Non-alcoholic hepatitis, a growing health issue’

Jaipur: Non-alcoholic liver disorder causing hepatitis is growing as a new health concern. A 56-year-old person who was never looked obese but his BMI index was higher than normal reached Sawai Man Singh (SMS) Hospital on Wednesday with complaints of blood vomiting. He was diagnosed with non-alcoholic hepatitis, which is known as Nonalcoholic Steatohepatitis (NASH).

Earlier, majority of the cases of fatty liver reported were of alcohol-induced hepatitis. But, now with population with obesity has increased, the cases of NASH has also increased significantly. Obesity is a major risk factor for NASH. Over the past 10 year, the population among women with (BMI ≥ 25.0 kg/m2) has increased from 8.9% to 14.1% and among male, it has increased from 6.2% to 13.2%, shows the latest National Family Health Survey 2015-16.

“This patient belongs to Didwana of Nagaur. He never had any disease. His BMI index and blood glucose was slightly higher than normal. During diagnosis, it was found that he had NASH. We conducted endoscopy to stop bleeding immediately. He has liver cirrhosis but it is not terminal cirrhosis, which require liver transplant as final treatment. In his case, his condition can be managed with endoscopic treatment and medicine,” Dr Ashok Jhajharia, assistant professor, gastroenterology department, SMS Hospital said.

Dr Jhajharia said that such cases with NASH are now frequently being reported. “Even in vegetarian population and those people who do not drink liquor, are being diagnosed with fatty liver, which is a bad sign. Over the past few years, the consumption of food which helps building up of fat in the liver has increased,” Dr Jhajharia said.

Health experts say that the biggest cause of NASH is building up of fat in the liver. “Fatty liver is common among those who drink a lot of alcohol. But, now we can see that the trend is changing now. We can see that 10% of all the cases of fatty liver are non-alcoholic in the hospital. It was not so in the past,” Dr Sandeep Nijhawan, senior professor and head of gastroenterology department, SMS Hospital, said.

He said that NASH is common in America and European countries but now India has also reporting increased number of cases. “Those with diabetes, obesity and heart problems are also vulnerable to NASH. It happens because of consumption of food rich in carbohydrates and with not much of protein. Such junk food is quite common, which is one of the reasons of NASH. Also, people are doing job sitting at one place without doing any physical work,” Dr Nijhawan said.

Doctors say that those with NASH should avoid food with fat. They should do lifestyle modification by reducing weight and do a lot of exercise.

The doctors conduct liver biopsy for final diagnosis of the disease. They also do Fibro Scan to find out if the liver has fibrosis and stiffness.

Apart from hepatitis due to non-alcoholic fatty liver and alcohol-induced fatty liver disease, there are Hepatitis A, B, C, D and E causing liver disorders.

“Hepatitis B and C virus stay in our system for a long time, they become chronic and can result long term adverse conditions. Hepatitis has a tendency to remain undetected, so it is important that people should take their symptoms seriously and should take consultation for better treatment and living. “Dr Vijay Sharma, Gastroenterologist, of a private hospital said.

Apart from chances of developing into chronic diseases, people with undiagnosed viral hepatitis are also accountable for unknowingly transmitting their infections to others and adding to the disease burden. “The fact that till date we do not have any vaccine for hepatitis C, which is an equally perilous infection as hepatitis B, prevention becomes even more crucial. On one hand while safe blood transfusion practices at blood banks and hospitals can prevent the spread of infection, on the other, it is the use of safe injection practices which needs to be ensured,” Dr Dinesh Agarwal, Gastroenterologist of a private hospital said.