18 Sep Fatty Liver Disease – A burning but treatable health problems
Fatty liver Disease treatment in gurgaon
Fatty Liver Disease – A burning but treatable health problems
Fatty liver has been defined as the accumulation of fat in the liver in the absence of recent or ongoing intake of significant amount of alcohol. Fatty liver has emerged as a major liver problem worldwide both in the developed and underdeveloped country. Fatty liver is divided into alcoholic fatty liver and nonalcoholic fatty liver (NAFLD).The prevalence of NAFLD is estimated to be 15%–46% in western countries and 8%–40% in Asian countries The prevalence of fatty liver varies from 20 to 35 % across all part of India. Thus it is major health burden.
Cause of fatty liver-chronic alcoholism, obesity, hyperlipidemia, diabetes, genetic inheritance, rapid weight loss and medication.
Spectrum of NAFLD
It includes fatty liver to cirrhosis. Now one of the common cause of cirrhosis is NAFLD.
Figure no-1: Spectrum of NAFLD
Fatty liver typically has no associated symptoms. You may experience fatigue or vague abdominal discomfort. Your liver may become slightly enlarged, and your doctor can detect this during a physical exam. All patients of chronic alcoholic, Diabetes, Hyperlipidemia, Polycystic ovarian disease, Obesity, abnormal liver function test should visit gastroenterologist to diagnose fatty liver and prognostication
Patients with Fatty liver have increased the risk of liver-related morbidity and mortality, Diabetes and cardiovascular risk.Fatty liver may lead to liver fibrosis and cirrhosis after 10 to 15 yrs.So there is a window of opportunity to treat and reverse fatty liver as early as possible. So it is a time to rethink.
Figure 2: Progression of liver damage
Approach when any patient has fatty liver
Blood investigations like Lipid profile, Glycosylated hemoglobin, Fasting blood sugar, Liver function test, Thyroid function test. Noninvasive test like-Ultrasound , Fibroscan or Fibrotouch
Why fibroscan or Fibrotouch?
It is the painless, noninvasive test to estimate the degree of fatty infiltration and to assess the degree of fibrosis in the liver. A simple probe is placed on the skin in between the lower ribs on the right side of the body. The probe transmits sound waves through the skin and transient elastography data are collected to estimate the degree of stiffness of the liver. Liver stiffness correlates with the amount of fibrosis or scarring that can cause progressive liver failure. Fibrosis is staged on a scale from I (minimal) to IV (severe), beyond which end-stage scarring, or cirrhosis, sets in.It is useful in guiding doctors as to when to perform a more invasive liver biopsy. Fibroscan has the ability to survey the complete spectrum of Non-Alcoholic Fatty Liver Disease (NAFLD), from simple and benign fat infiltration to Non-Alcoholic Steatohepatitis (NASH), to full-blown liver cirrhosis. The Early fatty liver disease is reversible with dietary changes and exercise, but as fibrosis sets in, the liver disease becomes more serious and progressively irreversible. So, a monitoring device such as Fibroscan can measure response to lifestyle changes and rationally direct the need for liver biopsy when the more serious disease is present.
Fatty liver is a reversible condition that can be resolved with changed behaviors like lifestyle modification such as weight lo(fig 3 and 4) and exercise, abstinence from alcohol and treatment of risk factors such as DM, Hyperlipidemia.
Figure no 3-Lifestyle modification and weight reduction
Figure no 4 –Diet with low calorie
Fatty liver is a significant health issue in India.It is closely associated with obesity, alcoholism, Diabetes, and hyperlipidemia. Fatty liver if not treated may lead to progressive liver damage .Fatty liver is a reversible benign condition.Fibroscan can accurately stage the disease and prognosticate the severity.It is helpful for monitoring the treatment response also. Simple life style modifications improve the fatty liver and its catastrophic consequences.
Our Gastroenterologist Team that cares
Dr.Atul Sharma – Best Gastro Doctor in Gurgaon Head and Sr.conasultant Gastroenterology and Hepatology
Dr.Rajesh Padhan – Gastroenterologist in Gurgaon: Sr.consultant Gastroenterology and Hepatology
Department of Gastroenterology and Hepatology at W Pratiksha hospital is well equipped with advanced technology and facilities like: Capsule Endoscopy, Colonoscopy EUS, ERCP, Fibroscan, Manometry and Biofeedback
Cases for reference:
Case study -1
A young male come for a health check.The investigation revealed all report normal except deranged Liver function test and lipid profile.He was referred to Gastro opd .He is nonalcoholic .He was diagnosed as the Non-Alcoholic fatty liver.He was counseled about the dietary modification and physical activity. The liver function improved within 1 month.
A young female came for infertility in Gynaecology OPD.On evaluation found to have PCOD with fatty liver. She was referred to Gasto OPD.On evolution found to have metabolic syndrome and NAFLD. She was counseled about the future risk of metabolic syndrome.
Case study -3
A long-term diabetic patient came to the Diabetic clinic.He has a history of fatty liver for a long time.On further evaluation, he has found that he had already developed liver cirrhosis. He is now on the follow-up in both diabetic and Gastro OPD.
Case study -4
A chronic alcoholic patient has a history of fatty liver for a long time which he was ignored for a long time as he was asymptomatic. On further evaluation, he has found that he has already developed compensated cirrhosis with portal hypertension.He is now under follow-up.
A young girl came to our skin OPD for excessive hair in the face.On further evaluation, she has found to have PCOD, Metabolic syndrome and fatty liver