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Fatty Liver – An Epidemic Brewing

Dr.Nivedita Pandey

What is fatty liver?

It is the excessive accumulation of fat in the liver. With time this fat begins to cause damage leading to a condition called Non Alcoholic Steato Hepatitis (NASH) which ultimately leads to cirrhosis.  In the early stages it is reversible but once NASH develops it more often leads to progressive liver disease.

How is fatty liver caused?

The single most important risk factor for fatty liver is obesity. Obesity is a rapidly growing global epidemic. India, with 41 million obese people, ranks third after the US and China in having the highest number of overweight people in the world. India’s women are more likely to be obese as compared to male counterparts. There were 20 million obese women in India in 2014 as compared with 9.8 million men.

Diabetes and high cholesterol are other risk factors.

Metabolic syndrome is a cluster of conditions — increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels — that occur together, increasing your risk of fatty liver.

Why is it serious?

Lack of awareness about the seriousness of this condition is a major concern. Fatty liver, if undiagnosed and untreated can not only lead to progressive liver damage but can also cause Liver cancer.

What are the symptoms of fatty liver?

Unfortunately most patients do not have any symptoms of fatty liver only. Symptoms begin to get noticed once liver disease progresses, these can include: loss of appetite, fatigue, jaundice, confusion or encephalopathy, bleeding with minor trauma.

How is it diagnosed?

It is usually diagnose on routine ultrasound. Liver functions test also need to be done to evaluate for any liver damage.

What are the grades of fatty liver?

Grade 1 fatty liver is an early stage that is usually reversible provided risk factors mentioned above are modified. As the stage of fatty liver progresses, liver damage is seen.

What is the treatment?

The corner stone of therapy is lifestyle change like dietary modification dn erxercis leading to weight loss.

Control of diabetes and high cholesterol is very important as well.

There are many drugs in the pipeline but none have been sufficiently studied to make a recommendation. Vitamin E has been shown to have some benefit.

If advanced liver disease is present transplant is a curative option.

When to see your doctor?

You must bring it to the medical attention of your doctor if you are diagnosed with fatty liver. If this is accompanied by liver test abnormalities you must see a liver specialist.

Can fatty liver be prevented?

Yes, Fatty liver is a disease of lifestyle. A holistic approach is required for prevention. Dietary change alone is not beneficial; it must be accompanied by exercise. Research shows that losing even 3-5% of the current weight can improve liver damage.

Consultant
Max Super Speciality Hospital, Saket

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