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Posted On Aug 19, 2021
Consultant - Medical Gastroenterology
Manipal Hospitals - Mangalore
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Fatty liver the new epidemic in India
It is a common myth that the fatty liver which is increasingly seen nowadays on ultrasound scans is harmless. However, the truth is that it is a progressive and life-threatening disease that can lead to serious diseases such as cirrhosis, chronic liver failure, or liver cancer and is also a marker of underlying serious systemic disease.
What is a fatty liver?
Fatty liver is a condition characterized by abnormal accumulation of fat in the liver which causes liver enlargement. The two major causes of fatty liver we encounter daily are alcoholic fatty liver and NAFLD (Nonalcoholic fatty liver disease). NAFLD is diagnosed in the absence of secondary causes of fatty liver, such as harmful alcohol use, viral hepatitis, or medications. Visit the liver hospital in Mangalore to know more about fatty liver disease.
What are the consequences of NAFLD?
NAFLD is a serious health concern that can progress, from a simple fatty liver to more advanced ones like non-alcoholic steatohepatitis (NASH), cirrhosis, and even liver cancer over time. It is a silent killer which shows no symptoms in the early stage and can remain asymptomatic for decades producing symptoms only once the liver is damaged beyond repair. NASH is known to be associated with higher incidence cardiovascular events. In fact, cardiovascular disease was the most common cause of death in NAFLD patients (38%), before non-liver cancer (19%) and cirrhosis-related complications.
What is the magnitude of the problem?
It is estimated that around 25% of the population worldwide is suffering from the disease. NAFLD which is the most common chronic liver condition in Western populations is slowly becoming the leading cause of liver disease in India and other Asian countries. NAFLD prevalence has slowly increased over time in the last two decades. However, the increase in prevalence over time is marked in Asian countries like India due to lifestyle changes. In India, the prevalence is estimated to be up to 32% in certain urban populations. The Government of India has recognized the problem of NAFLD and has integrated non-alcoholic fatty liver disease into the national NCD prevention program since February 2021.
What are the risk factors for NAFLD?
NAFLD is a modern lifestyle disease that evolves out of an unbalanced, faulty lifestyle characterized by excessive calorie intake and a sedentary lifestyle. Genetic reasons and racial differences are also known to contribute to this problem. Risk factors for NAFLD are Diabetes, obesity, high cholesterol levels, High blood pressure, glucose intolerance collectively known as metabolic syndrome. It is estimated that up to 70% of people with diabetes or Obesity have NAFLD. A unique aspect of NAFLD in India is the so-called “lean NAFLD” or “Non-obese NAFLD” seen in around 10% of the NAFLD. Here the person may be having normal body weight or can be very lean, but he develops diabetes, high cholesterol levels, and fatty liver disease due to a defect in the body energy metabolism. Here the visibly lean body habitus gives a false impression of good health and patients normally seek medical attention in the late stages of the disease.
If you or anyone you know have had the same symptoms then immediately visit a liver specialist doctor in Mangalore. The doctor will give you a proper examination and will tell you if you have fatty liver disease or not.
How do we manage NAFLD?
Fatty liver is not a benign disorder and can have lethal outcomes in some people over a long duration of time. The patients in whom fatty liver is detected should go through further tests to rule out secondary causes of fatty liver and to assess the degree of scarring and inflammation in the liver. Around 20% of liver inflammation cases have a chance of developing cirrhosis and around 5% have a chance of developing liver cancer.
There is no complete cure for the disease, however certain drugs can prevent the progression of the disease. The mainstay of treatment as of today is adapting to a healthy lifestyle. Lifestyle changes with exercise, weight loss, and a nutritious diet are important. 40 minutes of aerobic exercise such as brisk walking, cycling, jogging, or swimming should be stressed.
A balanced diet reducing carbohydrates with the moderation of amount of fat, avoiding saturated fat with adequate protein is recommended. weight loss of 7% to 10% of body weight is the goal of treatment which has been shown to improve biopsy features of NASH.
Most important is the management of blood sugar, hypertension, cholesterol levels, assessment of cardiovascular risks, and treatment of the same because the commonest cause of death in patients with NAFLD is cardiovascular events.
Among the three stages of NAFLD- fatty liver, fatty hepatitis(NASH), and cirrhosis – the first two stages are potentially reversible and have a long time interval for progress to the irreversible cirrhotic stage. However, The challenge is to bring such people with early Fatty Liver Disease to medical attention and motivate them to pursue a healthier lifestyle and appropriate medical care as the disease is asymptomatic during the early reversible stages of NAFLD.
It is important that the person with fatty liver disease should get proper treatment and diet. You can visit Manipal Hospital if you are looking for fatty liver treatment in Mangalore. They have world-renowned liver specialists working together with other specialists to give you the treatment and care you need.
Dr. Anurag Shetty
Consultant - Gastroenterology
Manipal Hospital Mangalore
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