'Grilling is very healthy, but under certain conditions'. Special Episode 1

Monika Rachtan
I invite you to listen to the podcast. First of all, the patient. Good morning. Monika Rachtan welcome you very warmly to a special episode of the podcast. And I think when this episode airs, it will already be on the programme. Patient first. I'm in the kitchen today. He is my guest. I have with me Dr Roland Kadaj Lipka Hello, Doctor.

Roland Kadaj Lipka
A very warm welcome to you. I hope to be able to say a few interesting things in these unusual circumstances.

Monika Rachtan
Because we are meeting here primarily for the patients, to say some interesting things for today. We are opening the summer season, the barbecue season, so we will prepare something healthy, which you will also be able to prepare at your gatherings with friends, but we will also talk about holiday matters, about how to pack a first aid kit, well, and about such various adventures that we may encounter from the side during these holidays. That's right, a gastro-anthropologist, because I didn't say you were a gastro-ederologist. What does this specialist do?

Roland Kadaj Lipka
This is a question that people often ask me. In general, the word gastro-edestinal practitioner is such a difficult word and not everyone knows what we do. We are not surgeons, but we are somewhat of a surgical specialisation as far as the doctor is concerned, but above all we deal with the gastrointestinal tract, the entire gastrointestinal tract from beginning to end, its diagnosis, diseases, functions, problems of the stomach and intestines, pancreas, liver and oesophagus. It is a very broad spectrum of different diseases, ailments that we try to remedy.

Monika Rachtan
OK. And I'll ask right away what patients might want to ask. That is, when to see a surgeon and when just to see your doctor?

Roland Kadaj Lipka
To the surgeon? When, first of all, it is necessary to remove all kinds of acute conditions, acute cholecystitis, acute appendicitis, then, of course, to the surgeon. On the other hand, all kinds of chronic abdominal pain problems or even acute sides that do not require surgical intervention are first and foremost welcome to us.

Monika Rachtan
OK. We're meeting in the kitchen, so I think we're going to cook something. I'm chiselling this pomegranate like this, because I'm cleaning it, but we're going to cook something today that you can boil or fry or bake or grill on your Grill. It depends what kind of barbecue they are, so maybe you can start by saying what you have prepared and then I will talk about my dishes.

Roland Kadaj Lipka
Yes, I'm not a professional chef first and foremost, but I will try to prepare, first and foremost, healthy food, the kind that, from a gastro entera log point of view, can be eaten by patients and in the most accessible way possible. I hope to succeed with this. What will I be preparing for you today? First and foremost, I will cover as we have discussed. I will take care of the meat part. So I have already taken it out. A little while ago I started to prepare the minced salmon marinated in a marinade of soy sauce, honey and. So I really like this recipe because it's very light and very simple. First of all, I've already got chicken wasting away in the fridge, one that's more Thai style. I think we'll make skewers afterwards, to go with some sort of light salad. I think this will be such my idea of such a healthy summer meal.

Monika Rachtan
Thank you so much for explaining and talking about all these dishes. I'll be the one to cook it due to the fact that at my place it's difficult with meat, but I do eat seafood and fish, so I'm keen to try this salmon as it all sounds very delicious. It's going to be prawns with pineapple at my place. The kind of skewers that can be prepared in 5 minutes when guests say oh, we'll be out in a minute. These skewers are a really good choice, provided only that we have too marinated in the fridge. The day before, on the other hand, I'll also make asparagus, because I'd like to show that vegetables on the barbecue do have their place after all, and that you can make something delicious out of them.

Roland Kadaj Lipka
This should be the main place in my opinion.

Monika Rachtan
It's like that, because barbecue, however, there are usually meats and we see that probably on the barbecue of the Poles, and yet vegetables can be there too. They are also, well and above all very healthy.

Roland Kadaj Lipka
Of course it is. First of all, the barbecue is a bit of a myth that needs to be dispelled. Yes, because in my opinion barbecuing is, against all odds, a very healthy form of food preparation. Of course, if you meet a few conditions. First of all, what goes on that barbecue, that is not done. At the very least, we try to avoid those greasy, most fatty foods like fatty sausages or fatty pork neck. Well, maybe not necessarily, but it's rather worth having on the barbecue, fish, poultry or vegetables, which you can use to add variety to your meal. Above all, these are grilled vegetables. First of all, they are healthy, they don't lose nutritional values as much as, for example, cooked ones, and, above all, they have a lot of such taste qualities, so you can reach for mushrooms, asparagus. The mushrooms and asparagus you mentioned, as well as peppers, courgettes and aubergines, we can make very nice and tasty dishes and delight our guests.

Monika Rachtan
Well that's what I grilled cheese about earlier too. I'm a cheese girl, so yes I grill feta cheese and I grill halloumi cheese and also you can spice it up nicely with vegetables, then it's all like that. Well, just not obvious. Guests are often surprised when they come to the barbecue and say but why this feta cheese in foil and still there you add tomatoes, onions? Is this going to taste good at all? It turns out that this is the best dish on the barbecue, but just coming back from that barbecue. Tell me, doctor. Doctor, could you tell me if this kind of barbecue in terms of what kind of barbecue it's going to be we have a gas barbecue. Does it make a difference from the point of view of exactly what might be happening to our digestive system after that barbecue? That is, that it is better to choose an electric barbecue, because then there is more certainty that two will not hurt us.

Roland Kadaj Lipka
They are mainly nowadays. There used to be, first of all, these charcoal barbecues and the problem was we didn't prepare food on those, but they were often burnt, parched, charred, almost sometimes black sausage and everyone said great, stomach great, because with charcoal it's a myth, we don't do that. Whereas, above all, nowadays charcoal can be too. Of course if we know how to make it properly, rather that they are well lit at a high temperature. Maybe not directly over the fire, more dangerously over the embers, but definitely easier. In my opinion, today it is simpler to choose either an electric or a gas barbecue. For these gas barbecues are super prepared. There are dishes, there are, it is not roasted. Above all, these grilled dishes are not so greasy. They are often deprived in stage a time during the preparation of the dish, so it is much better than frying, for example. We don't like frying as a gas, while grilling is as much as it can be.

Monika Rachtan
But if we decide to do this grilling, grilling with coals, and it turns out to be our food. And they were the best for our digestive system, so first of all, what can we expect, what can happen to us after such a strong barbecue? And 2 How do we deal with this? How do we protect ourselves?

