KOCHI: A paradigm shift in food habit and sedentary lifestyle (westernisation and lack of exercises) has resulted in the increase in lifestyle diseases such as Fatty Liver and inflammatory bowel diseases. The lifestyle diseases are now widely reported in the state, especially in Kochi.
The lifestyle diseases are found mainly in teens and middle aged people. Fatty Liver alone has witnessed 30 per cent increase compared to previous years. Despite increase in such diseases, majority of the people are still not aware of the risks and don’t undergo treatment on time. Fatty liver can progress into cirrhosis and Liver cancer, if not diagnosed and treated on time.
Non alcoholic Fatty Liver (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 causes of fatty liver. Evidences have emerged that patients with Fatty Liver or NAFLD may be at risk of developing metabolic syndrome and insulin resistance. The risk of cardiac illness is high in patients who have fatty liver and hence regular cardiac evaluation is advisable. The underlying disease (diabetes, dyslipidemia or hepatitis) should be treated properly. NASH can be controlled by doing regular exercises and weight reduction of at least 10 per cent. 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 and in such cases correlation with other blood tests and MR Elastography, which can detect the earliest changes of liver cirrhosis in fatty liver, is needed.
Another common problem widely found is bleeding from rectum. Most people assume that they have developed piles, which may be true but it needs to be evaluated to see what exactly caused the bleeding. The patient may be having illness like inflammatory bowel diseases such as ulcerative colitis or crohn’s disease or cancer especially in those older than 50, if they have any recent bowel habit change or weight loss. They should undergo a colonoscopic evaluation before they mistakenly assume it is just piles.
In recent times another disease commonly found is irritable bowel syndrome. It has a direct relationship with stress which people have. People may have loose stools or increased frequency of motion after taking food or when they are about to travel or go to a function. It can be treated with medication and occasional counseling. 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.
— (The author is the Senior Consultant and Head, Dept. of Gastroentrology Interventional Endoscopist and Endosonologist, VPS Lakeshore)