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Health: Options grow for patients with fatty liver disease, Hep C

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Janet Daily

Janet Daily


Gastroenterologists and colonoscopies go hand-in-hand, but few people realize the full extent of care available from a GI’s office.  

Janet Daily, a certified nurse practitioner specializing in gastroenterology at Williamson Medical Group in Franklin, offers more information about how GI practices diagnose and treat a broad range of disorders.

Hepatitis C

Once considered a disease with a grim prognosis, hepatitis C is now routinely cured with an eight- to 12-week course of oral medications. 

“I treat a lot of ‘Hep C’ patients, partly because the transplant world is now utilizing organs of donors with the disease,” Daily said. “Treatment over the last 10 years has come a full 360.” 

Not long ago, Hep C patients endured severe illness and dangerous weight loss for a 60-80% chance of being cured. Some would slip into remission and revert back to being Hep C positive. Daily said today’s treatments are 99% effective, with new medications designed to treat specific types of Hep C. 

That’s an impressive stat that Daily said too few people really understand.

“A lot of people know someone who’s been through the old treatment and they believe we’re still waiting on a better one, so there’s a big misconception about that,” Daily said. “There also used to be insurance company restrictions that made treatment very expensive, but most of those have been lifted and almost anyone can get treated now.” 

The Centers for Disease Control and Prevention recommend Hep C screening for everyone born between 1945 and 1965, when the risk of bloodborne diseases was still misunderstood. 

“If you’ve had a transfusion, shared razors or toothbrushes or have been in contact with someone with open bleeding you could be at risk,” Daily said. 

Anyone with unexplained elevated liver enzymes also should get screened for the disease, which often goes undiagnosed for decades until symptoms of liver cirrhosis develop.

 Fatty liver disease

As obesity takes a nationwide toll, providers such as Daily are seeing more and more patients with nonalcoholic fatty liver disease. In fact, this disease, known as NAFLD, is estimated to affect 80 million to 100 million Americans. The disease is broken down into two types: simple fatty liver and nonalcoholic steatohepatitis. 

The second type, known as NASH, is of particular concern to providers as it can lead to dangerous complications such as cirrhosis and liver cancer as well as insulin resistance and hypertension. However, monitored diet and exercise have proven to be extremely effective in the fight against NASH. 

General symptoms of NAFLD can include fatigue or elevated liver enzymes, but Daily said it often goes asymptomatic for years. 

“Patients have sometimes shown up in the ER vomiting blood, and by then, they’ve developed liver cirrhosis,” Daily said. “You want to catch it early so you can start reversing the disease.” 

Irritable bowel


Irritable bowel syndrome affects between 25% and 45% of Americans and is characterized by abdominal pain or discomfort and altered bowel habits. The exact cause of IBS is not known, although doctors believe it results from a disturbance in the way the gut, brain and nervous system interact, causing changes in normal bowel movement and sensation. 

“A lot of IBS patients come to us from their primary care provider with frequent abdominal pain with diarrhea or constipation that’s become chronic to the point of affecting quality of life,” Daily said. 

Diagnosis is based on symptoms, which can also indicate inflammatory bowel disease or celiac disease. Physicians can recommend dietary changes as well as over-the-counter medications and pelvic floor therapy. 

“A lot of people with IBS don’t really get the care they’re looking for, but there are things to do to get relief,” Daily said. 

Janet Daily is a certified family nurse practitioner specializing in gastroenterology at Williamson Medical Group in Franklin. To reach her office, call 615-791-2330.

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