COVID and Acid reflux

Gastroenterology

COVID and Acid reflux

The COVID-19 pandemic has not only affected millions of lives but also brought to light many complications and long-term health effects associated with the virus. One such intriguing connection has emerged between COVID-19 and acid reflux disease. Acid reflux, characterized by the backward flow of stomach acid into the oesophagus, often leads to symptoms like heartburn, regurgitation, and a persistent cough. Understanding the intricate link between COVID-19, cough, and reflux is essential to comprehending this virus’s complex and evolving nature.

COVID-19 and the Coughing Conundrum

COVID-19, caused by the SARS-CoV-2 virus, is primarily known for its respiratory symptoms. Coughing is a common symptom that can persist even after other symptoms have subsided. This persistent cough can be challenging for individuals in many ways, especially when it contributes to developing or exacerbating acid reflux disease.

The Cough-Reflux Connection

  1. Viral Infection and Cough: The SARS-CoV-2 virus primarily infects the respiratory tract, leading to inflammation and damage to lung tissues. In response, the body’s natural defence mechanism triggers a cough to clear mucus and irritants. Persistent coughing can be distressing for individuals who experience it during or after a COVID-19 infection.
  2. Increased Intra-abdominal Pressure: Coughing is a forceful action that increases intra-abdominal pressure, causing a surge in pressure within the stomach. This pressure, if consistently high, can force stomach acid to move back up the oesophagus, leading to acid reflux. When the lower oesophagal sphincter, a muscular ring that separates the oesophagus from the stomach, weakens or relaxes inappropriately, it becomes more susceptible to acid reflux events, especially during coughing fits.
  3. Impact on the Lower Esophageal Sphincter (LES): Frequent coughing may lead to microtrauma in the lower oesophageal sphincter, further weakening its ability to remain tightly closed. When the LES loses its competence, it becomes a less effective barrier against the regurgitation of stomach acid.
  4. Medications and Their Role: Many individuals suffering from COVID-19 symptoms or related coughing may be prescribed medications like corticosteroids to reduce inflammation. These medications can also weaken the LES and contribute to acid reflux.

Managing Acid Reflux in the Context of COVID-19

Managing acid reflux in the context of COVID-19 requires a multifaceted approach:

  1. Lifestyle Modifications:
    • Maintain a healthy weight to reduce abdominal pressure.
    • Elevate the head of the bed to prevent acid from flowing back into the esophagus.
    • Avoid large meals, especially before bedtime.
    • Limit trigger foods and beverages such as spicy foods, citrus, and caffeine.
    • Refrain from smoking and excessive alcohol consumption.
  1. Medications:
    • Proton pump inhibitors (PPIs) or H2-receptor antagonists can help reduce stomach acid production.
    • Antacids can provide temporary relief from heartburn symptoms.
  1. Breathing Techniques:
    • Learn to manage and control coughing fits, potentially reducing the strain on the LES.
  1. Consult a Healthcare Professional:
    • If cough and reflux symptoms persist, seek medical advice. A healthcare provider can evaluate your condition and recommend appropriate treatments.

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Dietian Consultation

Treatments

Dietian Consultation

Unlock the key to improved digestive health with our comprehensive Dietitian Consultation service at Liverpool Street Digestive Clinic. Our dedicated team of registered dietitians is here to empower you on your journey towards optimal well-being.

During our Dietitian Consultation, you’ll receive personalised guidance tailored to your unique dietary needs and goals. Whether you’re grappling with irritable bowel syndrome (IBS) or other stomach conditions, our experts will work closely with you to develop a nutrition plan that eases discomfort and enhances your overall digestive health. We start with the basics, emphasising healthy, balanced meals and a regular eating schedule. In some cases, more targeted dietary modifications like the low-FODMAP diet, known for its effectiveness in managing IBS, might be recommended.

Don’t let persistent digestive issues hold you back. Take the first step towards feeling your best by booking your appointment online or simply giving us a call. We’re committed to helping you achieve a happier, healthier gut. Your digestive well-being is our priority, and we’re here to guide you every step of the way.

