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| Topic: |
Digestive Diseases (DD) |
| Title: |
Bariatric Surgery: A Promising Solution for Nonalcoholic Steatohepatitis in the Very Obese. |
| Author: |
Shaffer, E.A. |
| Source: |
Journal of Clinical Gastroenterology. 40(Suppl): S44-S50. March 2006. |
| Abstract: |
This article reviews the use of bariatric surgery for management of nonalcoholic steatohepatitis (NASH) in obese patients. The author notes that the mainstays of treatment for NASH, diet and physical activity plus behavioral modifications, are not always successful, particularly in the very obese. Only limited evidence exists that liver enzymes improve with reduction in body weight. The drug therapy in current use has focused on treating insulin resistance and oxidative stress, but again with rather limited success. The author emphasizes that, in the severely obese, the best treatment option is bariatric surgery, which is safe and has been successful in producing a 61 percent weight loss overall. The result is improvement in diabetes mellitus, the metabolic syndrome, and presumably its sequelae. Early reports (and procedures) were attended with dramatic weight loss but markedly aggravated the inflammatory liver disease. In recent trials with more modest weight loss and less malnutrition, bariatric surgery reduced the fat, inflammation, and even the fibrosis in well-documented NASH. The laparoscopic adjustable banding procedure is deemed most suitable for this purpose. The author cautions that ongoing care will be necessary with a lifetime follow-up because of the metabolic and other complications from the weight loss. 4 figures. 59 references. |
| Format: |
Journal Article |
| Language: |
English. |
| Major Keywords: |
Digestive System Diseases. Nonalcoholic Steatohepatitis. Fatty Liver. Pathophysiology. Obesity. Risk Factors. Bariatric Surgery. Weight Loss. Patient Care Management. |
| Minor Keywords: |
Fibrosis. Cirrhosis. Liver Disease. Insulin Resistance. Metabolic Diseases and Disorders. Morbidity. Diabetes Mellitus. Inflammation. Surgical Techniques. Postoperative Care. |
| Publication Number: |
DDJA12627. |
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