Fatty liver complex? But it's not as simple as you think!

At present, as an important chronic non communicable disease, fatty liver disease has now become the world's largest liver disease instead o


At present, as an important chronic non communicable disease, fatty liver disease has now become the world's largest liver disease instead of viral hepatitis, serious harm to human health and social development. Although the fatty liver is a common disease, many people do not take it seriously, until with multiple complications but too late for regrets, the First Affiliated Hospital of Zhongshan University Department of Gastroenterology professor Zhong Bihui to answer all sorts of doubts in the prevention and treatment of fatty liver.

The final destination of fatty liver development is hepatocellular carcinoma Wrong! Fatty liver will be transformed into liver cancer? Zhong Bihui replied: "the probability of late conversion to fatty liver cancer is not greater than that of viral liver disease. More than 80% of patients with liver cancer are evolved from viral liver disease, there is a part of occult hepatitis B, hepatitis B virus DNA need to be detected." The so-called occult hepatitis B, hepatitis B surface antigen is negative, but positive for hepatitis B virus DNA. In fact, many of the clinical findings of liver cirrhosis, liver cancer patients with no obvious cause is caused by hepatitis B virus. Fatty liver, does not mean that it will enter the quagmire of cirrhosis, and then into the restricted area of liver cancer. Zhong Bihui said that the early treatment of fatty liver effect will be better, some patients are reversible. She stressed that the most important thing is to reduce weight! "Now to improve the living conditions, people eat meat and drink more, less exercise than before can buy grain in much happiness. But the attendant is that fatty liver is also unknowingly increased, the vast majority of patients with fatty liver is closely related to weight gain." Early fatty liver can recover for illness without medical help? Yes! From more than and 10 years ago, fatty liver has become a common state of middle-aged men, in recent years, civil servants, institutions of young men have gradually joined the ranks. The most interesting place is before the disease, go to hospital for examination, we can predict a pretty close, most of the patients with simple fatty liver are apple shape, waist and abdomen is abnormally enlarged, basically can not find where the waist. Zhong Bihui pointed out that these people not only have liver steatosis, often also associated with multiple metabolic disorders, namely we often say "high five": high blood sugar, high blood lipids, high uric acid, high blood pressure, weight gain, collectively referred to as "metabolic syndrome". "Without these metabolic disorders with pure fat only basic treatment, weight loss, diet and exercise is the optimal treatment, by reducing energy intake, increase consumption, which can effectively reduce the weight." Zhong Bihui also pointed out that, if it is a very mild fatty liver, there is no combined metabolic abnormalities, weight reduced to the normal range, fatty liver can be reversed, so early treatment is very important. How can we effectively reduce weight? First calculate the standard weight of each person, that is, the height of the individual -105, to achieve the most perfect value. However, not every patient can achieve standard weight through the efforts, the weight loss process is difficult. In this regard, Zhong Bihui said: we do not insist on standard weight, but require patients to lose weight at least half a year in the existing 5%-10% weight. Adhere to weight loss three months, after weight loss or reversible." In addition, not all patients with fatty liver are suitable for exercise therapy, and must be evaluated by a specialist. Zhong Bihui cited several cases is not suitable for sports: one is not more than three times the normal transaminase, to return to normal transaminase before exercise, to avoid increasing the burden of the liver; two had cardiovascular insufficiency, angina patients can not exercise, once the exercise can easily lead to sudden death; three is the fasting blood glucose (FBG) > 14mmol/L, blood sugar fluctuations, there are serious complications of acute metabolic complications of diabetes mellitus and heart kidney is not excessive exercise. Will fatty hepatitis patients rebound after withdrawal? Be on the cards! Professor Zhong Bihui said that more than 30% of patients with fatty liver will appear steatohepatitis, related to its metabolism. When the blood pressure value is high, it is difficult to reduce the transaminase, so the doctor will add lipid-lowering drugs if necessary. Today's guidelines indicate that high blood fat steatohepatitis can be used lipid-lowering drugs, but if the use of transaminase after more than three times the normal withdrawal. Will fatty hepatitis patients rebound after withdrawal? Professor Zhong Bihui says it is possible that the best treatment is long-term use of lipid-lowering drugs, the combination of treatment. She suggested that the majority of patients: first of all, do a good job of basic treatment, weight down. If you lose weight you can try to stop the drug, if the weight has not changed, it is easy to rebound after withdrawal. In addition, some patients after taking the drug transaminase decreased declined to stop the drug, the results of one or two months after a rebound, so it is important to follow the doctor's advice." It is understood that patients with fatty liver and high blood lipids should be assessed for risk factors, can go to the hospital carotid artery ultrasound to understand whether there is thickening of the carotid artery or intimal plaque. These signs are suggestive of atherosclerosis, further development of cerebrovascular accident. So, to manage patients with fatty liver is not easy, a lot of things to take precautions". Zhong Bihui stipulates that each of the newly diagnosed patients with fatty liver after a month to go back to hospital for review, re evaluation of the disease, regular follow-up. To sum up, it is important to control weight, diet, and exercise, regardless of the extent to which the patient is obese, and the physician deals with the metabolic syndrome according to the patient's condition. Fatty liver patients only treat liver without other, wrong! The reason for the death of fatty liver, most of which are not due to liver problems, ranked first in the cardiovascular and cerebrovascular diseases, such as myocardial infarction, cerebral infarction, etc.. Therefore, the management of blood lipids, blood sugar and blood pressure is very important. Zhong Bihui believes that the fatty liver can be used as a window, but also as a starting point, in addition to the evaluation of liver disease in the light weight, but also to deal with a variety of metabolic disorders, clinicians should have disease diagnosis and treatment of holistic thinking. The prevention and treatment of fatty liver disease involving multiple areas of preventive medicine and clinical medicine in the digestive, cardiovascular, endocrine, nutritional, imaging, exercise rehabilitation, disease and risk assessment, treatment of fatty liver disease development requires a multidisciplinary collaboration. Source: 39 Health Network medical guidance: No.1 Affiliated Hospital of Zhongshan University, Professor Zhong Bihui digestion



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