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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.

A Review of Primary Biliary Cholangitis

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Primary Biliary Cholangitis (PBC) is a chronic liver disease that causes damage to the bile ducts in the liver. Read on to learn more about this condition.

Causes and Risk Factors

PBC is considered to be an autoimmune disease. This means your body perceives your liver as invasive and attacks it. Your body’s T cells, which fight off bacteria and viruses, end up damaging cells in the bile ducts in your liver.

This condition may be caused by environmental factors as well as genetic factors. It is more likely to occur in women, people between 30 and 60, people who smoke, people with a family member who has PBC, and people who have been exposed to certain chemicals. Sex is one of the primary risk factors: around 90% of people with PBC are women.

Symptoms

PBC causes a few symptoms. These include intense itching, elevated cholesterol levels, swollen feet and ankles, musculoskeletal pain, darkening of the skin, and abdominal pain. In general, these symptoms develop gradually, and most people with PBC do not have symptoms when doctors diagnose them with the condition. Symptoms tend to develop over 5 to 20 years, becoming more significant over time.

Diagnosing Primary Biliary Cholangitis

In most cases, doctors diagnose PBC incidentally during a routine checkup or other medical visit. This is because symptoms tend to develop very slowly, and are often not present in the early stages of the disease. In many cases, your doctor may discover an abnormal result in a routine blood test, which leads them to further testing. If they do suspect you may have PBC, they will likely give you a blood test to measure anti-mitochondrial antibodies (AMAs). Doctors consider this the go-to test for PBC, since people almost never have AMAs present in their blood unless they have PBC. If your doctor does discover AMAs through the testing, that is a sign you likely have the condition.

Your doctor will also ask you about your medical history, along with your family’s medical history. This is to help determine if the disease may be present in your family already, which is a risk factor for you having it.

Treating Primary Biliary Cholangitis

There is no cure for PBC, but there are several treatments doctors can pursue to help manage your symptoms and disease progression. Over the long term, PBC can lead to liver failure since it damages your liver slowly over many years. If your liver fails, you will need a liver transplant, which is a major surgery.

To help mitigate damage, your doctor may prescribe a medication called ursodiol. This is a natural bile acid that can help bile flow through your liver more effectively. It can improve your liver function and reduce scarring. It is an effective treatment for a little over half of people with PBC.

There are many treatment options to address the symptoms of PBC as well. Your doctor may recommend antihistamines like Benadryl to help with intense itching, and eye drops to help with dry eyes. They may also prescribe calcium and Vitamin D to help maintain your bone strength, and if you have fatty stools there are other vitamin supplements they may recommend.

There are a number of lifestyle changes you can make to help manage PBC as well. These include avoiding alcohol or lowering your intake, staying hydrated, exercising regularly, and avoiding smoking. You can combine these kinds of lifestyle changes with your medications to manage PBC and improve your health outlook long-term.

Our experienced team at GHP has years of experience treating patients with conditions including PBC. 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.