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Top Foods To Steer Clear Of During Valentine’s Day Dates


February 14, 2020 Blog

With Valentine’s Day around the corner, many couples will have plans this week for a romantic date. While the ambience and taste of the food top the list of priorities when settling on a dinner location and menu, you might also want to consider the type of foods you’ll be having.

Uncomfortable situations like bloated stomachs, diarrhoea, excessive burping or flatulence are the last things you want ruining your after-dinner plans. But the fact is, you might not realise that certain foods you’ve eaten were the cause of the irritation. So, to avoid such a situation from occurring, keep a lookout for these foods you should avoid for the evening!

Foods to avoid on a date

  • Beans: Beans are notorious for causing bloated tummies and flatulence. Our digestive system is unable to digest oligosaccharides (a type of sugar) in beans. Thus the compound is only broken down in the large intestine, causing fermentation and gas production.
  • Coffee: Your favourite morning pick-me-up is a known irritant to the digestive system due to its acidic nature. Bloating and diarrhea are some possible side effects of having coffee, and this is made worse if you add milk and sugar.
  • Dairy products: Lactose intolerance needs no introduction, but dairy also contains other components like casein and whey that many people don’t know they are actually sensitive to. To be safe from the frequent toilet runs, opt for alternatives like almond or soy milk instead.
  • Garlic/onions:Like beans, garlic and onions are also flatulence-inducers, in addition to giving the eater pungent-smelling breath. While they are nutritious, having too much during a date may not be the best idea.
  • Fried foods: Fried chicken or fish and chips may sound like a tempting choice, but their high fat content means the digestive system is likely to be overloaded, resulting in discomfort like bloating or nausea.
  • Overly salty foods: High amounts of sodium in foods such as processed foods, canned foods, and cured meats causes water retention and bloating, which can make one look puffy or feel uncomfortable.
  • Carbonated drinks: The urge to burp after downing a can of coke is probably familiar to everyone. Not to mention, the high sugar content in sodas adds to the bloat and unhealthy nature of these drinks. For a safer, healthier choice, go for still water or tea instead.
  • Overly spicy food: *Resist the urge to show off your spice tolerance, because an overload on spice can cause stomach pain and diarrhoea. Existing reflux and stomach ulcers can also be aggravated by the acidity and capsaicin in hot spices. 

What to eat instead

With so many foods to avoid, you might be wondering what’s left to eat on your dinner date! Generally, you will want to stick to a meal that is lower on carbs, sugar, and sodium – as these are the main culprits of bloat and flatulence.

Here are two suggestions for a meal that is suitable for the occasion:

  • Chicken: *Choose a lean cut of chicken for a good source of protein that is less heavy than red meats. Just make sure to stay away from fried permutations, and go easy on the sauce if there’s any. You can pair this with a side of salad and baked potatoes for a balanced diet.
  • Salmon:  Salmon is a good source of protein and healthy fats, making it beneficial to heart health. It is tasty to boot, and wonderful paired with some cooked veggies and fragrant brown rice.


The above food guide is applicable for any meal wherein you need to make a good impression – meaning it is great advice for that high-stakes business meeting or a meal before a stage performance. It doesn’t mean you need to swear off garlic, onion, diary, coffee, or beans forever, as these foods also have their health benefits.

By avoiding these foods for the evening, you’re more likely to enjoy an embarrassment-free dinner date this Valentine’s! However, if you experience uncomfortable symptoms like bloating, stomach pain, persistent diarrhoea or constipation even without eating any of these common trigger foods, it may be a sign that something is wrong. It might be a case of food contamination, or other gastrointestinal problems like colon cancer. Do consult your doctor for a thorough examination, which may include diagnostic tests like a colonoscopy or CT scan.


February 4, 2020 Blog

With the Chinese New Year weekend just past, most people might be still recovering from the effects of the heavy feasting of one too many pieces of bak kwa and pineapple tart. The heavy-headedness and gastric pain are all too familiar – sometimes accompanied by heartburn and diarrhoea or constipation, over-indulging in rich foods during the holidays often has its consequences.

In fact, you might be gearing up for another round of gatherings and reunion meals this weekend, in true observation of CNY’s 15 days of festivity. To minimise your chances of suffering from a tummyache post-CNY meal, here are some tips you can follow:

Eat slowly: Over-eating is the key culprit when it comes to the cause of post-feasting tummy ailments. So, ignore the kiasu part of your brain that tells you to gobble up your favourite foods before they run out. Instead, take your time to eat. This gives your body time to register when it feels full, so that you can stop eating before you go over your limit.

