Fatty Liver Diseases

Hello friends.

I am Dr. Ravinder Pal Singh. I am a gastro and a liver surgeon. And a liver specialist. My main field of interest in the clinic says gastro surgery and liver disorders. I am co-founder of Centre for Healthy Liver and Healthy Human Clinics where we are dealing with all of your gastro problems and liver problems. Today we are going to discuss a problem called a Fatty Liver Disease. The reason why I have chosen this problem is that is not only it is a very commonly occurring problem nowadays But it is often ignored and misdiagnosed misunderstood and mismanaged. If we see in initial times the liver the main burden of disease on the liver was of viral hepatitis. But now fatty liver has far outgrown all liver disorders not only in our country but even in the world at large. In various cities which have been reported from various parts of the world the prevalence of fatty liver disease in general population from 5 to 15%, it can be even higher depending upon the population we are studying and depending on the type of patients we are studying and where the study has been conducted.

It is reported in more than 30% of the patients who are obese and more than 50% of patients who are super obese and are undergoing bariatric surgery for weight loss management. Dear friends when we started our career as a liver surgeon we used to do liver transplant for either hepatitis C or hepatitis B, But now even in the West not only in the West even in India what we had initially labeled as cryptogenic liver disease is now labeled as Fatty Liver Disease and has become one of the most common causes of not only initial part of liver disease but as well as in the cirrhosis and stage liver failure. So what I mean to say by this that not only the burden of the disease is enormous but consequences are also serious and can be fatal. If it is diagnosed at the right time and managed properly you can have a very healthy and fruitful productive life.

However I have seen in my clinics not only the patient coming from Delhi but also from various other states of India as well as abroad from Middle East and other countries who have been suffering from fatty liver disease which not only they the patients themselves have ignored as well as their physicians who have once they have found that their ultrasound report of the patient has shown that the patient has fatty liver disease they often ignore or not given due diligence to the report and have not referred these patients to Liver Specialists. So these patients often come to us in grade 3 fatty liver disease or in NASH nonalcoholic steatohepatitis and many of them have now been coming and history of liver disease where they are now suffering from liver failure or cirrhosis what we call in common language and are on the verge of a liver transplant. Many of these patients have already been transplanted or have undergone a liver transplant. So because of such an enormous burden of disease, I have chosen to take this topic today. Do a survey of our general population almost 5 to 15% to upwards up to 30% of the general population can have the problem associated with fatty liver disease.

Dear friends, we are seeing a lot of patients in our clinic who now after getting a bit vigilant about this disorder is coming even in initials parts of their fatty liver problems. Fatty liver disease is divided into grade 1 grade 2 grade 3 fatty liver disease depending upon the amount of fat that is there in the liver. It is a subjective assessment made by a ultrasonologist made by their ultrasound report. After grade 3 fatty liver disease, many of the patients can also progress further to nonalcoholic steatohepatitis or what we call as NASH and that to cirrhosis or end-stage liver disease and at last may progress to liver failure needing a liver transplant. Once these patients come to our clinic we assume a very holistic approach to them. We take a very good history about diet and lifestyle which have a lot to play not only as an ideological factor or as a causative factor for this disorder but helps us to plan out the treatment as well.

These patients are often screened for as I have told before for their diabetes thyroid lipid problems as well as various other metabolic problems. Then these patients often undergo fibroscan depending upon their liver enzymes they were depending upon various other reports these patients are given their treatment or management. Now the treatment here is as there is a big misconception that once you have a fatty liver disease then you undergo some treatment once your fatty liver disease becomes ok then you can go back to the previous way that you have been living. Now in Indian scenario fatty liver disease not only in Indian scenario but as well as in other parts of the world it is a lifestyle disorder. You have to change your lifestyle. Starting your clock from now till the time you are living. You have to have a healthy lifestyle have to have a lot of fresh vegetables fresh fruits have regular exercise eat healthy live healthy do regular weight drainings. Once control your weight put a check on your sugar put a check on your salt put a check on your alcohol content put a check on your smoking.

Once you follow these lifestyle changes many of these problems can get reversed even without medicines. However, the medicines are needed for your comorbid conditions. And once the fatty liver disease goes beyond grade 2 to grade 3 or late part of grade 2 or when their fibroscan reports show a very high-fat content or fibrosis content then they need some help in pharmaceutical management or in giving them some tablet or some form of therapy or the other. Grade 1 fatty liver disease if the patient comes to us well in time can be almost reversed most of the times and the patient can have a very normal healthy lifestyle ahead. With grade 2 the chances are less reduced to almost 50%.

However, with grade 3 we have to understand only half of them to get reversed. 30% will eventually go into liver failure and will need need subsequently transplant. So dear friends this is not a simple disease this is a spectrum of disorder this should not be ignored. Reach out to your liver specialist well in time take care of your liver, take care of your life. Dear Friends, I am always available for all your liver problems. I am just a phone call away. I am always there at my clinic available to you to take care of your this liver burden comfortzone.

Thank you.