South Dakota ranks second in the nation for the rate at which its residents die of liver diseases, and the fatality rate is rising overall with many experts now blaming poor lifestyle, drinking and eating habits for the increase in deaths.
While heavy alcohol consumption remains a major cause of deaths due to liver ailments, doctors are also seeing more liver disease caused by diabetes, obesity and the viral infection Hepatitis C or a combination of all four.
Data show that liver disease is also striking at a younger age with a particularly high death rate among people 30 to 39 years of age.
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.
Popular perception places the blame for liver disease on alcohol abuse, but a deeper look shows the causes are more broad than that.
In fact, the most common chronic liver ailment in the U.S. is a disease called non-alcoholic fatty liver disease, which can be related to diabetes or obesity. While doctors say very few people will actually develop liver failure due solely to fatty liver disease it can and does make other diseases of the liver worse.
Experts estimate that around 30 percent of Americans — roughly 100 million people — have non-alcoholic fatty liver disease.
Liver diseases also appear to be killing younger South Dakotans than other chronic diseases. Liver diseases were the third-leading cause of death for 30 to 39 year olds in South Dakota from 2013 to 2017.
For people age 40 to 59, liver disease was the fourth-leading cause of death behind cancer, heart disease and accidents.
Chronic alcohol abuse remains the leading cause of fatal liver diseases. But South Dakotans with the disease may be more susceptible to other liver conditions and the harmful effects of alcohol.
Fatty liver disease can also make people with Hepatitis C more likely to develop cirrhosis.
Dr. Ali Al-Hajjaj, a transplant hepatologist with Avera Health in Sioux Falls said he and his colleagues spend much of their time with patients talking about how to improve diet, get exercise and cut back on alcohol.
Healthy food 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 toward staving off liver diseases.