Remember the fibre: Sumptuous as your CNY goodies and reunion meal look, it is likely sorely lacking in fibre, making it a perfect recipe for constipation. So, listen to your elders and eat your greens this CNY. The mandarin oranges you use to greet the relatives are also a convenient and rich source of dietary fibre, as are most fruits, nuts, seeds, and beans.

Get moving: Walking about can help with digestion and reduce your chances of suffering from gastric reflux. You can offer to help with serving food or clearing away the dishes, or get your family to go for a walk together after the meal. Clocking in some exercise daily will also help your body feel less sluggish overall.

Drink a soothing tea after: After a huge meal, bloating is a common issue. Battle it by drinking a hot cup of chamomile, ginger, or peppermint tea. These teas have soothing properties that help to reduce bloating, indigestion, and gas. If these don’t sound like your cup of tea, you could also try capsule supplements that contain these herbs.

What to do if you already have an upset stomach

If you are already experiencing the uncomfortable symptoms of over-eating, you can find some relief by getting your diet and exercise back on track. Here are some things you can try:

  • Consume more fibre: Dietary fibre from fruits, vegetables, whole-grains, and beans are beneficial to overall digestive health and promotes healthy bowel movement.
  • Stay hydrated: Drinking plenty of fluids will help whether you are experiencing constipation or diarrhoea.
  • Take an antacid: Over-the-counter medications like Gaviscon can provide quick relief for indigestion and heartburn.

In most cases, you won’t have to worry as these digestive issues typically resolve themselves within a day or two. It is only when symptoms persist for more than a few days that it becomes a cause for concern. For example, if you experience chronic heartburn that doesn’t go away even after medication, your doctor may need to perform an endoscopy to check for other causes.

With these tips, hopefully, you won’t have to suffer yet again after another reunion meal!


January 21, 2020 Blog

Most people look forward to digging into delectable reunion meals during Lunar New Year, but at the same time, they dread the potential outcomes of doing so: weight gain.

The good news is, health professionals say that feasting for a day or two is unlikely to cause significant and lasting weight gain. However, it is true that over-eating can lead to uncomfortable acute conditions like acid reflux, indigestion, and gastric pain.

Frequent over-eating can also lead to a slew of chronic health conditions. When you consume too much, this forms an excess of free radicals in the body, which cause harm to DNA and body tissues. This is one reason why unhealthy diets and obesity are associated with a higher risk of non-alcoholic fatty liver, heart disease, and diabetes, as well as cancers like pancreatic cancer and colon cancer.

Thus, for the sake of your health, over-indulging is still generally not recommended. As this is easier said than done, here are some tips that may help you watch your food intake this weekend.

  • Drink up before eating: Prefacing your meal with a glass of water or bowl of warm soup helps you eat less later on, as the liquids partially satiate the tummy before you even begin eating.
  • Attack the proteins first: Proteins are the healthier option when it comes to filling up your belly. It makes you feel full quicker, and is better for you as compared to carbs or fats. Just make sure you’re going for the leaner cuts of protein or those with good fats – great examples are chicken breast or fish.
  • Use smaller plates: Using smaller-sized kitchenware forces you to take less each serving, while making you feel like you’ve taken more due to the overcrowded visuals of your plate. Plates with busy, colourful designs can have a similar effect. Additionally, having to get up to get another serving gives you a chance to think twice about whether you really need more.
  • Organise activities besides eating: You don’t have to limit yourself to the dinner table during Lunar New Year. Rally your family to join in some physical activities together, like going for a walk or cycle. You can also enjoy indoor activities like board games or karaoke with your relatives to draw the attention away from eating.
  • Don’t slack off on the exercise: In between visitations, try to clock in some exercise to keep your metabolism going. Simple home exercises like push-ups or sit-ups are a great way to beat the sluggish feeling – a short 15 minutes a day is better than doing nothing at all.

Undoubtedly, you will need a fair amount of self-control to conquer the temptation to devour everything in sight this Lunar New Year. But doing so will reap you the rewards of being able to enjoy the festivities without falling ill or suffering irreparable health consequences later on.

In fact, these tips are applicable for any time you are faced with an abundance of good food, new year or not. Keep them handy so that you can enjoy eating guilt-free every time!


January 14, 2020 Blog

The Lunar New Year festivities are known for being a time for family gatherings and feasting. The problem is, this is most often a recipe for throwing our health off-balance, leading to ailments like sore throat and gastric pain. Your elders may attribute this to one thing – and you’ve probably heard this before: the heatiness of Chinese New Year goodies.

The familiar notion, to some extent, governs the eating habits of most Singaporeans and Asians around the world, but have you ever stopped to wonder what ‘heaty’ means when it comes to food?

