Jeremy Tibble

20 December 2017

Don’t let indigestion spoil your seasonal celebrations

Christmas may well be the season to be jolly - but it is the time when stress, over indulgence and a lack of exercise can see many of us suffering rather uncomfortable bouts of indigestion.

Is it just a part of the Christmas celebrations or can you enjoy the extra treats without ’suffering the consequences’?

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Dr Jeremy Tibble, a Consultant Gastroenterologist at The Montefiore Hospital, looks at the causes of indigestion, how we treat it and what we have to do to avoid it altogether. But he also warned that people suffering indigestion regularly and for an extended period of time could actually be mistaking the symptom for something more sinister and urged them to see their GP or Gastroenterologist.

What is indigestion?
Indigestion is a very vague term that is used to describe symptoms that are attributable to the oesophagus, stomach and small intestine (duodenum). The symptoms are often pain or discomfort aggravated by eating or drinking - the feeling of nausea after food or the sensation of being over full. Also heartburn and reflux can also be described as indigestion.

How is it usually caused?
It is classically caused by acid reflux disease, gastritis (inflammation of the stomach) or ulcers in the stomach or small intestine. The stomach has natural defence against stomach acid but if this defence is damaged then problems can arise from naturally occurring acid.

The oesophagus on the other hand has no natural protection so acid refluxing out of the stomach into the oesophagus will cause symptoms. Helicobacter pylori - bacteria frequently found in peoples stomachs - can tip the balance towards damage from stomach acid.
Other things that increase stomach acid production can promote symptoms. These include smoking, acidic drinks such as wine and fruit juices and spicy food. Stress is another possible trigger.

Are there any causes that people aren’t so aware of?
The bottom of the oesophagus (gullet) has a muscle that tries to prevent reflux. However, this muscle can be relaxed by alcohol and, perhaps more surprisingly, by chocolate. Late night chocolate treats can classically results in nocturnal heartburn

What about alcohol – are spirits more likely to bring on a bout of indigestion than beers or lagers?
All alcohol will relax the lower oesophagus and promote reflux but fizzy drinks, such as lager, are more likely to cause reflux, especially when drunk in larger volumes. However all alcohol will cause some damage to the stomach so don’t believe the medical myth that you can use brandy to settle your stomach!

Besides abstaining for alcohols and saying ‘no’ to tasty treats what measures can people take to avoid indigestion?
Eating and drinking a number of hours before going to bed is a good option. Smaller and frequent meals tend to help as well. If reflux is the major issue propping the head of the bed on a couple of bricks helps increase effect of gravity at night thus reducing reflux.

Does a pint of milk at the start of the evening help or is that an ‘old wives tale’ started by the dairy industry?
Funnily enough, while the pint of milk theory is another ‘medical myth’ it is a fact that before the advent of modern anti-acid drugs, patients with ulcers were often treated with milk drips direct to the stomach.

If you do get indigestion what is the best way of treating it?
Modern drugs such as the PPIs (omeprazole etc) have transformed the management of indigestion by reducing acid production very dramatically. Also H2 blockers such as (ranitidine) reduce acid production. However, many of the over-the-counter remedies are only antacids that will neutralise the stomach acid for a relatively short period.

What conditions could the symptoms of indigestion be hiding?
The real worry about indigestion is that it could be masking something much more sinister. If lifestyle issues and a short course or tablets/medicine - maybe two weeks of treatment - does not resolve the issue then seeking medical advice is sensible.

The diseases that mimic indigestion are stomach and pancreatic cancer and gallbladder disease. Ulcers of the stomach and small intestine need to be diagnosed and treated effectively as the huge majority are curable without prolonged treatment.

The increasing age of the patient and the fact that these symptoms are new are indicators to investigate further. Oesophageal cancer can give symptoms similar to reflux and any sensation of food sticking and painful swallowing require urgent investigation. Visit you GP or a gastroenterologist as soon as possible.

Dr Jeremy Tibble holds a clinic on Mondays at The Montefiore Hospital, Montefiore Road, Hove. Visit or for a non-obligation enquiry, phone 01273 828 148.

CQC Outstanding

26 October 2017

CQC rates The Montefiore Hospital as Outstanding

The Montefiore Hospital in Hove has been awarded an overall ‘Outstanding’ rating by the country’s health watchdog, the Care Quality Commission (CQC).

Following a rigorous examination including an unannounced inspection earlier this year, the CQC inspectors have this week announced the highest rating possible for the private hospital.

With less than a dozen private hospitals rated as Outstanding in the UK, this is a significant achievement for The Montefiore Hospital and comes just a month before it celebrates its fifth birthday.

To get to the heart of patients’ experiences of care and treatment, the CQC inspectors put the hospital’s surgery, medical care, outpatients and diagnostics services under the spotlight and asked `are they safe, effective, caring, responsive to people's needs, and well-led?’.

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The Montefiore received an outstanding in two out of five key domains – effective and responsive – with a `Good’ rating in the other three.

