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Dr. Sonal Kumar on the silent epidemic of fatty liver disease
April 6, 2018
The first thing many of Dr. Sonal Kumar’s patients say when she walks into the room is, “My primary care doctor tells me that I have liver disease. But I don’t drink or do drugs. How did this happen?”
Through her clinical practice, research, and social media presence, Dr. Kumar — Director of Clinical Hepatology at Weill Cornell Medicine — helps patients find the answers they need.
Dr. Kumar sees that many patients know very little about liver disease or, worse, have received incorrect or misleading information.
“There are many other reasons for liver disease aside from drinking and intravenous drugs,” stresses Dr. Kumar. In fact, poor diet and obesity are the leading causes of nonalcoholic fatty liver disease, which is becoming the most common cause of liver disease in the United States and worldwide. This disease occurs when fat builds up in the liver, making it harder for it to perform necessary functions.
Many patients think of liver disease as something that happens to elderly patients who drank heavily throughout their life.
“Sadly, patients with nonalcoholic fatty liver disease are often not the elderly. In fact, they are getting younger and younger due to the rising prevalence of childhood obesity,” Dr. Kumar explains, “and those impacted with fatty liver disease (or any liver disease) usually have no signs or symptoms until the disease is in more advanced stages.”
Patients with fatty liver disease are at a higher risk for heart disease and, as the disease advances, experience abdominal swelling (ascites) or yellowing of the skin (jaundice).
Another commonly held belief is that liver disease cannot be treated; this is not true.
“With weight loss, fatty liver disease is in fact reversible, even if you have some scarring,” Dr. Kumar says. “We know it’s not easy, but there are dietary and lifestyle modifications that can be made.” She partners with nutritionists and the YMCA to help her patients get healthy.
The best way to prevent fatty liver disease, is to develop a healthy lifestyle and maintain a healthy weight. However, anyone can request a simple blood test with their primary care doctor to check their liver enzymes.
Researching future treatments
Dr. Kumar predicts that the most significant advances in hepatology will be treatment for fatty liver disease.
“Fortunately, Hepatitis C is no longer the major health threat that it used to be,” says Dr. Kumar. “There are currently no FDA-approved medications to treat fatty liver disease. We hope that will change in the next year.”
Currently, Dr. Kumar is conducting in Phase II and III clinical trials that evaluate the efficacy of potential medications for the treatment of fatty liver disease.
“We have to wait and see how the data plays out,” she says, “but we’re hopeful for promising results.” She is also investigating predictive factors for liver disease progression, as well as the effect of lifestyle changes on fatty liver.
Dr. Kumar actively shares insights into her research and other notable advancements in GI, hepatology, and liver disease treatment using Twitter (@SonalKumarMD).
Helping patients find better care
Dr. Kumar hears many patients describe their struggle to find the right gastroenterologist for their care. She believes that for preventative care, patients should seek physicians with extensive experience.
“When choosing a doctor for a colonoscopy or endoscopy,” she suggests, “find someone who has a lot of experience doing them, someone who does them often. That’s because the more you do, the better you become at doing them!”
When it comes to more complicated conditions, including liver disease, she stresses the importance of finding someone in tune with this rapidly changing field — a doctor involved with research, clinical trials, and the newest medications.
All patients, no matter the condition, should find a doctor who helps them feel informed and secure.
To help her patients, Dr. Kumar draws on her personal experience. Five years ago, her father had a massive heart attack that required bypass surgery. Dr. Kumar recalls, “My family and I were scared and — at times — felt uninformed. After that experience, I became even more committed to preventing that feeling with my patients.”
Her patients certainly appreciate this commitment. One patient, who participated in a clinical trial, writes, “Dr. Sonal Kumar helps me find solutions to problems I may be having and is very thorough. She makes me feel safe.” (Healthgrades.com)
Dr. Kumar — along with all physicians at Weill Cornell Medicine — are devoted to offering patients innovative treatments and relevant, cutting-edge information to feel empowered. She and our entire team of gastroenterologists and hepatologists are available to help patients receive the best care possible.
Visit Weill Cornell Department of Gastroenterology and Hepatology to learn about the conditions we treat.