Wave of silent diseases during pandemic worries experts – 08/30/2021

The large increase in cases of obesity, alcohol consumption and self-medication during the covid-19 pandemic triggered the number of silent diseases, such as those that affect the liver, the largest gland and the largest massive organ in the human body, and whose impact in the health of Brazilians now and also during the next decade worries specialists.

the president of IBRAFIG (Brazilian Liver Institute), Paulo Bitencourt, said in an interview to Efe Agency that viral, alcoholic and drug hepatitis, in addition to steatosis (fat in the liver), the main diseases that affect this organ of the digestive system, evolve without symptoms, even the development of cirrhosis and cancer.

Therefore, it is necessary to be aware of the conditions associated with a higher risk of developing these conditions, many of them aggravated during the pandemic, such as sedentary lifestyle and obesity, according to the specialist, who reported a “very large growth in cases of drug hepatitis” related to self-medication of drugs or supplements with the aim of early treatment or prevention of covid-19.

The doctor also warned of the increased frequency, in intensive care units (ICUs), of cases of acute alcoholic hepatitis, which can lead to liver failure in a few weeks due to alcohol abuse, and which has a mortality rate of about 50%.

In addition, the expert warned of increases in the consumption of industrialized and multi-processed foods in the pandemic and cases of weight gain, which should be reflected a lot, in Brazil, in the number of people with excess fat in the liver, which is already the largest cause of transplants in some states of the United States.

Obesity and sedentary lifestyle in the covid-19 pandemic

According to the coordinator of the liver disease department of the Brazilian Association for the Study of Obesity and Metabolic Syndrome (Abeso), Claudia Oliveira, steatosis affects between 20% and 30% of the world and Brazilian population, and its main factors are risk for liver fat weight gain, diabetes, high cholesterol and triglycerides, and sedentary lifestyle.

For this reason, weight gain is highly worrying in Brazil, where 60% of the population is overweight, and obesity already affects 20% of it.

“Liver fat is not such a benign disease, it can progress to more serious forms, including cirrhosis and liver cancer, and fat accumulation can occur in weeks or months, but fibrosis and inflammation take from seven to 10 years”, estimated the specialist.

Even so, Oliveira warned that this evolution is silent and can lead to steatohepatitis, which occurs when, in addition to fat, the patient has liver inflammation and even fibrosis (collagen deposit), a condition that has been growing a lot in the pandemic and that, as she warned, “is almost the second cause of transplants in Brazil”.

“Steatosis was already the main outpatient liver disease, but in the pandemic, with the increase in obesity, anxiety and binge eating and worsening of lifestyles that were no longer very good due to social isolation, we saw an increase in cases of liver fat during this period,” he said.

“The increase in alcohol consumption is also worrying, because it increases the fat in the liver by itself, so when you add a sedentary lifestyle, poor diet, obesity and even a higher alcohol intake, this is a very bad trio for these patients, and in the pandemic this was exacerbated,” he added.

Oliveira explained that, in the early stages of the disease, when there is more fat and little fibrosis, the treatment is weight loss, reduced calories, sugar and fructose consumption, and increased exercise, both aerobic and resistance activities. .

“At all stages, this change in lifestyle is recommended. So, as much as there is a need for a drug for fibrosis, for example, the ideal is for the patient to adopt these measures, otherwise, the medication alone will not be enough . So, he has to be aware. When the individual loses 10% of their weight, they already have an improvement in steatosis, inflammation and even fibrosis,” he said.

The doctor also recalled that, at the beginning of the pandemic, medical consultations were suspended due to the risk of contracting covid-19, which was another aggravating factor for the increase in liver diseases, due to the lack of monitoring and also diagnosis.

“Anyone over 45 years old, even to rule out viral hepatitis, must undergo serology for viral hepatitis, liver enzyme, ultrasonography,” he said.

Growth of self-medication and the “fake news” pandemic

Self-medication is a constant problem in the country - Getty Images - Getty Images

Self-medication is a constant problem in the country

Image: Getty Images

Another consequence of the spread of covid-19 and social isolation was the growth of self-medication, a public health problem in Brazil and which, according to specialist Raymundo Paraná, is due to a cultural issue in Brazil and also to the difficulty of accessing care. medical and health.

