Non-Alcoholic Steatohepatitis (NASH) and Celiac Disease EP025

Gluten Free RN

We typically associate liver disease with alcoholism. But the liver functions as a filter, and over time it can be damaged by certain pharmaceuticals and even food. In fact, research suggests a strong correlation between undiagnosed celiac disease and non-alcoholic steatohepatitis (NASH).

The Gluten Free RN shares a number of case studies in which a diet change reversed liver damage and prevented the need for an organ transplant. She also takes us through the alarming statistics regarding NASH in children and discusses her approach to treating NASH patients.

Listen to understand the obesity trends in the US and how a sedentary lifestyle plays a part in liver disease. Join Nadine’s campaign to educate the population about the benefits of a gluten- and dairy-free, whole food diet – and prevent NASH!

What’s Discussed:

Nadine’s introduction to NASH in children

• Videoconference of pediatricians
• Discovered NASH on autopsies
• Few had signs/symptoms

The fundamentals of NASH

• Liver failure caused by changing environmental factors
• Dietary culprits (e.g.: sodas, fast food, processed foods, alcohol, high fructose corn syrup, nutrient-deficient carbs)
• Up to 90% of patients undergoing bariatric surgery have fatty liver disease
• Only diagnostic tool is liver biopsy

Obesity trends in the United States

• 60% of people in 13 states will be obese by 2030
• Link between poverty and obesity

Why starving people are obese

• Lack of nutrient-dense food results in low nutrient levels
• Body compensates for deficiencies by storing fat as cheap energy

The correlation between undiagnosed celiac disease and NASH

• Celiac disease found in 10% of patients with unexplained abnormal liver panels and 3.5% of patients with NASH
• Anyone with bump in liver enzymes should be screened for celiac disease and given gluten-free diet option

The 2015 Canadian study re: liver transplant

• NASH as most common indication for liver transplant in North America
• NASH projected to be leading cause by 2025
• Identified obesity, sedentary lifestyle, highly processed foods, undiagnosed celiac disease, MS and type 2 diabetes as causes

The basics of non-alcoholic fatty liver disease (NAFL)

• Buildup of fat in liver cells
• Largely asymptomatic until have profound liver/organ failure

Which populations are at increased risk for NASH

• Obese
• Hispanic
• Native American
• Pediatric

Liver transplant statistics

• 16,000 people on waiting list for liver transplant
• Only 6,000 liver transplants performed each year

Case study demonstrating the reversal of liver damage on gluten-free diet

• 19-year-old woman referred for emergency liver transplantation
• Recovered quickly on gluten-free diet, normal liver and small intestines after 20 months
• No surgery required

The correlation between celiac disease and liver disease

• Celiac patients at increased risk of NAFLD compared to general population
• Most common cause of chronic liver disease in children and adolescents in western nations

How Nadine approaches a patient with NASH

• Examine diet (food as medicine/poison)
• Replace highly processed fats
• Leverage minimally processed foods

How to combat obesity

• Educate people about the value of nutrient-dense food
• Provide medical and social support

The liver as a detoxing organ

• Functions as a filter
• Can be damaged over time by foods, acetaminophen, alcohol

What a good, whole food diet looks like

• Gluten- and dairy-free (ideally Paleo)
• Includes meat and fish, nuts and seeds, organic fruits and vegetables

The need for access to accurate nutritional information

• Not influenced by politics, food corporations, agribusiness or pharmaceutical companies

Resources:

PubMed

“Sonographic Diagnosis of Coeliac Disease in a Case with Suspected Acute Liver Failure” in the European Journal of Gastroenterology and Hepatology

“Non-Invasive Diagnostic Biomarkers” by Dr. Rohit Loomba of UC San Diego

“Acute Cryptogenic Liver Failure in an Untreated Coeliac Patient” in the European Journal of Gastroenterology and Hepatology

“Increased Risk of Non-Alcoholic Fatty Liver Disease After Diagnosis of Celiac Disease” from the Journal of Hepatology

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Books by Nadine:

Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism