MANILA, Philippines — The figures are alarming: An estimated 18 million Filipinos are either suffering from liver disease or are at risk of getting it.
This is despite the fact that the liver is capable of regeneration and can actually repair itself. One of the most hard-working organs of the body, the liver produces bile that aids in digestion, converts food nutrients into energy, makes proteins that the body needs, stores iron, helps blood clot, and flushes out bacteria and toxins from the body. Strong and resilient, it is capable of regeneration and, even if 60% of it is damaged, a normal liver can repair itself.
The liver, however, has its limits. If subjected to abuse on a regular basis, it can only take so much before it starts showing signs of protest. In this case, its protest comes in the form of fatty liver disease.
Defined as the buildup of excess fat in the liver (or when fat makes up more than 5% of your liver’s weight), fatty liver disease, when left unresolved, can lead to cirrhosis of the liver, liver failure, or liver cancer. The progressive form of fatty liver disease called non-alcoholic steatohepatitis (NASH) is the leading cause of liver transplantation worldwide. While liver transplantation is possible, it is costly, and will set you back by millions of pesos.
How did fatty liver disease reach such silent epidemic proportions in the Philippines? Unhealthy diets, a sedentary lifestyle and the rising number of people with diabetes and obesity are mostly responsible, said Madalinee Eternity D. Labio, MD, a Hepatologist and Head of the Liver Unit, Makati Medical Center (MakatiMed).
“Having excess body weight and diabetes puts you at high risk for developing fatty liver disease,” she pointed out. “Although fatty liver can also result from excessive drinking of alcoholic beverages and certain medications, more Filipinos are being diagnosed with non-alcoholic fatty liver disease (NAFLD) owing to a diet rich in fat and sugar; a sedentary lifestyle; and the increasing incidence of diabetes among Filipinos.”
NAFLD is a silent condition with symptoms showing up only when the disease is far advanced, making early diagnosis challenging. “By then, a patient shows signs of liver failure, such as jaundice or yellowing of the eyes and skin, lethargy and mental confusion, fluid build-up in the abdomen called ascites, and vomiting of blood,” Dr. Labio shared. “These symptoms are red flags that signal advanced liver disease or liver cirrhosis due to complications brought about by fatty liver disease.”
Doctors diagnose NAFLD and its progressive form NASH (non-alcoholic steatohepatitis) through an ultrasound of the liver, a blood test revealing abnormal liver enzymes (ALT and AST), a special imaging test called transient elastography (FibroscanTM), or a liver biopsy.
Because there are no medications to treat fatty liver disease, keeping your liver healthy through diet and exercise, maintaining a normal weight, and avoiding excessive alcohol consumption, are the best ways to prevent fatty liver from progressing to liver cirrhosis.
“Making positive lifestyle changes improves not only your liver but your overall health,” Dr. Labio said. “If you have diabetes, high levels of cholesterol and triglycerides (fat in the blood), and have excess body weight, see your doctor regularly and have yourself checked if you have fatty liver.”
Adopt a healthy lifestyle and your liver will do what it normally does. “If diagnosed early enough, it is possible to decrease the fat in your liver, resolve liver inflammation and even reverse liver damage. Staying healthy and having your liver checked regularly prevents this silent condition from getting worse,” Dr. Labio reminded.
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