Sedentary lifestyle leading to rise in cases of fatty liver

Liver disease seems to have become a lifestyle disease in India with more cases of liver disorder being reported on a daily basis. While India is already one of worst affected developing countries infected by the hepatitis virus of all five kinds (hepatitis A, B, C, D and E), the increasing cases of both non-alcoholic fatty liver disease (NAFLD) and alcoholic fatty liver disease (AFLD), have further worsened the situation.

Liver specialists say over 10 lakh new patients are diagnosed every year in India with chronic liver disease and still people are not sensitised about liver diseases and ways to prevent them. They said hepatitis C is the worst type of virus, which if detected on time, can be completely curable. However, if ignored, it can lead to cancer. “One third of liver cancers in India are caused by hepatitis C. There are about 300 million hepatitis cases world over,” they added.

Experts further said as many as two lakh people have been screened in Punjab in the last five years for hepatitis C, of which 93 per cent have recovered. Besides, dedicated efforts are being taken to eliminate the disease by 2030.

Comparing the cases of hepatitis B with NAFLD and AFLD, the doctors said while cases of hepatitis B are declining in the state, the cases of fatty liver are on the rise. Though no definite statistics are available, the doctors say they have been observing at least 100 -150 new patients with NAFLD every month and nearly 100-120 cases of AFLD, with patients being across age groups.

They said while a few people have fatty liver due to other diseases such as polycystic ovary syndrome (PCOS), chronic hepatitis B, chronic hepatitis C or haemochromatosis (a genetic abnormality of iron storage), or reactions to drugs, however, NAFLD has become common and is seen in every third person in India.

Experts said NAFLD and its more severe form, non-alcoholic steatohepatitis (NASH), are due to accumulation of excess fat in the liver. But if not treated on time, it triggers inflammation, which can lead to the development of fibrosis, cirrhosis and liver cancer. Besides, there are currently no effective treatments for NAFLD and NASH, and management relies on lifestyle changes such as weight loss and exercise.

Throwing light on NAFLD and AFLD, Nawanshahr-based Dr Dinesh Verma, surgical specialist, said fatty liver condition occurs due to excessive build-up of fat which leads to scarring of liver.

“In severe cases, the scarring can lead to liver failure. Among people who drink a lot of alcohol, the condition is known as alcoholic fatty liver disease, while among those who don’t drink or take it in insignificant amounts, its metabolic dysfunction-associated fatty liver disease (MAFLD), also known as non-alcoholic fatty liver disease,” he said.

He further said prevalence of non-alcoholic fatty liver in obese children aged 5–18 years is also rising. “People sometimes think it is hereditary, but it is genetic disease. It comes quicker to those with metabolic syndrome, like patients who are overweight, diabetic, and have hypertension, heart disease, cholesterol problems, thyroid and PCOD,” he added.

Dr Verma said the only thing which would help patients with NAFLD is change in lifestyle. “If they improve their lifestyle with exercise and diet, that itself is more than enough,” he said.

Dr Amardeep Singh of Jalandhar said every third person in the district has a fatty liver. “In majority of the ultrasounds we do, even to diagnose other diseases, fatty liver is commonly found. But those having AFLD, they must understand that continued alcohol consumption can ruin their liver in more ways than one can imagine. It can damage the liver cell and leads to swelling and scarring,” he said.