‘Metabolic syndrome, poor dietary habits primary drivers; can be reversed in early stages; FibroScan, ultrasound, CT scan, MRI, liver biopsy tests for diagnosis’
Srinagar, Apr 20: As liver diseases continue to rise globally and across the Kashmir valley, health experts are calling for regular health check-ups and a shift toward healthier lifestyles to combat what they describe as a silent epidemic.
In an exclusive interview with the news agency – Kashmir News Observer (KNO) Correspondent, Jahangeer Ganaie, Dr Wahid Akbar, a Consultant Gastroenterologist at Amandeep and Ujala Hospital in Srinagar, spoke about the growing burden of liver diseases in the region, the alarming prevalence of fatty liver, and the urgent need for awareness and early intervention.
Here are the edited excerpts from the interview:
KNO: How many people are affected by liver diseases worldwide?
Dr Wahid Akbar: Liver diseases are a significant global health concern, causing millions of deaths each year. According to the World Health Organization (WHO), they are among the leading causes of mortality, with conditions like cirrhosis, liver cancer, and hepatitis contributing to a large number of cases. Fatty liver disease is a silent epidemic affecting children and adults, often as high as 30 per cent of the population.
KNO: What is the liver disease burden in Kashmir Valley?
Dr Wahid Akbar: Liver disease in the Kashmir valley is a major public health concern, characterised by an exceptionally high prevalence of fatty liver disease, affecting roughly 23 to 30 per cent of the population. A rising incidence of Hepatitis C and Alveolar Echinococcosis is also noted here. Metabolic syndrome and poor dietary habits are primary drivers, with fatty liver often leading to cirrhosis. A study conducted in South Kashmir revealed that out of more than 5,000 subjects screened for Hepatitis B, 2.4 per cent tested positive, highlighting the urgency of addressing this issue. With other variants such as A, C, and E, the combined prevalence of Hepatitis could be much higher. Liver disease due to alcohol contributes to 14 to 15 per cent of cases.
KNO: Can fatty liver be reversed?
Dr Wahid Akbar: Fatty liver disease can often be reversed, especially in its early stages. Making lifestyle changes such as eating a balanced diet, exercising regularly, maintaining a healthy weight, and avoiding alcohol can help reduce fat buildup in the liver. If left unmanaged, fatty liver can progress to more severe conditions like MASH, fibrosis, cirrhosis, or liver failure.
KNO: How often should I get my liver checked?
Dr Wahid Akbar: The frequency of liver health check-ups depends on factors such as lifestyle, medical history, and risk factors. People with obesity, diabetes, high alcohol intake, or a family history of liver disease should undergo regular screenings. For those at low risk, an annual liver function test is usually sufficient. Those with existing liver conditions may require more frequent monitoring based on their doctor’s advice.
KNO: What are the symptoms of an unhealthy liver?
Dr Wahid Akbar: Liver disease often develops silently, but as it progresses, symptoms may include persistent fatigue, yellowing of the skin or eyes, abdominal pain or swelling, unexplained weight loss, nausea or loss of appetite, dark urine and pale stool, and itchy skin.
KNO: Can all liver diseases be reversed?
Dr Wahid Akbar: Some liver conditions, such as fatty liver and mild fibrosis, can be reversed with lifestyle changes. However, advanced liver diseases like cirrhosis often cause permanent damage. Early diagnosis and timely intervention can help slow progression and improve liver function.
KNO: How does alcohol affect the liver?
Dr Wahid Akbar: Excessive alcohol consumption puts significant stress on the liver, leading to conditions like fatty liver, alcoholic hepatitis, fibrosis, and cirrhosis. The liver metabolises alcohol, but excessive intake can cause inflammation, scarring, and liver failure over time. Reducing or eliminating alcohol can prevent further damage and, in some cases, allow the liver to heal. Females are more prone to alcoholic liver disease as they are not able to metabolise alcohol as efficiently as males because they lack certain enzymes.
KNO: What is the burden of alcohol use disorder and alcoholic liver disease in Kashmir?
Dr Wahid Akbar: Alcohol intake has increased in Kashmir Valley, adding to the burden of liver disease, including cirrhosis. In one study, alcohol consumption was responsible for approximately 14 to 15 per cent of liver cirrhosis cases, with fatty liver being the predominant cause in Kashmir.
KNO: What tests help in diagnosing liver diseases?
Dr Wahid Akbar: Doctors may use various tests to assess liver health, including liver function tests to measure enzyme and protein levels, imaging tests like ultrasound, CT scan, or MRI to detect abnormalities, FibroScan to evaluate liver stiffness and fibrosis, liver biopsy to assess the extent of liver damage, and a hepatitis panel to check for viral infections.
KNO: When should I see a doctor for liver-related concerns?
Dr Wahid Akbar: It is important to consult a doctor if you experience persistent fatigue or weakness, yellowing of the skin or eyes, severe or unexplained abdominal pain, unexplained weight loss, dark urine and pale stools, or swelling in the legs or abdomen. Seeking medical advice early can help detect liver disease before it becomes severe.
KNO: Is liver transplantation the only treatment for severe liver disease?
Dr Wahid Akbar: Liver transplantation is considered in cases of end-stage liver disease or acute liver failure. However, many liver conditions can be managed with lifestyle changes, medications, and other non-surgical treatments. Early diagnosis and proper medical care can prevent the need for a transplant in many cases, or postpone a liver transplant for some time.
KNO: Any final message?
Dr Wahid Akbar: The liver is not just an organ but a lifeline to our well-being. Understanding its functions, recognising common disorders, and adopting liver-friendly habits helps us be proactive about our health. As advocates for our own well-being, let us take proactive steps towards liver health. Hence the theme: Solid Habits, Strong Liver. (KNO)