What are ‘heaty’ and ‘cooling’ foods?

Heaty and cooling are two ends of the continuum, and they hark back to Traditional Chinese Medicine (TCM) observations and teachings from 2000 years ago. While the concept is unheard of in Western medicine, the TCM perspective believes in the balance of ‘yin’ and ‘yang’ for optimal body health. Rather than being based on chemical composition, the classification of heaty and cooling foods is based on symptoms and effects that different foods have on the body.

⦁ Heaty foods

Heaty foods are classified for their ability to raise body temperature, stimulate the body, and promote blood circulation. Excessive consumption of heaty foods is said to tip the body’s balance, leading to ailments like fever, throat pain and irritation, acne, and mouth ulcers.

Most high-calorie foods fall under this category, as are foods cooked at high temperatures. Examples of heaty food include deep-fried foods, durian, red meat, chocolate, nuts, and spicy foods.

⦁ Cooling foods

Cooling foods, on the other hand, are characterised as foods that eliminate toxins from the body and cools the body down. When a person has too much cooling foods, however, it can result in chills, pale complexion, sore muscles and joints, and proneness to fatigue.

Foods in this category tend to be low-calorie foods that are cooked with low heat, or raw foods. Many also taste refreshing and soothing. Some examples are watermelons, coconut, cabbage, mangosteen, and green tea.

Common misconceptions

Apart from being just age-old traditions, the concept of heaty and cooling foods have stuck due to its relative reliability. Yet, there are a number of customs surrounding this that you may have questioned. Below, we go through some popular traditions relating to heaty and cooling foods to find out if they are scientifically valid, or just superstition.

1. Saltwater and durians

⦁ Statement: Drinking saltwater from the durian husks after eating its fruit will dispel the heatiness.

⦁ Science:  Drinking saltwater is not recommended due to the high salt content. There is also no reason to believe that drinking out of the durian husk will make a difference. Gargling saltwater, however, does help to draw out toxins and relief inflammation – you can do so using a normal mug or glass.

2. Pregnancy and papaya

⦁ Statement: Eating an excess of cooling foods like papaya and pineapple during pregnancy increases the risk of a miscarriage.

⦁ Science: There is no evidence to show that cooling foods cause miscarriages. However, some warn against eating too much pineapple and unripe papaya during pregnancy. Enzymes bromelain in pineapple and papain in unripe papaya may trigger early contractions and labour in women at the later stages of pregnancy.

3. Heaty foods and hemorrhoids

⦁ Statement: Consumption of heaty foods increases one’s likelihood of getting piles and worsen existing hemorrhoids.

⦁ Science: Common causes of hemorrhoids are increased pressure to the anal area due to frequent heavy-lifting, pregnancy, delivery, obesity, constipation, and diarrhoea. While there is no evidence that heaty foods directly cause piles, having too much heaty foods may lead to constipation, which can aggravate or cause the formation of piles. Eating cooling foods is thus not an effective method of piles treatment.

4. Chocolate and acne

⦁ Statement: Chocolate is a heaty food that causes acne.

⦁ Science: Research findings have been divided on this. There have been reports of chocolate consumption being linked to increased formation of pimples, but scientists have not been able to determine if this is due to cocoa itself, or the sugars, fat, or other components in chocolate.

The bottom line

Whether you are a firm believer in heaty and cooling foods, or more of a sceptic, one thing you can take away from the TCM perspective is to approach your diet with the principle of moderation in mind. The body needs nutrients from varied food sources, so make sure to get a balanced diet, and not over-eat only one type of food.

In addition, you should pay attention to how your own body reacts to different foods, as everyone’s body and tolerance to foods are different. Some people’s bodies react more aggressively to ‘heaty’ foods, while others find no problem consuming them frequently. By discovering your own body’s tolerance and sensitivities, you can avoid a lot of health problems down the road.


January 7, 2020 Blog

As the new year rolls around, some common new year’s resolutions people make include: Exercising, eating healthy, quitting smoking, or managing your alcohol intake. These often top the list of resolutions, showing how health is a top priority for many people.

A key step not to overlook in monitoring your own health is also by undergoing regular health checkups and screenings. If you are not already implementing these into your health routine, this year may be a good time to start.

What is health screening?

Health screenings are a vital part of personal healthcare as they can help you detect conditions early, even before symptoms arise. In turn, early intervention lets you and your doctor perform early intervention to keep your condition under control. By managing your condition from its infancy, you can significantly reduce your risk of developing further complications later on.

