World Liver Day: Why Nonalcoholic Fatty Liver Disease (NAFLD) Is The New Epidemic We Should Worry About

The liver is the only organ that can regenerate itself by replacing old or damaged cells with new ones. However, this function is affected as the liver struggles to remove fat.As scar tissue builds up, the liver has a harder time transporting nutrients throughout the body, increasing pressure in the surrounding veins. Over time, excess fat damages liver cells, causing inflammation. But what is most concerning is the tendency to ignore fatty liver disease when it is discovered, simply because they don’t feel the effects of it. Just because there is, they consider it a daily problem and not harmful.

Why should a fatty liver diagnosis be taken seriously?

About one-third of adults in India suffer from fatty liver. That is, 3-4 out of 10 people have fatty liver.This is a warning sign and indicates that these people may develop serious liver disease in their lifetime. may increase the risk of more serious conditions, including cancerTherefore, this condition should never be ignored.

Why should I be more concerned about non-alcoholic fatty liver disease (NAFLD)?

First, understand that there are two types of fatty liver: alcoholic and non-alcoholic. Alcoholic fatty liver is caused by excessive alcohol consumption. So how do we quantify excess? This means consuming 10 or more units of alcohol per week for men and 8 or more units per week for women over the age of 8. However, nonalcoholic fatty liver disease (NAFLD) occurs for four reasons: uncontrolled diabetes, dyslipidemia or excess bad cholesterol, and obesity (overweight of 10% or more of BMI). [BMI]) and a sedentary lifestyle. Lifestyle benchmarks typically include a lack of exercise, an unbalanced diet, excessive intake of fried and processed foods, sweets, and red meat. It can even cause neurovascular disease. In fact, our diet and lifestyle are the biggest reason NAFLD is currently prevalent worldwide.

Currently, NAFLD damages the liver, and one-third of adult liver transplants in this country are due to liver failure or liver cancer caused by it. More precisely, 35% of patients undergoing liver transplantation have their underlying NAFLD and 25% of them have alcoholic fatty liver disease. In other words, 60% of patients who need liver transplantation have fatty liver. The remaining 40% of liver transplants are due to other causes such as hepatitis C, hepatitis B, metabolic disease and acute liver failure.

How can I know if I have NAFLD?

The problem is that in the early stages there are no symptoms. So if someone has diabetes, obesity, dyslipidemia, poor diet, drinks excessive alcohol and does not exercise, that person is a sitting duck with fatty liver disease. You should have the following liver tests in your normal course, and have them done at regular intervals – a liver function test (LFT), an abdominal ultrasound, and a fiber scan. or NASH (non-alcoholic steatohepatitis), because the patient begins to experience pain in the right side of the upper abdomen, loss of appetite, and fatigue. , yellowing of the eyes, jaundice, fluid accumulation in the stomach and legs, blood in vomit and stools, confusion and drowsiness (this is because liver disease affects the brain). Approximately 25% of cases of liver disease may develop liver cancer.

Can NAFLD be reversed? How long does this process take?

If fatty liver is diagnosed in its early stages, the condition can be reversed with some control, but not completely. However, if the diagnosis is delayed, meaning that the liver is already inflamed or is in the end stage of liver failure, a liver transplant will eventually be required.

Dr. Arvinder Singh Soin

What precautions should be taken to reverse NAFLD in the early stages, and is it possible for individuals to fully regain their previous level of activity?

Fatty liver can be reversed if detected in its early stages, when only fat is present and there is no inflammation or fibrosis. If so), lose weight and maintain a proper diet, i.e. avoid processed foods, use olive oil, eat plenty of fruits and vegetables, eat whole fiber, legumes, and nuts. You should also do aerobic exercise. Ideally, do about 180-240 minutes a week to stop drinking alcohol and allow fatty liver to heal. There are certain drugs that can also help control fatty liver.

How many NAFLD patients are at risk of cirrhosis?

Approximately 10-15% of patients with untreated fatty liver develop cirrhosis. Approximately 10-15% of NAFLD patients who do not control causative factors eventually develop severe liver disease. Cirrhosis means that the liver has many scars. It is caused by continuous damage (excess fat and inflammation) to the liver over many years.

Have there been any recent breakthrough research or developments in the treatment of fatty liver disease?

Yes, there are drugs out there, but none of them are silver bullets. However, some good results have been obtained with drugs such as saroglitazar.There are also newer drugs that help with weight management by reducing appetite and improving fat metabolism.

Why is NAFLD such a big problem in India?

Unfortunately, our diet is full of sweet and oily foods. Moreover, the majority of Indians lead a sedentary lifestyle, with the exception of the manual laborers and the fitness-conscious younger generation in the city. Finally, India is the diabetes capital of the world. About 30-50% of people with diabetes have fatty liver. So, these three conditions – dietary imbalance, lack of exercise, and diabetes – make NAFLD a much bigger health problem than one might think.