29 Jul, 2018

Alcohol may no longer be the leading cause of liver cirrhosis in Kolkata.
Specialists dealing with the problem say the city has reached a tipping point, with more cirrhosis patients suffering from the non-alcoholic fatty liver disease (NAFLD) than the alcohol-induced variety. A combination of factors— related to lifestyle and diet — has gradually led to this scenario, say experts.

More dangerously for patients, NAFLD often remains undetected and is not entirely reversible, leading to liver cancer in around 5% of such cases. This is the most threatening form of liver disease now, more dangerous and prevalent than alcohol-triggered liver cirrhosis or acute hepatitis(Hepatitis B and C), say experts.

Triggered by an erratic lifestyle, high blood sugar, cholesterol and obesity, NAFLD remains dormant for several years, often with mild and non-specific symptoms that are ignored. Cirrhosis often sets in by the time treatment is sought, Fortis Hospitals director of digestive care Debasis Datta said. “Acute hepatitis or Hepatitis B and C are now treatable and can be prevented with vaccines but chronic hepatitis or NAFLD is not yet fully reversible. It can’t be cured but can be merely controlled. Some patients end up with liver cancer as detection happens mostly at an advanced stage. NAFLD is lifestyle-related and is responsible for more than 50% of liver cirrhosis cases in Kolkata now,” he added.

“There has been a sharp spurt in the number of patients over the past decade because of drastic lifestyle changes. Eating habits have turned unhealthy and physical activity is hardly there in our routine,” CMRI Hospital consultant hepatologist Saswata Chatterjee said.

He added: “A sedentary lifestyle coupled with over-eating results in fat deposition in the liver. With time, it results in NAFLD, particularly for those with high blood sugar, cholesterol and excess weight.”

The city was staring at an NAFLD epidemic, gastroenterologist Somnath Mukherjee said. “With growing affluence, Kolkatans are spending more on food and leisure and cutting out physical exercises, which has had a serious health impact. Along with cardiac diseases and diabetes, NAFLD is arguably the fastest growing disease in the city. With Hepatitis B and C now being treated effectively, NAFLD is the next big lifestyle disease,” said Mukherjee.

Early detection can help check the disease more effectively but that rarely happens, doctors say. “Unlike the heart, liver is hardly screened,” Datta pointed out. “It is the most neglected organ. So, by the time a patient goes to a doctor, considerable damage has been done. The best that can be done is controlling the disease by reducing weight, blood sugar and cholesterol. But a very advanced stage patient is likely to get liver cancer,” warned Datta.

NAFLD symptoms are vague and non-specific, experts agree. Fatigue, irritability, ascites or accumulation of fluid in the abdomen, blood vomit and renal impairment or infection are the more definite symptoms which show up at a later stage. ”Liver transplant is the only long-term cure but it remains inaccessible and too expensive for most,” felt Datta. A better way to combat the disease would be to alter lifestyle, gastroenterologist Abhijit Chowdhury said. “It’s surely the fastest growing lifestyle disease and, even if NAFLD does not already account for more than half the liver cirrhosis cases in Kolkata, it surely will in the next five to 10 years. We need to eat healthy and exercise regularly to prevent it,” he added.

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The Times of India