Not just alcoholics, diabetics and obese too prone to liver diseases

Hindi cinema’s first true superstar Rajesh Khanna could have lived more had he abstained from alcoholism. Kaka’s excessive drinking habit caused him liver problems resulting in his untimely death. On the World Hepatitis Day, the superstar’s later year struggle to recuperate could serve as an occasion to highlight the importance of liver; especially for those who want to stick around. 

While excessive alcohol is said to traditionally result in liver diseases, it is the emergence of non alcoholic category that has come up to be a major cause of concern given the relative lack of awareness about the trend.

The Non–Alcoholic Fatty Liver Disease (NAFLD) is becoming a major factor for chronic liver disease nowadays. The prevalence of NAFLD is about 10-30 percent in the general population in India.

But, the bigger cause for concern is the seeming lack of awareness about the causes for NAFLD. Dispelling the lopsided perspective on the disease, Dr Samir R Shah, founder trustee and honorary secretary at National Liver Foundation, a non-profit organisation promoting awareness and prevention of liver diseases explained the real causes.

He warned, “People feel that only those who regularly drink alcohol get liver disease. However, over the last twenty years it has been realised that people who are obese themselves or those who are diabetic and also those who have raised level of triglycerides in blood develop fatty liver and can progress to have serious liver disease even if they have never touched alcohol.”

That diabetic and obese people are more prone to NAFLD has been reiterated by Dr Manoj Kumar Sharma, associate professor at Institute of Liver and Biliary Sciences. Expressing concern over the growth of NAFLD, he said, “Of all the diabetic patients, there is a chance of two–third of them to have fatty liver disease. Of all the obese patients, about 50-60 percent of them will have fatty liver disease. In the general population ultrasound wise about 10-30 percent will have NAFLD.”

There are five known viruses that affect the liver: Hepatitis A, B, C, D and E. Hepatitis A and E are transmitted via fecal-oral route and Hepatitis B and C are transmitted through blood transfusion, sexual route and through the re-circulation of non–sterilized medical equipments.

Among all the forms of hepatitis, Hepatitis B Virus (HBV) is a major cause of concern worldwide. Around 40 million people in India are infected with Hepatitis B. Two billion people worldwide have been infected with the hepatitis virus and about 6, 00, 000 people die every year due to the consequences of Hepatitis B according to World Health Organization. Hepatitis B virus is 100 times more infectious than HIV.

About 150 million people are chronically infected with Hepatitis C virus, and more than 350 000 people die every year from hepatitis C-related liver diseases. In India, the prevalence of Hepatitis C is less than one percent.

Explaining the background of hepatitis, Dr Ajay Kumar, senior consultant in Gastroenterology and Hepatology at Indraprastha Apollo Hospital, New Delhi said, “Hepatitis is the inflammation of the liver and there are number of causes for the same. Viral hepatitis is one important cause and another important cause is alcohol consumption.”

Incorporation of Hepatitis B vaccine in Universal Immunization Programme (UIP) was implemented in a phased manner in 2002 in 15 city slum areas and 33 districts in India.

Emphasizing on the awareness to curb this deadly disease, Dr Shah at National Liver Foundation, said, “The awareness drive should be like Pulse Polio Programme.  More and more people should get aware about the availability of the vaccine. Babies should get vaccinated so that the next generation is free of Hepatitis B.”

Highlighting the preventive measures to be adopted to put a check on the transmission of Hepatitis B, Dr Kumar at Indraprastha Apollo Hospital said, “It is necessary to indulge in safe sex practices to prevent the spread of the virus. Also safe blood transfusion and safe use of sterilized medical equipments should be adopted to put a check on the spread of the virus.”

For checking NAFLD, Dr Sharma at Institute of Liver and Biliary Sciences said, “One should try to avoid fatty and junk food.   It is extremely necessary to engage in regular exercise and physical activity to avoid fatty liver disease.”