Kerala Launches Fatty Liver Screening Clinics to Tackle Rising NAFLD Cases

In a massive public health drive, Kerala's Health Department plans to open fatty liver screening units throughout the state. This step has been taken in response to the increasing number of non-alcoholic fatty liver disease (NAFLD) cases, a condition increasingly found among non-drinkers and women, leading to serious liver conditions like cirrhosis.

The first clinic will begin operations at Tirur District Hospital in Malappuram. The center, which may be the first in a district hospital anywhere in the country, will diagnose fatty liver disease through extensive blood work and imaging procedures. In addition to diagnosis, the clinic will provide customized diets and exercise plans based on patient-specific requirements for early intervention and successful disease management.

In the past, cirrhosis has been traditionally associated with alcohol abuse. However, according to recent statistics, the trend is changing, with more cases now occurring among non-drinkers.

The prevalence of NAFLD in India is not uniform, with rates ranging from 9% to 53% in the general population. [1] Urban populations specifically have higher rates, which are explained by inactive lifestyles, poor dietary patterns, and rising obesity levels. Alarmingly, one study cited a prevalence rate of 61.5% in some urban groups. [2]

NAFLD is a spectrum of liver diseases, ranging from simple fat deposition to more advanced conditions such as non-alcoholic steatohepatitis (NASH), which can lead to cirrhosis or liver cancer if left untreated. Although it has the potential to be severe, NAFLD is usually asymptomatic in its initial stages and thus tends to be underdiagnosed. Dr. Murali Krishnan M., consultant gastroenterologist at Tirur District Hospital, highlighted the asymptomatic nature of the disease, stating that early fatty liver is often discovered by chance during scans conducted for other purposes.

The importance of treating NAFLD is further accentuated by the current healthcare crisis faced by the state. According to recent reports, 375 patients in Kerala are awaiting kidney transplants. Among them, a notable percentage require transplants due to complications from metabolic syndromes, particularly in the form of end-stage liver disease.

Kerala’s health department plans to integrate fatty liver screening into routine lifestyle disease clinics, which currently treat conditions such as diabetes, hypertension, and obesity. This combined service will allow for the early identification of NAFLD in high-risk patients. In the near future, similar centers are planned for district hospitals in Thiruvananthapuram and Ernakulam, thereby expanding this vital healthcare service.

The pathogenesis of NAFLD is multifactorial, with metabolic syndrome, type 2 diabetes, and dyslipidemia being major risk factors. The progression to more advanced liver diseases highlights the importance of early diagnosis and intervention. Early lifestyle modifications, such as a healthy diet and regular physical exercise, have been found to halt or even reverse disease progression. Dr. Jeemon Panniyammakal, assistant professor at Achutha Menon Centre for Health Science Studies, emphasized that even familial genetic tendencies toward fatty liver can be mitigated through early lifestyle modifications.

Through early detection, holistic management, and public awareness, the state aims to curb the progression of this potentially debilitating disease, protecting the health and well-being of its citizens.

References

1. "Prevalence of Non-Alcoholic Fatty Liver Disease (NAFLD) Among Adults in Urban Goa." National Medical Journal of India. Available at: https://nmji.in/prevalence-of-non-alcoholic-fatty-liver-disease-nafld-among-adults-in-urban-goa/

2. "Prevalence of Non-Alcoholic Fatty Liver Disease in Indian Urban Population." Indian Journal of Community Medicine. Available at: https://journals.lww.com/ijcm/fulltext/2023/48040/prevalence_of_non_alcoholic_fatty_liver_disease_in.17.aspx

(Input from various sources)

(Rehash/Pragati Sakhuja/MSM)