In the CQC report, the inspectors’ highlighted how effective the hospital was in listening to patients and using this communication to make continual improvements to its services. The report said: “There was long-standing, consistent evidence that staff actively sought out patient and visitor feedback and made substantive improvements to the service as a result.”

This included the implementation of a patient experience committee and patient forums led by former patients and their relatives. Changes brought about because of patient feedback included the introduction of a lead nurse for pre-assessment, improved discharge pathways, and an initiative from the hospital’s head chef to introduce an on-demand hot meal ordering service so patients could order food at short notice.

And the inspectors praised the staff teams for being “consistently and demonstrably passionate about and motivated” by the hospital’s vision and strategy for providing quality patient services.

It noted that “staff shared strategies of improving care based on benchmarks, ensuring continual learning and focusing on internal staff development and promotion that helped to ensure everyone involved with the service, including patients, benefited as a result”.

There was “extensive evidence”, said the report, of effective, embedded multidisciplinary working and auditing. This included a physiotherapy team that proactively sought out opportunities for mutliprofessional learning and training and demonstrated how this improved patient experience and outcomes.

“I don’t think a single member of the team has been able to stop smiling since we heard this fantastic news,” said David Eglington, The Montefiore’s recently appointed hospital managing director. “This an amazing achievement and reflects a huge amount of work by so many. This rating is not due to one or two individuals, it is a result of high performing, passionate and caring teams throughout our hospital and reflects our motto of `brilliant basics, memorable moments’. I am particularly proud that the inspectors highlighted our strong relationship with our patients – welcoming patient feedback and acting upon this to continually improve our services is The Montefiore’s huge strength.”

The CQC carried out announced inspections on 23, 24 and 25 January 2017 along with an unannounced visit to the hospital on 4 February 2017. The full report can be viewed at

Jo Bayles

5 October 2017

Breast cancer has changed my life

A mother of two has told how being diagnosed with cancer has transformed her life. Jo Bayles now offers advice and support to other women who are going through treatment for breast cancer. She regularly returns to the Montefiore Hospital in Hove, where she underwent surgery and chemotherapy, to talk to other patients.

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The 42-year-old has also trained as a fitness instructor and has taken up training to help people recovering from cancer through their rehabilitation.

Mrs Bayles, from Ferring, near Worthing, was diagnosed with stage three breast cancer in 2015 and had to undergo a mastectomy.

She has put her subsequent recovery through the support from what she calls “Team Bayles”.

This includes her husband Hadleigh, her close-knit family and friends, a nutritionist, personal trainer, acupuncturist, life coach, masseuse and the oncology team at the hospital, where she still has regular check-ups.

Mrs Bayles said: “I don’t think I would know what I know now, understand life like I do now, and be as fit and healthy as I am now if breast cancer hadn’t happened.

“It’s like going back home when I go to the Montefiore.

“It’s a strange thing to say but the atmosphere in the chemotherapy unit was fun – we had a lot of laughs there, it wasn’t all about cancer.”

Among the people to help Mrs Bayles was Barbara Palloni, who specialises in oncology massage and reflexology.

Mrs Bayles said: “When I chatted with Barbara, it was the first time I thought ‘I am going to live’.

“She prepared a nasal aromatherapy spray to stop me feeling anxious before the surgery. I was so relaxed before the operation I actually fell asleep before they came to take me to theatre.

“She has magic healing hands and rather than just thinking I am going in for some horrible chemotherapy, I knew I was going to have a lovely massage as well.”

Mrs Bayles also had acupuncture just before each chemotherapy session which she said helped with reducing pain, relieve anxiety and put her in a positive frame of mind.

However the biggest aid to recovering was exercise.

After her course of chemotherapy, followed by radiotherapy, Mrs Bayles felt shattered with no energy. She said: “I felt finished – I had nothing left in me. I felt like I had totally lost Jo.”

With the help of a personal trainer, Mrs Bayles started doing seated exercises and soon was training several times a week.

Within three months, she was working out in a mainstream gym and now continues to train four to five times a week.

Mrs Bayles is now writing a book to share her knowledge and experiences of what helped her to beat breast cancer.

– it was such a positive experience that I want to give something back. I now have all this knowledge and know what a difference exercise can make that I want to share it with women going through a similar experience.

Even if at first, they only have the energy to come for a gentle walk with me down to the sea, I know first-hand that it will make all the difference to them.”

First published in The Argus October 2017.

Dr Paul Farrant

26 September 2017

Coping with Eczema in Children and Adults

It’s National Eczema Week from September 16 and although there is no known cure for this skin condition, The Montefiore Hospital’s consultant dermatologist, Dr Paul Farrant, says there is a lot that can be done to bring relief.

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Eczema affects people of all ages but is common in children, with around one in five youngsters having the condition. Fortunately, half of children will have grown out of it by the time they reach five years old and 90 per cent by age 10. Parents will be advised by their health visitor on what to do if their baby develops eczema, but for older children and adults whose eczema keeps recurring, try these tips.

