South Dakota ranks second in the nation for the health of the disease, and the fatality rate is second in the nation
While heavy alcohol consumption remains a major cause of death due to liver ailments, doctors are seeing more liver disease causes by diabetes, obesity and the viral infection Hepatitis C or a combination of all four. 30 to 39 years of age.
Popular perception places the liver for alcohol abuse, but a deeper look shows the causes are more broad than that. In fact, the most common chronic liver disease in the U.S. is a disease called non-alcoholic fatty liver disease, which can be related to diabetes or obesity. Experts estimate that around 30 percent of Americans – roughly 100 million people – have non-alcoholic fatty liver disease. About 3 to 5 million people might develop cirrhosis from the condition. Adnan Said, program director of transplant hepatology at the University of Wisconsin School of Medicine. So Said is a member of the National Medical Advisory Committee for the American Liver Foundation.
"Population-wise, I think fortunately, or unfortunately, a lot of liver disease can be affected by our life choices," Said said.  According to the federal Centers for Disease Control and Prevention, South Dakota's death rate due to liver disease was about 17.5 deaths per 100,000 people in 2017, the last year for which data is available. Only New Mexico's liver disease death rate was higher at 26.8 per 100,000.
Liver disease was the third leading cause of death in South Dakota from 2013 to 2017, following only accidents and intentional self-harm. For people age 40 to 59, liver disease was the fourth leading cause of death behind cancer, heart disease and accidents. Chronic liver diseases and cirrhosis are the state's 10th overall leading cause of death; The average age of death from liver disease in South Dakota is 55.
The rate of liver disease deaths is generally trending upward in South Dakota. In 2009, the state's liver disease death rate was 9.7 per 100,000 people. The rate grew every year until 2017 when it fell from 2016's rate of 18.3 to 17.5. The number of deaths in South Dakota due to liver ailments in 2017 was 153; from 2013 to 2017, 696 people died.
Chronic alcohol abuse remains the leading cause of fatal liver disease. But South Dakotans may have been affected by other factors.
South Dakota's binge drink more than the rest of the country, according to the CDC.
But according to the CDC's Behavioral Risk Factors Surveillance System, a phone survey in which adults self-report their behaviors, South Dakota Those are less likely to be heavy drinkers than those in the rest of the country. The CDC classifies heavy drinking as consuming eight drinks per week for women or 15 drinks a week for men.
The viral infection of hepatitis C is therefore a growing concern for the medical community when it comes to combatting liver disease.
An Estimated 3 million to 5 million Americans have hepatitis C, but because of it, they are diagnosed as having more than 100 percent of the disease
Baby Boomers are at the highest risk for the disease, though often through no fault of their own. The hepatitis C virus has not been screened for prior to 1992.
The disease also has a transfusion, organ transplants or tattoos or unclean needles for injections could have unknowingly been exposed to the disease Disproportionate effect on Native Americans, who make up about 30 percent of the state's hepatitis C cases but only about 15 percent of the state population.
There is also a growing number of younger people contracting Hepatitis C in South Dakota. South Dakota epidemiologist Joshua Clayton.
Doctors are also concerned about diet and alcohol and how poor lifestyle choices are causing liver ailments at younger age.
"I have seen some of the youngest cirrhotics in my Dakota career." Christine Pocha, a transplant hepatologist, or liver specialist, at Avera McKennan Hospital in Sioux Falls.
Almost any food or beverage consumed wants to have an effect on liver health. The main function of the liver is to clean the bloodstream of toxins. The liver is the first stop most nutrients. When someone spends a lifetime eating a diet overly heavy in processed sugar, bread and trans fat, the liver eventually gets a little sick.
The American Liver Foundation estimates nearly one-third of Americans, about 100 million people, have at least some levels of non-alcoholic fatty liver disease. Very few people actually want to develop liver failure due to that disease alone, but it can and does make other diseases of the liver worse. When combined with too much alcohol and not enough exercise, fatty liver disease can be deadly. It also makes people with hepatitis C more likely to develop cirrhosis.
Ali Al-Hajjaj, a transplant hepatologist with Avera Health in Sioux Falls.
Healthy foods habits such as eating more fruits, vegetables and legumes while cutting down on salt, sugar and alcohol, Al-Hajjaj said, can go a long way towards staving off liver diseases. Trying to get at least 60 minutes of exercise a day is essential too, he said.
If all that sounds familiar, it's because of a better diet. A healthy diet and exercise can help prevent everything from heart disease to diabetes. Doctors have been giving it up for decades, and Avera liver doctors are no different.
"Like all patients, some listen, some do not," said dr. Jeffery Steers, A liver and kidney and transplant surgeon working for Avera McKennan Hospital in Sioux Falls.
A big part of the problem, Al-Hajjaj said, is that high-sugar, high-calorie foods often are much easier to find and tend to be cheaper than more nutritious options. South Dakota's rural nature means it's time to get to a full-service grocery store.
"It's easier to find a chocolate bar and a beer than it is to find a good." meal, "Al-Hajjaj said.
Said, of the liver foundation, made much the same point. Areas defined as "food deserts" – areas that do not have ready access to a full-service grocery store or similar service. Those deserts tend to be located in areas of their population have lower median incomes or are dispersed over a wide area.
