Liver is the largest organ of body. It fights infections, regulates blood sugar, removes toxins, controls cholesterol, making proteins and releases bile to help digestion. The problems in relation to the liver were largely unaware in the public. With time the treatment and cure has improved for the infectious disease, hence now various that of liver, kidney, heart and neurological problems are the major challenges. These diseases are chronic and over time increasing due to increased life expectancy. Heart, kidney, neurological problems till yet received the major attention where as liver related problems still not known to many. The problem in liver disease is that majority remain asymptomatic and when diagnosed majority were late stages and too difficult to improve with medication and the treatments is too costly. But the beauty is that, liver is the most tolerant organ, with problem lasting for years can lead to the chronic disease. So little awareness on the risk factor and self-care with understanding can help us to live with a healthy liver.
Time has come now to think about the Liver and related problem.
According to the latest World Health Organization (WHO) data in May 2014, liver disease deaths in India reached 2.2 lakhs per year and constitutes of 2.44% of total deaths per year. Deaths from cirrhosis have been estimated to increase and would make it as the 12th leading cause of death in 2020. Cirrhosis is not only a concern because of death, but the treatment is costly, life long and takes your major junk of life to hospital. But the beauty of this disease is that, cirrhosis takes more than 15-20 years before problem occurs and early detection and treatment can prevent this. In the coming days this problem is going to be a major challenge and by small preventive steps we can help ourselves as well as to the society.
What are the major causes for liver disease in India?
The currently no large population based studies, to exactly give the statistics. However obesity and consequent fatty liver disease increasingly common. The fatty liver is a silent killer and over long-term progress to cirrhosis and as per global data, it will be the most common cause for cirrhosis in future. The alcohol related liver disease is progressively increasing which often present as jaundice but with continued intake lead to liver failure and cirrhosis and constitute nearly 34% of cases. Followed by this the viral hepatitis due to hepatitis-B and C is another common cause. These diseases remain silent for a long time and spread from mother to baby or by blood contact and can be prevented with efficient screening majors.
Cirrhosis is the end stage of liver damage where loss of liver cells and permanent scarring of the liver occurred. Cirrhosis can cause loss of appetite, weakness, yellowing of the skin (jaundice), blood vomiting or black stool, swelling of leg and abdomen as well as confusion or coma. Often liver transplant needed with these complications of cirrhosis. The periodic outbreak of jaundice due to poor hygiene, contaminated water often occur by hepatitis –A and E, these are short lasting disease with good recovery. But early detection and prevention needed as 1-2% cases, particularly pregnant female had a very high complication and risk of death.
Hepatitis B related liver disease- a major problem of India, yet preventable!!!
It is a virus infecting liver and is the major cause for chronic liver disease, cirrhosis and liver cancer, particularly in India, Asia and other developing countries. India has more than 37 million HBV infection; about 15–25% of them are likely to suffer from cirrhosis and liver cancer and may die prematurely. Of the 2.6 Crore (26 million) infants born every year in India, approximately 10 Lakhs (1 million) run the life-time risk of developing chronic HBV infection. It’s commonly from mother to baby without any fault and is preventable by simple screening of mother as well as vaccination to newborn. Blood transfusion, surgery, tattoo, multiple sex partners and injectable drug abuse further adds the burden. There is a need for awareness, detection and public health measures to prevent disease transmission and decrease the burden of the disease.
Another virus infection i.e. Hepatitis Cis mostly blood borne i.e. by contaminated blood transfusion, surgery, needle prick, unsafe syringe and injecting drug abusers. India is estimated at between 0.5% to 1.5% of population i.e. about 1 Crore Indians. It is most infectious virus i.e. 100 times more chance infection than the HIV. Once infected in 85% cases it becomes chronic liver disease may progress to cirrhosis and liver cancer in a period of 15-20 years. The small steps by us like safe needle use, precautions during surgery and blood transfusion and screening test may prevent this. Recently available drugs make the treatment easy and effective. This is has been planned globally to be eliminated by 2030, lets join hand to make it success Obesity and Lifestyle disorder –the time bomb for the generation next!!!
The burden of obesity has been steadily increasing with an estimated 1 billion people reported as overweight, and over 300 million people as obese (WHO 2005 report). In India it has been reported to be 5-28% i.e. one of every four Indians were overweight or obese. And the problem is expected to get worse as obesity is increasing due to urbanization, economical improvement and the sedentary life style due to entrance of modern technology and Internet. Being obese more and more people reel under excess body weight, even at a relatively younger age leading to the joint disorders and knee pain, fatty liver, cirrhosis, blood pressure, diabetes, and heart disease. Obesity has also emerged as a major public health challenge, considered as a time bomb that can explode anytime. Further, obesity among children and adolescents too is rising rapidly making the younger generation at risk from early age and a long life to survive with poor quality.
Alcohol related liver problem- the habits that kills you and your family!!!