This practice represents a great risk not only for the liver, but also for the individual’s health, either by not having a suitable scientifically proven treatment, by consuming toxic substances or by carrying out combinations between components that end up being harmful to the body.

“Self-medication with allopathics continues today, although more restricted due to public policies. But the issue of consumption of herbs, leaves, supplements, herbal medicines, became free and was quickly captured in a very commercial context on social networks, in the media and even even by health professionals,” said Paraná, who warned of the dangers of “grandma’s tea” or “traditional indigenous medications” not tested in a scientific context, which can even lead to death.

For Paraná, the ease of access to information has made people content with superficial information that does not refer to the source, which increases the public’s exposure to false news that can be extremely harmful to health, as was the case with the popularization of use of medications such as chloroquine or ivermectin for supposed early treatment against covid-19 or the use of multivitamins to protect against the disease.

“What is said quickly gains space and becomes a truth, this is the harm that fake news does. The situation is extremely serious, and during the pandemic the ground became more fertile for these malignant and malicious seeds. They proliferated a lot, a lot of misinformation,” lamented the specialist in hepatology.

In this sense, the head professor of Gastro-Hepatology at UFBA recalled that “there is no alternative to science, and he also attributes this fact to the lack of honesty and transparency of some health professionals.

On the other hand, Paraná also criticized the dichotomy between what is synthetic and what is natural, which he considered as “a perverse and dishonest marketing move”.

“What is natural is sanctified, and what is synthetic is demonized. It is not like that, only a professional who is not careful with honesty and ethics can convey information as untrue as this, as many allopathic medicines have natural origin”, he defended.

Alcohol, a villain of social isolation

Alcohol consumption increased - Getty Images - Getty Images

Alcohol consumption increased

Image: Getty Images

According to data from the ConVid survey, by the Oswaldo Cruz Foundation and carried out in partnership with the Federal University of Minas Gerais and the State University of Campinas (2020), 17.6% of the more than 40,000 respondents (18.1% among men and 17, 1% among women) stated that they drank more alcoholic beverages during this period. The greatest advance, 24.6%, was registered in the age group from 30 to 39 years of age, and the smallest among the elderly (11.2%).

The study also indicated that the greater the frequency of feelings of sadness and depression, the greater the increase in the use of alcoholic beverages, reaching 24% of people who have felt this way during the pandemic.

In total, 40% of the population felt sad/depressed and 53% felt anxious/nervous frequently (often or always). Among young adults (18-29 years), the percentages rose to 54% and 70%, respectively.

“Abusive alcohol consumption and Heavy Episodic Drinking, that is, the consumption of more than five drinks per occasion for men and four for women, usually within two hours, are very associated with the mental health changes that occurred during the covid-19 pandemic, which we know had a very big impact on mental health,” said the president of IBRAFIG, an institute linked to the Brazilian Society of Hepatology.

“This increase in alcohol consumption may increase the frequency of liver disease, especially liver cirrhosis in the long term, and alcohol is a substance that causes addiction, so what started during the pandemic may not go away. It may be a habit that causes it is here to stay and that can lead to a significant increase in liver disease,” he added.

Bitencourt also recalled that 48% of the causes of cirrhosis in the world are attributed to alcohol consumption, an important factor also in Brazil, where around 41% of the population consumes alcohol, with beer being the preferred beverage.

The expert also pointed out that, despite the consumption being more abusive among men with high purchasing power, the increase in consumption among women in recent years has been drawing attention, mainly because they have a greater predisposition to develop alcoholic liver disease.

A retrospective study released by the Pan American Health Organization (PAHO) in April 2021 also pointed out that alcohol consumption contributes to more than 300,000 deaths in the Americas, and that almost 65% of them correspond to people under 60 years old. of age and 64% occurred due to liver disease.

In addition, the numbers indicate that about 80% of deaths attributable to alcohol took place in three countries: the United States, Brazil (almost 25% of the total) and Mexico.