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Caring For Your Liver Non-Alcoholic Fatty Liver Disease on Course to Surpass Hepatitis-C as the Leading Reason for LiverTransplant

W e often think of alcohol abuse as the main underlying cause of liver disease, but even tee- totalers can contract fatty liv- er disease. As a matter of fact, the National Institutes of Health predicts that Non-Al- coholic Fatty Liver Disease (NAFLD) syn- drome will soon surpass Hepatitis-C as the leading reason for liver transplantation. NAFLD is characterized by an abnormal

“As it is mainly a diagnosis of exclusion, we want to make sure that other causes like alcoholic liver disease that can also cause fatty infiltration of the liver and other met- abolic and autoimmune causes have been ruled out before we can diagnose NAFLD.” Sometimes, NAFLD is caught due to an abnormal elevation of liver enzymes in routine blood work ordered by a primary care physician. In other cases, an ultra- sound conducted to explore the causes of abdominal symptoms may spot the fatty infiltration. Physicians may then refer the patient to a gastroenterologist for further evaluation. If left untreated, NAFLD can lead to liv- er failure, cirrhosis, and liver cancer. Al- though there is no cure for NAFLD, there are several treatment options available which center around a healthy lifestyle, says Dr. Suryawala. He explains that it is possible to prevent the onset of NAFLD with a healthy life- style. “Know your target BMI and work to keep your weight within the guidelines. Those suffering from diabetes should take measures to ensure optimal glycemic con- trol. Individuals with high blood pressure should never skip their medication and take steps to keep it well-controlled throughout the day. Those with high cholesterol levels should also remember to take their medication, while paying ex- tra attention to exercise and eating a healthy diet. Keeping all of these

accumulation of fat in the liver. The disease can be categorized by one of two sub-types: non- alcoholic fatty liver without any associated in-

flammation and non - a l c oho l i c steatohepatitis, which is non-al- coholic fatty liver accompanied by inflam- mation. Although the exact causes of NAFLD are still largely unknown, it appears to affect Kunal Suryawala, MD

obese individuals and those af- flicted with diabetes much more often than others. With the epi- demic of obesity now extending to early childhood, even young children have been diagnosed with NAFLD. However, most individuals are between the ages of 40 and 50 when they are first diagnosed. And studies have shown a prevalence for NAFLD within the Hispanic population. “Causes are still largely un- known,” says Kunal Suryawala, MD, NCH Gastroenterologist and Hepatologist. “In addition to individuals suffering with obesity and diabetes, other groups at risk include those with metabolic syndrome (hyperten- sion, hyperlipidemia, diabetes


Normal Liver

■ Obesity in general ■ Metabolic syndrome (Insulin resistant, hypertension, hyperlipidemia, diabetes and obesity) ■ Obstructive sleep apnea ■ Hypothyroidism ■ Polycystic ovarian syndrome HOWTO PREVENT THE ONSET OF NON-ALCOHOLIC FATTY LIVER DISEASE: ■ Maintain a healthy lifestyle ■ Stay within your target BMI ■ With pre-existing diabetes, make sure you have optimal glycemic control ■ With high blood pressure, make sure blood pressure is well controlled throughout the day and take medication ■ With high cholesterol levels, take medication

things under control will aid in minimizing the on- set of NAFLD.” “If patients are found to have fatty or enlarged liver, it is recommended that they are evaluated by a gastroenterologist to de- termine if their condition is related to NAFLD – or if there are other diseases involved,” adds Dr. Sury-

Nonalcoholic fatty liver disease

Nonalcoholic steatohepatitis

and obesity together), obstructive sleep apnea and women with polycystic ovarian syndrome.” Dr. Suryawala says that most people with NAFLD do not have symptoms. “It is most often discovered through imaging studies performed for other reasons,” he explains.

awala. “If so, we can get them on an appro- priate treatment plan that centers around a healthy lifestyle. Studies have shown losing as much as 7 to 10 percent of body weight is enough to cause improvement of the fat- ty accumulation of the liver and improve inflammation as well.”

■ Exercise regularly ■ Eat a healthy diet

Dr. Kunal Suryawala’s office is located at NCH Creekside, 1285 Creekside Blvd E. in Naples. To schedule an appointment call NCH Physician Group Gastroenterology and Hepatology at (239) 624-8070.

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