issues to examine their overall lifestyle choices, emotions and other mental components in the yoga learning journey. It is inevitable that most of us face different kinds of stress in our daily lives. Be it issues that are related to work, family or financial - it is also how we choose to deal with and find ways to destress. Some common examples of the effects of stress on the digestive system include esophagus spasms, indigestion, nausea, diarrhea, constipation, stomach ulcers, irritable bowel syndrome as well as other digestive ailments.

When we face stress, the body activates what we have come

to know as the “flight or fight” response in the central nervous system. In a matter of seconds, most of the blood in the body gets shunted out from the digestive system and into the major muscle groups. This has a negative impact on the contractions of the digestive muscles that help transport food through the body as well as the secretions and fluids necessary for healthy digestion. Unfortunately, many of us live in a constant state of stress and do not allow enough time for self-care and relaxation. On the other hand, our body does not know how to distinguish the stress that we may encounter at work, a difficult family situation or even watching a scary movie as they all boil down to the same impact. The modern Singapore lifestyle is so jam-packed with activity that just getting out the door to scheduled “recreational” activities can be stressful.

How does yoga help in having a better digestive system?Yoga incorporates exercises with rhythmic breathing. Breathing brings ‘life force’ into the body and ‘cleanse’ the body of toxic materials formed due to wrong diet, unhealthy lifestyle and accumulated stresses according to yoga therapists. It also helps to improve body balance and encourage rejuvenating the whole body system.

Remember how you feel after a good body massage or a good workout? Well, your digestive system feels much the same after a sequence of simple yoga postures. Your mouth, pharynx, esophagus, stomach, small intestine and large intestine make up your digestive system, with your teeth, tongue, salivary glands, liver, gall bladder and pancreas acting as accessory organs. Throughout the day, your

digestive system is ingesting food, secreting fluids, breaking down and digesting fibre, absorbing nutrients and defecating waste. This is when it is all working correctly. However, we might experience indigestion, acid reflux, bloating or even constipation when we do not eat regular meals or have existing gastrointestinal problems. There are certain simple, basic postures that you can easily incorporate into a regular practice to aid digestion.

For example:• Downward facing dog -

Improves digestion, stimulates appetite and alleviates constipation.

• Forward bending pose - Relieves digestive problems like constipation.

• Seated side bend - It stretches the stomach and intestines, alleviating constipation.

There are more reasons to do yoga than not to. Putting simple poses together in short sequences can be very effective and fast. We can gain many health benefits (listed below) just by having a good digestive system:

• A body that remains alert and active

• Strong bones and muscle• A light, supple body• Fat reduction and increasing

physical strength• Improved appetite• Increased capability of coping

with fatigue

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Let’s take a look at 10 separate sequences that you can practice at home, or you can do them altogether for a longer and more thorough routine.

Sequence #1 - Sitting on knees bentBegin by sitting on your heals with knees bent. To soften any strain on your knees, place a yoga block or folded blanket between your feet. Using your eyes to guide you, revolve your body to the right, twist and look over your shoulder. Hold and breathe for a count of 10, return to the centre and revolve to the left in the same manner. Return to centre. Do this sequence for about four to five times.

Sequence #2 - Extended ‘child pose’Extend your hands and arms forward into pose of the child. Try to place your buttocks on your heels. If this is too difficult, open your knees wider and keep your feet together as you extend. Continue to breathe smoothly without forcing your breath.

Sequence #3 & #4 - ‘Cat’ pose/stretchOn the inhale, round up into ‘cat pose’ by tilting your pelvis upwards and tucking your chin towards your chest. Round your back keeping your arms straight and your hips aligned over your knees.

On the exhale, tilt your pelvis downwards while gently arching the back and looking upwards to where the wall meets the ceiling. Move between the ‘cat pose’ four to five times before stretching back into ‘extended child pose’, finally rolling up to sit back on your heels. Repeat the entire sequence four to five times.

Sequence #5 - ‘Downward Facing Dog’From the inhale position of sequence #3, walk the hands out in front of the shoulders and spread the fingers and palms wide. Gently lift the knees off the earth a couple of inches. Keep the knees bent, press the chest back towards the thighs, draw the shoulder blades back and down the body and bring the belly button back towards the spine. Walk out the legs for a bit until the body is able to sink both heels down towards the earth. Breathe and hold for about one to three minutes. Settle down slowly on a seated position.

