Dr Sukrit Singh Sethi, Senior Consultant, Gastroenterology, Narayana Hospital, Gurugram, Haryana, is an expert in treating all complex GI and Liver conditions. On World Liver Day, Dr Sethi, gives a bird’s eye view of his specialty and the importance of liver care to stay disease free and healthy.
Dr Sukrit Singh Sethi
Senior Consultant Gastroenterology,
Narayana Hospital, Gurugram
Why is the liver known as the ‘Power House’ of the body?
Liver is considered the ‘Power House’ because it does many essential functions like help process nutrients from food, store and releases glucose, synthesis protein, cholesterol and bile, which is essential in digestion. The liver also detoxifies the body from drugs, alcohol and toxins, besides breaking down old red blood cells.
Which are the common liver diseases and how lethal is hepatitis to the organ?
Common liver diseases includes viral hepatitis which could be Hepatitis A and Hepatitis E, which are usually self-limiting and Hepatitis B, C and D, which are usually chronic infections of the liver. Non-alcoholic fatty liver disease is commonly seen in obese, diabetic as well as hypothyroid patients. Liver diseases also include liver cancer, known as Hepatocellular Carcinoma (HCC), genetic disorder like hemachromatosis, Wilson’s disease and also auto immune liver diseases or auto immune hepatitis. Any inflammation in the liver is known as hepatitis and when the condition becomes chronic it may lead to liver cirrhosis.
What leads to alcoholic and non-alcoholic liver diseases and the difference between the two?
Liver disease has three stages mainly fatty liver, hepatitis followed by cirrhosis or liver cancer. When a person consumes more than 40-60 gms (for men) and more than 20 gms daily (for women) alcohol daily, they are more susceptible to alcoholic liver disease. 40 gms equates to more than two drinks in a day and 20 gms measure is one drink. Liver diseases due to metabolic factors like diabetes, obesity is known as NAFLD, which follows the same sequence of stages. The possibility of liver cancer is also much higher in NAFLD than alcohol related liver disease.
What makes Narayana Hospital a hub for liver transplantation?
Narayana Hospital in Gurugram is renowned as a transplant centre where we do liver transplant regularly. End stage liver disease warrants transplant. We also do other therapies like plasma exchange on patients to reduce toxins in the liver. Endoscopic ultrasound guided biopsies and other weight loss endoscopic procedures are also done regularly such as intra gastric balloon placement along with endoscopic sleep gastroplasty, to reduce the volume of the stomach and weight. Besides, we offer comprehensive treatment for diabetes, thyroid and other liver related issues.
Why is liver disease increasingly common in the youth?
Incidence of liver disease is increasing in younger adults and even adolescents often due to rising consumption of alcohol from an early age, besides obesity and sedentary lifestyles. NAFLD is one of the most common chronic liver disease prevalent in the youth and it is because of the junk food diets that develops insulin resistance in childhood and leads to obesity. In some regions, viral hepatitis is endemic because of mother to child transmission and lack of vaccination.
How do you recognise symptoms of liver disease?
Early symptoms of liver disease include fatigue, upper abdominal discomfort, loss of appetite, weight loss, dark urine, yellow discolouration of the eyes, swelling in the abdomen or feet, itching in the skin and sometimes the patients can also present with Gastrointestinal bleed where they vomit blood or there is blood in stools. One should ensure regular investigation with LFTs and ultrasound abdomen and those excessively obese should undergo weight management therapy including an endocrinological evaluation, and follow a strict exercise regimen. Those with family history of liver disease should be screened more often.
What is your message for prevention and curbing of liver diseases?
Prevention of liver disease can be done by carrying out regular screening with Liver Function Tests (LFT), ultrasound of the abdomen and fibro scan, and obese patient should be counselled for weight loss. Those who consume moderate or increased alcohol should also undergo regular testing.
De-addiction counselling and support groups may help.
The silver lining is that, fatty liver is reversible with intervention in the form of exercise, diet or calorie restriction and certain supplements and one sees marked reduction in liver fat content. If you are overweight or morbidly obese, one should undergo endoscopic or bariatric procedures for weight loss, which helps prevent liver disease in the long run.