There is an extensive number of screening tests available, so it will be useful to find out from your doctor about which are recommended for you. As a general guide, the health screenings you should undergo at each age are outlined below:

Age 20-29

At this age, the risk for most chronic conditions are still low, so doctors don’t usually see a need for a battery of tests. Instead, look out for obesity through a body-mass index measurement, and keep track of your blood pressure. These two factors can inform you of your risk of cardiovascular disease, which is something to be concerned about, especially if you have a family history of heart disease.

Other routine checks you will want to keep up with are your usual vision and dental checks. In addition, sexually active persons should consider being tested for sexually transmitted diseases. Women are also recommended to go for pap smears once every three years to check for cervical cancer.

Age 30-39

The risk of cardiovascular disease and diabetes picks up around this age band, so doctors recommend starting to go for comprehensive blood tests. The blood tests can tell you your blood glucose and cholesterol levels, which are key indicators for diabetes and heart disease respectively.

Watch out for thyroid disease – which affects metabolism and overall body functions – with a thyroid function test, which detects the level of thyroid hormone in your blood. Another test you may consider is the vitamin D deficiency test, which measures the level of vitamin in the blood. Vitamin D is suggested to be important for preventing and treating diabetes, and its deficiency has been associated with increased risk of death from cardiovascular disease and cancer.

Age 40-49

As an ongoing effort to detect and manage your heart health, you should continue to keep track of your blood pressure and cholesterol, or start if you haven’t. In addition, as you enter your forties, the risk for cancers like lung cancer, prostate cancer, and breast cancer become more concerning.

Heavy smokers at high risk of lung cancer should get a lung cancer screening. For men, you should begin to get checked for prostate cancer especially if you are obese, on a high-fat diet, or have a family history of prostate cancer. For women, a mammogram once every 2 years is recommended.

Age 50 and above

The risk for chronic conditions and cancers continues to rise as a person passes the fifty-year mark. One silent killer that does not often present symptoms till a late stage is colon cancer. For detection of colon cancer, an endoscopy of the colon (colonoscopy) every 10 years or a yearly faecal immunochemical test is highly recommended.

Other common conditions for this age include ailing vision, increased forgetfulness, and hearing loss. You should get these monitored regularly at a holistic health checkup, and be on the lookout for the onset of dementia.

Health screenings for you

For personalised recommendations taking into account your lifestyle and family’s medical history, do consult your doctor. With regard to cost, you won’t have to worry about footing the bills – in Singapore, citizens and PRs enjoy generous subsidies on various health screenings. Consult your GP or enquire at a polyclinic to find out more about the schemes you are eligible for, and kick off your new year with a commitment to better health!


January 2, 2020 Blog

Bloody stools is an alarming symptom, especially if it persists beyond one or two days. If the bleeding occurs lower down the intestinal tract, the blood can be visible as red-coloured or stained stools. Other times, blood in the stools appears as dark-coloured or black stools if the source of blood is further up the gastrointestinal tract. A majority of cases of bloody stools are attributed to non-serious conditions like hemorrhoids. Yet, bloody stools can also be a sign of other severe situations like colon cancer. Not knowing the cause of bloody stools can be greatly distressing, thus it is useful to be able to recognise the tell-tale signs of the common hemorrhoid versus a more worrying condition like colon cancer.

Common symptoms of hemorrhoids and colon cancer

Besides bloody stools, other common symptoms that hemorrhoids and colon cancer share can result in them being mixed up. These include:

  • Rectal bleeding
  • Feeling of incomplete bowel movement

Symptoms of hemorrhoids

Having a basic understanding of hemorrhoids is crucial to distinguishing it from cancer. Hemorrhoids (also called piles) is the condition of swollen veins in the anus, lower rectum or just outside the anal opening. As such, most of the symptoms are localised at the anal area – there should not be any symptoms affecting the digestive processes per se. Here are some symptoms of piles that should not be present in a cancer like colon cancer:

  • Itching of the anal area
  • Pain in the anal area, especially during bowel movement
  • Bright red blood in stools
  • Lump outside the anus (only for external hemorrhoid)

Symptoms of colon cancer

On the other hand, colon cancer or colorectal cancer is a condition where abnormal cell growth occurs in the colon (large intestine), forming a tumour. Due to its location in the intestine, the tumour often affects gastrointestinal functions. However, the symptoms of colon cancer may not arise until it has advanced to a later stage. The following are some signs you should look out for that commonly occur in colon cancer patients, but that don’t occur for hemorrhoids:

  • Changes to bowel movement, e.g. diarrhoea or constipation
  • Nausea, vomiting, or weight loss with no apparent cause
  • Abdominal distension (swelling of the belly) – a sign of bowel obstruction
  • Gastric pain symptoms

How can your doctor check the cause of your bloody stools?

