The liver is the second largest organ in our body and should be given the same importance as the brain and the heart. It is a key player in the body’s digestive system. The liver functions are very important in our body and contribute to the digestive functioning for effective metabolism. Over the past decade, there has been a steady rise in the number of cases of liver disease. World Liver Day is observed on the 19 th of April every year. At Medicircle, on the occasion of world liver day, we are speaking to eminent gastroenterologists and hepatologists to build awareness about the healthy functioning of the liver.

Dr. Priyanka Udawat is a reputed Pediatric Gastroenterologist, Pediatrician, and Gastroenterologist in Mumbai with over 13 years of experience. She has been bestowed with an appreciation for exceptional devotion in the yoga 2017 Award. She currently practices at SL Raheja and  Fortis Hospital in Mumbai. She holds membership in the Indian Academy of Pediatrics And Indian Society of Pediatric Gastroenterology Hepatology Nutrition. Dr. Priyanka is an experienced, skilled, and awarded doctor in her field of specialization. 

A healthy liver needs a regular testing

Dr.Priyanka Udawat says, “Liver screening is very important. Sometimes, there are hidden liver diseases that do show any symptoms clinically. We should always know the liver health status in spite of being totally asymptomatic. Liver health might get affected in the following cases 

Overweight or Obesity  Diabetes  Long-term medications  Stressful lifestyle  Alcoholics and smokers Family history of liver cancers or cirrhosis  Liver toxicity

Check underlying liver disease to avoid liver damage in the long run 

Dr.Priyanka explains, “There are chances where there may be no signs or symptoms related to liver disease. There may be hidden underlying liver disease. You should be aware of your family history and BMI. Now-a -days, even lean individuals are coming up with complaints of fatty liver and NASH. The liver is one of the organs very important for body functions like metabolism and detoxification. If 80 % of the liver is functioning, it will not show up any symptoms. Symptoms show up after a large part of the liver is damaged. This leads to delayed diagnosis. Liver diseases are asymptomatic initially always. 

Later at the end, when we are getting some scarring or cirrhosis, that moment you will have jaundice, abdominal distension, swelling in your legs or they may be very nonspecific symptoms like weakness, loss of appetite. So these are subtle signs. If you're having a loss of appetite, tiredness, and weakness, we should consult the doctor. We should be always precautious about our health and check  whether any kind of these risk factors are present and get screened regularly.”

Tips for healthy liver

For Fatty liver, the mainstay of treatment is your diet and lifestyle change that is a very important aspect.  Medicine cannot cure fatty liver. It's all about what we are consuming, BMI, and lifestyle factors.

Alcohol: If a person is having fatty liver, he should stop alcohol and smoking because there is an alcohol-induced fatty liver which is very common in alcoholics. So there are two varieties of liver disease:

Alcoholic liver disease   Nonalcoholic fatty liver disease.

So people who are taking alcohol should stop that or at least they should reduce their consumption because it predisposes them to fatty liver. 

Diet: Your diet is very important. So if you are an obese individual, cut on the 

Refined sugars.  Trans fats Red meats White rice Fatty heavy junk food Oily fried foods Sweets

Include -

30 minutes of brisk walk  Consume more vegetables, fruits, and whole cereals,  Sweets and fatty things should be avoided in our diet 

This will help in weight loss and thereby, reduce the fat which is accumulated in the liver This is important for people with type two diabetes mellitus which happens because of insulin resistance. 

Treatment for NASH (Non-Alcoholic Steatohepatitis)

Dr, Priyanka says, “There is a disease called NASH which is Non-Alcoholic Steatohepatitis. (NASH) leads to chronic fatty liver inflammation because of fat-induced damage to the liver cells And once there is damage to liver cells, liver inflammation sets in which results in NASH. But in this case, the main thing is diet and lifestyle change. So at least 30 minutes of brisk walk is very important even for healthy individuals to prevent and to treat the fatty liver apart from the dietary modifications and apart from abstinence from alcohol and smoking. So, you should be really careful in following their regular routine and should follow a healthy diet and workout to stay fit.”

Keep your liver healthy with these tips 

Dr, Priyanka says, “These are two main important things to make liver healthy 

Toxic elements: Remove all the toxic elements that you are consuming through certain medications either herbal or conventional. 

Lipid profile: Reduce cholesterol levels. Lipid profile should be checked regularly. Certain medications should be prescribed in case of high cholesterol and triglycerides.

Genetics: After the age of 25, you should get your sugar and blood pressure levels checked regularly if you have a genetic link to diabetes and hypertension.

Metabolic disorders: Metabolic disorders like obesity should be checked. 

You will definitely need an expert hepatologist opinion to know the cause of liver inflammation in this particular individual.”

Are supplements the answer to healthy liver?

Dr. Priyanka says, “Maintaining a healthy liver by your healthy lifestyle, diet routines, avoidance of alcohol, oily fatty fried. There is not a single supplement for the liver which can work for any person. There are many things coming up, some liver detox on Vedic things, some powders and capsules which are not required. If you're living a healthy lifestyle that is enough for a healthy liver. There are not enough scientific studies to suggest that this particular pill or supplement can reduce the fatty liver. We should not be dependent on supplements. Healthy lifestyle and diet are key for a good liver.” 

The need for a liver transplant 

Dr. Priyanka informs, “In the case of fatty liver and NASH, we should know the extent of damage and inflammation of the liver. Continuous and permanent drinking can damage the liver and make it totally stiff causing cirrhosis. Life survival can be difficult and you may need a liver transplant. So there are studies where a lot of cases who don't have major diseases, but due to long term fatty livers which are converted into NASH and finally cirrhosis need a liver transplant.

If the liver disease can be easily prevented by lifestyle and diet change instead of going for the liver transplant Also if you are not taking care of it, there is an incidence of liver cancers in these patients. 

Investigations for liver

Dr. Priyanka informs, “ Screening is must and should include the following investigations”

Liver screening methods.  Blood liver function tests  Liver enzyme levels  Level proteins in the body like albumin Ultrasound of abdomen  Fibro scan Hepatitis B and hepatitis C screening

Consult your hepatologist regularly

Dr. Priyanka informs, “ If you are having following symptoms like:

Abdominal vague abdominal pain,  Right-sided abdominal pain  Generalized weakness or Loss of appetite or loss of weight, Breathless  Weakness Swelling in legs Tremors,  Mental confusion

In these cases,  you should always think about whether you are suffering from some chronic liver disease and get yourself tested.

Childhood Obesity is alarming these days 

Dr. Priyanka says, “Childhood obesity is very much increasing because of consumption of a lot of heavy oily fatty fried food junk food.  So even in kids, we are seeing fatty liver cases even in kids which are difficult to treat. So, there should be proper education about childhood obesity and fatty liver even in school. So we can make parents aware of it and educate children. The prevalence of fatty liver in India is around 9% to 32%. It depends upon the risk factors that we have  around 30% of the population suffering from fatty liver depending upon the risk factors

Detox can be done with a healthy lifestyle

Dr. Priyanka says, “Detox means we should take care of our health. We should remind ourselves of a healthy lifestyle. Wrong diet, antibiotic exposure, alcohol intake, and sedentary lifestyle result in disturbance of gut microbiomes. So detoxing liver and gut is very important for a healthy lifestyle.”

(Edited by Dr. Rati Parwani )