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That Liverish Feeling

Non-alcoholic Fatty liver disease is emerging as a major health concern in India
twitter-logo E Kumar Sharma   New Delhi     Print Edition: November 17, 2019
That Liverish Feeling

Liver diseases caused by excessive alcohol consumption are quite common all over the world. But a new and growing worry is the non-alcoholic fatty liver disease, or NAFLD, that has got nothing to do with drinking. This condition usually results from high build-up of fat in liver cells and is often linked to obesity and type II diabetes.

"My studies over the past decade show that fatty liver disease is emerging as a major health concern in India. In fact, one in three adults from major urban areas of relatively richer states gets affected. I have also seen this condition among adolescents and it is very worrying," says Dr V. Mohan, a specialist in diabetes care for nearly three decades and Co-founder of Dr Mohan's Diabetes Specialities Centre headquartered in Chennai. Experts in this field attribute the disease to unhealthy diet and lifestyle, lack of physical activity and specific medical conditions such as obesity and diabetes. According to Dr Mohan, at least 33 per cent of NAFLD patients are in the early stage of the disease, but eventually, they may suffer from severe health problems, including liver cancer in some cases.

"Fatty liver has emerged as a major trigger for a liver transplant, which was not the case two decades ago," says Dr K. Ravindranath, Chairman of Gleneagles Global Hospitals and a gastroenterology and laparoscopy surgeon.

"Genetically, Indians are more prone to fatty liver disease and they are increasingly falling victims to an unhealthy lifestyle," says Dr D. Nageshwar Reddy, a gastroenterologist and Chairman of Hyderabad-based Asian Institute of Gastroenterology and AIG Hospitals. "The number of patients doubled over the past few years. Now I see about 30-40 fatty liver cases every day," he adds.

"Our liver normally stores some amount of fat, but when it becomes excessive, it is described as a fatty liver condition," explains Dr Reddy. This condition also results from insulin resistance. Typically, the fat deposited in the liver goes into circulation within the body. But that does not happen if the body already has excess fat. Consequently, liver cells try to absorb the fat within them, get inflated and end up damaging the liver and causing fibrosis (formation of scar tissue). This condition may slowly progress into cirrhosis of the liver, thus causing extensive damage to the liver tissue.

New treatment: It can be difficult to cure fatty liver disease as symptoms are not there during the initial reversible stage. However, advanced technology and new medicines may soon control liver deterioration. According to Dr Reddy, some genes have been identified and research is on to understand their possible association with obesity and related disorders. For instance, the ADIPOQ gene is responsible for adiponectin, a protein hormone that controls glucose level and fatty acid breakdown. Then there are new drugs currently under trial and technology-based new treatment techniques.

Take, for example, endoscopic duodenal mucosal resurfacing, which is being used in India for about a year. This is a minimally invasive procedure to bring down insulin resistance and control fatty liver. But the best remedies are all about dietary management and a healthy lifestyle. In case you are overweight, get an annual fibroscan done. It is a simple ultrasound test which examines the liver condition and alerts you early on.

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