“International NASH Day – held annually during the second Thursday in June – is dedicated to increasing awareness about non-alcoholic steatohepatitis, or NASH, among various populations: the general public, at-risk patients, the medical community, public health authorities, and the media.”
Keeping International NASH (Non Alcoholic Steato Hepatitis) day in mind it is important for healthcare professionals, particularly Gastroenterologists and Hepatologists, to highlight lifestyle changes for a healthy liver and healthy life in general. We came out with a slogan in 2019 – “Nirogg Jigar, Tandarusst Punjab” but this being a global event and the relevance of this event being immense for our younger generation, which is fast adopting a lifestyle of sedentary lifestyle (especially in India). Liver abnormalities or diseases to a Hepatologist (Liver specialist) medically means,
1) Alcohol
2) Hepatitis A
3) Raised Body mass index (obesity)
4) Hepatitis B
5)Hepatitis C
6) Diabetes
7) Drugs – recreational and over the counter
8) Hepatitis E
Amongst these, raised body mass index and Diabetes are included in NASH. Alcohol and Hepatitis are not part of this spectrum, there is an acceptable amount of alcohol that is mentioned as relatively safe (8 grams per week). This so called ‘safe’ amount is actually very little but over many years can probably still cause damage to the liver. However, evidence suggests from western data that this small amount will not damage the liver substantially.
Gastroenterologists and Hepatologists internationally believe that the paradigm of alcohol being ‘not responsible’ to ‘responsible’ or vice versa needs to rest in high risk cases. In Punjab in particular (and North India in general) we frequently see patients with raised body mass index, borderline Hba1c and enthusiastic alcohol intake regularly, which predisposes them to serious liver damage. Hepatitis C has been out of equation now that the government took up cudgels against it and is seen lesser than before in clinical practice although still not eradicated.
The Gastroenterologists and Hepatologists in Amritsar and Chandigarh (where I practice myself) are doing a lot to bring the word out and minimise the damage of this pandemic of fatty liver or NASH and hope to eradicate it. We, through GI Rendezvous and Gastroenterology and Liver Forum have been doing a lot for this cause in Chandigarh and Amritsar.
