Liver Diseases

Non-alcoholic fatty liver disease (increasingly common with rising obesity and diabetes), viral hepatitis (mainly B and C), alcoholic liver disease, and — in specific populations — autoimmune hepatitis and inherited conditions like Wilson's disease. Liver cancer is often a late complication of chronic hepatitis or cirrhosis. Most liver disease is silent until late — routine blood tests often catch it first.

Fatty liver is fat buildup in liver cells, common in people with obesity, diabetes, or metabolic syndrome. It's often found incidentally on ultrasound. Simple fatty liver may cause no problems; but a subset progresses to NASH (inflammation), fibrosis (scarring), and eventually cirrhosis. Weight loss (7-10% of body weight) is the most effective treatment. It's now the leading liver problem in urban India.

Hepatitis B vaccination is part of India's routine immunisation schedule for children born after 2002-2011 (varies by state). Adults who weren't vaccinated as children should discuss it with their doctor — especially healthcare workers, people with multiple sexual partners, and anyone with liver disease. Hepatitis A vaccine is worth considering for children and travellers. No vaccine exists for hepatitis C.

There's no completely 'safe' amount — but the risk of liver damage rises steeply above about 21 drinks per week for men, 14 for women, over years. Binge drinking is particularly damaging. People with existing liver disease, hepatitis B or C, or fatty liver should avoid alcohol entirely. Individual susceptibility varies — some people damage their liver at low intakes, others tolerate more.

Yellowing of skin or eyes (jaundice), swelling in abdomen or legs, easy bruising or bleeding, confusion or altered behaviour, dark urine, pale stools, itchy skin, or vomiting blood. These are late signs — most liver disease is caught earlier on routine blood tests (elevated liver enzymes, low albumin, high bilirubin). Any persistently abnormal liver blood tests deserve a gastroenterologist's opinion.