Nonalcoholic fatty liver disease : A growing epidemic in Kerala

Dr Charles Panackel
Dr Charles Panackel

What is fatty liver?

Fatty liver is a life style disorder affecting millions of people in Kerala. It is a reversible condition wherein fat accumulate in liver cells leading to enlargement of liver, inflammation and liver cell destruction. Two common causes for fatty liver are alcohol intake and non- alcoholic fatty liver disease or NAFLD. NAFLD is a disorder of fat metabolism wherein the fat can accumulate in the liver in excessive amounts, thus resulting in a fatty liver.

NAFLD is a chronic yet silent disease, which means that most patients live with it for several years without experiencing any symptoms and are mostly unaware of their liver condition. NAFLD can progress to more serious disease stages, such as advanced fibrosis, cirrhosis, liver failure or liver cancer.

What are the risk factors?

Nonalcoholic fatty liver or NAFLD is a lifestyle disorder and is mainly seen in persons with metabolic syndrome. Components of metabolic syndrome are obesity, diabetes, hypertension, high cholesterol or triglycerides in blood. Persons with various combinations of these four diseases are at risk of developing fatty liver of NAFLD. With sedentary lifestyle and changing diet pattern’s among Keralites, obesity and diabetes have become an epidemic.

It is difficult to obtain an accurate estimate of NAFLD prevalence given the fact that NAFLD is a silent disease, and a disease that remains difficult to diagnose for the time being, But the trends are clear: non-alcoholic fatty liver disease (NAFLD) is growing to become the most common chronic liver condition in Kerala in relation to the obesity and type 2 diabetes epidemics.

Various studies have shown that Kerala is the diabetes capital of India with a prevalence of diabetes as high as 20% ─ double the national average of 8%. Obesity is also on the rise among our children with 50% of children in urban area’s being obese. Recent National health survey has shown that Kerala is becoming the capital of lifestyle diseases.

How to diagnose NAFLD?

The diagnosis of NAFLD is often made during an ultrasound examination of liver. The ultrasound examination stages NAFLD as Grade one to three. The severity of disease is accessed by help of liver function tests, fibroscan of liver and liver biopsy. All persons with risk factors for NAFLD or symptoms suggestive of NAFLD should have an ultrasound liver and liver function tests.

How to treat NAFLD?

Lifestyle modifications are the main stay of treatment of NAFLD. Always advocate for an active lifestyle . Aim to take at least ten to fifteen thousand steps a day. Avoid snacking in between meals and avoid empty calories.                                                            

Dr Charles Panackel
Consultant in Hepatology and Liver Transplantation,Aster Medcity
(The views expressed by the author are his own)

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