Doctors talk about non-alcoholic fatty liver disease – Times News Online



Lehigh Gastroenterology Associates LLC is venturing in a new direction, one that they hope will help their patients fight bulge and non-alcoholic fatty liver disease, or NAFLD.

For many people, NAFLD won’t cause any serious health problems, but for 6.5%, the disease can progress to non-alcoholic steatohepatitis, according to the National Institute of Diabetes, Digestive and Kidney Diseases, US Department of Health. and Social Services. NASH occurs when NAFLD progresses to inflammation of the liver and damage to the liver. This damage can progress to fibrosis, that is, scarring of the liver. NASH can also progress to cirrhosis of the liver, which can then progress to liver cancer. When this happens, a person’s greatest hope for survival is a liver transplant.

According to the NIH, up to 70% of overweight people suffer from NAFLD and more than 90% of people with extreme obesity have the disease. Even 10% of children have NAFLD.

BMI is an indicator

A body mass index between 18.5 and 24.9 is considered normal. A BMI between 25 and 29.9 is considered overweight. A BMI of 30 to 39.9 is obese, and a BMI over 40 is extreme obesity.

BMI is calculated by calculating BMI by dividing weight in pounds by height in inches squared and multiplying by a conversion factor of 703 or by using the NIH calculator on their website at www.nhlbi / health / educational / lose_wt / BMI / bmical .htm.

“Anyone with a BMI over 30, I can bet you they have fatty liver disease, and that’s been a lot of people,” said Dr. Ahmed Hasan, gastroenterologist at Lehigh Gastroenterology Associates and affiliated with St. Luke’s University. Health Network.

“Even if you lose 20 pounds, you will be going in the right direction.”

Treatment of NAFLD

Hasan said that there are no drugs that can reduce the amount of fat in the liver. The only way to treat NAFLD is to lose weight.

For this reason, Hasan, who also has a master’s degree in public health, has become interested in helping his patients lose weight. He and Dr. Mahreema Jawairia, another physician in his practice, attended the Blackburn Harvard Obesity Course in Boston. There they learned a method to help their patients lose weight.

They developed a program for their medical practice in which to enroll 100 patients to start and help them lose weight for six months. They applied for a grant from the Pennsylvania Medical Society, which focuses on preventive medicine, and received it.

Hasan said the company gave them the grant because no other state program was as comprehensive. Grant money is used for gym memberships, an app for patients enrolled in the program, and nutrition counseling. Medical insurance should cover most of the costs, as NAFLD is a medical condition, he said.

Losing weight can also help some people with diabetes to stop taking their medications, as well as reduce the need for knee or hip surgery, as the extra weight is removed from the body and helps reduce apnea. sleep, Hasan said.

“It’s like a whole bunch of pounds just losing weight,” he said.

Board-certified in obesity medicine by the American Board of Obesity Medicine, Dr. Jawairia leads the program at Lehigh Gastroenterology Associates.

The program begins with a detailed assessment. This includes an assessment that focuses on the patient’s history, body composition, energy expenditure, concomitant medication use, as well as a physical examination and laboratory tests.

Some symptoms of NAFLD are feeling full without eating a whole meal or pain in the upper right quadrant where the liver is located. Symptoms of NASH can include this same pain and elevated liver enzymes. Liver enzymes are not routinely checked by a primary care physician, Hasan said. If liver enzymes are elevated, an ultrasound is ordered. People with fatty liver disease may have normal liver enzymes.

“The moment you see elevated liver enzymes, it means the inflammation has set in,” Hasan said. He wants to catch people before the enzymes develop.

What can be done

Jawairia said that patients will be on a low-calorie diet, a very low-calorie diet, a Mediterranean diet or the like, depending on the patient and their co-morbid medical conditions. They will track their calorie intake using a free app that will allow them to record their daily calorie intake, water intake and body weight as well as their level of physical activity.

Patients will also be encouraged to exercise, which will be adapted according to their physical and medical problems.

“The level of physical activity will be encouraged to increase each week based on their progress, as it improves metabolic, musculoskeletal, cardiovascular, pulmonary and mental health,” Jawairia said.

In the long term, patients should aim to lose 1 to 2 pounds per week. To do this, most people need to burn 500 to 1,000 more calories each day than they eat.

Patients will come to the office for weekly visits, which will focus on what they are recording and any obstacles that have arisen. Jawairia said they will work with patients to help them overcome these obstacles.

After 3 to 6 months, an ultrasound will be taken of the right upper quadrant to monitor the improvement of the liver.

Hasan said he thinks the program is better than going straight for weight loss surgery because it teaches people how to eat, what to eat, and how much exercise they need to live healthy lives.

“We shouldn’t be taking the shortcut. We should talk to them, ”he said.

Dr Ahmed Hassan

Dr Mahreema Jawairia

Non-alcoholic fatty liver disease is the second leading cause of liver cancer. Doctors have said that losing weight can help. METROGRAPHY


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