Roland Kadaj Lipka
Above all, let's try not to eat a lot, because that's the key problem, because it's not even the big biggest problem of what we eat and how we eat it, but above all how much of it we eat. So this is also the time, the importance, that when preparing food on the barbecue you should eat a lot. That or a normal meal should not be too late. Not three sausages, not pork neck yet above all. What we will still eat or drink on this barbecue, because it is important to make sure that we at least try not to consume alcohol or hard-to-digest food, because this is also very, very important. Unfortunately, because this is the main problem. Often overeating, not even what we eat is the biggest problem. So if we make sure that it's from that barbecue, that the food is as good as possible, that it's not burnt, not burnt. So let's also pay attention to quantities, because this is a very important thing, and if it happens that we overdo it, well, first of all.

Roland Kadaj Lipka
It is not pretty. You need to give the digestive tract a rest for a while, drink water, rehydrate the body, possibly, if there is severe pain, you can help yourself with medicines of this kind or those available to alleviate the discomfort. Of course, this can be done. But if it goes on for a long time and does not subside spontaneously after a few hours, then it is advisable to see a specialist.

Monika Rachtan
It is I who will let the doctor go to the fridge as he is heading before the next question. But I will also ask about such a situation as far as your doctor is concerned. It once happened that a patient came to your doctor from such a grill with some such severe problem. For example, should any group of people who do not suffer from some chronic disease pay special attention to what they consume during this barbecue and could something unexpected like this happen?

Roland Kadaj Lipka
Of course it does. Unfortunately, during these periods around May Day, these longer weekends, it happens. It is unfortunately so quite common when I consult patients in or around this period. Patients come in and say that, unfortunately, they have overdone it. NIWA Quite. Note If patients have gallbladder stones, if there is not too much or unfortunately fatty foods, because this unfortunately promotes the ejection of bile into the digestive tract or.

Monika Rachtan
What it means there.

Roland Kadaj Lipka
Because in the sense if we have in the language of life bile accumulates, that's the working name for it. In this connection. It serves us for digestion when we eat a lot of hard-to-digest fatty foods. This is one the digestive tract has to cope with. Related to this. It replenishes the digestive enzymes just by dumping bile into the digestive tract. And unfortunately, in these situations it can happen that, for example, if there are some small deposits, they move into the bile ducts.

Monika Rachtan
So it's sort of like these off-the-shelf balls.

Roland Kadaj Lipka
Pebbles, to put it simply, such pebbles hinder the outflow and then there can be stress or acute inflammation, whether of the gallbladder or bile ducts, the worst can happen, because acute pancreatitis is a very serious disease, which unfortunately can happen, especially if, for example, we consume alcohol. So it's important to pay attention to this.

Monika Rachtan
You said the doctor about this pancreas. It seems to me that this is the kind of organ whose disease we all fear in Poland, because this pancreas is also perceived by patients as a disease that can be life-threatening. And what is it exactly like? Which pancreatic conditions are so most dangerous? And perhaps how do patients take care of the health of this pancreas?

Roland Kadaj Lipka
Unfortunately, this word pancreas here or pancreatic diseases, and this is my hubby. So patients very often when they hear the word pancreatic disease they already think it's a verdict almost like that. We don't know what the disease is yet, but it's already a verdict. It's already a problem because it's a particle. We all know that if someone has a diseased pancreas, it is already necessary to get on with the world, which is not true in the first place, because there are many diseases of the pancreas. Above all, the worst ones, such acute conditions. These are acute pancreatitis caused. Most often they are caused by alcohol consumption. You don't have to be an alcoholic at all to have acute pancreatitis. Sometimes some patients develop such conditions even after consuming one beer or the proverbial glass of wine. Therefore, it is sometimes difficult to guard against this, but we can take care of it precisely by eating less fatty foods less often. This is worth bearing in mind. Of course, there are a whole host of different other diseases that can. There could be chronic conditions or some minor cysts, or of course the worse cancers. But to everyone, don't be afraid if anything.

Roland Kadaj Lipka
We are concerned, that's when you invite me, your colleagues, it's time to consult. And perhaps this problem that we are worried about is not so serious at all. It just needs to be looked after, and the main thing to look after is diet, lifestyle, proper nutrition, physical activity. This should always be kept in mind.

Monika Rachtan
But I would also like to ask about what I think is a bit of a myth, because the doctor did not use the wording that you should follow an easy-to-digest diet when you have these problems, but nevertheless in these recommendations you often see the word easy-to-digest diet, .

Roland Kadaj Lipka
Lightweight is a bit of a phrase that we all seem to know what it is, but nobody has seen it. And it's something that's good for everyone. Everyone's eating habits are different, so if I'm talking to patients, I always try to ask what those eating habits look like. It doesn't look different for everyone. For one the norm is to eat one meal a day once to a full meal, for another the norm is not to eat at all, or some fasting, or either. Eating very often different types of food and therefore it is worth paying attention to this. And the question. An easily digestible diet with everything As I stated there is no perfect answer. It is now accepted that the Mediterranean diet is synonymous with a healthy diet, which means more frequent meals 4 5 times a day, a large amount of vegetables and fruit, and meat can also be included in this diet. They don't have to eat cold meat every day, they don't have to have red meat every day. It's worth paying attention to that too, and above all it's worth eating more often and less of it.

Roland Kadaj Lipka
Well, I think this is such a remedy of this easy-to-digest diet.

Monika Rachtan
Well, yes. Our introduction to the conversation was such a bit of education related to what to do to eat healthier, to protect yourself from disease. But I'll ask you, please take it easy.

Roland Kadaj Lipka
Let me prepare myself here in the meantime, because answering questions of divisibility is like not looking.

Monika Rachtan
OK, I am going to ask you one more question because you said about this Mediterranean diet. I think a lot of people are going to be enjoying this diet while on a wonderful holiday and I would like to ask about packing a first aid kit for the holidays. Well, of course we take plasters, we have children, that sort of thing, but the medicines are worth stocking up on and does it matter where we are going how this first aid kit should be structured?

Roland Kadaj Lipka
Of course it is. Above all, it is worth having your medicines with you. Above all, it's worth knowing where we're going, because everyone. Holidays are a bit different. Such an anecdote is my wife always checks. There's a pharmacy wherever we go, so that's kind of it. And it's more with the doctor, Not my wife, not the doctor. Whereas always check is the nearest pharmacy. But it's not pointless either, because that's when we can know what we need to take with us. Because if we are going to a civilised place, where even or abroad there are different situations, so if we have close access to health services, we do not need to take a whole bag of different kinds of medicines with us. On the other hand, if we are going somewhere further afield, it is already worth thinking about the fact that this pharmacy is not around the corner. It is as if they pay attention to this, and they always prepare for trips today. We pay a lot of attention to this. How do you prepare it? First of all, as I said, the question is where are we going? What might we face there in that situation?

