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Lifestyle is the Leading Cause of Liver Disease

The most common causes of liver disease globally are Non-Alcoholic Fatty Liver Disease (NAFLD) and excessive alcohol consumption. NAFLD is closely linked to a diet high in processed foods, sugars, and unhealthy fats, combined with a sedentary lifestyle that contributes to central obesity. This can lead to fatty liver, non-alcoholic steatohepatitis (NASH), type 2 diabetes, and metabolic syndrome. On the other hand, making healthier lifestyle choices such as avoiding alcohol, practicing safe sex, and steering clear of intravenous drug use can significantly reduce the risk of alcohol-related liver disease and viral hepatitis B and C infections.

Alcohol Can Harm the Liver, But safe limits May Prevent Damage

Excessive alcohol intake can damage not only the liver but also the pancreas and central nervous system. While complete abstinence is the safest choice, moderate consumption limited to 10–12 units per week and spread over at least three days may allow the liver to metabolize alcohol effectively and reduce the risk of liver damage. It’s important to avoid binge drinking. A standard unit is calculated using the formula: Alcohol by Volume (ABV%) × volume (ml) ÷ 1000. These guidelines apply only to individuals with a healthy liver. For those with fatty liver, alcoholic liver disease, pancreatitis, or chronic hepatitis B or C, any alcohol intake is strongly discouraged, as it can significantly worsen their condition.

Liver Disease Is a Slow and Silent Killer

A common question patients ask is, “Why don’t I have any symptoms?” Liver diseases whether caused by alcohol, fatty liver, hepatitis B, or hepatitis C often progress silently over 5 to 15 years. The transition from hepatitis (inflammation and liver cell injury) to cirrhosis (permanent liver scarring) happens gradually and usually without noticeable symptoms. By the time signs like jaundice, fluid buildup (ascites), internal bleeding, or confusion (hepatic encephalopathy) appear, the damage is often advanced and irreversible. That’s why individuals with risk factors should undergo regular checkups and take early action such as avoiding alcohol, losing weight, adopting a healthy diet, and taking antiviral treatment for hepatitis B or C to prevent progression.

Fatty Liver Cannot Be Reversed by Medicine Alone

Many patients ask for medications to treat fatty liver. While certain drugs can help reduce liver inflammation associated with NASH (Non-Alcoholic Steatohepatitis), they do not reverse fatty liver itself. The most effective way to reverse fatty liver and prevent it from progressing to fibrosis or cirrhosis is through sustained weight loss, achieved by adopting a healthy diet and regular exercise. In some cases, bariatric surgery may be considered. Similarly, for alcohol-related fatty liver, complete abstinence from alcohol offers the greatest benefit. Medications play only a limited, supportive role in treatment.

Jaundice Is a Symptom, Not a Disease – Be Cautious with Alternative Medicines

In many parts of our country, it's common for people to turn to traditional or alternative remedies when they develop jaundice. However, it’s important to understand that jaundice is not a disease by itself—it is a symptom that can arise from a variety of underlying conditions, such as liver infections, gallstones, cancers, immune disorders, or blood diseases.

Acute viral hepatitis often resolves on its own over time. Unfortunately, fear and misinformation can drive people toward unproven treatments from unqualified practitioners. When jaundice naturally improves, these remedies are wrongly credited for the recovery. In reality, many severe cases of liver damage seen in ICUs are due to Drug-Induced Liver Injury (DILI) caused by these unsafe alternative medications.

Proper evaluation and treatment by qualified medical professionals are essential. Trusting self-proclaimed healers without scientific knowledge can lead to serious, even life-threatening, complications.

Curable Liver Cancer Can Only Be Detected Through Regular Screening

Liver cancer in its early stages usually shows no symptoms. Unfortunately, by the time signs such as jaundice, abdominal pain, or fluid buildup (ascites) appear, the disease is often too advanced for curative treatment.

The key to catching liver cancer early—when it is still treatable—is regular screening, especially for people at high risk. Individuals with conditions like alcoholic liver disease, NAFLD (non-alcoholic fatty liver disease), Hepatitis B or C, autoimmune liver disease, and other metabolic disorders should undergo periodic check-ups using imaging techniques and tumor markers.

Early detection offers the best chance for successful treatment so don’t wait for symptoms. Be proactive about your liver health.

Liver Oncology Is a Specialized Field

Liver cancer treatment is complex and requires a dedicated subspecialty. The liver is particularly sensitive to radiotherapy, and traditional chemotherapy is often ineffective for liver tumors. Instead, specialized treatments such as targeted therapy, immunotherapy, and advanced locoregional procedures like TACE (Transarterial Chemoembolization), TARE (Transarterial Radioembolization), Microwave Ablation, and RFA (Radiofrequency Ablation) are used.

Liver surgery demands a deep understanding of liver anatomy and function, along with advanced technology and collaborative decision-making. Since liver cancer often develops alongside chronic liver disease, some patients may be candidates for a curative liver transplant.

Effective management of liver cancer requires care from highly specialized centers with a multidisciplinary team—hepatologists, liver surgeons, interventional radiologists, liver imaging experts, and transplant specialists. These integrated teams offer expertise beyond what is typically available at general oncology centers, ensuring the best outcomes for patients.

Not Every Cirrhosis Patient Requires a Liver Transplant

The decision for liver transplantation is based on liver function—not just structural damage seen on imaging. While cirrhosis may be evident on scans, it doesn't automatically mean a transplant is needed. Liver transplant carries a risk, with a mortality rate of 5–10%. Therefore, we only consider transplantation when the risk of dying from liver disease exceeds the risk of the procedure itself.

Transplant evaluation is typically considered when liver function deteriorates, such as a MELD score above 16 or advanced Child-Pugh stage (late B or C). Exceptions are made for patients with complications like refractory ascites, recurrent encephalopathy, or liver cancer. Careful assessment by a specialized liver team is essential in making this decision.

Liver Transplant Is a Proven Treatment for End-Stage Liver Disease

Liver transplantation is not an experimental option—it is the only definitive and time-tested treatment for end-stage liver disease, practiced successfully for over 40 years. In India alone, more than 5,000 liver transplants are performed annually, with success rates ranging between 90–95%.

The outcome largely depends on the patient’s overall health and the severity of their liver disease at the time of transplant. That’s why timely referral to specialized liver transplant centers—without losing valuable time on ineffective or unproven treatments—is crucial for achieving the best possible outcomes.

Dr. R. Phani Krishna