"It's easier to find a chocolate bar and a beer than it is to find a good meal." – Dr. Ali Al-Hajjaj, transplant hepatologist with Avera Health in Sioux Falls
Alcohol use higher among affluents
Alcohol has long been known to cause liver damage. Exactly how and why the damage occurs is not well understood.
South Dakota, according to a report from the institute, which consumes 10th in the nation in terms of alcohol per capita. Still, the state reports a slightly lower rate of heavy drinking than the rest of the country.
Data gathered by the South Dakota Department of Health shows the poorest of the state's citizens actually drink less than the more well off. About 47 percent of those who come up with household income is less than $ 35,000 a year.
It should be no surprise then, that college-educated people who tend to have higher incomes tend to drink more often than those who don ' t have a degree and make less.
Nearly 60 percent of white people having a drink in the last 30 days. In the Native American community, only 40 percent of respondents report drinking in the past month. [Datedinthelast30days
The DOH data shows 13 percent of women and 24 percent of men report binge drinking at some point. Meanwhile, 6 percent of men and 5 percent of women report drinking heavily.
About 19 percent of people making $ 35,000 a year or less said they had binged on alcohol in the past 30 days, but about 22 percent of people making $ 75,000 or more per year reported binge drinking.
The number of steady heavy drinkers in the population does not vary much.
Convincing more people to cut back on their drinking, Hajjaj said, could go a long way towards reducing the number of deaths, early or otherwise, of liver disease.
Joshua Clayton, South Dakota's state epidemiologist, explains what is driving the death in deaths related to liver disease.
Liver viruses also a concern
There are three well-known types of viral hepatitis, all of which affect the liver. Two of them, Hepatitis A and Hepatitis B, have been very well controlled in the U.S. through vaccinations.  Hepatitis C is a major concern. The blood-borne disease does not have a vaccine. May develop liver failure.
The disease can be spread through an infected person's blood.
Hepatitis C is not well-tracked because of the presence of a hepatitis C surveillance program in place, said Clayton, state epidemiologist. [19659006"TheCDCisjustgettingitshandsaroundhelpingbetterbuildbetterprograms"Claytonsaid
About 75 percent of Americans infected with Hepatitis C are those born between 1946 and 1964. The CDC estimates that about 3 percent of all baby boomers have the disease, which is more than any other age group.
Hepatitis C cases are found in younger adults. The average age of people infected with hepatitis C in South Dakota is 44. The disease also has a disproportionate effect on the state's Native American population. The average age of a Native American diagnosed with Hepatitis C is 39, compared to 49 in the state's non-Native population.
As a potential lethal infectious disease, hepatitis C is the list of illnesses that must be reported to the state Department of Health. Because of that, Clayton said the state is a good idea of where infections are taking place.
Once a person is diagnosed with one of the states, one of the state's infectious disease specialists has to deal with them. 19659006] "There's a lot of risk factor information we do not have," Clayton said. If we have that, we can figure out how to intervene. "
While prevention is the best option, the disease can be cured. Over the last 10 years or so, a group of medications called "direct acting antivirals" has been developed.
The hepatitis C-positive organ donors for transplants, said Steers, the liver and kidney and transplant surgeon.
19659006] A full six-to-eight-week course of hepatitis C medication can cost anywhere from $ 26,000 to $ 90,000 ifather directly from the manufacturer. Health insurance companies usually negotiate for lower drug prices.
The high price tag for the drug Medicaid patients in South Dakota. The state's Medicaid program claims to have a biopsy showing significant liver damage and proof that they can not be approved for the drugs. These restrictions have been awarded to the State's Medicaid Program for the National Viral Hepatitis Roundtable, a group of advocates for hepatitis prevention and treatment.
Access to healthcare limits treatment
Many South Dakotans live far from a hospital with a full slate of specialty care. Pierre, the state's capital city, for example, did not have a cancer treatment center until 2018.
For specialty care as hepatology, patients have to travel either to Sioux Falls or Rapid City. Sioux Falls is the only option.
"Unfortunately, I do not see a way to many patients to take care of it," Steers said.
In small towns, liver disease treatments are reduced. Said said.
The Veterans' Administration and Avera Health are providing these types of care remotely in South Dakota, but it can not replace in-person medical visits. "Steer said."
What can help all liver disease patients, whether they've got Hep-C, fatty liver disease or any other liver affliction, is early detection, Pocha said. Screening for abnormal levels of alanine aminotransferase, or ALT, can catch most liver diseases.
"It all starts with the family physician," Al-Hajajj said.
Once a patient and their doctor know there's an issue, they can be referred to a hepatologist for a deeper look at what's going on. Al-Hajjaj said the team at Avera McKennan Hospital can usually take someone within a week.
South Dakota's rate of liver disease deaths has been on the rise for at least 10 years, DOH data show.
"If anything, the numbers may appear," Steers said.
Because the liver affects so much, a lot of deaths due to liver illnesses are not reported accurately, Steers said. He said he was diagnosed with the disease, but he wants to get the death of the patient.
Research from the CDC has also found that deaths caused by liver disease driven by hepatitis C are under-reported. More effort, both Al-Hajjaj and Pocha said
"I think people need to understand that the liver is just as important as the heart "Pocha said."
Steers said there is no machine that can make up for a failing liver, once it goes, it goes and, "it's a slow and painful death." . "
Where to get free testing for Hepatitis C in SD Aberdeen
402 S. Main St.
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