Roland Kadaj Lipka
Well, of course, all kinds of diseases, infections that we can even bring from Poland, that is.

Monika Rachtan
Which ones? Diseases.

Roland Kadaj Lipka
Colds, catarrhs of various kinds, sunstroke so to speak, we need to equip ourselves first and foremost with antipyretics, anti-inflammatories, all those available, such over-the-counter, painkillers the key is worth taking care of in your pharmacy for various reasons. Bandages are basic. It is also always a good idea to have some with you so that when something happens you can deal with the situation. Above all, but it is also worth noting whether we need good insurance, for example. This is also worth mentioning. When going abroad, don't underestimate the issue of health insurance. This is a big one. A very important point that, firstly, you do not. Do I hope you know, and if you don't, I will tell you that there is such a thing as the European Health Insurance Card EHIC. We are insured within the European Union, but you have to produce such a card yourself on the internet. It is the easiest way. I did it recently, to be honest, and it took 15 minutes. I ordered the card on the website and it arrived in my mailbox. And with such a health insurance card we can be insured within the European Union.

Roland Kadaj Lipka
This is important because we can benefit from the same health care as in the country. In addition, if we are going on an organised trip or less. It is worth taking out additional insurance

Monika Rachtan
Why do this? On the one hand, we have the European Health Insurance Card, which generally guarantees us access to medical care. I am a young person, I am not likely to have any serious illnesses. I don't know what could happen to me. I might break a leg, I might start. I'll expose myself by cooking something and I'll take advantage of this care that the EHIC gives me. And what is this insurance for? An extra one yet?

Roland Kadaj Lipka
First of all, the question is where are we going? Because if we are going to a country where, as someone would come to Warsaw, then indeed healthcare is well developed. There, we can go to the ED at any time and get help there. On the other hand, if we go to a country where this public care is not of the highest standard, so to speak. It is often the case, for example, that private care is more developed even on islands or in tourist resorts. And it is worth paying attention to this when choosing insurance. For example, does this insurance cover all forms of, for example, public and private healthcare? Pay attention to this, with this availability. The second point is not to waste time on holiday, as this is also an important aspect. Why not? Often, if the problems are not too serious, something happens to us, we restore ourselves or we get treatment, that is not usually the reason why we would have to interrupt this holiday. So it seems to me that it's worth it then to have this private care, so that we don't waste time with young children. These are all such purely human problems, so it's worth paying attention.

Roland Kadaj Lipka
Another important thing which I always ask about when taking out an insurance policy is whether transport to Poland is possible, if something happens to us and we can't get back on a scheduled flight, it doesn't have to be that serious, but it's enough if we get our leg in a place where we can't bend it, because we twist it. Suddenly we find that we are unable to get on the plane. And then with that In this situation, medical transport is required. So it is worthwhile that our insurance also covers medical transport to Poland, that we will not often use. Of course, the extent of this will always be ultimately decided by our insurer, but in situations where we can't actually get on a plane, it can save our lives, our wallets, because it's not colossally expensive. It costs a lot of money and it's worth thinking about. And as far as the insurance premium is concerned, it doesn't particularly increase it.

Monika Rachtan
That this is an issue I think is also important, because when we have chronic illnesses, we think we are looked after in Poland, we are looked after. Our doctor writes us a prescription, tells us, for example, in a gastroendocrine disease, what medication we can take. But it's also often the case that when we go on holiday, these attacks or situations that we don't expect may occur in the course of this chronic disease, we're in a new place, different surroundings, different factors that we haven't come into contact with before, and some problems may also arise. And we may need this specialist care, i.e. not just an ordinary ED, but a doctor, a specialist, such as a Gastroenterologist.

Roland Kadaj Lipka
Firstly, there are several aspects. Yes, First of all, we can run out of medicines, they can get lost in our luggage. Exactly, these are things like that, So I also often write certificates for patients, for example, that they can take medicines abroad and what they are for, and I usually take them in English. It's just so that patients are protected, just in case, that they can safely transport a medicine across borders. Patients with diabetes require insulin, which often has to be stored under very specific conditions. Yes, in a fridge, these conditions are not always the same, so it can happen that for some reason, for example, we need to take medication abroad to get it, to buy it back. So it's worth having this specialist care available as well. So, too, remember to take your medical records with you as much as possible. If you have a chronic illness, it is worth asking your doctor for a certificate. If you are taking such and such medication, because if you come in and just say so, or ask for some medication, you may not get this help either, so it's as if you expect it.

Roland Kadaj Lipka
So let's remember to cover all possible eventualities in order to make this holiday as enjoyable as possible for us in front of everyone, so that we don't have to have any unpleasant situations.

Monika Rachtan
We, as well as trying to impart knowledge to you, are also trying to cook something. So I prefer to move the doctor a little bit, because I.

Roland Kadaj Lipka
I am already finishing here, so.

Monika Rachtan
Burner, so I wouldn't want to.

Roland Kadaj Lipka
Let's swap places quickly.

Monika Rachtan
Get the doctor dirty. Well, yes, these medicines and all that seems so quite important that we don't think about it. With this luggage, after all, it's such a simple matter. And where does the doctor hide it?

Roland Kadaj Lipka
Varies, some usually in hand luggage. Nevertheless, because I travel with children, I always have them in my hand luggage, while I often put some of them simply in my checked luggage. But if such things can be purchased at any time, it is usually not a problem.

Monika Rachtan
Okay, okay, I thought about one more thing, which is so important, because the doctor said that it all depends on where we are going. I thought that sometimes it could be that after all, we're going on a trip where we're going to be exposed one hundred percent to some different environmental factors that could, for example, trigger an allergy in us. We might come into contact with something, something we've never come into contact with before, and this allergy could arise. Is it worth thinking in this direction too?

Roland Kadaj Lipka
Of course it is. Above all, in my opinion, not either. It is not worth doing on your own, because it is, in my opinion, illusory. I know that we are all doctors, and particularly at family events of all kinds, the subject of health is always on the agenda. However, in my opinion, if we have any doubts, we should first of all ask our GP. He or she may be able to prescribe us some medication just in case we get an allergic situation or some traveler's diarrhoea.

Monika Rachtan
A primary care doctor. I apologise for going into the word as the kind of doctor who can offer us very little, and it turns out that this primary care doctor, even in the case of such journeys, well this is a terribly valuable doctor who can give you such a prescription and you will feel safe during this journey.