  • Avoid soap and soap-based products. Buy soap substitutes which will keep the moisture in the skin and create a barrier to irritants.
  • Ideally, moisturise your skin several times a day. The most effective moisturisers are ointments, which have fewer preservatives than creams, but are stickier. To prevent staining clothes, opt for cream-based moisturisers during the day and apply a thick layer of ointment at night.
  • Scratching damages the skin so if the eczema becomes 'angry', apply a topical steroid to reduce the itchiness and give the skin a chance to heal. Topical steroids are best applied once daily at bedtime to the affected area only.
  • If your hands are in and out of water all day long, wear cotton gloves under protective gloves. Avoid biological washing powders, fabric conditioners and fragranced products. Wear natural fibres such as pure cotton, and if possible, silk, especially for underwear, nightclothes and bed linen, as they absorb sweat and allow the skin to breathe. The National Eczema Society’s website has a list of recommended clothing stockists.
  • Eczema in children and food allergies: although many parents are concerned their child’s eczema is linked to certain foods, especially dairy products, it is advisable not to eliminate them from your child’s diet without first seeking advice.
  • Children will naturally build up a tolerance to certain foods as they grow older, and it is important to keep calcium in their diet if possible. Allergy testing is usually reserved for children with very severe eczema.
  • Adults who have eczema that only effects certain areas may have developed a form of eczema called contact allergic eczema. Common allergens include nickel from cheap jewellery and preservatives in creams. This can be investigated with patch testing.

When to see your GP:

  • Make an appointment with your GP if the eczema continues to be inflamed even after regular use of moisturisers and OTC steroids. You may be prescribed a higher strength steroid.
  • If you have a flare up of eczema, the correct use of prescribed creams should bring it under control within seven to 10 days. Go back to your GP if your skin is not responding to medication after three weeks - you may be referred to a skin specialist.

What else can be done?

Your dermatologist may offer a range of treatments, including phototherapy, wet wraps and medicines which suppress the immune system. Next year, a new injection therapy could be coming to the UK. Clinical trials have shown that 50 to 70 per cent of eczema sufferers respond very well to this new treatment.

Dr Paul Farrant, holds a clinic on Wednesdays at The Montefiore Hospital, Montefiore Road, Hove. To find out more, visit or phone 01273 828 148.

First published in Brighton and Hove Independent on Friday 15th September 2017.

The content of this article is provided for general information only, and should not be treated as a substitute for the professional medical advice of your doctor or other health care professional.

David Eglington

31 August 2017

New Hospital Director joins The Montefiore Hospital

David Eglington, The Montefiore’s new hospital managing director, is delighted to be back in Hove.



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The 40-year-old father of two could have chosen to live anywhere in the UK when he moved back to England after spending four years in Dubai as regional clinic director for Mediclinic Middle East.

But when the role of hospital managing director became available at The Montefiore he jumped at the chance.

He said: “I used to live in the area and I love Brighton and Hove so do my family. There is nowhere else in England we would rather live.”

Now he cycles to work having dropped his children at local schools and spends his spare time with his family watching Sussex Sharks and Brighton and Hove Albion.

As hospital managing director, David sees his new role as two-fold.: “to ensure our team of staff and consultants deliver cutting-edge, best practice healthcare and to be recognized as the independent provider of choice in our region. If our patients receive safe, high quality care and are happy with the service, the business growth will come naturally as they will be prepared to recommend us to their family and friends.”

After achieving a BA Honours Business Studies Degree, David spent his early career years in marketing roles before switching to the healthcare sector 15 years ago.

When he first joined Spire Healthcare in 2005 he was quickly selected for the company’s fast track programme which identifies potential future hospital directors.

Today The Montefiore’s new hospital managing director says he is looking forward to applying his experience and post-graduate study to ensuring the state-of-the-art hospital, which will celebrate its fifth anniversary in November, continues to go from strength to strength.

The Montefiore Hospital is part of the award-winning Spire Healthcare group and has the most up-to-date operating theatres and diagnostic equipment as well as being among the first hospitals in the country to offer new procedures to treat breast cancer and hip problems.

The hospital also offers a range of rapid access, one-stop clinics for a range of symptoms and injuries, to ensure fast and efficient diagnosis and treatment.

The Montefiore Hospital opened in Hove in 2012 and patients have fast access to appointments, diagnostic tests and treatments.

The Russell Outpatient suite has eight individual consulting rooms with comfortable waiting areas.

The Ryle Day-care Suite has individual rooms for recovery as well as a post-op ward. Should the procedure require an overnight stay, patients have their own private room with end suite facilities and TV.

Restaurant standard cuisine is prepared by head chef Daniel Tullett using fresh, locally sourced ingredients.

Montefiore’s partners include Sussex County Cricket Club, St James Montefiore Cricket club and Spring Orthopaedic Group.

First published in The Argus August 2017.

Mr Ammar Alanbuki

21 August 2017

Health and Wellbeing – Prostate Cancer

Advice from Mr Ammar Alanbuki, consultant urological surgeon, who has recently joined the urology team at The Montefiore Hospital in Hove. Mr Alanbuki holds clinics on Tuesday afternoons and during August and September will be holding free advice clinics on that day.

