Gastroenterologist Dr Kalayarasan Raja warns ‘silent liver disease’ is rising in young adults; know causes and signs

The liver is one of the body’s most important organs, responsible for several essential physiological functions, including detoxification, metabolism, bile production and protein synthesis. Therefore, liver damage can affect the entire body and disrupt the processes that keep it functioning properly.

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However, the worry is that most liver diseases do not have obvious warning signs and may progress for years before noticeable symptoms emerge. This is why awareness and early detection are important. One such condition is metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as non-alcoholic fatty liver disease (NAFLD)

To understand why MASLD is emerging at a younger age and whether the damage can be prevented, Prof (Dr) Kalayarasan Raja, senior consultant – surgical gastroenterology, robotic HPB & GI surgery at Apollo Hospitals, Chennai, answered some questions for HT Lifestyle in an interview.

But first, let’s understand why the liver is a source of concern, with health experts reiterating that symptoms often appear only after the condition has progressed.

“The liver lacks pain receptors, meaning that diseases can progress without causing any pain. Additionally, owing to its high resilience, it will continue to perform key metabolic functions while incurring significant damage,” Dr Raja said.

For these reasons, symptoms of liver disease are often detected quite late. The gastroenterologist added that this is also true for MASLD, warning that this ‘silent liver disease’ is alarmingly being reported among young adults.

Dr Raja described, “Metabolic dysfunction-associated steatotic liver disease (MASLD) is a group of liver diseases that arises when the body stores a lot of fat in the liver.”

Describing how MASLD progresses, the gastroentrologist said that it may initially begin as simple fatty liver before advancing to a more serious stage involving inflammation and liver-cell injury.

“What may start as simple fatty liver (steatosis), which is the continued accumulation of fat in the liver without much inflammation, may progress to Metabolic dysfunction–associated steatohepatitis (MASH), which is characterised by fat accumulation along with inflammation and liver-cell injury.”

The doctor then pointed out that symptoms such as fatigue, abdominal discomfort, bloating, and unexplained weight changes may appear at this stage. These symptoms require medical evaluation, as this condition, if left untreated, may continue to progress, causing long-term damage, liver scarring and shockingly, even liver failure.

“MASLD commonly occurs in people with existing conditions like metabolic dysfunction, dyslipidemia or the imbalance of lipids in the body, obesity, insulin resistance and type-2 diabetes. It is considered a lifestyle disease that is driven by modern dietary habits, high-calorie intake, poor sleep patterns coupled with stress, and physical inactivity,” he added.

What can prevent MASLD?

Your lifestyle plays a major role in this disease, from influencing its development and progression to helping prevent it. This is why the doctor recommended, “Maintaining a healthy diet, incorporating regular exercise or physical activity of any kind into your routine, managing blood sugar levels, avoiding alcohol and certain toxic medications, smoking cessation, and monitoring lipid profile along with regular health checkups can help to a great extent.”

Prevention requires a holistic approach that goes beyond managing diet or body weight, with special emphasis on regular screenings.

Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.