Fatty liver

Fatty liver is the excess accumulation of fat in the liver.

What is fatty liver disease?

Fatty liver is  very common condition and a lot of people come with apprehensions about it and usually with vague or unrelated symptoms most often carrying  on ultrasound report.

Fatty liver is a term which describes deposition of fat in the liver. Normally also there is 5 to 10% of liver weight is fat. When it becomes more than 10% it becomes fatty liver. It is reversible condition which can be resolved by changing lifestyle. Typically it causes no symptoms and does not cause permanent damage. Only when there is excessive deposition and if it produces inflammation it does progress to hepatitis and damages liver. It gives enough time to mend ways.

It is a common disorder. Usually every fourth or fifth ultrasound picks excess fat in liver but there is no inflammation or damage is present as evidenced by normal liver function tests. Age is no bar but usually it is seen between 30-50 years. If it is caused by an underlying condition it is become harmful to the liver. If cause is not recognized or treated.

What are its symptoms ?

Typically no symptoms are present. Fatigue or vague abdominal symptoms may be present. However if inflammation occur poor appetite weakness and pain may result.

What are the causes of fatty liver?

Most common cause is alcoholism. One should not take more than 20gm alcohol per day as that is a safe limit.

Besides alcohol other causes include

• Obesity
• Hyperlipedemia which is detected by lipid profile test
• Diabetes
• Genetic
• Rapid weight loss
• Side effects of aspirin, steroids, tetracycline

What are the types of fatty liver?

Alcoholic fatty liver:

This is earliest stage of alcohol related liver disease. Abstaining will cause fatty liver to subside even within 6 weeks.

Non alcoholic fatty liver:

When there is no intake of alcohol but still there is fatty liver it is known as non-alcoholic fatty liver disease (NAFLD)

Steatohepatitis:

When the fat in the liver causes deranged liver function tests it is know as steatoheaptitis. When the fat was due to non-alcoholic fatty liver disease then the resulting steatohepatitis is known as non-alcoholic steatoheaptitis (NASH). If left untreated it can lead to permanent scarring of liver (cirrhosis) and eventual live failure.

What are the risk factors fornon-alcoholic fatty liver disease?

Overweight or obesity, uncontrolled diabetes, uncontrolled cholesterol or triglyceride levels, and malnutritions are risk factors.

How is fatty liver diagnosed?

Your doctor will ask for history of alcohol intake, diabetes, supplement use. On clinical examination liver is found to be enlarged.Liver function tests, blood sugar, lipid profiles, thyroid profile are essential in work up. Ultrasonography shows a brighter liver than usual and is most common way in which fatty liver is diagnosed. Fibroscan is a new modality by which one can detect the stiffness of liver and quantity damage to liver if any.

What is the treatment for fatty liver disease?

Most important is to reduce risk factors like

• Limit alcohol intake
• Manage lipids
• Lose weight
• Control blood sugar
• Control thyroid profile

Decrease sugary and fatty foods in diet and increase physical activity.  Decreasing calories by eliminating fatty foods and foods high in sugar is important to lose weight and heal liver. Healthier food like fresh fruits, vegetables, whole grains are important. Red meat should be replaced by white meat in non-vegetarians.

Medications or surgery are usually not helpful for fatty liver disease.

How can we prevent fatty liver disease?

• Avoid alcohol or drink in moderation
• Take medications for diabetes or high cholesterol
• 30 minutes exercise most days
• Maintain healthy weight
• Avoid sugary and fatty meal, eat healthy food.