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With the exclusion of prostate cancer, what other prostate problems are there?

Increased visits to the toilet, struggling to start and/or finish doing a wee or are getting up in the night several times? Then you might have a problem with your prostate. While men will go to their GP with the fear this could be cancer, it is more likely to be a benign (non-cancerous) enlargement of the prostate which affects one in three men in their 50s. The enlarged prostate presses on and blocks the urethra, causing bothersome urinary symptoms.

Lifestyle changes such as reducing the amount of liquid consumed before bedtime and avoiding alcohol and caffeinated drinks can help. If symptoms continue, medication will be prescribed for up to a year, but after that, surgery may be necessary. This could involve removal of part of the prostate, or using a new technique called Urolift which lifts or holds the enlarged prostate tissue out of the way so it no longer blocks the urethra.  

Another prostate problem, more common in men aged 30-50, is prostatitis which causes pain within the pelvic and genital area, and sometimes while urinating. If it comes on suddenly, it is likely to be an infection which can be treated by your GP with antibiotics. Chronic prostatitis (symptoms come and go) can be treated with painkillers and you may be referred to a urologist.

The process of checking for prostate cancer. (is it possible to carry out self-checks or always best to visit a doctor first?).

If you have concerns about any changes in your normal urinary function, or pain or have a family history of prostate cancer, make an appointment with your GP. Prostate cancer is not something you can check for yourself. Going to the toilet more frequently is often the trigger for men to visit their GP. As well as a rectal examination to see if the prostate gland is enlarged, a blood sample will be taken to test for prostate specific antigen (PSA) levels. Don’t panic if your first PSA test is raised, it doesn’t necessarily mean cancer. Of those with a raised PSA level, only 30% are likely to have prostate cancer.

What are the treatments for Prostate Cancer?

A diagnosis of prostate cancer doesn’t immediately need treatment or an operation. In recent years, urologists have adopted a `watch and wait’ approach to men who have a localised, non-aggressive prostate cancer – that is, cancer within the prostate gland itself. This means active monitoring to check the cancer doesn’t grow and therefore avoid invasive treatments which can damage sex life and cause incontinence.

Men on an `active surveillance’ programme are monitored closely with blood tests, repeat scans and sometimes repeat biopsies to ensure it is safe to continue this approach.

If the initial diagnosis shows the cancer to be localised but aggressive, or if the cancer has grown during `active surveillance’, you will be offered treatment such as surgery or radiotherapy.

For cancer that has gone beyond the prostate gland, there is a range of treatments from hormone therapy to painkillers to enable the patient to continue to lead a normal life.

First published in Sussex Business Times August 2017.

The content of this article is provided for general information only, and should not be treated as a substitute for the professional medical advice of your doctor or other health care professional.

Mr Goldie Khera

29 June 2017

Has a groin injury stopped you from cycling?

All eyes will be on the London to Brighton Cycle Ride this weekend, but there will be some who will watch with envy. If a groin injury has stopped your cycling efforts in its tracks, there is effective treatment that can have you back in the saddle in no time. The Montefiore’s laparoscopic surgeon, Mr Goldie Khera, explains.

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We have been in the grip of a cycling bug ever since the 2012 Olympic Games. More than two million people across the country now cycle at least once a week, an all-time high according to British Cycling, the sport's governing body in the UK. But with it has come an increase in groin injuries that were more commonly associated with the football and rugby fields.

Gilmore’s groin is a tear in the abductor muscles and causes chronic pain in the groin and down the inner thigh.

Men are the more common sufferers and once it strikes, it can be painful and debilitating. For years, medical advice was to rest and the pain would go away. However, as soon as you start riding again, the discomfort will be back with vengeance.

It shouldn’t be confused with a groin hernia - a painful soft tissue injury in which part of the bowel pokes through into the groin at the top of the inner thigh forming a bulge. The protrusion increases when you change positions, cough or perform any physical activity.

Both types of groin injury are treatable with laparoscopic (keyhole) surgery. For a groin hernia, three small incisions are made into the stomach area and a mesh is stitched over the weak spot in the muscle to make it stronger. A similar technique has now been developed for Gilmore’s groin, with a mesh or sutures used to strengthen the muscles in the groin and inner thigh area.

After the operation, you will be advised to have a staged return to cycling, building up slowly over a few weeks. Within a few months you could be fully back in the saddle.

Whether you have noticed a bulge in the groin or are suffering groin and inner thigh pain, make an appointment with your GP who needs to refer you to a consultant surgeon for further investigation.

See a GP now or go to A&E if you have a hernia and:

  • it feels hot
  • it’s hard and tender
  • it’s suddenly painful
  • you have a fever
  • you have blood in your poo

Mr Goldie Khera, laparoscopic and bariatric surgeon, holds a clinic on Wednesday evenings at The Montefiore Hospital, Montefiore Road, Hove. For a non-obligation enquiry, phone 01273 828 148.