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Sequence #8 - LocustFrom a prone position, bring the chin to rest on the mat and the arms by the sides. Let the hip bones relax into the mat. With an inhalation, lift the chest and legs a few inches off the floor. In this pose, the continued abdominal breath offers the opportunity to self-massage the intestines as the body gently rocks with breath. Hold this pose for about 30 seconds to two minutes. Release the body back to normal and rest. Repeat this pose for about four to five times.

Sequence #9 - Supported ‘Reclining Hero’Come to standing on the knees and bring the buttocks to sit on the feet. Bring a pillow or blanket to stack behind the body in line with the spine’s trajectory. Bring the hands behind the body to frame the pillow/blanket for support. With an exhalation, gently lower the spine to rest on the support of the pillow/blanket, continue breathing deeply and hold your breath for about one to three minutes. Use your arms to support the body when coming out of the pose. Release the legs right in front of the body for a couple of breaths before coming down onto the back again. Repeat this pose for about four to five times.

Sequence #10 - Legs against the wallFrom a seated position, bring one hip to the wall and lay down the torso in a diagonal line away from the wall. Gently swing the legs around to the wall and position the body into an ‘L’ shape with the legs resting against the wall and the buttocks firmly on the ground – if your buttocks can’t stay against the wall, use a folded blanket or firm pillow as a support underneath your lower back. Once the body and your breathing settles in, choose to keep the legs pointing directly up or open them into a ‘V’ shape. Hold the pose for at least one to five minutes. HN

Sequence #7 - Extended Side Angle CombinationWith an inhalation from sequence #6 position, bring your torso back to the centre and the right hand next to the right hip. At next inhalation, pick your hips off the ground. Extend your left leg and place your left foot on the ground. Once settled, extend your left arm over the left ear and reach into a full side body stretch. Hold the pose for 30 seconds to 2 minutes. When finished, bring your hips back slowly to the ground and take the same combination of poses on the left side. Repeat both sequence #6 and #7 for the right leg and do both sequences for about four to five times.

Note: All yoga poses recommended are merely suggestions. You may want to join a yoga class or consult a yoga instructor for more information on the yoga poses that can maintain and/or improve your digestive health.

Sequence #6 - Seated Side BendFrom a seated position, extend the right leg and open it out to the right. Bend the left knee and bring the left foot to the inner right thigh. Place the right hand on the right leg and turn the torso towards the left knee. With an inhalation, extend the left arm up. Next, with an exhalation, arch it over towards the right. Hold this pose for about 30 seconds to two minutes.

37HealthNews

Made Me Smile

Mr Tay Puay Chai DaveSeniorAmbulanceDriveratRafflesHospital 24 Hour Emergency Department

Whether rain or shine, he will hit the road once an emergency strikes.

#MadeMeSmile is a Twitter hash tag that is used to sharing on what made you beam. It could be your experience with us and/or someone who made you smile during your visit. Simply follow and tag us @RafflesMedGrp and share with us something that made you smile today.

How would you describe your daily routine? My daily routine begins at 8am. I start off by checking the ambulance so as to ensure that all the equipment is intact. Next, I would check to see if the Global Positioning System (GPS) is in order. This is to prevent any delay from happening due to a faulty GPS. After everything is checked, I would proceed on to wait for calls which can range from non-emergency calls like a house call or a call for transfer to emergency ones that could be life-threatening. In times of emergency, my main duty is to ensure that the casualty is transported safely and timely from their location to our hospital for medical attention.

What do you like most about your job? Bringing someone to the hospital for proper treatment and seeing them discharged is something that makes me feel good about my job. As an ambulance driver, it also gives me a great sense of satisfaction when I see the patients coming back personally to thank me for my service.

Why do you think “service with a smile” is important?I feel that it is important for one to provide good service. Imagine if you step into a shop and find the salesperson looking at you with a sullen face, I don’t think anyone would like that. This applies in our healthcare industry as well. A great smile and some comforting words definitely make a great difference to someone who is in pain. It may not improve their condition physically but psychological wise, a smile helps in reducing the fear that these patients may have when they are in a hospital.

Speaking of challenges, how do you maintain a smile on the road?Even with the lights and sirens turned on, drivers may not necessarily give way to you when there’s an emergency. This is one of the many challenges faced on the road. In such situations, I always keep my calm and stay focus by looking out for traffic. To me, patient’s safety is the top priority.

It’s Dave to the Rescue!

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Ask The Experts

Such discomfort in the upper abdomen and bloatedness especially after meals may be due to a condition known as Dyspepsia.

Stomach acid irritation and abnormal movement with slow emptying of stomach content are the main underlying problems for dyspepsia. These symptoms are aggravated by irregular meals, excessive intake of fatty, spicy and sour food. Study or work stress may further worsen symptoms.