Alcohol and liver problems closely related as it affects the younger generation, in the age group of 25-50 years and mostly were from middle or lower income groups. It ruins life and destroys the happy family. The treatment is costly and the severe liver disease is usually fatal despite treatment. Once liver problem started subsequent any small dose of alcohol is like a poison. If early detected and treated the disease can be totally prevented, you can take a normal life, enjoy your family life and excel in your professional or business life. Alcohol intake and road traffic accident is a common cause of death, also crimes under influence of alcohol is embracing to you and your family or social position too. According to the report, around 30% of the total population of India consumed alcohol in the year 2010. It was also revealed that over 11% of the population in India indulged in heavy or binge drinking. This implies that the alcohol consuming population of our country loses most years of their life because of drinking and its consequences and the problem is going to be a more serious one in near future with improved income or social status. We need a strong motivation, good family support and strict laws to curb this problem and at present some states also declared alcohol free, others may follow soon.
Liver cancer-Curable when detected early, know and prevent!!!
The liver cancer has been steadily rising at an alarming rate, liver cancer was recognized as the 4th most common cancer in males and accounted for 37% of all infection-related cancers in females in India. Hepatitis B and C were the major cause, however with improved quality of life, the fatty liver related cirrhosis is also becoming a major concern. In contrast to western countries in India/Asia the liver cancer is detected late where treatment options are very limited leading to a high rate of cancer related death. This is all due to lack of annual health check up, awareness and poor sensitization among the health care providers to monitor. Lets join hand, target high-risk group, encourage regular health check up and offer treatment at early stage.
Tips for Happy Life and Healthy LiverDiet- must be balanced one, all food groups to be included but it should be less of fat and carbohydrates. Hence a balance of grains, protein, dairy products, fruits, vegetables and fibers needed.
- Include green leafy vegetables, Cabbage, Broccoli, Cauliflower, carrot, apple and walnut.
- Lot of fibers such as fresh fruits and vegetables, whole grain breads, rice and cereals needed.
- Prefercooking food in olive oil, eat garlic and use turmeric in food
- Take lemon, lime juice and green tea (coffee is also good for fatty liver)
What should I know about my diet for fatty liver?Avoid the following foods in your diet:
sFood rich in High carbohydrate food based on simple carbohydrate Like white bread, white rice, sugar, high calories fruits like banana, mango, grapes, chikoo, custard apple, vegetables like roots and tubers like yam, arbi, potato.
- Foods rich in fat: Like butter, ghee, margarine, groundnut, coconut and all fried foods etc.
- Foods high in cholesterol: Like egg yolks, red meat, shrimps, prawns, liver, cheese, and processed meats.
- Junk food: Carbonated drinks, fried food or fast food like burgers, pizzas.
- Maintain body weight
- Do regular exercise
- Never Skip a meal
- Eat small frequent meals.
- 12-15 glass water intake/day.
- 500ml oil used monthly and 15ml/day/
- Non-veg better option fish and egg white that to be limited quantity/
- Add more fiber in regular diet like green vegetable, leafy vegetable, salads, sprouts, negative calories fruits like whole apple, whole guava etc.
Exercise and healthy life style
- Daily exercise preferable aerobics (running, jugging is enough), Yoga and meditation are also good.
- Avoid over weight (weight roughly you can calculate i.e. the ideal body weight in kg should be your height in cm-100. For example a person with 5 feet 6 inches height i.e. 165 cm should have a weight of 15-100=65kg).
- Adequate sleep i.e. 6-8 hours of sleep needed, Avoid daytime sleep unless you are sick, elderly, pregnant or kid.
- Holistic approach through healthy eating, exercise and stress relieving techniques such as yoga and pranayama is also good
- Practice safe sex and use condoms.
- Regular Health Checkup- at least yearly above 35 years age is the easiest and apparently best way to detect early and take necessary steps. We all should follow and practice “prevention is better than cure”.
Prevent injury to liver
- Say NO to Alcohol, Smoking and Drugs: Alcohol, Smoking and Drugs can damage or destroy liver cells. Even don’t be target of passive smoking.
- Consult your doctor before starting any medication. Avoid Over the Counter Medicines. Only take medication that is prescribed by a physician. There could be a possibility that the over the counter medicines or an inappropriate dose can harm the liver.
- Get vaccinated. Get vaccinated against hepatitis. There are vaccines for hepatitis A and hepatitis B.
- Ensure safe injection practice-say no to second use of syringe.
- Avoid Contact with the Infected Blood -as this can result in spreading the hepatitis virus. Avoid sharing razors, razor blades, toothbrushes etc.
- If you want to get inked by some fancy tattoos or do body piercings, be sure that it is done with complete hygiene and safety.
- Avoid unhealthy, roadside vendor food and prefer clean or boiled water as much possible.
Lets spread awareness about liver infections, take positive actions to know your status by getting tested, and finally seek timely treatment to cut needless deaths from the preventable and treatable infections.A physically active life, healthy diet, remaining thin & lean, by avoiding alcohol and getting vaccinated- the small and simple steps, costs little but will reward us a lot in long run.
By Dr Ashok Kumar Choudhury