Blog Archives

Understanding Liver Disease in the Obese

A new study looks at what is associated with a form of fatty liver disease that can lead to advanced liver disease. For the study, researchers looked at the livers of patients undergoing gastric bypass surgery.

Nonalcoholic fatty liver disease is found in 65 percent of obese people and is believed to happen in 90 percent of those morbidly obese. While nonalcoholic fatty liver disease is relatively benign, nonalcoholic steatohepatitis (NASH) is a form of fatty liver disease that is a concern. NASH can progress to fibroids which can then lead to cirrhosis and end-stage liver disease. The problem is in many cases of NASH there are no symptoms until it progresses to advanced liver disease. Researchers from the University of Washington School of Medicine looked at the risk factors for NASH in patients who were undergoing gastric bypass surgery.

Forty-eight patients agreed to have a liver biopsy done when they were having gastric bypass surgery. Researchers did not include patients who reported drinking more than two alcoholic beverages a day or who had cirrhosis. Study authors looked at who had NASH or severe fibrosis, the body mass index of the patient, the triglycerides level, and if the patient had diabetes.

Researchers report 33 percent of the patients had NASH and 12 percent had fibrosis. They also found 65 percent of the patients had moderate to severe fatty liver disease. Researchers report no difference in the age, sex, body mass index or triglyceride level between patients with and without NASH or advanced fibrosis. They also report the odds of NASH were 128-times greater and the odds of severe fibrosis 75-times greater in patients with diabetes. Researchers say the body mass index of the patient before the surgery was not associated with the likelihood of having NASH or severe fibrosis.

Study authors conclude fatty liver disease and NASH is common among patients undergoing gastric bypass procedures. They say diabetes and not body mass index is associated with NASH and the progression of fibrosis.

Safer Surgical Weight Loss

(Ivanhoe News 2000) — Can’t lose weight? You’re not alone! Experts say obesity is at an all time high. Nearly 55 percent of Americans are overweight. While surgery is not the best option for everyone, thousands undergo stomach-reducing surgery. Now doctors say a new technique can help without all the complications of earlier surgeries.

Kathie is a fraction of the woman she used to be. This mother of two used to weigh 332 pounds.

“I had tried every diet there ever was. I had high blood pressure; I had problems with my ankles, my knees. I work as a nurse, and I was to the point where by the time my 12-hour shift was over, I would go home, and I couldn’t walk. My feet were so sore,” says Kathie. She underwent a new surgical procedure that not only changed her life but saved it, too.

Kathie had a new type of gastric bypass surgery called the Micro-Pouch. Doctors James Sapala and Michael Wood say, like the traditional procedure, the stomach is reduced to the size of a grape. With the new procedure, it is unlikely the stomach will expand.

Michael Wood, M.D., of the St. John Detroit Riverview Hospital in Michigan says, “The Micro-Pouch works by limiting the amount of food that can be taken in at one time and also is a restriction on how fast they can take it in.”

Patients lose an average of 11 pounds a month. Around 30 percent of traditional procedures must be re-done because of stretching and tears to the stomach. Doctors claim that doesn’t happen with the Micro-Pouch (because it’s so small).

James Sapala, M.D., a bariatric surgeon at St. John Detroit Riverview Hospital says, “We redesigned the operation, and we found that with the small pouch our re-do rate dropped from 30 percent to 35 percent to zero.”

Kathie was the first patient to have the Micro-Pouch done. She says, “It’s a completely different life. My only regret is that I didn’t have surgery 10 years before I did.”

By waiting, she was able to get it done with fewer risks. Kathie still eats a lot of the same foods she used to eat. However, a healthy lifestyle is now a lifelong process.

Patients who have the Micro-Pouch procedure must follow a diet and behavior modification program and be monitored for life. Also, some women may have to have additional surgery to remove excess skin. The procedure is only for people who are 100 pounds overweight or more.