India faces rise in fatty liver, colorectal cancer

India is seeing a rise in gastrointestinal diseases such as fatty liver and colorectal cancer, experts said on Tuesday, highlighting the need for greater focus on their early detection and prevention.

Ahead of the World Congress of Gastroenterology (WCOG) 2026, experts from AIIMS, Delhi, said improvements in hygiene, vaccination and public health measures have helped reduce several communicable and preventable diseases, but the country is now witnessing a growing burden of metabolic and lifestyle-related gastrointestinal conditions.

The World Congress of Gastroenterology (WCOG) 2026, which will be held for the first time in India from September 30 to October 3 at Yashobhoomi in Dwarka, will bring together gastroenterology experts from across the world to discuss the changing burden of digestive diseases.

Dr Pramod Garg, professor and head of the Department of Gastroenterology and Human Nutrition at AIIMS, said, “India is facing an epidemiological shift at this time. We have made significant strides in controlling preventable disease through awareness, vaccinations and improving quality of life, however, alongside these, we are now seeing metabolic disease on a scale we have never handled before.” 

Fatty liver disease has emerged as a major concern, with an AIIMS-led systematic review and meta-analysis finding the condition in 38.6 per cent of Indian adults and 35.4 per cent of children, said Dr Shalimar, professor in the department of Gastroenterology at the hospital said.

The disease is closely associated with diabetes, obesity and hypertension and can remain silent until liver damage has progressed, he said.

According to experts, India is facing a rise in the form of metabolic conditions such as fatty liver disease and colorectal cancer alongside persistent infections such as Helicobacter pylori and intestinal worm infestations.

A recent study has also reported clinically significant liver fibrosis in one in four patients with Type 2 diabetes. India included fatty liver disease in its National Programme for Prevention and Control of Non-Communicable Diseases in 2021, followed by guidelines for its detection at the primary-care level.

“The disease is easy to find if we look for it, and we become aware only after the patient falls ill. This is a greater challenge than before — we must move away from only treating diseases; we must now actively promote good health,” Dr Garg said.

Colorectal cancer is another growing concern, with doctors reporting an increasing number of cases among younger adults. India recorded 40,430 new cases among men and 24,433 among women in 2022, according to available data.

Blood in the stool, persistent changes in bowel habits and unexplained weight loss should not be dismissed as routine gastrointestinal problems, experts said.

“India has never been short of gastroenterologists or technology. What we have lacked is the habit of taking early symptoms seriously,” said Dr Govind Makharia, professor at AIIMS and chairman of the local organising committee for WCOG 2026.

“Any symptom that persists beyond two to three weeks should be evaluated,” he said.

Persistent infections also remain an important part of India’s gastrointestinal disease burden. H pylori, which is associated with peptic ulcer disease and gastric cancer, remains widespread, while intestinal worm infections continue to affect children and can contribute to anaemia and undernutrition.

At the same time, conditions such as celiac disease and inflammatory bowel disease (IBD), once considered uncommon in India, are increasingly being recognised.

A community-based study led by AIIMS found celiac disease in approximately one in 96 people in northern India.

“Inflammatory bowel disease and celiac disease were textbook rarities in India when I trained, and we now see them every week,” said Dr Vineet Ahuja, professor at AIIMS and secretary general of the Crohn’s Colitis Foundation of India.

The WCOG 2026 will focus on advances in diagnostics, endoscopy, therapeutics, gut microbiome research and artificial intelligence-enabled healthcare, besides examining the changing global burden of gastrointestinal diseases.

The congress is being jointly hosted by the Indian Society of Gastroenterology, Indian National Association for the Study of the Liver, Crohn’s and Colitis Foundation of India, Indian Pancreas Club and Indian Neurogastroenterology and Motility Association, in partnership with the World Gastroenterology Organisation.

The experts stressed that earlier evaluation of persistent gastrointestinal symptoms and timely preventive interventions could help detect and manage several conditions before they progress.