Dr. Roy J. Mukkada, Senior Consultant & Head, Dept. of Gastroenterology
Fatty liver and inflammatory bowel diseases were unheard two decades ago. However, both the diseases are now widely reported in the state, particularly in Kochi. The huge increase in lifestyle related diseases such as fatty liver is contributed by a paradigm shift in the food habits and sedentary lifestyle (westernization, lack of exercises) of people.
Life style related diseases have been witnessing a sharp increase in recent times and are found mainly in teens to middle aged people. The fatty liver disease witnessed 30 per cent increase compared to the previous years.Though such cases have been increasing, majority of the people are still not aware of the risks and don’t undergo evaluation and treatment on time. Fatty liver can progress to cirrhosis and liver cancer, if not diagnosed and treated on time.
Non alcoholic fatty liver disease (NAFLD/NASH) is the commonest cause of cirrhosis in people who don’t consume alcohol. Obesity, Diabetes mellitus (uncontrolled), Dyslipidemia or Hepatitis B and C infections are some of the other cause of fatty liver. Evidences have emerged that patients with Fatty Liver or NAFLD may be at risk for development of metabolic syndrome and insulin resistance. The risk of cardiac illness is higher in patients who have fatty liver and hence regular cardiac evaluation is advisable. Treat the underlying disease properly (diabetes, dyslipidemia or hepatitis) and do regular exercises and weight reduction of at least 10 percent which will help in controlling NASH.
In difficult cases, when there is difficulty in achieving adequate weight loss after diet and physical exercise, bariatric surgery may be considered as a viable option to reduce weight which in turn will improve diabetes and improve fatty liver. Day care procedures like Endoscopic Intra gastric Balloon or Angiographic Embolization may also be done for weight reduction.
There are certain genetic diseases which cause iron and copper overload and deposition in liver which in turn can lead to cirrhosis. There is no need to worry if the ultrasound gives a report of fatty liver, we would need to correlate with other blood tests and also MR Elastography, which can detect the earliest changes of liver cirrhosis in fatty liver.
Another disease, which has increased in recent times, is irritable bowel syndrome. The disease has a direct relationship with stress which people have, among which work-related stress is the commonest. People may present with loose stools or increased frequency of motion after taking food or when they are about to go for a travel or function. It can be treated with medication and occasional counseling. But the importance is differentiating it from other major illnesses like inflammatory bowel disease or colon cancer. So they should get medical advice especially if there are alarm symptoms like weight loss or bleeding from anus, age above 50 and family history of such illness.