Lifestyle and diet modification usually helps. You can take small and regular meals to reduce fullness after a meal. A short course of acid blockers that help to reduce acid, and prokinetic agents that enhance stomach emptying may be needed for those with severe recurrent symptoms. Probiotics may also help in reducing bloatedness by reducing the bad bacteria in the gut that lead to excessive fermentation and gas production.

The cause of Irritable Bowel Syndrome (IBS) is still unknown but it is postulated to be related to abnormal contractions of the small and large intestines. Some develop IBS after a bout of gastroenteritis even after the infection had been treated or resolved. People with IBS tend to suffer from some form of anxiety or depression as both conditions can affect the intestines.

Based on a reported study in 2004, estimated prevalence for IBS is 10 percent in Singapore whereas the global prevalence is 10 percent to 20 percent. IBS can affect both genders and all ages but it is more common among young adults and females.

An individual with IBS should not have to worry about the condition as it is neither a life-threatening bowel disorder nor will it increase the risk of bowel cancer. With proper medical advice and treatment, individuals with significant IBS symptoms can still experience health improvement and satisfactory quality of life.

One should always seek medical help when they experience symptoms such as weight loss, fever, blood in their stools, vomiting, worsening or severe abdominal pain and severe diarrhoea to confirm if they are suffering from IBS.

Dr Kelvin ThiaSpecialist in Gastroenterology & ConsultantRaffles Internal Medicine Centre

Dr Law Ngai MohSpecialist in Gastroenterology & ConsultantRaffles Internal Medicine Centre

Q1

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I usually do not feel hungry at all before meals. In fact, I often feel quite full. Despite eating my lunch at 12 noon and not snacking in the afternoon, I would still feel full before my dinner at 6.30pm. Is there a problem with my digestive system?

What causes Irritable Bowel Syndrome (IBS) and how prevalent is IBS in Singapore? Does one need to worry about IBS and when should one seek medical help for IBS?

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Social Media

June #AskRMG Dr Alvin Ng Winner: Chia Pei Chwen

After our seminar on ‘Loving Your Heart and Saving Your Brain’ in May, we invited Dr Alvin Ng to have a LIVE chat with our fans to address more heart questions such as the type of foods to consume and the things to take note of to prevent heart conditions. If you had missed it, scan the QR code to get a recap of the session.

May #AskRMG Dr Seng Shay WayWinner: Polly Kwong

Ever wondered if certain supplements help in the process of getting pregnant? Or what exactly contribute to getting a better chance of getting pregnant? We invited Dr Seng Shay Way, our specialist in Obstetrics and Gynaecology to address all your concerns. Scan the QR code to get a comprehensive recap of the session.

April #AskRMG Dr Abel SohWinner: Davis Tan

What’s a healthy blood sugar level before one hits the danger of having diabetes? Is it also true that with a family history of diabetes, it is highly likely that my children will also suffer from diabetes? In April, we had Dr Abel Soh, an endocrinology specialist to answer questions related to diabetics, diabetes mellitus, thyroid disorders and adrenal and pituitary disorders. Scan the QR code to find out more.

An initiative by Raffles to bring our social media fans closer to us, #AskRMG is a monthly online chat session between our Facebook and Twitter followers and our Specialist of the month. Every last Wednesday of the month, you can log on to Facebook or Twitter to pose questions you have to our specialist for a unique LIVE consultation with our specialist. The best question gets to win shopping vouchers.

Connect with us for the latest health tips. Here’s what you have missed…

<NEWS>On behalf of the Board of Directors, Management and staff of Raffles Medical Group, we would like to congratulate our Executive Chairman, Dr Loo Choon Yong on being awarded THE BUSINESSMAN OF THE YEAR at THE SINGAPORE BUSINESS AWARDS 2013.

<RELAX>Did you know one of honey’s myriad benefits is it can relax your mind and body? Honey is known to contain tryptophan which helps to reduce anxiety and relax the nerves. Honey is also known to be rich in potassium which helps to fight off stress hormones in the body and relax the nervous system.

<EAT SMART>Remember that dieting does not mean depriving yourself of your favorite foods, but having a balanced intake of essential nutrients and watching your food and calorie intake. Have a healthy weekend!

Kicking start to a brand new series of health tips videos is ‘Healthy Fasting During Ramadan’. Watch and subscribe to us at www.youtube.com/RafflesHospital for more.

Raffles Medical clinics are Community Health Assist Scheme (CHAS) accredited. You can also pick up your application forms from us directly.