Often, symptoms alone are not enough to give you a complete diagnosis. Doctors will combine your reported symptoms with your health history and risk factors to decide if further tests need to be conducted to rule out other health conditions. Sometimes, the situation is not so clear-cut, especially if the presence of one condition serves as an aggravating factor for the other, as it has been found to occur.

If you have been referred to a gastroenterologist, they may conduct one of several tests to find out more about the condition you have. These may include:

  • Colonoscopy: A type of endoscopy where a long thin tube with an attached camera is inserted through the rectum to examine the lower intestinal tract.
  • Stool sample test: A series of tests performed on a sample of faeces.
  • Biopsy: Collection of a small tissue sample to test for cancer.

After diagnosing your condition, a consultation with your gastroenterologist can also offer you more information on piles treatment or the prospects of colon cancer in Singapore.


December 11, 2019 Blog

Abdominal pain is a common health concern in children and adults. In fact, what people often term ‘stomachaches’ can arise from countless different problems, and not all originate from the stomach organ. Pain that arises from the stomach is typically felt as a pain in the centre of the upper abdomen, and more accurately termed ‘gastric pain’.

What causes gastric pain?

Ranging from a dull ache to a throbbing pain, gastric pain can arise from minor issues like flatulence (gas) and indigestion, or signal a more severe problem like gallstones or bowel obstruction. Here are some underlying issues that can result in gastric pain:

  • Flatulence (Gas)

Gas occurs naturally in the digestive tract due to the digestive processes. Sometimes, gas buildup causes a feeling of bloatedness, pressure, fullness, and mild pain. Usually, the pain comes in waves, and the abdomen may swell. Accompanied by burping or passing of gas, increased flatulence after eating certain foods is normal. Common flatulence-inducing foods include beans, garlic, and cauliflower.

Pain from gas is often fleeting and non-serious. If it is uncomfortable, some over-the-counter medications usually ease the pain and bloatedness quite quickly. However, if it occurs with fever, persistent vomiting or diarrhoea, or unbearable pain, a visit to the doctor is recommended.

  • Indigestion

The full, uncomfortable, burning sensation in the upper abdomen shortly after eating is often labelled as indigestion. Sometimes, the pain or burning feeling can also be felt in the mouth, throat, or chest. Also known as ‘dyspepsia’, indigestion is commonly the result of an acid buildup in the stomach. It can be caused by certain foods, or by eating too quickly.

In some cases, recurring indigestion may be a sign of underlying issues like acid reflux (e.g. GERD) or a stomach ulcer. If symptoms of indigestion occur frequently and are accompanied by severe pain or weight loss, a doctor’s advice may be required to help diagnose and manage the condition.

  • Stomach virus (stomach flu)

Although referred to as ‘stomach flu’, the stomach virus is not strictly a type of flu. Also called ‘gastroenteritis’, it typically manifests as nausea, vomiting, diarrhoea, and gastric pain. Some people may experience lethargy, headaches, or muscle aches as well. Most cases of gastroenteritis recover within a few days without medical intervention.

The key concern is to prevent dehydration. Thus, patients are usually advised to suck on ice chips, sip on water frequently, or consume an electrolyte drink. People with gastroenteritis should also avoid heavy meals and ease back into eating using foods that are easy to digest, like plain crackers, bananas, and toast.

  • Gallstones

When cholesterol or bilirubin forms solid particles in the gallbladder, these are called gallstones. Having gallstones that are small in size and number may not cause problems. However, large or numerous gallstones can result in symptoms like pain, vomiting, and fatigue.

The problems arising from gallstones happen when they form a blockage in the gallbladder. This can lead to impaired functions in the liver and pancreas, as well as jaundice. In some cases of gallstones, they are passed out naturally by the body. But in other cases, medication is needed to dissolve the stones, or a doctor may recommend surgical removal of the gallbladder.

  • Liver or pancreas issues

Sometimes, gastric pain arises from problems in the liver or pancreas. Inflammation of the liver (hepatitis) or pancreas (pancreatitis) often results in abdominal pain, hampered organ functions, and other symptoms. Although less often the case, upper abdominal pain may also be due to liver cancer or pancreatic cancer.

Other accompanying symptoms of liver or pancreas problems include yellowish eyes or skin (jaundice), nausea, vomiting, unusually dark urine, and pale or oily stools. Depending on the diagnosis, liver or pancreatic issues can be managed with lifestyle adjustments, medication, or surgical treatment.

  • Bowel obstruction

Bowel obstruction occurs when tissue blocks the intestinal pathway, hindering or completely blocking off the passage of digestive waste. It may be caused by an inflamed intestinal wall, fibrous scar tissues, or tumour growth (e.g. colon cancer). On top of intense pain and constipation, bowel obstruction can lead to vomiting of bile, abdominal swelling, and rapid weight loss. The pain is usually worse after eating.

