Surprising New Connections Found Between Food Insecurity And Liver Disease

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Liver disease is routinely associated with alcoholism and excessive alcohol consumption. However, non-alcoholic fatty liver disease (NAFLD) is actually the most common form of liver disease in the United States. One in 3 adults and 1 in 10 children in the United States suffer from the disease. NAFLD is characterized by excessive fat stores in the liver that leads to inflammation, liver scarring (cirrhosis), liver fibrosis, and liver-related morbidity. NAFLD is usually caused by diabetes, insulin resistance, being obese or overweight, having high blood pressure, having polycystic ovarian syndrome, or having elevated levels of cholesterols or triglycerides. 

Food Insecurity and NAFLD

A study released in October found that 32% of adults with NAFLD were also suffering from food insecurity. According to the USDA, food insecurity is “a lack of consistent access to enough food for an active, healthy life.” Food insecurity is directly caused by a lack of financial resources, and can be connected to many social and physical determinants, such as low wages, lack of affordable housing, high medical costs, health problems, lack of social support, lack of access to educational opportunities/work training, lack of transportation, physical barriers (of the built and natural environment), and other socioeconomic conditions. Food insecurity affects communities across the United States; an estimated 1 in 9 Americans are food-insecure.

Until this point, very little research has been conducted in the United States concerning the connections between food insecurity and health outcomes. Dr. Ani Kardashian, an assistant professor of clinical medicine at the University of Southern California Keck School of Medicine, presented thoughts on the research at the International Liver Congress 2021:

“This study really highlights the importance of us focusing on upstream social determinants of health in the long-term outcomes of people with NAFLD and advanced liver fibrosis…Future studies should focus on designing interventions to reduce food insecurity in our at-risk patients with fatty liver disease.”

Addressing Food Insecurity to Reduce Rates of NAFLD 

As Dr. Kardashian discussed, treating food insecurity like a public health risk could result in better outcomes for those suffering from NAFLD and related conditions. But how do we address something as pervasive and widespread as food insecurity?

Change starts at the local level. Supporting reputable organizations such as Feeding America and mutual aid funds can help. Volunteering at local organizations, contacting your government representatives, educating your community, or even organizing a food drive can incite change. Donating to your local food bank or food pantry is beneficial as well. In Louisville, Dare To Care is an option. In Lexington, God’s Pantry is a widely known resource. In Southern Indiana, Hope Southern Indiana and Center for Lay Ministries are two highly-regarded options. Visit foodpantries.org to see more food pantries near you. There are many ways we can inspire change, and it begins with individual action.

For more information about diagnosing digestive conditions, reach out to Gastroenterology Health Partners (GHP) today. Our clinicians have a passion for seeking out and refining new treatments and advanced solutions for those suffering from disorders of the digestive system. Each of our physicians offers expert specialization, evaluating and treating the entire spectrum of digestive conditions. To learn more about the treatment options available to you, schedule an appointment at one of our locations throughout Louisville, Lexington, and Southern Indiana.

Liver Transplant: An Overview

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A liver transplant is a surgical procedure in which doctors remove a diseased liver and replace it with a healthy one. This may involve replacing the entire liver or just a section of it. Here’s what you need to know about this procedure.

When is a liver transplant pursued?

A liver transplant is often the best option for people with uncontrollable liver failure. In most cases, liver failure in adults is caused by a chronic condition. For instance, cirrhosis is one factor that leads to liver failure over time. Hepatitis B, hepatitis C, alcoholic liver disease, cancer, and some genetic diseases can also cause liver failure in adults. Children sometimes need a liver transplant as well, often due to genetic disorders or diseases affecting the bile ducts or liver.

Before the procedure

Leading up to a liver transplant, doctors assess your condition with rigorous testing to see the severity of your liver failure and whether you should get a liver transplant. This includes blood testing, diagnostic testing, a psychological evaluation, and more. All of these factors go into whether you may be placed onto the national liver transplant waiting list. Some reasons people are not able to get a transplant include having a chronic untreatable condition, having metastatic cancer, drinking too much, and having severe heart issues.

If you are able to get a transplant, you’ll be placed on the waiting list. People who need a transplant most urgently are at the top of the list, and people with a less urgent need are further down the list. Your place on this list is determined with a structured scoring system called the Model for End-Stage Liver Disease (for children under 12, the Pediatric End-Stage Liver Disease (PELD) is used instead).

If you are preparing for a transplant, your doctor will discuss the steps you need to follow before the procedure. These steps can include avoiding eating and drinking 8 hours before the surgery. If you are receiving a transplant from a living donor, your surgery will be scheduled out in advance. However, if you are receiving a transplant from a deceased donor, you may be called to the hospital for an immediate procedure.

During the procedure

During a liver transplant, doctors sedate you and make an abominable incision while monitoring your vital signs. They remove the diseased liver (or portion of liver) from your body and replace it with the healthy donated liver. They work to connect your blood vessels and bile ducts to the new liver. This is a long process and can take up to 12 hours depending on your situation.

