This is a syndrome in which the liver is laden with fat, the fat contained in the liver can be variable but it is at least more than 5% of the liver cells, if they are liver fat or triglyceride we term this as fatty liver. And some patients with fatty liver are associated with inflammation and others with scarry, and this progress is called nash cirrhosis. This is one of the commonest causes of chronic liver disease, world wide and also in our country. Even young children and adolescents are falling prey to this disorder. This is partly genetic, epigenetic, environmental and lifestyle related. So, it’s not uncommon for young children to be glued to the screens and then eat whatever comes their way. Carbonated beverages are a big culprit to cause this disease. Unfortunately there is no proven therapy for this disorder except weight loss, and weight loss is extremely difficult as these patients are generally overweight, so, already they are with various joint issues, sleep disturbances, there are associations with other disorders too including Cardiovascular disorders, menstrual irregularity, hypothyroidism, uric acid going up, lipids being abnormal and then these people are also highly predisposed to cardiovascular syndrome as well as affection of Cancers in various parts of the body. In fact this syndrome is one of the most common causes of Liver transplantation, now in our country and also in the western world.
Like I said there is no approved medical therapy. The only thing that works is weight loss and that has to be achieved by curving the calorie intake as well as by exercising regularly. It has been seen that if you lose 10% of your baseline weight then you can even reverse this scar tissue which has been led down in the liver. However this happens frequently and even in a smaller proportion of patients this is obtained.
So, again like I said that this is a lifestyle disorder of life style, parents have to play a very responsible role and when we are seeing the patients in the clinic every effort should be made to see if there is a metabolic perturbation which has led to this condition and try to treat that. Be it diabetes, hypertension, displedemenia, all of these disorders can be treated medically, and that can affect the natural history of this disorder.