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What is the transverse abdominis muscle

Gastroenterology

What is the transverse abdominis muscle (corset muscle)

The transverse abdominis muscle, commonly referred to as the “corset muscle,” plays a vital role in maintaining trunk and spine stability. Located deep within the abdominal wall, beneath the rectus abdominis (the “six-pack” muscle), it is considered one of the core muscles. This article aims to provide insights into the significance of the transverse abdominis muscle and offer effective training methods to strengthen it.

 

Understanding the Transverse Abdominis Muscle: The transverse abdominis muscle is a crucial component of the core musculature, contributing to the stability and support of the trunk and spine. It functions by compressing the abdominal contents, providing a corset-like effect. Strengthening this muscle is beneficial for overall posture, athletic performance, and injury prevention.

Effective Exercises for Training the Transverse Abdominis Muscle:

  1. Plank Exercise: The plank exercise is a classic and highly effective method for targeting the transverse abdominis muscle, along with other muscles in the abdominal wall and core. To perform a plank, assume a push-up position and support your body weight on your forearms and toes, maintaining a straight line from head to toe. Hold this position for a specified duration, gradually increasing the time as your strength improves.

  2. Side Plank Variation: Similar to the standard plank, the side plank primarily engages the transverse abdominis muscle and also activates the oblique muscles on the sides of the abdomen. To perform a side plank, lie on your side and prop yourself up on one forearm, with your legs stacked on top of each other. Keep your body in a straight line and hold the position for a prescribed time, gradually increasing the duration as you progress.

  3. Pilates Method: Pilates exercises are renowned for their emphasis on proper posture, alignment, and core stability. Numerous Pilates exercises effectively target the transverse abdominis muscle. Some notable exercises include the hundred, rolling like a ball, and single-leg stretch. Incorporating these exercises into your routine can significantly strengthen your transverse abdominis muscle.

  4. Vacuum Exercise: The vacuum exercise is a simple yet effective technique specifically designed to engage the transverse abdominis muscle. To perform the vacuum exercise, stand with your feet hip-width apart and draw your belly button toward your spine, contracting the transverse abdominis muscle. Maintain this contraction for several seconds before releasing. Repeat the exercise for multiple sets, gradually increasing the duration of the hold.

Important Considerations: To maximize the effectiveness of these exercises, it is crucial to perform them correctly. Pay careful attention to maintaining proper form and technique throughout each exercise. Begin with manageable levels of intensity and gradually progress as your strength and endurance improve. Consulting with a medical professional or physical therapist before commencing any new exercise program is highly recommended, particularly if you have pre-existing medical conditions or concerns.

Conclusion: Strengthening the transverse abdominis muscle is essential for trunk and spine stability, and it offers numerous benefits for overall fitness and well-being. By incorporating exercises such as planks, side planks, Pilates routines, and the vacuum exercise into your fitness regimen, you can effectively target and strengthen the transverse abdominis muscle. Prioritizing proper form and gradually increasing the exercise difficulty will lead to improved strength and enhanced core stability. Always prioritize your safety and consult with a healthcare professional to ensure the suitability of these exercises for your specific circumstances.

Corset muscle exercises

for bloating, and abdominal wall pain

The corset muscle, also known as the transverse abdominis muscle, is deep in the abdomen that provides support and stability to the spine and pelvis. Strengthening the corset muscle can help improve posture, reduce the risk of injury, and alleviate low back pain.

Here are a few exercises that can help strengthen the corset muscle:

Hollowing

Lie on your back with your knees bent and feet flat on the floor. Take a deep breath in, and as you exhale, draw your belly button in towards your spine. Hold this contraction for a few seconds before releasing and repeating. This exercise can also be done in a standing or kneeling position.

Planking

Start in a push-up position with your arms straight and your body in a straight line. Engage your corset muscle by drawing your belly button in towards your spine, and hold this position for as long as you can. Make sure to maintain proper form and avoid arching your back.

