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Leading Medicine Magazine, Vol 7, No 1 - 2013

Dr. Howard Monsour Jr. Leading Medicine • Volume 7, Number 1 TREATING FAT T Y L IVER DISE ASE LOSE WEI GHT According to Dr. Howard Monsour Jr., studies here at Methodist and elsewhere have shown that a program of cardiovascular exercise, three times a week for 30 minutes, and a loss of 12–15 percent of body weight, e.g., a 260-pound man slimming down to 220, will yield signifi cant changes in the fat composition of the liver. CHANGE YOUR D IE T Patients should consider shopping only the perimeter of the grocery store because that is typically where one fi nds the fresh fruits and vegetables, meats and breads for a healthier, more balanced diet. The aisles are where the processed, often high-sugar and high-fat foods are lurking. TAKE ANTI OXIDANTS Studies show that when patients with NAFLD took 400 to 800 units of vitamin E each day, there were considerable reductions in liver fat content, infl ammation and fi brosis (scarring). ASK YOUR PHYSICIAN ABOUT ANT I D IABE T IC MEDICAT IONS Patients who do not respond to other treatments or who have advanced to NASH can benefi t from antidiabetic medications such as rosiglitazone and pioglitazone. These patients are often insulin resistant, and these medications increase insulin and fatty acid sensitivity, and in turn, appear to help reduce liver damage that excess amounts of both can cause. E XPLORE OTHER OPT IONS Consult your physician about other options such as statin drugs; gastric sleeve or bypass for morbidly obese patients; or a daily course of fi sh oil. n Please consult your physician before starting any new treatment program. When these elevated enzymes appear, physicians will look for other conditions that have also been linked to NAFLD, such as central obesity — weight gain around the waist — high cholesterol, high triglycerides, high blood pressure or diabetes to determine if further screening is advised. This further screening may initially include ultrasound, CT or MRI examinations. These imaging studies can reveal if the liver is enlarged, and suggest the presence of fatty liver disease, but the only positive diagnosis is through a liver biopsy, in which a small sample of liver tissue is removed and microscopically evaluated. TREATMENT Once a patient is diagnosed with NAFLD, the next step is developing an effective treatment plan. “At The Methodist Hospital, we have a multidisciplinary team approach to dealing with fatty liver disease,” Monsour explains. “Our patients are served by a group made up of an endocrinologist, a lipidologist, a diabetologist, a dietician, and if necessary, a surgeon, so that all aspects of diagnosis, treatment and lifestyle adjustment are covered.” In addition to patient care, Methodist is actively involved in researching the causes of fatty liver disease. Researchers at The Methodist Hospital are investigating fatty liver disease at the genetic level, searching for underlying causes of the disorder and analyzing population data to define what groups are genetically more predisposed to develop it. HARD WORK AND OPTIMISM For Bourquardez, the care that she’s received at Methodist has put her on the right track to a better quality — and hopefully longer — life. “I wish that I had gone to Methodist four years earlier,” she says. “Once you’re diagnosed with fatty liver disease, you have to consider it a lifelong challenge to control it because the alternatives are too scary. Everyone on my Methodist team works so hard to keep me focused and accountable; I just love going to them!” n For more information on fatty liver disease, visit methodisthealth.com/FattyLiverDisease. i n a d d i t i o n 49


Leading Medicine Magazine, Vol 7, No 1 - 2013
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