Due to the risk of intestinal wall tearing or becoming infected, bowel obstruction is considered a medical emergency. An immediate visit to the hospital is required to provide medical intervention, pain relief, and if required, emergency surgery to remove the obstruction.

When should you visit a doctor for gastric pain?

While mild and occasional cases of gastric pain usually resolve itself, the more severe and recurrent cases require a visit to the doctor to diagnose the problem and recommend treatments. Here are some examples of gastric pain that should not be ignored:

  • Gastric pain accompanied by:
  • Persistent changes to bowel movement, e.g. pale, black, or bloody stools
  • Persistent diarrhoea or vomiting of more than 12 hours with no improvement
  • Fever
  • Rapid weight loss
  • Gastric pain in persons with weakened immune systems, e.g. young children, elderly persons, persons with auto-immune diseases like HIV, and persons with cancer
  • Gastric pain arising after injury or consumption of medication
  • Gastric pain that is extremely intense and debilitating

At the doctor’s, diagnosis methods may include an examination of your diet and lifestyle, imaging methods such as gastroscopy, colonoscopy or CT scans. Only then can the doctor ascertain the cause of your gastric pain and prescribe treatments to address the root problem.


November 22, 2019 Blog

Fatty liver is the umbrella term for the condition where liver cells contain more fats than is considered normal. Someone is considered to have fatty liver disease when the fat content in the liver exceeds 5-10% of the organ’s weight. Common risk factors for fatty liver are excessive alcohol intake and obesity.

At its early stages, fatty liver disease is a mild condition that often shows no symptoms. As such, many people live with fatty liver without having the condition diagnosed. Yet, fatty liver is not a disease to be simply glossed over. If left uncontrolled, fatty liver can escalate into serious and irreversible health problems down the road.

The potential complications of fatty liver disease are described below:

  • Liver inflammation and scarring: Direct effects of accumulated fats to the liver typically proceed in three stages – hepatitis, fibrosis, and cirrhosis.
    • Hepatitis is the inflammation of the liver caused by excess fats in the organ.
    • Fibros is refers to the scarring that occurs when the liver heals itself from the inflammation. If damage is persistent, the repeated healing process results in a thick buildup of fibrous scar tissue.
    • Cirrhosis is the later stage of fibrosis when the scarring has caused impeded functions in the liver.
  • Liver failure: When the liver has sustained enough damage to impair its functions, it is referred to as liver failure. Signs of a failing liver include jaundice, nausea, diarrhoea, fatigue, and hemorrhoids (piles), amongst others. In addition, more serious complications can arise due to liver failure, like internal bleeding and kidney failure.
  • Ascites: Referring to the buildup of fluid in the abdomen, ascites can occur due to liver scarring at the cirrhosis stage. As scar tissue builds up, it puts pressure on the walls of blood vessels, pushing liquid into the abdominal cavity. The swollen abdomen can lead to shortness of breath, restricted mobility, and a higher risk of infection and hernia.
  • Esophageal varices: These are swollen veins in the oesophagus that may arise from liver scarring. When scar tissue accumulates, blood flow to the liver is reduced, causing increased pressure in the blood vessels at the esophagus. It is considered a medical emergency if the esophageal varices rupture and bleed. Thus, patients with advanced liver disease should periodically be screened for the onset of swelling veins in the esophagus. Varices are usually diagnosed through endoscopy.
  • Increased risk of metabolic diseases: Fatty liver causes the overproduction of glucose and triglycerides, which are two key components of metabolic syndrome. With metabolic syndrome, there is also an increased risk of developing type 2 diabetes and heart diseases.
  • Increased risk of gastrointestinal cancers: Persons with fatty liver have shown a higher likelihood of developing cancers in the gastrointestinal tract, like liver cancer, pancreatic cancer, and colon cancer. Some studies estimate that the risk is 90% higher in fatty liver patients as compared to patients without the disease.

The good news is, fatty liver can be managed with some lifestyle changes before it compounds into a severe health issue. If you are at risk of developing fatty liver, or are already diagnosed with the condition, you can reduce the damage done to your liver by reducing your alcohol intake, adopting a healthier diet, and losing weight if you are overweight.



November 8, 2019 Blog

Fatty liver disease is a condition in which fats accumulate in liver cells. Two types exist – alcoholic fatty liver disease (AFLD) and non-alcohol fatty liver disease (NAFLD). As their names suggest, AFLD is triggered by excessive alcohol intake, whereas NAFLD is not. Instead, NAFLD is commonly associated with obesity, unhealthy diets, and sedentary lifestyles.