First published in Brighton and Hove Independent on Thursday 29th June 2017.

The content of this article is provided for general information only, and should not be treated as a substitute for the professional medical advice of your doctor or other health care professional.

Dr Paul Farrant

12 May 2017

Advice on looking after your skin in the sun

It’s Sun Awareness Week (May 9-15) yet despite decades of national health messages, people living in the south have the highest incidence of skin cancer. What are we doing wrong? Dr Paul Farrant, consultant dermatologist at The Montefiore Hospital in Hove, has some answers.

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I think we need to take our cue from the French and Spanish when it comes to being out in the sun. When it’s lunchtime, they disappear off the beaches to find shade, often leaving the Brits to soak up the rays.

We need to realise that the sun is at its most harmful between midday and 3pm during the summer months, whether you are in England or on the Costa del Sol. So, if you are sitting on Brighton beach at lunchtime, you are putting yourself at the risk of skin cancer if you don’t cover up with a long-sleeved shirt or find some shade to sit in.

And we are not applying sun cream properly. A recent survey by the British Association of Dermatologists shows eight out of ten people are failing to adequately apply sunscreen before going out in the sun. Around two-thirds of people also fail to reapply sunscreen every two hours as recommended.

My team and I see around 120 people a week who have been referred to us because their GP suspects skin cancer, and every year we treat around 200 cases of melanoma – a type of skin cancer that can spread to other organs of the body and even kill. But you can reduce your risks and still have fun in the sun:

  • The best way to make sure you get adequate coverage of sun cream is to apply it indoors before you head to the beach or outside. Use a mirror, or a member of the family, to check you have not missed any areas.
  • Be generous – most people put on a third to half of the recommended amount to achieve the sun protection factor (SPF) stated on the bottle. They then have false reassurance that they are protected from harmful sun rays. Apply a layer, let it dry and then apply another on top. Do this before you go out and then reapply every few hours or after swimming.
  • Look for a sunscreen that offers both UVA and UVB protection. A sunscreen with an SPF of 30 and a UVA rating of 4 or 5 stars is a good standard of sun protection in addition to shade and clothing.
  • Clothing as sun protection is often underestimated. People that work outdoors, eg gardeners, builders, roofers or people with outdoor hobbies, are particularly vulnerable and need to keep their shirts on! As well as applying sun cream, pulling on a long-sleeved shirt with a close weave when it gets to midday will reduce the risk of skin cancer in later life. UV suits for children are excellent for protecting young skin. And if you are bald or have thin hair don’t forget to wear a sunhat.
  • Check your skin thoroughly at least every few months. See your GP if any moles have changed or you notice black, ugly-looking irregular-shaped moles. The majority of skin cancer can be surgically removed if caught early.

    Dr Paul Farrant, holds a clinic on Wednesday afternoons and evenings at The Montefiore Hospital, Montefiore Road, Hove. Visit or for a non-obligation enquiry, phone 01273 828 148.

First published in Brighton and Hove Independent on Friday 12th May 2017.

The content of this article is provided for general information only, and should not be treated as a substitute for the professional medical advice of your doctor or other health care professional.

Brighton Fringe come to The Montefiore Hospital

26 April 2017

Brighton Fringe come to The Montefiore Hospital

Art lovers and visitors to The Montefiore Hospital in Hove, will be able to view a unique photographic exhibition during Brighton Fringe which starts on May 5.

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Nine years and 425 photographers later, Tim Andrews will be showcasing the results of his personal journey with Parkinson’s disease – a progressive and incurable disease of the nervous system marked by tremor, muscular rigidity, and slow, imprecise movements.

On display in the hospital’s reception area will be 40 prints specially chosen for the free exhibition, all with a common theme – images of the Brighton resident in various poses and settings taken since his diagnosis.

“When I saw the results of my very first modelling session nine years ago, I looked at the photo and saw a human being with power and prospects, which is not something I had felt since my diagnosis in 2005,” says Tim, 65, a retired solicitor.

He has entitled the photographic project “Over the Hill” which, he says, is a rallying battle cry, rather than a negative comment on his illness.

Professional photographers involved have included famous names such as Rankin (whose subjects include Kate Moss and Scarlett Johansson), Harry Borden (Baroness Thatcher, Mo Farah) and Jillian Edelstein (Nigella Lawson, Colin Firth) but also many photographers from the Brighton area, as well as students and amateur enthusiasts. Some of the photographers have made the effects of Parkinson’s a central theme of their image by concentrating on parts of the body most affected by the tremors. Other photographers have used the camera to bring a sense of stillness to his body that defies the reality of the disease.

Tim says: “It has been a fascinating journey. I have always loved photography but never had the patience or skill to practice it successfully. However, being a model has enabled me to collaborate with brilliant practitioners of the art and to be part of the artistic photographic process.”

The Montefiore Hospital will be the 10th exhibition for the Over the Hill project, and the first time the hospital has taken part in the Brighton Fringe.

