Top Liver Disease Specialist Talks Strategies for Battling Liver Disease

Helping physicians and patients deal with “silent” epidemic

December 2019

Gastroenterologist and hepatologist, Stephen Harrison, M.D., medical director of Pinnacle Clinical Research in San Antonio, Texas, and visiting professor of hepatology at the University of Oxford in Oxford, England, has launched a new podcast to talk about the alarming growth in nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) in the United States.

Here’s a look at the topics he has covered to date:

In “Prevalence of NAFLD in the United States”, Dr. Harrison discusses how NAFLD, which has been linked to increasing rates of obesity and diabetes, is increasing in prevalence year over year. In a five-year prospective study of 835 patients, including all age groups, genders, and ethnicities, researchers found an overall prevalence of 35-37% for NAFLD and 15% for NASH. This provides a better picture of the impact of liver disease and reveals that NASH rates are higher than expected. Those most at risk include Hispanic Americans (60% NAFLD, 25% NASH), Asians and Caucasians (40% NAFLD, 20% NASH) and African Americans (20% NAFLD, 5% NASH).

In “Collaboration Between Specialists and PCPs in NAFLD Management”, Dr. Harrison discusses how over-burdened primary care physicians need guidance surrounding discussions of fatty liver disease with their patients. First, as most physicians know, NAFLD is common in their communities. It’s also important for them to understand that a substantial portion of patients is progressing to a state of liver disease that puts them at risk of decompensation or cancer down the road. Partnering with a liver specialist will become increasingly important for further evaluation of fatty liver because enzyme test results are only half the story.

In “How to Talk to Patients About NAFLD”, Dr. Harrison discusses how to communicate with patients at risk of fatty liver disease. They may be overweight or obese, have diabetes or hypertension, or be metabolically obese. This means they may have a family history of liver disease or liver cancer or are worried about risk because a relative died from cirrhosis. Once the physician has eliminated alcoholism, they should inform the patient that there is both a genetic and nutrition component to fatty liver disease. While genetics can’t be fixed, losing just 10% of body fat can result in significant improvement of liver health.

In “Key Takeaways for Management of NAFLD and NASH”, Dr. Harrison discusses how clinicians should focus on risk factors and utilize liver enzymes with a FibroScan examination, a pain-free, non-invasive examination of the liver, by either purchasing this device or partnering with a liver specialist or gastroenterologist who utilizes this technology to screen for liver disease. While there is currently no FDA-approved treatment for NAFLD, over 40 clinical trials are being conducted which show great promise, so there is hope for patients.