Roland Kadaj Lipka
The GP, in my opinion, is probably the most important doctor when it comes to health care, because first of all, as the name suggests, he is a GP. They are really very good Specialists who have a very broad knowledge and they should take care of us first and foremost. Even if we have a chronic disease, of course we go to these specialist clinics. I also see patients at the specialist clinic, but first of all, the availability of these appointments, I realise this myself, is not as optimal as we would like it to be, and I often give some recommendations and react when something very critical happens. However, if a patient feels well and requires any kind of monitoring or supervision, it is the GPs who do the monitoring, so let us not underestimate their role. It seems to me that this is a very important aspect, and, above all, in such everyday situations, when we want to go somewhere, to travel, it is worth taking advantage of such help.

Monika Rachtan
Well, I think that attention in primary care is a very important specialist, and it is also a doctor who is close to the family, who should know the family, usually knows the family, also takes care of other family members, so it is also easier for him to carry out this treatment and also from these other family members can learn something. So I think that is valuable. Sorry, I'm going to go with the pan here on the issue of using this doctor and not just thinking of him in terms of prescribing, duplicating prescriptions from specialists.

Roland Kadaj Lipka
Of course, of course it is. I think it is worthwhile, in order to get it right, not to underestimate this role, first of all, to turn to this doctor in any such problems, too. Exactly when, what to take, how to prepare for a trip? It is worth paying attention to this.

Monika Rachtan
All right, and I'll also ask you about this preparation of the aid, because earlier we also talked a little bit about what topic we were going to cover. And you were talking about the fact that traveller's diarrhoea is such a significant problem, and what can be done about it? Is there any way to be specially prepared so that this holiday is nice and pleasant and that it doesn't appear? Or is it worth combating quickly when it does appear?

Roland Kadaj Lipka
First of all, the first question is what is travellers' diarrhoea? Well, whether we call it the Pharaoh's Curse or the Monte Zuma Curse, or some other region-specific term. Be that as it may, it is usually contact with foreign intestinal problems.

Monika Rachtan
That is, we are entering a new environment.

Roland Kadaj Lipka
We walk a new environment, we drink water that has a different bacterial composition in it than what we drink every day. Is there a food that is different? It just is, and it's often our body's defensive response and that this diarrhoea occurs, the feeling comes up. So it's worth knowing that, where are we going? This is also something that, as we mentioned, the GP may be able to remedy beforehand. We can some diastolic medicines with us, drink a lot of water, know that when we are somewhere and such a situation may arise, so that we have a supply of water. Above all, what is worst or diarrhoea is not the diarrhoea itself, even though it is not very pleasant. Instead, it is the dehydration and electrolyte disturbance. That is to say, it is worth buying electrolytes from the pharmacy, having them with you that are soluble in water. When we are somewhere we should have a supply of water with us to replenish the water deficiency in a difficult situation. I also rather recommend to avoid constipating medicines, that is such medicines, which are to stop diarrhoea in a given moment for the reason that, paradoxically, we do not know what is the matter with us, because, yes, it may be contact only with foreign, such intestinal flora, as it should be said, but often it may be some pathogen, which, however, is pathogenic and at the moment when there is diarrhoea to be excreted by the organism in connection with this.

Roland Kadaj Lipka
By using drugs that inhibit this diarrhoea, we can paradoxically do ourselves more harm. So it is more likely that the constipating drugs are used when you need to get to a doctor's surgery or get home by plane, and most often these acute symptoms pass quite quickly. If there is no serious cause, they pass within a few hours of the day. Usually we are already feeling better by then and replenish fluids, while acute symptoms are more frequent and then often pass.

Monika Rachtan
OK, I'm going to ask about one more like this. Here we are talking about how to pack for the doctor and so on and so forth. You get very nervous when a patient comes to see your doctor and already has a recipe for what your doctor should do.

Roland Kadaj Lipka
Because this is a difficult question. Well unfortunately we live in the age of Dr Googling and Wikipedia nurse. That's unfortunately the way we live in this day and age and it seems to me that each of us first and foremost if we have any kind of ailment the first thing we do is google and write what's in there, what's with the diarrhoea and so on. Unfortunately, this advice is often wrong, so I encourage people to approach this with a lot of criticism. However, to be aware that this advice may not always be right. If we have any doubts, we should first of all consult a doctor, even a pharmacist. In a pharmacy, this is often already very much the case. Of course he encounters this on a daily basis. Patients also come to him and ask what they are eating, what for diarrhoea, what for vomiting, what for something else, what for a cold. So that's always some form of contact too.

Monika Rachtan
OK, valuable tip. We also get it.

Roland Kadaj Lipka
Of course it is. Unfortunately it is. Sorry, I have to look in the oven. I'm going to take out my baking tray because I wanted to bake bread.

Monika Rachtan
It's good, and I think it's about to land in the oven too. Right? Because he's marinating in there.

Roland Kadaj Lipka
Yes we'll get to that in a moment. First, I'd like to brown the bread a little bit.

Monika Rachtan
I'll tell the story.

Roland Kadaj Lipka
To make such croutons.

Monika Rachtan
About my asparagus, which is already in the pan and can be on the grill at your place. We fry them lightly in butter, but you don't really need to use any of that butter. You can, for example, simply douse these asparagus in olive oil and sprinkle them with salt and pepper and they will really be very tasty. I still cut them up after frying and throw them into a salad. Salads are I already have cherry tomatoes, I have pine nuts, I have spinach leaves and I have my beloved feta cheese. Plus salt, pepper, balsamic vinegar And it's really a very nice dish, It's also so filling because of the fact that we have cheese and asparagus in there, and I highly, highly recommend it. Doctor, how's your work going there?

Roland Kadaj Lipka
I'm slowly trying on making a sauce for the chicken. i can manage on the side of this situation, so we have to fit in somehow.

Monika Rachtan
Right.

Roland Kadaj Lipka
Just turn down the gas and it's perfect. It's based on coconut milk, peanut butter, soy sauce and I think it will.

Monika Rachtan
All right, but let me also ask you about the most common disease that the gastroendorologist treats. What is it that patients most often come to your practice with?

Roland Kadaj Lipka
Mostly with such.

Monika Rachtan


Roland Kadaj Lipka
Daily legal problems. Most often bloating, gas, abdominal pain, abnormal bowel movements These are the most common problems.

Monika Rachtan
Disturbance of bowel rhythm please explain.

