Amidst the backdrop of India’s burgeoning health landscape, a concerning trend is emerging: the rise of lifestyle-related diseases, particularly those affecting the liver. With unhealthy habits taking a toll, fatty liver diseases, including Non-Alcoholic Fatty Liver Disease (NAFLD) and Non-Alcoholic Steatohepatitis (NASH), are becoming alarmingly prevalent. Numerous epidemiological studies suggest that NAFLD affects around 32% of the population, highlighting the significant burden of liver disease in India. This silent epidemic underscores the urgent need for proactive public health measures to address the issue. Amplifying awareness and advocating screening are the steps to intercept the progression of the silent threats and avert the looming crisis.

Understanding the Stealthy Progression
NAFLD, characterized by excessive fat accumulation in the liver not caused by alcohol, can progress to its more severe form, NASH, which involves inflammation and damage to liver cells. Elevated co-morbid conditions, such as diabetes, obesity, and lipid levels, lead to severe fatty liver disease complications. The stealthy progression of NAFLD to NASH is a significant concern, as most patients remain unaware of the liver’s deteriorating health in the early stages and become aware during critical conditions like liver cirrhosis or liver failure.

This danger underlines the importance of regular screening, particularly for those with pre-existing conditions such as type 2 diabetes, metabolic syndrome, obesity, and dyslipidemia. Timely detection can halt disease progression with a concerted effort from healthcare providers and patients.

Navigating the Diagnostic Challenges
In healthcare, very few puzzles are as tricky as diagnosing NAFLD and NASH. This spectrum of fatty liver diseases ranges from simple steatosis to non-alcoholic steatohepatitis and further to cirrhosis and liver cancer. Unlike other illnesses that come with obvious warning signs, fatty liver diseases quietly build up until they cause serious harm. Even when symptoms arise, identifying these conditions can be difficult, especially for patients with other pre-existing conditions.

While healthcare professionals rely on standard tools, such as liver function tests and imaging studies, to diagnose liver conditions, liver biopsy remains the gold standard for effectively diagnosing fatty liver diseases. However, a pragmatic approach is required to identify patients at a high risk of liver-related complications for timely medical and healthy lifestyle interventions.

Outlining the Treatment Landscape
In the absence of definitive treatment for fatty liver diseases, ‘Prevention is better than cure’ reads true. Incorporating proactive lifestyle choices with controlling associated diseases offers hope in mitigating the impact of fatty liver diseases. Although patients adhere to treatment plans for better health outcomes, there is an urgent need for effective pharmacological interventions. Research into potential medications that target fat accumulation, inflammation, and fibrosis is ongoing and promising.

Today, healthcare professionals treat the risk factors of liver diseases with medication, as there is limited medical intervention for treatment. Saroglitazar, that is used for the treatment of type 2 diabetes mellitus, dyslipidemia, NAFLD and NASH, is approved by the Drug Controller General of India to treat fatty liver diseases. Even though medications or surgeries are recommended to restore health in severe conditions, lifestyle management will continue to remain the mainstay in treatment outcomes.

Empowering through Multidisciplinary Action
Effective management of fatty liver diseases hinges on a multidisciplinary collaborative approach that harnesses the collective expertise of healthcare providers, researchers, policymakers, and advocacy groups. Comprehensive awareness and education strategies are the cornerstones in the battle against this multifaceted disease, empowering individuals to take charge of their health and thwart disease progression.

While healthcare professionals constantly educate patients, they look for care partners for day-to-day management. Patient support programs like Livalert become care partners in a patient’s journey and empower them with information, resources, and support networks. These initiatives play a vital role in enabling patients to bridge the gap in awareness, education, and access to care.

While the Ministry of Health and Family Welfare, Government of India, advocates for public-private partnerships to be integrated with other programs to monitor and evaluate liver diseases, the healthcare industry must lead the charge and confront the silent threat of liver diseases. On Global Fatty Liver Day, let’s leverage the power to raise awareness and educate everyone to act now, screen today, and pave the way for a healthier future.

This article was first published in CNBC TV18 on 13^th June 2024.