After the procedure

Following a liver transplant, you will spend a few days in intensive care until your condition is stabilized. During this time, doctors will monitor your condition to ensure the transplant has gone well. You will likely be on a ventilator to help you breathe initially. You may also receive IV drips, antibiotics, and anti-rejection medications to help fight against your body’s immune response to your new liver. After you have stabilized, you may spend a week or two more in the hospital in a general non-intensive care room to recover.

Once you have returned home, you will need to follow your doctor’s instructions on keeping your surgical area clean. You should report any symptoms like jaundice, fever, bleeding, or redness around the incision site.

You will also need to take anti-rejection medication indefinitely following the transplant. This involves taking immunosuppressants that weaken your immune response so that your body doesn’t reject your new liver. This puts you at a higher risk of infections, and can also increase your blood pressure and put you at risk for diabetes. Fortunately, over time you will be able to take less medication as your body adjusts. You should consult with your doctor closely to follow the best plan.

Our experienced team at GHP has years of experience treating patients with liver conditions. We can help establish the best plan of care for your situation. Contact any of our office locations to learn about the options we offer and schedule an appointment today.

Cirrhosis: What You Need to Know

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Cirrhosis is a condition in which your liver is scarred and suffers permanent damage. Here’s what you need to know about the condition. 

Causes and Risk Factors

When the liver is damaged, it attempts to repair itself and scar tissue forms. Over time, this scar tissue builds up and makes it difficult for the liver to function. Cirrhosis is the term for late stage damage. Damage can be caused by various conditions and diseases. These include chronic alcohol abuse, syphilis, chronic viral hepatitis, some genetic disorders, and nonalcoholic fatty liver disease. 

Risk factors for cirrhosis include excessive alcohol consumption, having viral hepatitis, and being overweight. Each of these factors can lead to some of the diseases and conditions listed above, which can damage the liver and lead to cirrhosis over time. 

Symptoms of Cirrhosis

There are several potential symptoms of cirrhosis. In the early stages of disease, many people do not experience any symptoms. Symptoms and complications often occur in later stages of disease, when it is more severe. These include severely itchy skin, fatigue, nausea, loss of appetite, jaundice, easily bleeding and bruising, and fluid accumulation on the abdomen. 

Diagnosis

In cases of early-stage cirrhosis, most people do not have symptoms, and diagnosis is likely to be incidental through a routine blood test or doctor’s visit. In general, doctors diagnose cirrhosis through a combination of physical exams, blood tests, medical history, and symptoms. Often, doctors will order additional testing to confirm a diagnosis. They may do this through blood testing, imaging tests, or biopsy. Imaging tests and biopsies can help determine the extent of cirrhosis, and blood testing can help identify the underlying cause of the condition. For example, blood testing may help identify elevated bilirubin levels, creatinine levels, or hepatitis infection. 

Treating Cirrhosis

Treatment approaches for cirrhosis vary based on the extent and cause of liver damage. Typically, treatment will focus on preventing or treating any symptoms and slowing the rate of scar tissue buildup on the liver. If doctors catch cirrhosis early, the underlying cause may be treatable to reduce any further damage. For example, if someone has developed it as a result of chronic alcohol abuse, their doctor will likely recommend they quit drinking. They may be encouraged to join an alcohol addiction program if quitting is difficult.

If hepatitis causes cirrhosis, there are medications that can treat the virus to prevent further liver damage. If it develops due to nonalcoholic fatty liver disease, focusing on weight loss and controlling blood sugar can help. Additionally, there are often medications that can help treat symptoms and complications like pain, itching, and osteoporosis. In late-stage cases, when the liver has too much damage to function, a liver transplant may be the only option. 

Prevention

Preventing and managing cirrhosis entail several lifestyle behaviors. Avoiding alcohol, practicing safe sex, exercising regularly, eating a healthy diet, and using over the counter medicines carefully are good prevention measures. 

Our experienced team at GHP has years of experience treating conditions including cirrhosis. We can help establish the best plan of care for your situation. Contact any of our office locations to learn about the options we offer and schedule an appointment today.

 

What is Jaundice?

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Jaundice causes the whites of the eyes, skin, and mucous membranes to turn yellow as a result of heightened levels of bilirubin. Here’s what you need to know about the condition.  

Causes and Risk Factors

Jaundice is ultimately caused by bilirubin levels that are too high. Bilirubin is a yellow chemical in hemoglobin, the part of red blood cells that carries oxygen. The body builds new red blood cells when old ones break down, and the liver processes the old cells. When the liver is unable to process these old cells properly, bilirubin builds up in the blood and deposits in the skin. The yellow color of bilirubin is what causes the yellowing of skin in jaundice. 