Roland Kadaj Lipka
In the sense that something has changed in rate and quantity. As a rule, each of us has been digesting more or less similarly all our lives, so if we have 2 bowel movements a day then that is the norm, 3 a day is borderline, but sometimes once every two days is also the norm. On the other hand, if something has changed, we are suddenly concerned in some way. Also, patients come in frequently, so that's kind of another aspect. Another thing is heartburn, heartburn, burning, chest pain. These are the kind of situations that often require consultation with that patients go through. But probably the most important symptom that patients come to us with today is bloating. A lot of patients come to us, particularly women, but not only men. Where do you come to us, doctor, because I can't do it anymore, because I wake up in the morning and I have a completely flat stomach. It's great, and in the evening it's like I'm pregnant. The ladies often say that other people, seats on the bus and it's a very big discomfort for these people And it's often the case that they live with it for years, and it turns out that we can deal with it.

Monika Rachtan
So I think this is most often the cause of such bloating.

Roland Kadaj Lipka
Most often these are disorders of the intestinal problem, because it is often the case that patients first try, with Google of course alone. I started talking here, but I'll explain everything to you in a moment, because this is a very broad and very complicated problem. For all intents and purposes, as patients start to say, they often look for help themselves. We often spend years looking for diets that suit us. It is often the case that these diets go wrong. We restrict a great deal of food in our diet or nutrients, and often in a completely unnecessary way, because it is very often the case that these problems are due to a disturbance of the intestinal microbiome problem, i.e. a disturbance in the composition and amount of bacteria in our, in our intestines. And this is what we can deal with most often.

Monika Rachtan
Yes, I'm sorry, but I'm going to get into the word again and ask if it's the case that this microbiome of ours changes as we get older, so that, for example, today I can eat a lot of things and there let them do, it looks a certain way and nothing is, and it might happen, so in my life it will happen and there it will change and the milk, which was ok for me yesterday, might already be a challenge today.

Roland Kadaj Lipka
More often than not, these are not changes that are overnight. It's also worth pointing out that these are not changes that are overnight. And I'll take the liberty of putting out the burner for you maybe.

Monika Rachtan
Thank you very much.

Roland Kadaj Lipka
Okay, these are not changes. As I started to say these are not changes, they progress from day to day. These are often issues that are years in the making and they often are. We change the environment, we start living in a different place, we move, we get married. Because it is often the case that people who live in the same household have a similar intestinal problem. We reassure ourselves of this, well necessarily, because it's like we're living.

Monika Rachtan
This is the truth.

Roland Kadaj Lipka
So it's situations like that, the stresses that maybe affect it, or the people we work with, saying not these factors, all the environmental factors.

Monika Rachtan
Stress, the people we work with, ie.

Roland Kadaj Lipka
Stress, work, stress? That is what I meant. On the other hand, you have to pay attention to this, because unfortunately these are the kind of factors that intensify the discomfort and intensify the feeling.

Monika Rachtan
I'm going to ask you about one more thing that I read on a forum recently, because there's a lot of questions that come up in the podcast here, too, on a partisan forum. And it was this forum that was about people with hypothyroidism and there was a young girl who posted pictures of herself, showed her belly and just wrote that people were congratulating her on the fact that she was pregnant and she wrote that she wasn't just having these pictures and there someone wrote to her about gluten, belly. And there's something in general, because that's what the doctor was saying about these diets and all that, that we just kind of put things together ourselves sometimes, we don't necessarily consult the doctor. And I wanted to ask how it, what does it look like? Is it just that gluten can be the cause of such. Does it have to be definitively given up then?

Roland Kadaj Lipka
And yes and no. It depends. That is the best answer. The answer to all kinds of questions It depends. Because, as I said before, it is very often the case that patients try to diagnose themselves. That or they read the internet. I have Hashimoto's, it's definitely necessary to take gluten out of the diet. But it's not really. No, you don't, you don't need to. We don't do these things. We don't do it on our own because it might actually be the case that the person has celiac disease. Then you actually have to eliminate that gluten from the diet. On the other hand, let's do a diagnosis first. You need to see a specialist to have tests done in this direction. And unfortunately, this is a bit of a nightmare. There are tests, tests that are very simple, because there are actually two or three blood tests that can be done to determine this.

Monika Rachtan
I immediately ask what patients are asking, because it is important I go through, I would already like to know if I can do it on the National Health Service.

Roland Kadaj Lipka
Only in the context of specialist advice, of course, most often yes. Here, as far as GP advice is concerned, I am afraid not. However, I am not sure about this, I would have to check and I do not want to mislead someone.

Monika Rachtan
In the comments for you, so that you too know how to deal with such a situation.

Roland Kadaj Lipka
On the other hand, these are primarily blood tests and it is not at all necessary to do a gastroscopy straight away, which is the key point, because it is often the case that patients want to diagnose celiac disease first, with a gastroscopy. This is no longer the case. The first order of blood test, because there is no according to the guidelines, according to the diagnostic standards and there is no yak without an elevated transglutaminase IGA Unless these are special cases, but I think that was also too much and too detailed to talk about now. But as I said in the introduction I will just finish the thought. We don't eliminate gluten ourselves from the diet for the reason that, first of all, it can be completely different, and secondly, we make it more difficult for ourselves to make a diagnosis, because in order to make a diagnosis for celiac disease in a good way later on, this person may have it in the first place. Unfortunately, you have to do what's called a gluten provocation, which is simply to put that gluten back into the diet, and often there's no consent from the patients. Yes, they are afraid because they are starting to get better for various reasons, yes? In general, it's an interesting topic too, because all kinds of elimination diets, I'm a bit of a specific one.

Roland Kadaj Lipka
Well, I don't like these elimination diets for the reason that the question is what is the reason for the diet, if it's worldly, someone doesn't want to eat something, go ahead, they don't have to, it's ok. You just have to be consistent as it were. I have no problem with that. On the other hand, if it is caused by some kind of ailment, then unfortunately initiation diets often don't solve it, but only cause patients to eat less and less or poorer. This is because patients come in and say that they only eat potatoes, also they are not able to eat anything else. And it turns out to be a completely different problem, because, for example, what we started talking about. But when it comes to flatulence, a very common cause of this is suspicion or some kind of flatulence, abdominal pain, abnormal rhythm, bowel movements we were talking about earlier are the syndrome of bacterial proliferation of the small intestine, i.e. a situation when our intestinal problem starts to develop in an abnormal way, and above all not in the place where it should, i.e. for example bacteria from the large intestine start to emigrate to the small intestine.

Monika Rachtan
Do we have any influence on this?

