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Almost a fifth of adults and as many as 70 percent of people with type II diabetes have fatty liver disease.

By JUDY SIEGEL-ITZKOVICH
Disease (photo credit: Wikimedia Commonscourtesy)
Disease
(photo credit: Wikimedia Commonscourtesy)
I am a 54-year-old man with type II diabetes, diagnosed five years ago. I am 10 kilos overweight, but I try to exercise when I can. Recently I was diagnosed with a “fatty liver,” or non-alcoholic steatohepatitis, which I am told could lead to cirrhosis of the liver and serious consequences. Is there any way – through lifestyle changes – to avert the evil decree and rid myself of my fatty liver? – M.R., Beersheba
Prof. Ran Tur-Kaspa, chairman of the liver institute and internal medicine D department at Petah Tikva’s Rabin Medical Center-Beilinson Campus, replies: Non-alcoholic fatty liver disease (NAFLD) is usually a part of metabolic syndrome associated with type II diabetes, overweight and too much low-density lipoprotein (“bad cholesterol”). It results from improper nutrition, excessive eating, the lack of physical activity, and too much stress. Excess fats and triglycerides build up inside liver cells, causing swelling and inflammation.
Almost a fifth of adults and as many as 70 percent of people with type II diabetes have fatty liver disease.
Almost all heavy drinkers of alcohol also have it. A growing number of obese children also have the condition, and this is very worrisome.
Untreated, it can lead to cirrhosis – the replacement of liver tissue by fibrosis, scar tissue and regenerative lumps that occur as a result of a process in which damaged tissue is regenerated – leading to reduced functioning of the liver and possibly even the need for a liver transplant.
Treating the associated causes of NAFLD will – in many cases – improve and even reverse the fatty changes in the liver. I suggest that you go to experts for reducing weight, treating your diabetes very strictly and reducing your “bad cholesterol.” Regular physical exercise, even just walking 30 to 60 minutes a day, and eating a lot of vegetables and whole grains can be of immense help. Also, reduce your intake of alcohol, as even “social drinking” can contribute to turning fatty liver into alcoholic fatty liver disease.
My husband had an operation for an aneurysm in the aorta eight years ago, and he is now 84. He was being checked by a vascular surgeon and sent for an ultrasound once a year. The doctor prescribed support stockings for poor circulation, and an abdominal belt, as he has quite a bulge there since the operation.
The original doctor no longer works for our health fund. The new cardiologist gave my husband a very superficial examination and said everything was fine.
He said he thought my husband no longer needed the stockings or the belt. When I questioned this, he said he would give him the prescription for stockings, but didn’t think he needed them. The fact is that his ankles swell up if he neglects to wear them, so he does. My question is whether he still needs an ultrasound scan once a year.
– R.L., Jerusalem
Prof. Ariel Roguin, director of interventional cardiology at Haifa’s Rambam Medical Center, who was at a medical conference abroad when he received this query via The Jerusalem Post, sends this advice for R.L.: I think he does need to undergo the annual ultrasound.
My daughter is only a few weeks pregnant with a first baby. She called me very worried, saying she had some vaginal bleeding. I tried to calm her down and sent her to the gynecologist. Does this symptom mean a spontaneous abortion? R.R., Tel AvivProf. Moshe Mazor, deputy chairman of obstetrics/gynecology at Soroka University Medical center, and his colleague Prof. Eyal Scheiner, answer: Vaginal bleeding is quite common in pregnant women and sends many to the emergency room. Vaginal bleeding occurs in about a fifth of pregnancies. It can be worrisome, but there can be many causes – some harmless and some serious. It is often insignificant, as it could be the result of the embryo’s implanting in the uterine wall. During the first and last trimester of pregnancy, it may also mean a miscarriage is coming. Closer to the end, it could mean separation of the placenta from the uterus and bring about premature birth, but there are drugs that can be given to reduce the risk and to treat it. Your daughter should definitely go to a gynecologist for an immediate checkup.
■ Rx for Readers welcomes queries from readers about medical problems. Experts will answer those we find most interesting.
Write Rx for Readers, The Jerusalem Post, POB 81, Jerusalem 91000, fax your question to Judy Siegel-Itzkovich at (02) 538-9527, or e-mail it to jsiegel@jpost.com, giving your initials, age and place of residence.