Bird Dog

Start on your hands and knees, with your hands directly under your shoulders and your knees under your hips. Engage your corset muscle by drawing your belly button in towards your spine, and then lift one arm and the opposite leg off the ground while keeping your spine in a neutral position. Hold for a few seconds before returning to the starting position and repeating on the other side.

Dead Bug

Lie on your back with your arms extended towards the ceiling and your legs bent at a 90-degree angle. Engage your corset muscle by drawing your belly button in towards your spine, and then slowly lower one arm and the opposite leg towards the floor while keeping your spine in a neutral position. Return to the starting position and repeat on the other side.

It’s important to remember to breathe throughout each exercise and to start with a level of difficulty that is appropriate for your fitness level. As always, it’s a good idea to check with an NHS or a private physiotherapist before beginning any new exercise program, particularly if you have a history of low back pain or other medical conditions.

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What can you see during an abdominal ultrasound?

Gastroenterology

What can you see during an abdominal ultrasound?

An abdominal ultrasound is a medical imaging test that uses high-frequency sound waves to create images of the organs and tissues within the abdomen. During an abdominal ultrasound, a doctor or a  sonographer (technitian) applies a special gel to the patient’s skin and uses a handheld probe to generate the sound waves and capture the images.

An abdominal ultrasound can provide valuable information about the following organs and structures:

  • Liver: The ultrasound can assess the size, shape, and texture of the liver and detect any abnormalities, such as cysts, tumors, or cirrhosis.
  • Gallbladder: The ultrasound can detect gallstones, evaluate the function of the gallbladder, and identify any inflammation or infection.
  • Pancreas: The ultrasound can evaluate the size and shape of the pancreas and detect any abnormalities, such as cysts or tumors.
  • Spleen: The ultrasound can assess the size and texture of the spleen and detect any abnormalities, such as an enlarged spleen or a mass.
  • Kidneys: The ultrasound can evaluate the size, shape, and texture of the kidneys and detect any abnormalities, such as cysts, tumors, or kidney stones.
  • Abdominal blood vessels: The ultrasound can evaluate the blood flow in the major arteries and veins within the abdomen, such as the aorta and the vena cava.
  • Abdominal fluid collections: The ultrasound can detect the presence of fluid within the abdomen, such as ascites, which can be a sign of liver disease or other underlying conditions.

In addition to these organs, an abdominal ultrasound can also help diagnose other conditions such as hernias, abdominal pain, and digestive tract problems. The images obtained during an abdominal ultrasound can help guide further diagnostic tests or treatments as needed.

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What is a private colonoscopy

Gastroenterology

What is a private colonoscopy ?

A private colonoscopy is a medical procedure in which a patient pays for a colonoscopy through a private health insurance policy or out-of-pocket, rather than through the National Health Service (NHS) in the United Kingdom.

A colonoscopy is a procedure in which a thin, flexible tube with a camera at one end (called a colonoscope) is passed into the rectum and colon to examine the inside of the large intestine. The procedure is used to diagnose and treat conditions such as colon polyps, diverticulitis, and colorectal cancer.

In a private colonoscopy, the procedure is performed in a private hospital or clinic, and the cost of the procedure is usually covered by a private health insurance policy or paid for out-of-pocket by the patient. Private colonoscopies are usually performed by a consultant gastroenterologist, and the patient typically has a shorter waiting time for the procedure than they would if they were on the NHS.

While a private colonoscopy is a more convenient and potentially quicker option, it is also usually more expensive than an NHS colonoscopy. It’s important to carefully consider the cost and benefits of a private colonoscopy and to discuss any questions or concerns with a medical professional before making a decision.

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What is a private gastroscopy? 

Gastroenterology

What is a private gastroscopy?

A private gastroscopy is a medical procedure in which a patient pays for a gastroscopy through a private health insurance policy or out-of-pocket, rather than through the National Health Service (NHS) in the United Kingdom.