“We feel extremely privileged to be hosting some of Tim’s amazing collection of photographs and I am sure the exhibition will create a lot of interest and discussion among our visitors and patients,” said The Montefiore Hospital director, Andy Wood.

The exhibition is free and will run from May 5 until May 26. However, a collection box will be available in the reception area for the Brighton and Hove branch of Parkinson’s UK, and many of the photographers have committed to make a donation to the local charity if any prints are sold.

First published in Inside Sussex April 2017.

Physiotherapists bring hope to African hospital

21 April 2017

Physiotherapists bring hope to African hospital

Physiotherapists at The Montefiore Hospital in Hove have turned their recycling efforts into a charitable cause.

In the past six months, they have collected more than 750 unwanted crutches from patients and these are now on the way to a poorly equipped hospital in the Republic of Somaliland, east Africa. Once there, the crutches will be used by victims of car accidents and the past civil war.

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“Our patients leave crutches with us once they no longer have use for them, but we felt terrible just throwing them away,” says Gary Nicholson, physiotherapist with Radius Healthcare, a partner with The Montefiore Hospital. “We made contact with a small charity called African Appeal that is now taking our crutches to Somaliland which is great news for the patients there.”

In the UK, strict health and safety rules mean crutches cannot be reused and even charity shops are reluctant to accept them from donors. All donated walking aid equipment is thoroughly checked by The Montefiore team and their African Appeal partners to ensure they are in working condition before being transported the 7,064 miles to Hargeysa, the capital of the Republic of Somaliland.

Nasser Soufi, a Bristol-based postman who is leading the African Appeal charity with his work colleagues, says: “There is a huge demand for this equipment in the main hospital in Hargeysa. When I visited last year, three crutches were being shared by several hundred people. Many are victims of car accidents as the roads in Somaliland are rough and hazardous. We are very grateful to The Montefiore Hospital helping us with this project.”

The African Appeal team have already made one trip to Hargeysa hospital and set off again on Wednesday, April 12, for a second trip to deliver the crutches.

First published in The Argus on 15 April 2017.

3 March 2017

Feel your best for 2017

So here we are at the start of a new year, and with a new start comes pre-work fatigue. Here, consultants from The Montefiore Hospital in Hove provide you with all the advice you need to tackle those niggling health problems in the new year.

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Back and Neck Pain
“Back and neck pain is a major cause for working days lost, so start 2017 with a New Year’s resolution to look after your back. If you haven’t already, give up smoking as the chemicals in tobacco smoke poison the intervertebral discs. Drink plenty of water especially if you are in an air-conditioned office – your intervertebral discs naturally lose water during the day. Get up from your desk and move around whenever the opportunity arises. If you do develop some back pain, over the counter (OTC) anti-inflammatories, such as paracetamol and ibuprofen, will help as well as keeping moving – lying down for long periods at home is counterproductive. If your back pain doesn’t get better within a few weeks or becomes increasingly painful, or if you have leg or arm pain also, visit your GP or a spine specialist,” Mr Michael Cass, Spinal Surgeon.

“90% of migraine sufferers are unable to work or function normally during their migraine attacks. There are some lifestyle changes you can make to reduce the migraines – drink plenty of water to ensure you don’t become dehydrated, limit alcohol and caffeine intake, and stick to a routine bedtime and waking up time wherever possible. Avoid regular use of OTC medicines, especially those which contain codeine as this can aggravate the headache. Take a painkiller as you feel the headache coming on. Supplements such as magnesium, riboflavin and CQ10 can also help. If the migraines occur several times a month, see your GP. Sussex GPs will be provided updated guidelines in 2017 on how to better help patients with migraines and when to refer you to a specialist,” Dr Romi Saha, Neurologist.

Heavy Periods
“One in five women suffer debilitatingly heavy periods that not only affect concentration at work, but even force them to take sick leave on a regular basis. Try an OTC medicine called mefenamic acid (also known as Ponstan) to reduce the pain and lessen the bleeding. If you are obese, losing weight could also help to lighten the periods. If symptoms continue, visit your GP for prescription medication. You may also be referred to a specialist for assessment to exclude other causes such as hormones, polyps or fibroids.” Mr Faz Pakarian, Gynaecologist.

Benign Enlargement of the Prostate
“Are you frequently leaving your desk to go to the loo or getting `caught short’ in a meeting? You might have a benign enlargement of the prostate which affects one in three men in their 50s. Limiting caffeine and alcohol intake, and reducing the number of drinks before bedtime, will solve the problem for most men. If not, surgery may be necessary. New surgical procedures are now available which relieve the symptoms of urinary flow without resorting to cutting or removing prostate tissue, and so preserving sexual function. Discuss the options with your GP, urologist, and importantly your partner,” Mr Andy Symes, Urologist.