The incidence of fatty liver disease is on the rise worldwide and in Singapore. Some estimates put the prevalence of fatty liver in Singapore at 30-40%, which is higher than the world average of roughly 24%. If left untreated, fatty liver disease has the potential to escalate into fibrosis and cirrhosis, which impair the functions of the liver. This can ultimately lead to liver failure and liver cancer.

How does diet play a part in liver health?

As a significant contributor to fatty liver disease is diet, one of the primary ways to combat it is by altering one’s diet to a healthier one. An appropriate diet can help with weight loss, which reduces the risk factor of attaining liver disease. In individuals with the disease, a drop in weight of 10% is significant enough to decrease liver enzyme to healthier levels.

A balanced diet will help the liver receive the necessary nutrients it needs to operate smoothly. Thus, a liver-healthy diet will also be beneficial for overall liver health, reducing the risk factors for liver diseases, and benefitting patients with other liver conditions like hepatitis B and C.

In general, the recommended diet for optimal liver health is one that is low-fat, reduced in calories and high in fibre. Below are some recommendations of foods to include and to avoid in your diet.

Foods to include:

  • Cruciferous vegetables: Greens like broccoli, cauliflower, cabbage, kale, and Brussels sprout contain glutathione, a compound that promotes the detox functions of the liver. These fibre-rich vegetables also give a feeling of fullness, which prevents overeating and helps with weight loss.
  • Fatty fish: Fish like salmon, tuna, trout, and sardines are packed with omega-3 fatty acids, which are considered healthy fats. Omega-3 fatty acids have been found to lower fat levels in the liver and reduce inflammation. As an alternative to other meats, it can reduce consumption of unsaturated fats from other meat sources.
  • Nuts & seeds: Almonds and sunflower seeds are sources of vitamin E, an antioxidant that has been associated with improved liver health. Walnuts contain omega-3 fatty acids, glutathione, as well as arginine, an amino acid which assists liver cleansing processes.
  • Cold-pressed, organic oils: Olive oil, hemp oil, and flaxseed oil are high in omega-3 fatty acids, and are healthier alternatives to butter, margarine and vegetable oil. The unsaturated fat content helps to reduce liver enzyme and fat levels in the liver.
  • Garlic: The popular herb contains sulfur and selenium, which are known to help the liver remove toxins and boost antioxidant levels in the liver. Garlic also flavours food, reducing the amount of unhealthy seasoning like salt and sauces that would be added otherwise.
  • Low-fat dairy: The protein in milk helps in tissue reparation, and protects the liver from damage. For a healthier option, opt for skimmed or fat-free milk.
  • Coffee & tea: Caffeine has been found to bring unhealthy liver enzyme levels down. Green tea also contains catechin, an antioxidant that assists liver function. Some studies find that green tea can also reduce fat levels in the liver.

Foods to avoid:

  • Alcohol: The main contributor to AFLD and numerous other liver diseases is excessive alcohol intake. Alcohol in the body damages liver cells, and over-consumption can cause inflammation and scarring. Alcohol also causes the body to store more fats, contributing to fatty liver.
  • Added sugar: High blood sugar leads to increased fat buildup in the body, including at the liver. Sugary foods to avoid include cakes, cookies, candies, and sweet drinks.
  • Fried food: Due to the amount of oil used in frying, these foods are typically high in fat and calories. Thus, they do no good to health and are huge contributors to weight gain.
  • Salt: Heavy sodium intake can damage the liver by causing inflammation and cell death. For a healthy diet, the recommended daily intake of sodium should not exceed 1,500 milligrams.
  • Processed grains: White rice, pasta, and bread are made of highly processed grains, which have a higher glycemic index (GI) than its less-processed counterparts. High GI foods lack fibre and raise blood sugar, leading to fat buildup and weight gain.

As with all diet recommendations, consistence and moderation are paramount to its success. If you are at high risk of liver disease or have already been diagnosed with a liver condition, you should speak to your doctor about a personalised diet plan.



October 31, 2019 Blog

Pancreatic cancer is known as a silent but deadly illness because symptoms are rarely noticed until it has reached an incurable stage. At an estimated 2% incidence rate in Singapore, pancreatic cancer itself is not a common cancer. However, there is a high mortality rate for those diagnosed with the disease, making it one of the top cancers to take lives in Singapore.

Symptoms of pancreatic cancer

The key to battling pancreatic cancer is to spot it early and have it treated as soon as possible. However, early-stage pancreatic cancer is known to have unnoticeable or vague symptoms. The safest way to go about it is to know your own body. If any of these symptoms arise unusually and cannot be traced to other known conditions, it is always best to go to a doctor for a thorough checkup.

