Jaipur, April, 2019.

Non-alcoholic fatty liver disease (NAFLD), one of the most common chronic liver problems is increasingly tightening its grip on the urban population owing to sedentary lifestyle and high-sugar diet pushing risk factors such as obesity, doctors say. With increased migration to rural to urban areas in search of livelihood, the number of affected people may rise in coming years.

“We get 150-200 patients a month and the numbers have risen by 30 per cent in past 5 years. While ideally the liver should have very little fat deposit, urban lifestyle often causes it which in turn may damage liver seriously – early-stage NAFLD does not usually cause any problem, but unless diagnosed and treated on time, it can lead to serious liver damage, including cirrhosis. Poor dietary habits, high intake of fat and less of protein become the triggering factors of NAFLD. Increasing consumption of high carb low fibre diet due to reduced intake of vegetables and fruits, coupled with low physical activity is responsible for cholesterol imbalance, and lead to health issues such as obesity that further raises the chances of fats accumulation in the liver,” says Dr. Neeraj Nagaich, Gastroenterologist, Fortis Escort Hospital, Jaipur.

NAFLD develops in four stages. The first and more prevalent is simple fatty liver (also known as steatosis) which is a harmless build-up of fat in the liver cells and may only be diagnosed during tests. In the next stage it turns into non-alcoholic steatohepatitis (NASH), a more serious form of NAFLD where the liver becomes inflamed. This may progress to fibrosis where persistent inflammation causes scar tissue around the liver and nearby blood vessels. The last and most advanced stage is cirrhosis caused by years of inflammation. At this stage, the liver shrinks and becomes scarred and lumpy. The damage is permanent and can lead to liver failure and liver cancer.

“Obesity is the prime cause for NALFD. Other factors may include diabetes, genetic inheritance, medical side effects and hyperlipidaemia. Those who are overweight, particularly with a lot of fat around your waist causing an apple-like body shape, high blood pressure, high cholesterol, metabolic syndrome combining diabetes, high blood pressure and obesity, are over the age of 50 and have a habit of smoking are at an increased risk of developing NAFLD. Though rare, even children can experience NAFLD, primarily caused by genetic reason. Early diagnosis holds the key to treatment – diagnostic tests such as liver ultrasonography, computed tomography scan, magnetic resonance imaging and controlled attenuation parameter can detect fatty liver. Among these, ultrasonography is the most commonly used method,” says Dr. Neeraj Nagaich, Consultant-Gastroenterologist, Fortis Escort Hospital, Jaipur. t

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