Roland Kadaj Lipka
Is it influenced by race, nutrition? On the other hand, as I said, these disorders often don't develop within a moment. It is often the case that these patients have already been living with this for a longer period of time, in the sense that somewhere we have changed our lifestyle and so on. So it's not that we wake up in the morning with some kind of, some kind of ailment, It often builds up. At some point it gets to a point where it bothers us in that situation. So here we have the influence to, first of all, eat better, But not always for the best, but we can manage it and, first of all, we can then refer for specialised examinations. Often patients who forcibly google, well because we talked about if. Type sibo into Google, because that's what it's called for short, which is small intestine bacterial proliferative syndrome, you can do a so-called hydrogen breath test. Often patients already come to me with the test ready and then, of course, you can already introduce a suitable diet.

Monika Rachtan
I would still ask what it consists of and if patients can do it themselves, is it worth doing yourself and how do you go about getting it done?

Roland Kadaj Lipka
Of course, all tests should be done with a referral from a doctor. That's sort of the crowning principle, not to treat yourself. But as I say what it looks like in practice, because there is also nothing to conjure up the reality that this is not the case, well, because it is.

Monika Rachtan
Also wait to see the doctor.

Roland Kadaj Lipka
Of course it does.

Monika Rachtan
He does himself before. Because he cares about time.

Roland Kadaj Lipka
Yes, of course they do. So it's as if patients often self-diagnose, or they hear somewhere already, or they get a referral from their GP for example... But it's such a simple test for me, because it's a 3-hour test mostly measuring hydrogen in the exhaled air, which drills down the concentration of that hydrogen in the gut.

Monika Rachtan
Are we blowing some kind of balloon?

Roland Kadaj Lipka
It is such a special device that measures this level. We need to be fasting for the right amount of time, not taking probiotics or antibiotics beforehand. This is also important for the measurement to be as correct as possible. What is more, the test lasts three hours, which means that we drink a special sugar solution, usually lactose or glucose, during this time. And as a result of these subsequent measurements, the concentration of hydrogen in the exhaled air is measured and we are able to estimate more whether there is in fact an overproduction of hydrogen in the person over time after the consumption of sugar, which is broken down by intestinal bacteria in the gut.

Monika Rachtan
Before asking what does this diagnosis give the patient? First of all, how does it change the patient's life? Its fasting treatment is introduced. When such a diagnosis is made, I would ask what does fasting mean? Because it appears that not everyone knows.

Roland Kadaj Lipka
Fasting, in the simplest terms, no food, no drink. That is, if the patient on the day of the examination mostly. Unless there are some study-specific recommendations not to eat or to eat for longer or shorter periods, then you should. Fasting, on the other hand, is primarily without food, but also without drink.

Monika Rachtan
Possibly into the water too.

Roland Kadaj Lipka
Not water is acceptable. Water in the sense that if we are going for a blood draw, of course you can have two glasses of water so that it doesn't get thicker. It doesn't contaminate the blood beforehand dehydrates it. This is important, this is important, this is an important element. Well, no? Not carbonated, of course. Whereas generally it's a few hours without food, without drink. That's the way it should be. When patients come for endoscopic gastroscopy, it is without food, without drink, not after coffee, It sometimes happens that patients have not eaten, have had a coffee and, for example, come for gastroscopy. This is not how we do it.

Monika Rachtan
And then who says? Well thank you, please come back in two months.

Roland Kadaj Lipka
It depends, of course, on the possibilities, deadlines and schedule. On the other hand, it is often the case that if the patient is not significantly predominant, it is investigated because it is dangerous for the patient. In this situation, more but, for example, water can be drunk in preparation for a colonoscopy. This is also important. Moreover, it is also often the case that to ask the doctor or secretary even who makes the appointment for the examination.

Monika Rachtan
Or let's read the card we received.

Roland Kadaj Lipka
Yes, or is the card, Where is the card? Did we get it or did we not get it? Can we get it? We should, and we didn't get it.

Monika Rachtan
Let's admonish ourselves when we sign up for research

Roland Kadaj Lipka
Yes, of course it does. How to. How do you prepare properly for the study? As a last resort, you can always look, look at the internet, but those are also very important elements. So, in the sense of preparing yourself in the right way for a colonoscopy, and this we could talk at great length and perhaps not for this section by the food. But, but these are also important elements. It is hard for this gastroscopy that it does not mean that it is enough not to eat in the morning, but, for example, blood pressure medication. Very often patients, especially the elderly, but not only, for example, do not take their medication in the morning.

Monika Rachtan
And this has to be accepted?

Roland Kadaj Lipka
You have to take the ones you need for blood pressure, because that is important. It is known that diabetes medication is maybe not necessarily so as not to cause hypoglycaemia, but if you are not sure what medication to take, just ask .

Monika Rachtan
I have just thought about the fact that it is the failure to take medication for high blood pressure that may disqualify a patient from such a procedure at all. Well, because if the doctor measures the patient's blood pressure and it's, say, 200 over a hundred and something 120, then that patient is automatically no longer a candidate for such an examination, because you have to save that patient's life and not examine them.

Roland Kadaj Lipka
First and foremost, it causes us to deal with lowering this pressure, most often, and to help with it, because these are sometimes values that are downright dangerous for patients. So I am not talking about a test, as it very often becomes, because it is impossible already on a given day, a test to get this pressure down to the right values, it often ends the day, sometimes for a longer or shorter period of time. It happens differently. I don't want to generalise, but it does vary. However, above all, it is worth taking care of yourself. I always explain to patients that this is their health, so don't be afraid to ask. The same goes for medical records, what you need and always ask. Difficult situations like this. We are not all doctors, the real kind, and we have the right to simply not know certain things.

Monika Rachtan
We moved back in time a little bit in our kitchen, but that was only because the doctor here spoke professionally. We don't cook, we're more of a hobbyist, so we wanted to catch up a bit so this episode didn't take too long either. And what's more, we're back to sibo patients.

Roland Kadaj Lipka
Because that's how we ended up talking about Sibo and everything you want, that it's very important for them to. Obtain for the reason that in a situation where they manage to investigate and actually manage to confirm that these complaints are probably related to it. This is very often what I hear in the doctor's surgery, how am I if nothing has helped yet. It still is. They haven't got the medication, but they're already happy because they know what I'm eating, what's wrong with me. Because it's often the case that these are really often long-standing problems and patients don't know what's wrong with them and it stresses them out, excludes them socially. They have problems in personal relationships. Even this situation of often young adolescents who are entering into adult first relationships and first loves. And all of a sudden the second problem bloating is whether on the first, on the first date. I think this is not the best thing, so it really manages to help these patients. Of course, that's when the specialist treatment comes in, it's a long time to talk about it, what can possibly be recommended then, but above all it's then under the guidance of a specialist.

