Fatty liver set to emerge as top cause of liver cirrhosis, says expert

Unaddressed fatty liver is seen to be the top emerging cause of liver cirrhosis worldwide, including the Philippines, in the next few decades, urging Filipinos to maintain a healthy lifestyle, according to a health expert on Wednesday.

As treatments and vaccines have become available for Hepatitis B and C—the main culprit of liver cirrhosis—the overall prevalence of the disease has not declined. Fatty liver is now emerging as one of the rising main causes, particularly in Western countries by 2030, Dr. Mara Teresa T. Panlilio, a gastroenterology and transplant hepatology specialist, said during a forum led by the Philippine College of Physicians.

“This trend is likely to be observed globally, including in the Philippines by 2050,” Ms. Panlilio said. “We are seeing a continuous rise in fatty liver disease, which is expected to become the number one cause of liver cirrhosis worldwide due to lifestyle factors, such as heavily processed diets and oversized sugary drinks,” she added.

According to Harvard Health Publishing, liver cirrhosis is a condition in which normal liver cells are replaced by scar tissue, interfering with the organ’s normal function.

Globally, there are 112 million people with compensated cirrhosis, or a reversible stage of liver cirrhosis, Ms. Panlilio said, citing the 2017 Global Burden of Disease Study.

If a patient has unaddressed fatty liver disease, excessive fat buildup can overwork the liver, eventually leading to scarring, or cirrhosis, Ms. Panlilio said.

She explained that in the early stages of liver cirrhosis—usually within 10 to 35 years from the initial exposure to risk factors—patients may have no symptoms.

If left unaddressed, the condition may progress up to decompensated cirrhosis, when symptoms appear and other liver-related complications may develop.

Common symptoms of advanced cirrhosis include jaundice, abdominal swelling due to fluid accumulation, kidney failure, vomiting blood, and in some cases, liver cancer.

Fatty liver can develop from high cholesterol, type 2 diabetes, and metabolic conditions such as obesity.

This means that even with little or no alcohol consumption, liver cirrhosis may still develop if poor diet and a sedentary lifestyle contribute to these underlying conditions.

According to a 2022 report by the Hepatology Society of the Philippines, at least 18 million Filipinos are overweight or obese and may be at risk for fatty liver disease, also known as non-alcoholic fatty liver disease (NAFLD).

Ms. Panlilio emphasized that not all patients with fatty liver will develop cirrhosis, as reversing risk factors through a comprehensive lifestyle approach is possible.

“Fatty and oily foods should be reduced. Sugar intake should be limited. Sedentary behavior must be minimized,” she said.

She also advised monitoring liquid calorie intake, which can add significantly to total calories even if food consumption is controlled.

Apart from lifestyle changes, she encouraged vaccination against Hepatitis B and C, especially for infants, to prevent the leading causes of liver disease and cirrhosis.

She also recommended avoiding excessive alcohol consumption and the improper use of medications.

January is recognized as Liver Cancer and Viral Hepatitis Awareness and Prevention Month, according to the Department of Health.

The forum was part of an initiative led by the Philippine College of Physicians and the Department of Health to raise public awareness about liver disease. — Edg Adrian A. Eva