Fatty Liver – Can it be treated?

 

Fatty Liver – Can it be treated?

Yes it can be reversed!!

Fatty Liver is the most common liver disease worldwide. It affects 30% of all our population. It is already on verge of becoming number 1 cause of liver failure and hence liver transplant. With hepatitis B and hepatitis C going down, it is going to be the most common cause of primary liver cancer. With the sheer number of patients, it is going to be a great burden on healthcare.

The question that comes to our mind is, “If it is so dangerous, how can we prevent it and can it be treated?”

Gone are the days, when an ultrasound showing fatty liver was ignored equally by the patients and the doctors. With awareness of this deadly disease growing, we all are equally concerned about its management. There is a misconception that grades of fatty liver mentioned on ultrasound tells you the stage of liver disease. Ultrasound and SGPT (ALT) are not efficient to pick up early liver disease caused by fatty liver (discussed in previous blog). Everyone who gets diagnosed with fatty liver needs to be evaluated thoroughly for co morbid conditions like diabetes, hypertension, thyroid disease, sleep apnoea and cardiovascular diseases. Obesity and cholesterol need to be tackled. The stage of liver disease needs to be evaluated by elastography. Once that is done treatment can be decided. There are 5000 tonics available in market for liver support and none of them have been proven to be safe or efficacious.

If you have fatty liver, do not ignore it – consult your best doctors for liver disease

So, what you need to do for fatty liver??

1. Exercise – Most important aspect of disease management. It decreases fat and improves muscle mass. 150 minutes of exercise per week is must. It should be a combination of cardio and resistance exercise
2. Diet control – No specific diet except Mediterranean and keto diet has been shown to be effective. Intermittent fasting, although seems alright, it must prove its benefit in clinical trial. Hypocaloric diet is the one that is recommended. Starving, fasting, and cutting down specific foods completely is not a long-term solution. However, one must avoid fructose rich diet
3. Weight loss – the target of above two should be weight loss. 10% weight loss from your current weight has definite benefit for fatty liver. It is also believed to reverse fatty liver related fibrosis.
4. Pharmacotherapy (Drugs)–Do not take any drugs just for overall wellbeing. A lot of agents are being marketed for liver detoxification and liver health improvement. Studies have shown that they are not effective. Instead,it gives false sense of security preventing you from achieving lifestyle modification. There are drugs recommended by various international guidelines and are result of years of research. Vitamin E, Pioglitazone, Obeticholic acid (pending FDA approval), Saroglitazar, GLP RA, SGLT2i are just some of these. Your doctor will look at the stage of your liver disease as well as the comorbid conditions before choosing any of these agents. Kindly consult your doctor before popping any pill.
5. Obesity care –There are various endoscopic and surgical techniques available to reduce obesity which will help reverse fatty liver. If you have fatty liver disease and BMI more than 35, your doctor may suggest bariatric procedures.

Preventing fatty liver by lifestyle modification remains of paramount importance.

If you have fatty liver, do not ignore it – consult your liver specialist at the earliest!

Dr. Pathik Parikh is the Best Liver Transplant Physician in Ahmedabad.