Monika Rachtan
OK. I'm going to ask one more thing, because I often think to myself that gastroendrology patients are talked about as patients who need to be treated by a multi-specialist team. When we have a gastroendrologist, primarily a primary care physician. Today we have spoken, and in addition we also have a dietician. Maybe a dietician should appear. We would very much like a dietician to appear, but often a psychiatric consultation is needed.

Roland Kadaj Lipka
Of course they do . It is often the case that these are problems that occur, one could say collectively. They intermingle, in fact, because it is often the case that patients with diseases, disorders, in fact, because it is a treatment of various mental disorders, have problems with the gastrointestinal tract, and these very often go hand in hand. It is not the case that one results from the other, because it is often the case that if a patient with gastrointestinal problems is offered a psychiatric consultation, it is not because we think that he or she has invented the illness, but it is often the case that these complaints can be fed by various types of anxiety disorders, depressive disorders and it is often not possible to break this spiral, because one spurs the other on. A patient who has a gastrointestinal disorder, very often has an anxiety disorder, an anxiety disorder, a depressive disorder, and this in turn exacerbates the gastrointestinal complaints. So we fall into such a vicious circle.

Monika Rachtan
Well, it is precisely this phenomenon of a vicious circle. I often say that this phenomenon of a vicious circle is very common in the case of intestinal diseases, but you also spoke about this, about these relationships, about this shame, about the fact that these ailments can significantly affect the patient's quality of life. And I thought of another group of diseases, inflammatory bowel disease, because there it is sometimes the case that these patients' lives are changed so significantly by the disease in an instant. And I would also like to draw the public's attention to the fact that when, for example, we see such a patient with a stoma, it is necessary to behave culturally

Roland Kadaj Lipka
These are all sorts of problems in that not every person with inflammatory bowel disease has a stoma together. Nowadays, fortunately, we have a lot of medicines available that make it possible to avoid surgical treatment. This is worth bearing in mind. Above all, however, these are diseases. As I say, as you said, these are diseases that are often embarrassing. They are diseases that often require frequent specialist care, frequent hospital visits. Sometimes, yes, but often on such simple, ordinary things. What I wanted to say, however, is that for these patients it is sometimes more embarrassing and for everyone else. These people often lose their jobs, because often these symptoms start suddenly and require hospitalisation. Not everyone will always support. Every employer understands these problems, that with this patient is just sick and sometimes just physically they may not be able to come to work because they have diarrhoea, because they have bloody, sometimes diarrhoea, because it is exacerbated to it. It's a big problem and often patients actually suffer from it in the most normal way.

Roland Kadaj Lipka
So here it is always worth paying attention to this. Moreover, it is often the case that these toilet attendants are also so trivial, but they are there. Patients exchange maps of public toilets in order to know how they should sometimes get around. There are organisations, patients' organisations, that take care of this, such as the iotel patients' association or various awareness campaigns about these diseases. And there are actually apps that indicate where that nearest toilet is for these patients. So, and for these patients it's really very, very important in this situation and it's rather worth, it's also worth talking about for this patient who sometimes can happen like this at any time. Come to us at work, at the company. Sometimes you may even be knocked at home. He needs it suddenly, but you don't. So it's not because he can't take care of his physiological problems at home. These patients actually can often have this problem. So this is worth talking about. And often such a crowning achievement in this is that surgical treatment and actually less frequently, because it is less frequent, but it happens that patients end up with stomas.

Roland Kadaj Lipka
It's not a judgment for these patients either, because they are doing great. Very many people even I would say from our surroundings have a stoma and themselves. I don't even have one and other people don't even know they have one. It is possible to live, it is possible to live normally. There are patients. He has one patient who started when he just started having the condition. He is well enough to have started skydiving, mountain climbing. It has started. It became an equine. What then? Yes, absolutely, that it does. On the other hand, it is actually the case that these patients often require some kind of extra cooperation. How else does one become accustomed to these sights? Yes, it's not all it's possible to do, it's only possible to offer, so as not to be ashamed. And also, no, it doesn't do that social ostracism, because that's also important to be tolerant. That is such a worthwhile message in my opinion, to be tolerant.

Monika Rachtan
He talked a lot about this treatment on the internet and what is on the internet. It's not worth treating and it shouldn't be treated. Whereas I think that such a useful place is the patients' Facebook groups. And we don't go on them to get cured there, but to get support. Or it's such valuable tips, for example about that toilet map.

Roland Kadaj Lipka
Support is always good. This has its, unfortunately, like everything has its light and dark sides. Because, first of all, the Facebook group is not a substitute for the doctor, that is also an important element, and unfortunately I have the impression that it is only the patient, the groups themselves also, and I got this, let's not do that, let's not do that. Whereas I got this about, then maybe you too will be helped by this bad treatment, because it criticises the treatment of another, another patient, because someone shared on Facebook, so I warn against such things. That's the dark side. On the other hand, first of all, it's a support group. Also, I'm not alone with the problem that it's not just me suffering from pancreatic disease, liver disease, intestinal disease and so on. You can often get advice, maybe not strictly medical advice, but advice for everyday life. Yes just about the availability of toilets and yes how do they deal with certain issues, often intimate ones? Sometimes it is the case that patients are ashamed to ask the doctor about something, or a young patient has come in, for example, and to see the doctor. This is not always a comfortable situation.

Roland Kadaj Lipka
It's known, these are human things and they just won't ask about something during the visit, well because it wasn't appropriate and so on. And then they go onto the Facebook group. Let's take advantage of that. Everything is for people, but it's always with a light touch. So that we know what we want to get there and don't replace that with specialist advice.

Monika Rachtan
Okay, then I will ask one more thing. And I didn't say I was going to ask this so it's going to be a surprise because I don't know if you remember, but I'm sure I mentioned that a partner in our project is the Institute for Patients' Rights and Patients' Education and this institute deals with the Humanisation of Medicine and that's it. And what does the Humanisation of Medicine mean to you doctor?

Roland Kadaj Lipka
The humanisation of medicine? In my opinion, above all, such a natural approach. In the sense that the patient.

Monika Rachtan
Seeing a person's face.

Roland Kadaj Lipka
Yes, first and foremost, to see the person, also the patient is not just another number, another hour or another so-called 'Iksinski' on our visit. I often try to learn a bit from Professor Jędrzejczak when I was still at university. I remember where an eminent, in my opinion, haematologist, where he said that when, for example, you go for a round and it starts to happen that a young doctor can say here lies pancreatic cancer. No, this is not where the pancreatic cancer lies, this is where the patient lies first and foremost. And it's important to have that attitude. And I also try to pass this on to younger colleagues. In the field I work with, that they should have this approach, that is the patients, and also what the patient comes with the disease is the patient comes, not the disease comes to us. It's important that we treat the whole patient, not their test results. This is also important and, above all, to see the patient as that other person and that partner, because this is also important. The doctor-patient relationship is such an interesting statement that this relationship, relationality is very important.

