Fatty liver disease is a rising cause of liver damage in India
Close to 1 in 5 people in India have excess fat in their liver and 1 in 10 have fatty liver diseasehealth Updated: May 19, 2017 18:33 IST
Doctors are seeing an alarming increase in the number of people suffering from fatty liver, which is a worrying trend as fatty liver could lead to liver damage and even liver cancer.
With increased obesity and metabolic diseases like diabetes, non-alcoholic fatty liver leading to hepatitis and eventually cirrhosis is an emerging problem. “We always talk about viral hepatitis, but non-viral hepatitis caused by our lifestyle will be the biggest cause of liver morbidity and mortality in the next 20 years,” said Dr Neelam Mohan, director of paediatric hepatology and liver transplant at Medanta – the medicity..
20% of the people with non-alcoholic fatty liver disease will get liver cirrhosis in 20 years, about the same proportion as among the alcoholics. Liver cirrhosis is a condition in which chronic damage to the liver causes scar tissues to replace healthy liver tissues.
“With the new vaccines and medicines, the burden of viral hepatitis will slowly reduce while the lifestyle related disease will go up,” she said.
Vaccines against hepatitis A and B have helped prevent viral hepatitis, but the numbers of deaths caused are still on the rise. In 2015, viral hepatitis caused 1.34 million deaths globally, a number comparable to deaths caused by tuberculosis and HIV.
“But while mortality from tuberculosis and HIV has been declining, deaths from hepatitis are on the increase. Viral hepatitis is now recognised as a major public health challenge that requires an urgent response. Vaccines and medicines to tackle hepatitis exist, and WHO is committed to helping ensure these tools reach all those who need them,” said Dr Margaret Chan, WHO Director-General.
What is hepatitis?
Hepatitis is a term used for inflammation of the lever. The inflammation can be cause by viral infections, excess fat on the lever or autoimmune diseases.
There are four common types of viral hepatitis – Hepatitis A and E that are caused by contaminated food and water and Hepatitis B and C that are blood-borne.
Hepatitis A and E
The food and water borne Hepatitis is common during the summers. “There is usually a rise in the number of people coming in with food or water borne hepatitis during the summers, usually because they consume unhygienic water or water. It is easy to avoid the infection by shunning food from road-side stalls and drinking filtered water. It is also advisable not to have meat that is not properly cooked,” said Dr SK Sarin, director of the Institute of Liver and Biliary Sciences (ILBS).
People with Hepatitis A come in with acute fever, abdominal pain, diarrhoea, nausea and vomiting, loss of appetite and dark coloured urine. “Patients coming in with these symptoms must get tested for Hepatitis. There are chances that they are confused with malaria or typhoid initially. In such cases, doctors might prescribe paracetamol, which get metabolized in the liver, putting additional pressure on the diseased organ,” said Dr Sarin.
Although Hepatitis A and E are self-limiting diseases that have no long-term effect on the liver, in serious cases they might cause acute liver failure.
One in thousand children and one in hundred adults can end up having to get a liver transplant after a severe bout of food borne hepatitis. “0.1 – 1% of people affected by Hepatitis A might need a liver transplant. The percentage seems little but in terms of numbers it is a lot if you look at the prevalence of the disease. In fact, hepatitis A leading to acute liver failure is one of the commonest reason for liver transplant in children,” said Dr Anupam Sibal, paediatric hepatologist at Indraprastha Apollo Hospital.
“The infection is serious in people who are obese, elderly, diabetic or already have an underlying liver condition like cirrhosis, where already a percentage of liver in not working. Hepatitis E can be bad for pregnant women,” said Dr Mohan.
Hepatitis B and C
New WHO data reveal that an estimated 325 million people worldwide are living with chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infection. The WHO Global hepatitis report, 2017 indicates that the large majority of these people lack access to life-saving testing and treatment. As a result, millions of people are at risk of a slow progression to chronic liver disease, cancer, and death.
Universal hepatitis B vaccination can reduce the burden of people living with the disease and progressing on to cirrhosis later in life. “With universal immunization we will be able to control the disease that starts showing signs 30 years later and goes into cirrhosis maybe 40 years later. Even though the burden of the disease is not during the childhood, it can be prevented using the vaccine during childhood,” said Dr Mohan.
Oral drugs are also available for Hepatitis C, which has a cure rate of 95 – 100%, she said.