Thursday, September 25, 2008

New Hope for Patients With Advanced Liver Disease

PRNewswire/ -- While there are many causes of advanced liver disease, fatty liver, or NASH (nonalcoholic steatohepatitis), has become the second leading cause of liver transplant in the United States. Obesity, along with elevated cholesterol and diabetes, has long been known to cause increased fat stores, which may be injurious to the liver.

Such was the case in Sonny B., a patient at Atlanta Health Institute. Sonny had a long history of obesity and had tried many weight loss programs over the years. During his youth, weight was simply a nuisance that didn't prevent any activities. As time passed, Sonny developed diabetes, hypertension, elevated cholesterol and sleep apnea. He was noted to have elevated liver enzymes, and fatty liver, or NASH, was suspected.

Physicians often suspect this condition in patients with abnormal liver tests on their blood work or with an ultrasound of the liver showing increased fat. A confirmation of the diagnosis often requires a liver biopsy and a study of the liver tissue under the microscope. Unfortunately, NASH can induce inflammation and scarring in the liver, resulting in cirrhosis and organ failure.

Sonny's diagnosis of cirrhosis and the development of some very dangerous complications came despite his best efforts to lose weight. He began having episodes of confusion (encephalopathy), life-threatening intestinal bleeding (esophageal varices), and abdominal and leg swelling (ascites/peripheral edema). Sonny's liver appeared to be severely compromised, and a liver transplantation was recommended at a well-known university liver transplant center. To his dismay, Sonny did not qualify for transplant due to his excessive weight-502 pounds. He needed to lose 150 pounds before he could be considered-a near impossible feat considering his severe medical problems and deconditioning.

"The management of fatty liver and NASH has consisted of better diabetes and cholesterol control and weight reduction in the obese," said Dr. William Lyday, GI/Liver subspecialist and co-founder of the Atlanta Health Institute. "Sadly, many patients with this condition are unable to lose sufficient weight and may be too unhealthy for liver transplant. Many patients with NASH succumb to their disease, developing end-stage liver disease, and for various reasons cannot qualify for liver transplant."

In a desperate attempt to save Sonny's life, his wife Marilyn encouraged him to enroll in a new weight management program in Atlanta. Dr. Lyday and Hitesh Chokshi, both GI/Liver subspecialists at the Atlanta Health Institute, were using the OPTIFAST(R) nutritional products in their weight management programs. Upon their direction, Sonny began an intensive program of calorie restriction, weekly meetings with a doctor and dietitian, and a weekly class with other OPTIFAST patients.

In the past, patients like Sonny B were often considered hopeless cases and too high risk to undergo weight loss therapies. However, the combination of GI/Liver specialists using OPTIFAST nutritional products resulted in almost immediate benefits. Within two weeks, Sonny was off all his diabetes medications, and over the following weeks he stopped all of his blood pressure medications. His swelling decreased, his mental function improved and his activity level skyrocketed. After losing close to 100 pounds in just two months, Sonny is a new man, with very few obvious symptoms to suggest liver disease. His liver function may very well continue to improve, making liver transplant unnecessary. Time will tell, but Sonny is happy with his newfound health that he didn't believe was possible just two months ago.

Sonny will continue in the OPTIFAST weight management program at the Atlanta Health Institute as the doctors transition him back to eating regular foods. Upon reaching his weight loss goals, he will remain in Atlanta Health Institute's lifelong maintenance program which also utilizes OPTIFAST products and prevents recurrence of obesity.

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