“I had a slight swelling in my stomach”: there are no signs of fat in the liver usually

“I had a slight swelling in my stomach”: there are no signs of fat in the liver usually

Pensioner Heides Paulo Pinto, 67, has always taken care of his health. But in the case of an epidemic, medical examination is left for later, especially at the most critical moment, with the increase in cases and deaths from Covid-19, and it is still without a vaccine against the disease.

When things improved last year, he looked for doctors who were already part of his routine, a urologist and a cardiologist. A specialist passed an abdominal ultrasound, which identified a liver disorder, mild nonalcoholic fatty liver disease – the disease is also known as “fatty liver” or “fatty liver”.

“I was surprised because I didn’t feel anything. Sometimes I had a certain swelling in my stomach, I thought it was normal, from diet, to eat a lot, but it didn’t go away,” recalls the retiree who lives in Rio de Janeiro. As a result, the cardiologist suggested that he look for a hepatologist who specializes in diseases affecting the liver, For further investigation.

When the doctor passed another test, an elastography, which assesses the consistency of the liver, the result showed that the disease, in fact, is advanced.

“During the pandemic, I was very anxious and ate more. Living in Rio, I used to ride a bike and go to the gym, but during this time, I stopped,” Hydes says.

Treatment includes healthy habits

According to Andrea Evangelista, a hepatologist at the Advanced Liver Center at HSVP-RJ (São Vicente de Paulo Hospital in Rio de Janeiro), there is no specific treatment to solve the problem. “Studies show the benefits of some medications that help with steatosis: improving inflammation, but without removing fat from the liver,” explains the doctor who even treated Heides.

Hydes is back in the gym and gaining muscle

Photo: personal archive

What happens in most cases is treating obesity or diabetes with medications that also help reduce the extra fat present in the liver cells.

Therefore, the main way to treat the disease is to make lifestyle changes: a balanced diet and frequent physical activity. Therefore, the retiree also began attending a dietitian – at which point he resumed healthy eating habits.

“I learned to read the labels of the foods I bought better,” he says. “It has completely changed, and it was nothing drastic.”

Hydes’ dietary changes included the following measures:

  • Significantly reduced consumption of processed foods, especially ultra-processed foods, such as canned juices, ready-made sauces, and pork;
  • Include more fruits and vegetables in the diet;
  • More cereals and grains were added;
  • Low alcohol consumption – which was already low.

In about 4 months, HYDES I actually managed to get the problem under control, also relying on the constant practice of physical activity. She even went from 75 kg to 66 kg. “I’ve already lost 9 kg and gained muscle mass. With the help of a personal trainer, I started doing physical activity,” says the retiree, who has resumed cycling.

It’s this balancing thing. You are very unbalanced. Now I’m fine, we don’t realize that exercise and a good diet are key. HYDES Paulo Pinto, 67

“Of course, sometimes, when I feel like eating something, I buy it, without overdoing it like I used to. But today, I eat more fruits and grains, for example, and less fatty foods.”

Heides Paulo Pinto, 67 - Personal Archive - Personal Archive

Hades tackled the problem without drastic changes

Photo: personal archive

Hydes says the doctors congratulated him on his effort from the start. “Looking at the old photos, I realize how much better I am today.”

Silent, the disease can be dangerous if left untreated

Hepatic steatosis occurs when liver cells (liver cells) fill with fat inside. For this reason, the disease is known as “fatty liver” or “fatty liver”. The main causes include being overweight (overweight and obesity), a sedentary lifestyle, diabetes, and high cholesterol and triglycerides.

Because the disease usually has no symptoms, diagnosis is more difficult. “The screening test is an abdominal ultrasound, which is part of the routine for people who are overweight, obese, diabetic or pre-diabetic, as well as those with high cholesterol,” explains the doctor from the Hospital of São Vicente de Paulo.

According to the hepatologist, most cases benign, being “only” a sign of danger to the patient. However, you must be very careful with the diagnosis, as not treating the fatty liver can increase the risk of developing other diseases, such as steatohepatitis, an inflammation of the organ that leads to a fibrosis (scarring) process.

Heides Paulo Pinto, 67 - Personal Archive - Personal Archive

Retire while training with the character

Photo: personal archive

Evangelista highlights, “Everything that becomes inflamed in the body is repaired with scarring. The liver does the same. But in some cases, this development can lead to cirrhosis, which is a risk factor for liver cancer.”

To address the problem, the two mainstays, according to the doctor, are diet and physical activity – as mentioned above. “The patient needs to change their lifestyle,” he says. “This is not to ‘close your mouth’ to food, but rather to re-learn how to eat well.”

The importance of food

It is necessary to avoid processed foods – as Hydes did -, especially ultra-processed foods, which are products produced by industry and should be avoided. Some examples are: packaged juices, instant noodles, soups, crackers, packaged snacks, and ice cream.

“A healthy, balanced diet, according to the needs of each patient, is the basis for the prevention and management of non-alcoholic hepatic steatosis, as well as many other health conditions,” explains nutrition expert Jamil Tahim, MSc at UECE (Ceara State University). “In this particular case, a real diet is necessary.”

according to tahimIt is important to include fiber, vitamins, minerals, proteins, polyunsaturated fats, monounsaturated fats, and complex carbohydrates. The specialist provided important nutritional advice and suggestions to include in the diet.

  • the fruit: Apple, banana, watermelon, papaya, grape, kiwi and watermelon.
  • Vegetables and greens: broccoli, chayote, lettuce, carrots and turnips;
  • Carbohydrates in their complete form: Bread, rice and pasta.
  • Fiber, grains and seeds: Oats, chia, flaxseeds, sesame and sunflower.
  • tubers: Potatoes and cassava.
  • Legumes: Beans, peas, chickpeas and lentils.

According to the nutritionist, it is necessary to limit the intake of alcohol, because it has an inflammatory potential, which intensifies the overload of liver function by producing substances that increase the risk of toxicity that is metabolized in the liver.

Finally, it confirms that physical exercise is essential for disease management, as it improves the functional capacity of our body and increases the sensitivity to the action of insulin, a hormone that regulates the metabolism of glucose uptake after ingestion. From food, avoid high blood glucose.

“This action is important to prevent the metabolism from converting excess glucose into a form of fat that, among other places, is deposited in the liver, exacerbating the severity of the disease,” he says. cook them

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