A gastroscopy is a procedure in which a thin, flexible tube with a camera at one end (called an endoscope) is passed down the throat and into the stomach to examine the digestive tract. The procedure is commonly used to diagnose and treat conditions such as acid reflux, indigestion, and stomach ulcers.

In a private gastroscopy, the procedure is performed in a private hospital or clinic, and the cost of the procedure is usually covered by a private health insurance policy or paid for out-of-pocket by the patient. Private gastroscopies are usually performed by a consultant gastroenterologist, and the patient typically has a shorter waiting time for the procedure than they would if they were on the NHS.

While a private gastroscopy is a more convenient and potentially quicker option, it is also usually more expensive than an NHS gastroscopy. It’s important to carefully consider the cost and benefits of a private gastroscopy and to discuss any questions or concerns with a medical professional before making a decision.

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What is a selfpay colonoscopy?

Gastroenterology

What is a selfpay colonoscopy?

A self-pay colonoscopy is a procedure in which a patient pays for a colonoscopy out-of-pocket, rather than through a private health insurance policy or the National Health Service (NHS) in the United Kingdom.

A colonoscopy is a procedure in which a thin, flexible tube with a camera at one end (called a colonoscope) is passed into the rectum and colon to examine the inside of the large intestine. The procedure is used to diagnose and treat conditions such as colon polyps, diverticulitis, and colorectal cancer.

Self-pay colonoscopies are usually performed in private hospitals or clinics, and the cost of the procedure is usually higher than if it was covered by a private health insurance policy or the NHS. However, for patients who do not have private health insurance or are not eligible for NHS treatment, a self-pay colonoscopy may be a good option if they want a quicker and more convenient option.

It’s important to carefully consider the cost and benefits of a self-pay colonoscopy and to discuss any questions or concerns with a medical professional before making a decision. You may also want to compare prices and services offered by different private hospitals and clinics before making a final decision.

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What is a self pay gastroscopy?

Gastroenterology

What is a self pay gastroscopy?

A self-pay gastroscopy is a procedure where a patient pays for a gastroscopy out-of-pocket, rather than through a private health insurance policy or the National Health Service (NHS) in the United Kingdom.

A gastroscopy is a procedure in which a thin, flexible tube with a camera at one end (called an endoscope) is passed down the throat and into the stomach to examine the digestive tract. The procedure is commonly used to diagnose and treat conditions such as acid reflux, indigestion, and stomach ulcers.

Self-pay gastroscopies are usually performed in private hospitals or clinics, and the cost of the procedure is usually higher than if it was covered by a private health insurance policy or the NHS. However, for patients who do not have private health insurance or are not eligible for NHS treatment, a self-pay gastroscopy may be a good option if they want a quicker and more convenient option.

It’s important to carefully consider the cost and benefits of a self-pay gastroscopy and to discuss any questions or concerns with a medical professional before making a decision. You may also want to compare prices and services offered by different private hospitals and clinics before making a final decision.

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What is Gastroparesiss

Gastroenterology

What is Gastroparesiss

Gastroparesis is a medical condition in which the muscles of the stomach don’t work properly, causing food to move through the digestive system more slowly than it should. This can lead to a number of symptoms, including:

  • Nausea and vomiting
  • Abdominal bloating and pain
  • Heartburn or acid reflux
  • Unintended weight loss
  • Feelings of fullness after only a few bites of food
  • Blood sugar fluctuations in people with diabetes

The exact cause of gastroparesis is not always clear, but it can be caused by a variety of factors, including:

  • Diabetes: High blood sugar levels can damage the nerves that control the muscles in the stomach, leading to gastroparesis.
  • Idiopathic: In some cases, the cause of gastroparesis is unknown, and it is referred to as idiopathic gastroparesis.
  • Surgeries: Certain surgeries, such as those for gastric bypass or removal of part of the stomach, can cause gastroparesis.
  • Infections: Infections, such as viral infections, can damage the nerves in the stomach and cause gastroparesis.
  • Medicines: Certain medications, such as opioids, can slow down the muscles of the stomach and cause gastroparesis.