Jaundice is relatively common in newborns- many babies develop it in their first week of life, and it often goes away without issue. In adults, jaundice can be a sign of various problems. These include liver diseases (like alcoholic liver disease, cirrhosis, and hepatitis), blood diseases, infections, blocked bile ducts, and viruses. 

Symptoms of Jaundice 

There are several symptoms of jaundice that people can experience at different levels of severity. Some people may not even have any symptoms. Ultimately, the symptoms a person experiences will depend upon underlying causes and the speed at which disease develops. In short-term cases, often caused by infections, symptoms typically include fever, abdominal pain, chills, flu-like symptoms, yellowed skin and eye whites, dark urine, and clay-colored stool. If a case is not caused by infection, symptoms can include weight loss and itchy skin. Abdominal pain is also common when pancreatic or bile duct cancers cause jaundice. 

Diagnosis

Jaundice is diagnosed through a few different steps. Doctors first perform physical exams to check for signs of liver disease. These signs include yellowing and bruising of the skin, spider angiomas (blood vessels that collect near the skin surface), and palmar erythema (red coloration in the fingertips and palms). They also perform urinalysis to check bilirubin levels in the urine, which can indicate jaundice. They often perform serum testing to confirm findings from urinalysis as well. Additionally, they may want to pursue imaging of the liver through an MRI, CT, or ultrasonography to further confirm any diagnosis. 

Treatment and Prevention for Jaundice

Treatment for jaundice entails treating the underlying causes and complications of the condition, as well as any symptoms. For instance, if acute viral hepatitis is a cause, it will go away as your liver heals.  Treatment may entail treating the hepatitis symptoms. Surgery can help unblock bile ducts in cases of blocked ducts. A drug called cholestyramine can be used to limit itching if itchy skin is a symptom. 

Preventing jaundice entails preventing the various underlying causes. This means that limiting alcohol intake, avoiding hepatitis infection, and maintaining a healthy weight and cholesterol levels can all reduce your risk. 

Our experienced team at GHP has years of experience treating conditions including jaundice. We can help establish the best plan of care for your situation. Contact any of our office locations to learn about the options we offer and schedule an appointment today.

 

Lowering Your Risk of Liver Disease

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Liver disease is a general term used to cover multiple types of diseases that affect the liver and its functions in the body. These diseases include cirrhosis, cancer, infectious hepatitis, and blood flow abnormalities, to name a few. 

The liver has a role in many important bodily functions, including iron storage for red blood cell production, bile production, and generally digesting food and getting rid of toxins. Liver disease can affect these functions negatively and eventually lead to serious outcomes if untreated. 

Liver disease can be caused by a variety of things, come of which are controllable and others which aren’t. Luckily, though, there’s a lot you can do to reduce your risk. Let’s take a look at some key factors you can manage to lower your risk for liver disease. 

Exposure to toxins

A healthy liver helps filter out toxins from the blood. However, when too many toxins are present over time, the liver can become damaged. Chemicals found in household products, pesticides, and the like can cause liver damage over time if ingested. Always read warning labels for any chemicals you use to make sure you are employing proper safety measures and practices. Wash your fruits and vegetables before consumption too. In fact, go for clean produce and fruit when you can- pesticide-free food is the best way to ensure you aren’t overexposed to toxins when you eat. 

Alcohol consumption

Liver injury can occur due to alcohol abuse. When you drink too much over a long period of time, this starts to cause fat accumulation in your liver and can eventually lead to more damage. There are also other coinciding factors that can increase risk, like smoking. 

One key way to lower your risk of liver disease due to alcohol consumption is to decrease use. Abstaining from alcohol is incredibly effective in lessening damage, and in earlier stages of fatty accumulations in the liver may even reverse some damage. Even just reducing your amount of consumption to a healthier level is significant. For reference, moderate drinking is defined as up to 1 drink per day for women and up to 2 drinks per day for men. Heavy drinking is defined as 8 or more drinks per week for women and 15 or more drinks per week for men. 

Infection

Liver disease can also develop as a result of infection, which can occur from viruses or parasites. Viruses causing liver damage may be spread through close contact with an infected person, their blood or semen, or contaminated food and water. It’s important to take precautions to avoid virus exposure, including using protection during sex, avoiding needle sharing if you use drugs, and ensuring clean equipment is used on any tatooing equipment you come in contact with. 

Obesity, Diabetes, and High Cholesterol

Obesity, Diabetes, and High Cholesterol can lead to fatty accumulations in the liver. This can turn into nonalcoholic fatty liver disease, which like other types of liver disease, can become more severe over time. Fortunately, liver health can be improved by cutting simple carbohydrates and adding in more healthy fruits, vegetables, and proteins to your diet. 

Our experienced team at GHP has years of experience helping patients manage and treat liver disease. We can help you establish the best plan of care for your situation. Contact any of our office locations to learn about the options we offer and schedule an appointment today.