As a guide, here are the common symptoms of pancreatic cancer:

  • Poor appetite and weight loss: As the pancreas is an integral part of the digestive system, the impaired function of the pancreas often results in poor digestion. This manifests as malnutrition, declining weight, and lack of appetite.
  • Abdominal bloating: Digestive problems also cause gas build-up from undigested food in the digestive tract. Pancreatic cancer may also cause ascites, which is a build-up of fluid in the abdomen, making the tummy area appear swollen.
  • Nausea and vomiting: As the tumour grows larger, it can block part of the digestive tract and impede digestive functions. This causes fluids to back up in the digestive system and leads to nausea and vomiting symptoms.
  • Pale/greasy stools: When the pancreas’ function is compromised, it has problems digesting nutrients. Undigested fats are excreted in the stools, causing the appearance of pale and oily stools. Malabsorption can also contribute to diarrhoea and/or constipation.
  • Back pain and abdominal painIf the tumour grows in a location that presses against nerves or other surrounding organs, patients may feel pain at the back or abdomen area.
  • Jaundice: The natural breakdown of aged red blood cells turns them into bilirubin. When bilirubin pigment builds up, it causes skin and whites of the eyes to yellow. Normally, bilirubin is broken down by bile, but when the tumour obstructs the flow of the bile duct, the digestion of bilirubin can be hindered, thus causing jaundice.

Diagnosis methods for pancreatic cancer

While it is difficult to pinpoint pancreatic cancer from its symptoms, some people are fortunate to have the tumour detected early from other health examinations and diagnostic tests. Several scanning methods are able to visually identify growths on the pancreas. If you or your doctor suspect any abnormalities in your pancreas, here are some examinations your doctor may recommend:

  • CT scan: Computer tomography is a method of X-ray that compiles multiple scans of the body at varying depths to give a ‘3-D’ perspective of the body tissues. Suitable for almost any part of the body, it can be used to visually check for abnormal growths on the pancreas.
  • MRI: Magnetic resonance imaging uses magnetic waves to produce detailed images of organs and structures inside the body. It gives more high-definition images than CT scans but is also more expensive.
  • PET scan: Positron Emission Tomography involves the injection of radioactive fluid into the body. As the fluid travels in the bloodstream to different organs, it shows up more prominently on the X-ray scan. This method can be combined with a CT scan to better visualise the tumour growth and affected areas.

These images are helpful for detecting growths on the pancreas, but cannot determine if the tumour is cancerous. To confirm the nature of the tumour, the doctor needs to obtain a small sample of tissue from the tumour for analysis. This procedure is called a biopsy. Your doctor may conduct a biopsy of one of the following types:

  • FNA: Fine needle aspiration involves the insertion of a fine needle with an attached syringe into the body. The method is performed with the assistance of an imaging scan (MRI, CT scan, or ultrasound), and is used to obtain tissue samples from the target organ – in this case, the pancreas.
  • ERCP: Endoscopic retrograde cholangiopancreatography is a form of endoscopy where a long flexible tube is inserted through the oral cavity to the small intestine, near the pancreas. Medical instruments can pass through the endoscope to take images and tissue samples.
  • EUS: Endoscopic ultrasound is similar to ERCP in that it utilises an endoscope to reach the intestines. In EUS, a small ultrasound device is attached at the tip of the endoscope, allowing for a better view of the digestive tract and pancreas. A small needle on the endoscope may be used to retrieve tissue, or the EUS can be used in conjunction with FNA.

These diagnostic tests can typically be carried out on an outpatient basis at hospitals or specialist clinics. As performing these procedures require specialised training, you will need to find doctors who are certified and well-reputed in these techniques. For example, ERCP and EUS should only be performed by a doctor trained in advanced endoscopy in Singapore.

Recent advancements in pancreatic cancer diagnosis

In more recent advancements, medical researchers have found success in using blood tests as a diagnosis method for pancreatic cancer. While the existing blood test for Ca 19-9 is not a reliable test for pancreatic cancer, new blood tests for other markers in the blood have been shown to have better accuracy rates in diagnosing pancreatic cancer. Although it may take some time for this new method to become better established and available in the market, it offers hope for a reliable, non-invasive diagnostic test for pancreatic cancer in the near future.


An awareness of the symptoms of pancreatic cancer is crucial for defending oneself against the illness. If you observe any abnormalities in your digestive health, or are a high-risk individual for pancreatic cancer, you may want to consult a gastroenterologist for a thorough examination. Your doctor can provide you with further information about pancreatic cancer and its costs.

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