With rise in cases of liver transplants which has set an alarming situation in the medical fraternity, Prof Anil Arora, Director, Institute of Liver Gastroenterology and Pancreatico Biliary Sciences, Sir Ganga Ram Hospital discussed the solution to prevent liver ailment, with Drug Today Medical Times’ Rohit Shishodia.
Non-communicable diseases such as diabetes, hypertension, heart diseases and cancer are often linked with liver diseases. Overweight and consumption of alcohol are also major risk factors for liver ailments. Doctors say overweight is another pandemic which is often neglected by people.
DTMT: What is the trend of liver ailments these days?
Liver diseases are increasing due to three major reasons including excessive consumption of alcohol, sedentary lifestyle, and working from home, consumption of fast food and more computer work rather than outdoor activities. Hence, all this leads to increased food intake, increased calorie intake and less exercise. This also leads to increased body weight which results in deposition in excessive fat in the liver.
So this is basically related to overweight, diabetes, hypertension, heart disease, stroke, cancer and kidney diseases. If you control the weight you will be able to control so many diseases.
DTMT: Which liver disease is increasing these days?
Non-alcohol liver diseases are increasing rapidly. Lack of exercise, fast food, spicy and oily intake, overeating are causes of non-alcohol liver diseases. There is a need for physical activities and movement of the body. If you keep sitting for hours and have unhealthy eating habits; deposition of fat starts which leads to diabetes, heart ailments, TB, stroke, cancer and kidney ailments.
It is understood that 30% to 40% of liver diseases are due to alcohol consumption. Overweight, diabetes, hepatitis B and hepatitis C are other factors which cause liver diseases. Hepatitis B is totally treatable while hepatitis C is totally curable.
DTMT: What age group is the most vulnerable to liver diseases?
If you look at the world data, most of the countries report liver diseases especially in the younger population. In fact, if you see Delhi’s data, 30% of children in public schools are overweight. In the US, 40% to 50% of the population is overweight. It is becoming a pandemic. We are more concerned about Covid at present. Covid will come and go and it also has vaccines but nobody is bothered about fatty liver diseases and the overweight problem. The fatty liver diseases are going to increase as they don’t have vaccines. Mental preparation and behavior is required to tackle it.
DTMT: What if a youngster like 20-year-old has fatty liver?
Initially it starts with simple fatty liver as fat starts depositing on the liver gradually. After 10 to 15 years, fat starts deteriorating the liver which is known as end stage liver disease or cirrhosis of the liver.
If you take precautions like controlling sugar, weight, avoiding sweets, taking a low-fat, low carbohydrates and high protein diet and performing various exercises, you can prevent cirrhosis of the liver.
But if cirrhosis occurs, then there is risk of developing complications such as diabetes, hypertension and heart diseases.
DTMT: How many patients do you see for liver transplants per day?
We see two-three patients everyday who need liver transplants. But the problem is that it is the patient who has to arrange a liver donor and expense of liver transplant.
If you compare the western world, cadaver transplantation is carried out more than living donation. In Indian setups, especially in North India, living donation is more prevalent but it has more expensive and people have to arrange donors also. 85%-95% people in India cannot afford to pay for liver transplantation and they don’t have a donor.
DTMT: What is your message to people to keep a healthy liver?
85% of liver can be saved if you are not overweight, less intake of sweets, stop taking alcohol, keep checking hepatitis B and C. Take treatment you have hepatitis B and hepatitis C. Take vaccine of hepatitis A and B if not taken. But most of the people don’t take these measures seriously. They keep increasing weight, eat sweets, don’t exercise and ignore hepatitis B and C.
It is sad to see that 95% of liver diseases which can be prevented by people themselves are ignored. In the end, these liver diseases convert to end stage liver diseases and there is no option left except liver transplantation, which is expensive and has other hurdles such as arranging donors.
DTMT: What should be an ideal diet for healthy liver?
Ice creams should be avoided. It should have fewer sweets. It should have less carbohydrates but should be protein rich.