Roland Kadaj Lipka
And also to return that one will read these recommendations with understanding and follow them, because this is also important, because medicines not taken do not work. This is the key point, if we do not build a good relationship with the patient, and the non-fulfilment, non-understanding will see that we see them as human beings first and foremost. This can often unfulfill recommendations even though they are, for example, brilliant. This is also important in my opinion. This is how I understand it.

Monika Rachtan
There is one more important thing I would like to mention, and that is that we will probably have to disappear again to show you at the end what we have prepared to finish the dishes. But that's what I'm thinking about, and I would also like to appeal to our viewers so that this very patient-doctor relationship is not just built unilaterally by the doctor, but that it is also built by the patient, because we often say that it is the doctor who should see the human being in the patient. But I also think that patients should see the doctor as a human being who is at work, doing his or her job, giving it, even though it is a very special profession, but it is also you who are working the services, providing the visit, and that the doctor, for example, has the right to leave, for example, has the right to make a mistake and make a typo. And that in such a situation, however, it is necessary to behave culturally and with understanding. And that situations like. These are just great. They do not improve the relationship at the level of the doctor patient and certainly the doctor works and the patient does not gain.

Roland Kadaj Lipka
This is a very difficult subject. It seems to me, because it's like I said, it's kind of a service job. Maybe we don't like the term, the term, because, well it's kind of starting to turn us in the wrong direction as we would like it to, but actually there is such a big wishful thinking on the part of patients. It comes from all sorts of things. It seems to me that it's not necessarily out of ill will either, because it's often the case that there's simply no access to a doctor. The patient has already been kept waiting for a very long time, he more or less knows what he would like, even some sort of examination. It's just that it's already such a long wait for an appointment that the attitude is already that I've waited so long, so I won't leave here either if I don't get what I expect. These are things like that. And it's actually worth noting from the patients' side as well, that they will. We're human beings too, and physically we also have our passions, our interests, our families. We're here at work too, and after work we're like any of us.

Monika Rachtan
This is very important, very relevant in terms of the humanisation of medicine. It should be noted. The doctor is pulling his salmon out of the oven, so I may still tell you a little bit about the salad, because I don't know if I haven't modified it. Maybe a comparison of what I said at the beginning. So in mine there's grilled asparagus, there's cherry tomatoes, there's spinach leaves, there's of course salt, pepper balsamic vinegar and olive oil. And we've got I've thrown in capers and pine nuts from myself, also such a summery mix, perfect for a barbecue with such accessible ingredients. Yesterday I read on the internet that let's eat asparagus while it's around, because it's very short, and I really like it, so I hope it meets with your approval. Well, and I think the Lord Doctor is shouting me down a bit because I grilled the prawns but they got a bit burnt. Have you juiced yet with the eye of the gastro endiconologist?

Roland Kadaj Lipka
I think they are OK.

Monika Rachtan
More.

Roland Kadaj Lipka
It is ok. Well, maybe not all, but I think ok. But I think we can forgive ourselves this little bit of confusion because it comes from the fact that first and foremost we are talking as if cooking is not at the forefront, yet we are trying to give you as much knowledge as possible. I also struggle with my chicken injections so that they come up nicely and don't resemble prawns.

Monika Rachtan
I would also like to ask you one more thing, because I have made no secret of the fact that in this programme I want the questions that appear in various places on the Internet, above all from patients, to finally reach the doctors and that these questions should be asked. And it's not so much questions that, for example, I'm going to read to the doctor that Gustav and there and that something has happened and that the doctor should not have diagnosed, I'm more concerned with the kind of questions that can be clarified. So can you please encourage questions to be asked to Mr. Doctor We will meet sometime. I don't know if at a potluck or in other circumstances and will answer questions like that.

Roland Kadaj Lipka
Of course it is. I think that there are a whole series of questions that can be answered, that we are interested in, that do not always have to be dealt with medically straight away, but that these are often such life issues. I think, however, that despite everything, we have not covered all the problems that we could. Well, no, because I am not thinking, I am not thinking here, in this kitchen, until this evening, maybe even until tomorrow. On the other hand, as much as possible. Of course it is. I think there are many aspects that are very interesting. You can see that in many aspects in different people, too, that you are curious, what are you passionate about? I think it is. Sometimes that's the case as well. So I think as much as possible these medical questions, not metric of course.

Monika Rachtan
Doctor, well then, here we have managed to get drunk today.

Roland Kadaj Lipka
This is how I managed to cook mostly part on vision part out of vision. In the meantime I managed to make a bread salad with cherry tomatoes, with pistachios and goat's cheese. In the meantime, I've taken out the already baked salmon marinated in soy sauce with chilli peppers and honey, and here come these hopefully healthy chicken skewers with curry in the pan.

Monika Rachtan
And more sauce today too.

Roland Kadaj Lipka
The peanut sauce from the back was made yet is a sauce based on coconut milk and peanut butter. It's maybe not the most healthy anymore, because it's such a but, but I think as a supplement in not a small amount it won't hurt.

Monika Rachtan
And Mr Doctor, it was very nice for me to cook with you in this kitchen. I told the doctor that if I wasn't a journalist, I would probably become a cook. But you can't see that from these prawns. I really enjoy cooking. I hope that you will start the holiday and barbecue season with healthy cooking, with healthy eating. And that you will find all the advice from the doctor in today's programme useful. I wish you all the best in your travels through Poland, Europe and the world.

Roland Kadaj Lipka
Thank you very much, I was also very pleased. This is a completely new experience for me. A new entourage , even though I spend a bit of time in the kitchen with everyone in the house, but so to speak, to talk yet to cook. It's such a big divider of attention, and men are famous for dividing their attention. I hope I've managed that, it's been a pleasure. I hope I managed to pass on a lot of valuable and worthwhile information, because that was the purpose of our meeting in the first place, and above all to do some good. And I hope it will also taste good, because I tried to choose these dishes in such a way that they would be healthy. What you're talking about at the very beginning, So that they meet the criteria of healthy dishes and all tasty, so that you can say that you can cook tasty and healthy.

Monika Rachtan
Yes, yes. Well, we are about to try all these dishes. I also wish the doctor a good meal. I also wish you good food and good health. Above all.

Roland Kadaj Lipka
Thank you.

Monika Rachtan
Thank you very much.