Gastroparesis can be diagnosed through a number of tests, including a medical history, physical examination, blood tests, upper endoscopy, and a test called gastric emptying study, which measures the time it takes for food to move through the stomach.

Treatment for gastroparesis involves a combination of dietary changes, medications, and, in severe cases, surgery. This may include changes to the texture and consistency of food, eating small, frequent meals, and avoiding foods that are high in fat and fiber. Medications that help to regulate the contractions of the stomach muscles, and promote the emptying of food from the stomach, can also be helpful. In severe cases, a gastric electrical stimulation device, or a gastrostomy tube, may be necessary to provide nutrition and relieve symptoms.

If you are experiencing symptoms of gastroparesis, it is important to consult a healthcare professional for an accurate diagnosis and appropriate treatment.

 

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Allurion Programme For Weight-Loss

Allurion Weight Loss Balloon

Allurion Programme For Weight-Loss

It is widely known that even a small weight loss (starting at 5% of initial weight) greatly benefits the health of overweight or obese individuals. It can lower the risk of developing type 2 diabetes and enhance the health and blood sugar management in those already diagnosed with the condition .

What is the new data from Allurion?

The Allurion Programme has achieved a significant milestone by clinically proving its effectiveness in treating individuals with type 2 diabetes and prediabetes, leading to disease remission (where blood sugar levels fall below the diabetic range).

This innovative approach, which involves a gastric balloon pill that can be swallowed effortlessly, provides healthcare professionals with a new option to support their patients with diabetes and prediabetes. The groundbreaking data supporting this program has undergone peer review and has been published. It was also chosen by a panel of experts for presentation at The Obesity Society (TOS) Obesity Week 2021.

What were the main results from the clinical study?

The published data reveals that the Allurion Gastric Balloon Programme can effectively treat type 2 diabetes and prediabetes, leading to disease remission.

The clinical study involved 226 patients who followed the Allurion Programme for weight loss. All participants were initially diagnosed with either type 2 diabetes or prediabetes, indicating a high likelihood of developing type 2 diabetes in the future.

On average, patients lost 17.7kg (equivalent to 16.2% of their initial body weight) within 4 months.

Throughout the trial, researchers monitored the patients’ haemoglobin A1C (HbA1c) levels, which indicate blood sugar control (lower numbers indicating better health). At the beginning of the trial, all patients had unhealthy HbA1c levels, corresponding to a diagnosis of prediabetes or type 2 diabetes.

For patients with type 2 diabetes, their HbA1c levels improved from 7.0±0.6% to 5.5±1.1%. Similarly, for those with prediabetes, their HbA1c levels improved from 6.0±0.2% to 4.9±0.7%. These significant reductions in HbA1c resulted in complete disease remission for both groups within just 4 months, as their HbA1c levels reached the normal range observed in individuals without diabetes.

How does this compare with bariatric procedures?

Research conducted on individuals with obesity and type 2 diabetes who undergo bariatric surgery has shown that a weight loss of approximately 15kg can lead to remission of type 2 diabetes in the majority of cases. The chances of achieving remission are higher if the weight loss occurs closer to the time of diabetes diagnosis and is rapid.

The groundbreaking data on the Allurion Programme builds upon these studies, indicating that a lifestyle change program combined with the Allurion Balloon (previously known as the Elipse Balloon) can also provide substantial and transformative health benefits with clinical significance.

Maintaining healthy lifestyle changes and weight loss is vital to sustain these health benefits. Published evidence demonstrates that the Allurion Programme – a lifestyle change programme, digital tools and the temporary Allurion Balloon (formerly known as the Elipse Balloon) – delivers sustained weight loss, with up to 95% of the weight lost maintained by patients a year down the line. (Ref:2)

Why is this topic so important?

The prevalence of Type 2 diabetes and prediabetes is at an all-time high, with approximately 5 million people in the UK alone diagnosed with diabetes and nearly 14 million individuals at a high risk of developing the disease (prediabetes). Moreover, there are likely more undiagnosed cases, and these rates are continuously increasing.

