THIRUVANANTHAPURAM: Cirrhosis, previously associated with alcohol consumption, is now becoming more common among non-drinkers due to lifestyle factors. Concerned with the increase in liver diseases, the state health department has decided to set up screening centres.
The first centre is being established at the Tirur District Hospital, in Malappuram. This facility, likely the first fatty liver clinic in a district hospital in the country, is equipped for diagnosing fatty liver disease, conducting blood tests, and providing medication. It also offers personalised diet and exercise plans for patients.
According to hepatologists, non-alcoholic fatty liver disease (NAFLD), which affects over 50% of the population, is contributing to a rise in cases of cirrhosis. Women and children are among those affected. Despite high incidence, NAFLD often goes undiagnosed in its early stages.
“Cirrhosis used to be linked primarily to alcohol consumption. Our data shows that more women and non-drinkers are affected by NAFLD. The fatty liver clinics are for screening and early intervention,” said Dr Bipin K Gopal, state nodal officer for non-communicable diseases (NCDs). Similar centres will be established at district hospitals in Thiruvananthapuram and Ernakulam.
Data collection has been difficult due to restrictions on using scanning machines in communities. The new facilities will screen people who visit lifestyle-disease clinics for conditions like diabetes, hypertension, and obesity. “It is hard to diagnose fatty liver in its early stage without screening. Often, it is detected when people undergo scans for other conditions. NAFLD is a silent disease,” said Dr Murali Krishnan M, consultant gastroenterologist at Tirur district hospital. He leads the fatty liver clinic at the facility.
Nearly 5-10% of those with NAFLD develop serious conditions like cirrhosis and liver cancer. “Fatty liver in its initial stage is not considered a disease, but it increases the risk of other health problems. Lifestyle changes can prevent progression. Those with hepatitis should be monitored and receive appropriate medical care,” he said. In 2024, there were 81 confirmed and 14 suspected hepatitis A deaths in the state.
Dr Jeemon Panniyammakal, additional professor at the Achutha Menon Centre for Health Science Studies, in Sree Chitra Tirunal Institute for Medical Sciences & Technology, noted that the state has a high rate of NAFLD, based on hospital detections.
“Mild to moderate fatty liver wasn’t a concern in the past. But progression from mild to moderate to severe, which necessitates liver transplantation, is very high in our community. Sometimes it progresses faster than alcoholic fatty liver,” he said. Dr Jeemon is of the opinion that even genetic risk of getting fatty liver can be minimised through lifestyle control.
Individuals who are obese or diabetic are at higher risk of NAFLD. If untreated, the disease can lead to cirrhosis and liver cancer, possibly requiring a transplant.
Currently, 375 patients in the state are awaiting kidney transplant, of which 336 are men and 39 are women, according to K-SOTTO.