Liver disease is emerging as a major public health concern in India, often going unnoticed until it reaches advanced stages. Despite being largely preventable and manageable in its early phases, it continues to contribute significantly to mortality and disease burden.
According to global estimates, liver diseases account for nearly two million deaths annually, and India alone contributes to about 18.3 per cent of these deaths. This makes the country one of the most affected globally, highlighting the urgent need for awareness and early intervention.
Data from the Global Burden of Disease study, as cited in a Lok Sabha reply referencing ICMR findings, further underscores the severity of the issue. In 2017, India recorded approximately 0.22 million deaths due to cirrhosis and other chronic liver diseases. Over the decades, the contribution of cirrhosis and its complications to overall mortality has steadily increased in India since 1980, unlike in countries such as China, where the trend has stabilised or declined. Chronic liver diseases (CLDs), including cirrhosis, are driven by multiple factors in the Indian context, most notably non-alcoholic fatty liver disease (NAFLD), alcohol-related liver disease, and viral hepatitis B and C, along with autoimmune conditions.
Compounding the problem is a critical lack of awareness. A recent India-based study found that nearly 94 per cent of people were unaware of fatty liver disease. Researchers also pointed to widespread misinformation, low testing rates, and significant knowledge gaps, all of which delay diagnosis and treatment. In a country where risk factors are rising rapidly, this lack of awareness can have serious consequences. Therefore, separating myths from facts is essential to improving public understanding and encouraging timely action.
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Myth 1: You have to drink a lot of alcohol to get cirrhosis.
Fact: One of the most common misconceptions is that cirrhosis is exclusively linked to heavy alcohol consumption. In reality, cirrhosis can develop even in individuals who do not consume alcohol at all. A significant contributor is MASLD, where fat accumulation in the liver leads to inflammation and scarring over time. People with conditions such as obesity, diabetes, or metabolic syndrome are particularly at risk. Even low to moderate alcohol intake can worsen liver damage in such individuals. This means that alcohol is not the sole cause, and focusing only on drinking habits can lead to missed diagnoses in non-drinkers.
Myth 2: If you don’t have symptoms, you don’t have liver disease.
Fact: Liver disease is often called a “silent disease” for a reason. In its early stages, it rarely presents noticeable symptoms. Many individuals may feel completely normal while fat accumulates in the liver or scar tissue begins to form. Symptoms such as jaundice (yellowing of the skin and eyes), abdominal swelling, or confusion typically appear only in advanced stages. This silent progression makes regular screening crucial, especially for those with risk factors like obesity, diabetes, or a family history of liver disease. Blood tests measuring liver enzymes and imaging techniques like elastography can help detect issues early, even before symptoms arise.
Myth 3: Liver damage is irreversible.
Fact: Unlike many other organs, the liver has a remarkable ability to regenerate. Early-stage liver damage can often be reversed if the underlying cause is addressed. For instance, individuals with MASLD may see significant improvement by losing excess weight, adopting a healthier diet, and increasing physical activity. Similarly, stopping alcohol consumption in alcohol-related liver disease can halt and even reverse damage. In cases of viral hepatitis, appropriate medical treatment can improve liver health. However, there is a critical threshold—once liver disease progresses to advanced stages with complications like severe scarring, fluid accumulation, or mental confusion, the damage may become irreversible, and a liver transplant might be the only option. This highlights the importance of early diagnosis and timely lifestyle changes.
Myth 4: All fats are bad and should be eliminated from the diet.
Fact: Not all fats are harmful, and completely eliminating fats from the diet is neither necessary nor beneficial. The type and quality of fat consumed play a far more important role than the quantity alone. Healthy fats, such as monounsaturated and polyunsaturated fats found in foods like olive oil, nuts, seeds, and fatty fish, have anti-inflammatory properties and may support liver health. On the other hand, trans fats and excessive saturated fats should be minimised as they contribute to metabolic dysfunction and fat accumulation in the liver. Some level of fat intake is essential for normal body functions, including maintaining cell structure and metabolism. Emerging research has also explored how different types of fats influence liver fat accumulation through complex biological mechanisms, suggesting that dietary recommendations should focus on balance and quality rather than elimination.
Myth 5: There is a “safe” amount of alcohol for everyone.
Fact: While moderate alcohol consumption is often considered acceptable for the general population, there is no universally “safe” level for individuals with liver disease or those at high risk. Even small amounts of alcohol can worsen liver damage in people with existing conditions such as fatty liver disease. Studies indicate that moderate or occasional drinking may accelerate the progression from simple fat accumulation to more severe stages like cirrhosis. Because it is difficult to define a safe threshold for individuals with varying susceptibility, many experts recommend complete abstinence from alcohol for those diagnosed with liver conditions. This precaution is particularly important in populations where metabolic risk factors are prevalent.
This story is done in collaboration with First Check, which is the health journalism vertical of DataLEADS