by Dr.Vijaykumar C Bada | 19 APR 2018
NON-ALCOHOLICS HAVING LIVER DISEASE ON THE RISE
KNOW FEW FACTS:
Liver is the second largest organ in the body and is a key player in our body’s digestive system. Everything we consume, including medicine, passes through the liver.
It fights infections, regulates blood sugar, removes toxins, controls cholesterol, making proteins and releases bile to help digestion. We cannot survive without the liver, it can be easily damaged if we don’t take proper care.
Symptoms of liver damage do not present themselves till very late. Diseases such as hepatitis A, B, C, Hepatocellular cancer and cirrhosis often occur because of bad lifestyle choices, excessive consumption of alcohol and drugs, continuous intake of unhealthy food over a long period of time, sedentary lifestyle and lack of exercise.
Fatty liver disease means you have extra fat in your liver.
Heavy drinking puts you at risk for it. Over time, too much alcohol leads to a buildup of fat inside your liver cells. This makes it harder for your liver to work.
But you can get fatty liver disease, even if you don’t drink a lot of alcohol.
Nonalcoholic Fatty Liver Disease (NAFLD)
Like the name says, alcohol isn’t involved in this condition. There are different types of NAFLD.
Simple fatty liver means you have fat in your liver, but you may not have any inflammation in your liver or damage to your liver cells. It usually doesn’t get worse or cause problems with your liver. Most people with NAFLD have simple fatty liver.
Non-alcoholic steatohepatitis (NASH) is another type. It’s much worse than simple fatty liver. NASH means you have inflammation in your liver. You may also have damage to your liver cells. The inflammation and liver cell damage that happen with NASH can cause serious problems such as:
Fibrosis: scarring of the liver
Cirrhosis: lots of scarring in the liver, which can lead to liver failure and death
About 20% of people with NAFLD have NASH.
For ALD, the cause is too much alcohol. You may be even more likely to get it if you drink a lot and
Have chronic viral hepatitis especially hepatitis C
NAFLD is more likely if:
You are overweight or obese
Your body doesn’t respond to insulin as it should (called insulin resistance)
You have high levels of triglycerides or “bad” (LDL) cholesterol or low levels of “good” (HDL) cholesterol
You have type 2 diabetes
You have metabolic syndrome. This is a mix of conditions that make you more likely to get type 2 diabetes and heart disease.
With metabolic syndrome you may have any three of these conditions:
Large waist size
Low levels of HDL (good) cholesterol
High Blood Pressure
High blood sugar levels
NAFLD may also be due to certain genes that make the condition more likely.
The reason why some people with NAFLD have simple fatty liver and others develop NASH isn’t known. It’s possible that genes may be a reason. You may be more likely to have NASH if you:
Have high blood pressure
Have high triglycerides or abnormal cholesterol levels
Have type 2 diabetes
Have metabolic syndrome
Currently, there is no cure for a severely diseased liver and therefore it is critical to take care of this multi-functionary organ and gland. The only way to manage a failed liver is to get a liver transplant.
NAFLD is related to insulin resistance and the metabolic syndrome and may respond to treatments originally developed for other insulin-resistant states (e.g. diabetes mellitus type 2) such as weight loss, metformin, and thiazolidinediones. Up to 80% of obese people have the disease. NASH is regarded as a major cause of cirrhosis of the liver of unknown cause. Most people have a good outcome if the condition is caught in its early stages.
Most people with NAFLD have few or no symptoms. Patients may complain of fatigue, malaise, and dull right-upper-quadrant abdominal discomfort. Mild jaundice may be noticed, although this is rare. More commonly NAFLD is diagnosed following abnormal liver function tests during routine blood tests.
A liver biopsy (tissue examination) is the only test widely accepted as definitively distinguishing NASH from other forms of liver disease and can be used to assess the severity of the inflammation and resultant fibrosis.
Non-invasive diagnostic tests have been developed, such as Fibrotest, that estimates liver fibrosis, and Steatotest, that estimates steatosis.
Treatment of NAFLD typically involves counseling to improve nutrition and consequently body weight and composition. Diet changes have shown significant histological improvement. Specifically, avoiding food containing high fructose corn syrup and trans-fats is recommended.
Gradual weight loss may improve the process in obese patients; rapid loss may worsen NAFLD. Specifically, walking or some form of aerobic exercise at least 30–45 minutes daily is recommended.
Weight-loss surgery leads to improvement and or resolution of NASH in around 80% of people.
Pediatric nonalcoholic fatty liver disease (NAFLD) was first reported in 1983. It is currently the primary form of liver disease among children.
progression toward a more advance stage of disease among children is dependent on age and presence of obesity.
Early diagnosis of NAFLD in children may help prevent the development of liver disease during adulthood] This is challenging as most children with NAFLD are asymptomatic with few showing abdominal pain.
The only treatment shown to be truly effective in childhood NAFLD is weight loss.
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