Obstructive Sleep Apnoea (OSA)
“If you wake up several times in the night feeling like you can’t breathe you may be suffering from OSA This leads to exhaustion and reduced concentration at work, and can be dangerous if handling machinery or driving. Alcohol aggravates the problem so reduce your intake. Losing weight and increasing overall body tone through exercise will also help. However, if the problem continues see your GP. You may be referred for sleep tests to monitor your oxygen levels. A proven treatment is Continuous Positive Airway Pressure (CPAP) therapy which provides steady air pressure via a mask or nose piece,” Mr Mike O’Connell, Ears, Nose and Throat Consultant.

Irritable Bowel Syndrome (IBS)
“Sitting through meetings at work can be torture if you are experiencing abdominal pain caused by IBS. Stress, eating poorly and drinking to excess will worsen IBS symptoms which include diarrhoea, constipation and or pain. Avoid common food triggers such as milk or dairy products, wheat and gluten, and vegetables such as onions, broccoli, brussel sprouts and beans. Peppermint oil capsules can be an effective treatment. For short-term use, try anti-spasmodics, anti-diarrhoeas and painkillers, but if symptoms continue, or include severe pain or persistent rectal bleeding, then see your GP. You may require referral to a specialist for more detailed examination of the bowel,” Dr Mark Austin, Gastroenterologist.

Carpal Tunnel Syndrome (CTS)
“Tingling sensations, `pins and needles’ and pain in your hands and fingers? Then you could have CTS, a common condition that can be aggravated by poor positioning of your wrists while using your keyboard or mouse and prolonged exposure to vibrations from using hand tools or power tools. Rest your hands frequently and take anti-inflammatories. If you regularly wake up in the night with a numb hand or the pain is becoming constant, then see your GP who may refer you to a specialist. Most people can be treated without surgery and you might be advised to wear a wrist splint,” Mr Chris Williams and Ms Lisa Leonard, Hand Surgeons.

“Diabetes and work don’t always mix. How do you manage food, medicines, rest, monitoring, and exercise especially if you’ve got demands and deadlines? The rise in obesity has led to an increase in the number of people having Type 2 diabetes. Symptoms include increased thirst, frequent urination, and fatigue. See your GP if you are concerned. It can be managed with the latest medication, but lifestyle changes, such as losing weight, can reduce or even put Type 2 diabetes into remission. If you have Type 2 diabetes, ensure you have a yearly blood test, an annual eye check and your feet examined regularly,” Dr Sunil Zachariah, Endocrinologist.

Don’t allow a health concern to continue without seeking the advice of your GP and/or a specialist. In many cases, advice on lifestyle changes, plus OTC and prescription medication will help alleviate the symptoms to allow you to function once again at work.

First published in Sussex Business Times January 2017.

The content of this article is provided for general information only, and should not be treated as a substitute for the professional medical advice of your doctor or other health care professional.

3 March 2017

Useful tips on tackling the trauma of tinnitus

If ringing in the ears is literally driving you to distraction, you may have tinnitus. Don’t let it ruin the quality of your life as there is plenty that can be done to help. Hearing experts at The Montefiore Hospital in Hove have `sound’ advice.

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Ringing, whistling, humming or buzzing…. all words that have been used to describe a noise inside the head that only you can hear. Around 30% of us have had tinnitus at some point, but one in ten people experience it all the time. For many, this `phantom’ noise is extremely distressing, causing insomnia, lack of concentration and can lead to depression. Don’t let it get to this stage - visit your GP who may refer you to an Ears, Nose and Throat (ENT) consultant.

What can be done?

  • Often the first visit to an ENT consultant may be your only visit – for many people, the reassurance that this noise is nothing sinister stops them worrying and then, in turn, the tinnitus naturally becomes less intrusive.
  • Tinnitus often goes hand in hand with hearing loss, so you may be referred to an audiologist to have hearing levels checked. A hearing aid will not only improve hearing, but also the tinnitus.
  • Tinnitus can be triggered by mental or physical changes such as changing jobs or a stressful event. Patients may be referred for stress management or cognitive behavioural therapy.
  • A tinnitus masker may be recommended. This is a tiny device that emits low levels of a sound that you choose, such as the sound of waves breaking on a beach. You are in control of the volume and can switch it on and off, however it is recommended that you wear the device for a couple of hours every day. The masker can `trick’ the brain into not hearing the tinnitus. Try this: stand next to a tap turned on full. If you only hear the water, and not the ringing in your ears, chances are a masker could benefit you.

What can you do to help yourself?

  • If you are struggling to sleep, use environmental noises to mask the sound of the tinnitus. Open a window at night so you can hear traffic, have a ticking clock in the room, or turn on a radio or TV to a low volume, not loud enough to be intrusive, but at a level that overrides the noise in your head.
  • Check your medication – tinnitus can be triggered by certain drugs, such as aspirin. However, take advice from your GP before changing medication.
  • Protect your ears from loud noises which can exacerbate tinnitus. For sample, wear ear protectors when mowing the lawn.
  • Don’t push earbuds into your ear – if you think wax is the cause of the tinnitus, have your ears cleaned by a medical professional.
  • Visit the British Tinnitus Association website for more advice –

Seek urgent medical advice if tinnitus occurs suddenly, is in just one ear or is causing dizziness, or you have sudden hearing loss.