The impact of this situation extends beyond the personal health and well-being burdens faced by individuals affected by complications such as amputations, vision loss, premature death, higher hospitalization rates, and increased likelihood of experiencing depression, among others. It also places significant financial strain on the NHS and other public services, accounting for about 10% of the total NHS budget.

There is an urgent need for scalable and effective treatment options. Weight management is recognized as a crucial therapeutic aspect for most individuals living with obesity and type 2 diabetes, highlighting the importance of having a range of effective weight management treatments available.

The health benefits associated with weight loss are noticeable even with a modest 5% reduction, and these benefits continue to increase with further weight loss. A weight loss of 7% can make a significant difference in preventing the development of type 2 diabetes. For individuals on the verge of diabetes, a weight loss of 7-8% can effectively bring them back from the brink.

These results will undoubtedly bring great satisfaction to the medical community, as they have the potential to significantly improve the health and well-being of their patients. It is crucial to acknowledge that obesity has far-reaching health implications, with over 200 possible complications affecting various organs and systems. Therefore, this weight loss will not only deliver individual health benefits but also contribute to overall health improvement and enhance quality of life.

What is the difference between type 1 and type 2 diabetes?

The provided data solely focuses on patients who are either at risk of or have been diagnosed with Type 2 diabetes.

Diabetes is categorized into two main types: type 1 and type 2. Although they share similar symptoms and potential complications, they are distinct diseases. Type 2 diabetes accounts for approximately 90% of all diabetes cases.

Type 1 diabetes is an autoimmune disorder characterized by the inability of the body to produce insulin, a hormone necessary for regulating blood sugar levels in the bloodstream and cells.

On the other hand, type 2 diabetes is a condition where the body produces insulin, but it does not respond to it in a normal manner.

For individuals with type 2 diabetes, the disease may develop gradually over several years. In fact, they may remain unaware of their condition until symptoms of complications arise. Uncontrolled and elevated blood sugar levels can lead to various short- and long-term health issues.

How can type 2 diabetes be prevented?

The risk of developing type 2 diabetes is influenced by various factors, some of which can be controlled while others cannot. Certain lifestyle choices and modifications have been proven to help prevent or delay the onset of type 2 diabetes and prediabetes. The first step is to assess your risk by taking Diabetes UK’s quick risk quiz.

Diet plays a significant role, and adopting a healthy and diverse eating plan is the most effective approach to prevent type 2 diabetes. This entails consuming ample fruits, vegetables, lean proteins, wholegrain carbohydrates, and healthy fats.

Physical activity is crucial, and according to the NHS, adults should aim for 150 minutes of moderate-intensity activity per week. This can be achieved by engaging in 30 minutes of exercise each day, five days a week.

Managing weight is a powerful strategy to lower the risk of type 2 diabetes. Striving to achieve and maintain a healthier weight is particularly important for individuals living with obesity and type 2 diabetes, as weight management is considered the foremost therapeutic measure.

Is a balloon as extreme as having a gastric band?

The Allurion Balloon is inserted by a doctor during a quick 15-minute consultation. Administered as an easy-to-swallow gastric balloon pill, it does not necessitate anesthesia, endoscopy, or surgery.

Offering an alternative to weight loss surgeries like the gastric band and gastric bypass, the Allurion Balloon (previously known as the Elipse Balloon) provides patients with additional options. While it is not intended to replace bariatric surgery, this temporary gastric balloon pill can serve as an early intervention or be utilized by individuals who prefer or are unable to undergo surgery.

Although bariatric surgery, which reduces stomach size, is highly effective, the anesthesia poses potential risks for individuals with obesity. Furthermore, those considering surgery must undergo extensive physical and psychological preparation. The procedure is costly, and there are long waiting lists in the UK.

The swallowable gastric balloon pill offered by Allurion can be used at an earlier stage or for those who opt out of surgery or are not suitable candidates. It is particularly beneficial for individuals seeking substantial weight loss, providing an alternative to weight management surgeries or for those who have found that diet and exercise alone are not effective.

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