Advice from Mr Tony McGilligan, Consultant ENT surgeon and Ben Tranter, audiologist at the Sussex Audiology Centre who both hold weekly clinics at The Montefiore Hospital, Hove. For more information visit or for a non-obligation enquiry, phone 01273 828 148.

First published in Brighton and Hove Independent on Friday 17th February 2017.

The content of this article is provided for general information only, and should not be treated as a substitute for the professional medical advice of your doctor or other health care professional.

Dr Romi Saha

25 January 2017

Useful tips on tackling painful migraines

Sussex GPs will soon be receiving new guidelines on how to treat migraine patients more effectively. This is good news for sufferers as often their symptoms can be misdiagnosed. Dr Romi Saha, neurologist at The Montefiore Hospital in Hove, says that, as well as effective treatments, there is a lot people can do to help themselves.

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If your headaches make you light, noise or smell sensitive and all you want to do is lie down in a dark room, then these are likely to be migraines.

Some people complain of one-sided headaches, while others notice zig-zag lights or sparkles before their eyes. However, every sufferer is different and around two-thirds don’t experience these symptoms.

But for 90% of migraine sufferers, an attack can be debilitating, leaving them unable to function normally.

You can get migraines for the first time at any age, but people often have had their first one by the time they are 30, and attacks usually get less severe as you get older.

If you are getting symptoms several times month, then make an appointment with your GP but also try these self-help tips:

Lifestyle changes:

  • Don’t allow yourself to get dehydrated – drink at least two litres of fluid a day
  • Avoid skipping meals
  • Limit your alcohol intake
  • Reduce the amount of coffee or tea you drink and avoid caffeinated drinks like Red Bull – it might help get you through a tough day, but can trigger a headache later.
  • Stick to a routine bedtime and waking uptime where possible. Many people find they have a migraine attack at the weekend because they have spent weekdays going to be at 10pm and getting up at 6.30am, then suddenly they are up until midnight on a Friday night and lie in bed on Saturday.
  • Exercise for at least 30 minutes three times a week

Natural remedies: Magnesium, riboflavin (a B vitamin) and Co-enzyme Q10 can help ward off a migraine. They can be bought in a supplement form from health food shops or the natural remedy aisle of high street chemists or can be found naturally in the following foods -

Magnesium: dark chocolate, bananas, low fat yogurt, nuts and seeds, avocadoes, soy beans, leafy greens and fish.

Riboflavin: milk, meat, eggs, nuts, enriched flour, and green vegetables

Coenzyme Q 10: chicken, herring, mackerel beef, roasted peanuts, sesame seeds, pistachio nuts, broccoli, cauliflower, oranges, strawberries and soybean oil

Painkillers: Avoid regular use of OTC medicines, especially those which contain codeine as this can aggravate the headache. Take a painkiller as you feel the headache coming on. However, taking any form of painkiller on more than 10 days a month can lead to analgesia overuse which can make the headache worse. Visit your GP who can recommend alternative, and more effective, painkillers. Patients with debilitating symptoms may be referred to a neurologist to rule out other causes of the headache.

Dr Romi Saha holds a neurology clinic on Monday evenings and alternative Tuesday afternoons at the Montefiore Hospital, Montefiore Road, Hove. Visit or for a non-obligation enquiry, phone 01273 828 148. For more information, visit

First published in Brighton and Hove Independent on Sunday 22nd January 2017.

The content of this article is provided for general information only, and should not be treated as a substitute for the professional medical advice of your doctor or other health care professional.

Faz Pakarian

25 January 2017

Hove clinician urges women not to miss their smear tests

A Hove gynaecologist has stressed the importance of keeping up to date with smear tests in Cervical Screening Awareness Week (January 22).

Consultant gynaecologist Faz Pakarian, who practices at private healthcare provider The Montefiore Hospital in Hove, said figures show that 20 per cent of women do not attend their cervical screening appointments.

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Mr Pakarian said: “Cervical cancer is a preventable disease. The signs that it may develop can be often be spotted early and it can be treated before it even fully starts.

“While around 750 women each year in the UK die of cervical cancer every year, figures show that many of those who develop the disease have not been screened regularly. The single biggest risk factor for developing cervical cancer is not being regularly screened, yet it is thought that as many as one million women a year are missing out.”

Women aged 25 to 49 are invited to attend smear tests every three years; those aged 50 to 64 are invited every five years. The screening can detect abnormal (pre-cancerous) cells in the cervix in order to prevent cervical cancer.

Mr Pakarian said: “It is important to get the message across that cervical screening is not a test for cancer, but instead allows for detection of abnormalities at an early stage.

“The routine of attending a cervical screening should be an important part of every woman’s health regime but for many women this message just isn’t getting through. Early detection is key to increasing survival rates so educating everyone about the disease, its symptoms and ways to prevent it is very important.”

First published in Brighton and Hove Independent on Sunday 22nd January 2017.