Fatty Liver

A number of illnesses linked to steatosis in the liver are together referred to as steatotic liver disease (SLD), which is commonly known as FLD or fatty liver disease. When a person has fat buildup in the liver due to alcohol or any other reasons, the liver is extensively damaged and requires immediate care. When fat accumulation exceeds 5% of the weight of your liver, it becomes a critical issue.

What is Fatty Liver Disease?

Fatty liver, also known as Hepatic steatosis, develops when the liver accumulates excessive fat. The liver is the second-largest organ in your body. It is responsible for filtering dangerous toxins from your blood, in addition to helping in the processing of nutrients from food and beverages. 

An excessive amount of fat can lead to liver inflammation, which can damage and scar the liver. Severe liver inflammation may cause various liver conditions, such as liver cancer and cirrhosis. 

Who is at risk for fatty liver disease?

People with metabolic syndrome who also suffer from the following conditions are more likely to develop fatty liver disease -

• Insulin resistance and diabetes
• Lipid panel anomalous
• Increase in belly size
• High blood pressure
• Gained weight

Anyone who has had a liver transplant might also develop a fatty liver condition. This may result in-

• Cardiovascular and heart conditions
• Liver inflammation
• Liver carcinoma 

Fatty Liver Disease Types

There are two types of fatty liver diseases - 

NAFLD or Non-Alcoholic Fatty Liver Disease 

The cause of NAFLD is unknown, but obesity and diabetes might increase the chance of contracting it. There are two forms of non-alcoholic fatty liver disease, as given below:

• Simple fatty liver, which is the presence of fat in the liver without any associated liver cell injury or inflammation. Usually, it doesn't worsen or result in liver issues.
• NASH, or nonalcoholic steatohepatitis, is a liver disease that causes the liver to swell and leads to inflammation. This can result in major issues, such as liver cancer, liver cirrhosis, and fibrosis, which may necessitate a liver transplant.

Alcoholic Liver Disease

This is a condition caused by drinking alcohol. If a person continues to drink more than the liver can handle, ALD may result in major issues. Some of the major consequences of ALD are - 

• Pain or discomfort on the upper right side of the abdomen, though symptoms aren't usually present.
• Liver enlargement that might cause fever, nausea, vomiting, abdominal pain, and jaundice (yellow eyes and skin).
• Liver cirrhosis is the hepatic accumulation of scar tissue. Along with the same symptoms as alcoholic hepatitis, it can also cause large-scale fluid accumulation in your abdomen, high hepatic blood pressure, internal bleeding, behavioural shifts, enlarged spleen, and many more.

Fatty liver disease associated with alcohol usually worsens and develops into alcoholic hepatitis. It could develop into alcoholic cirrhosis over time.

Symptoms of Fatty Liver Disease

Here are a few fatty liver disease symptoms - 

• Obese individuals
• Anyone suffering from diabetes
• Individuals with high cholesterol
• Women going through menopause 
• People with excessive abdominal fat
• People who have high blood pressure

Causes of Fatty Liver

Alcoholic fatty liver problems are primarily caused by the excess deposition of fat in liver cells, a condition that can arise from various circumstances. Overconsumption of alcohol can lead to AFLD, altering the metabolic function of the liver.

The leading cause of fatty liver problems in individuals who do not consume alcohol is still unknown. However, it can be said that these individuals' bodies either produce excessive fat or do not metabolise fat effectively. People who consume minimal alcohol but develop fatty liver disease may be affected by one or more of the following factors:

• Excessive fat
• Diabetes type 2 insulin resistance
• High blood fat levels, especially triglycerides

The following are other possible causes of fatty liver - 

• Side effects of various medications during pregnancy
• Infections like hepatitis C and a few uncommon genetic disorders

Diagnosis

Fatty liver disease typically manifests without noticeable symptoms. Therefore, the healthcare provider may conduct blood work to identify the condition. Elevated levels of liver enzymes in the blood work results suggest inflammation of the liver due to fat accumulation. To diagnose fatty liver, the doctor may request the following tests -

• Liver Imaging: CT Scan, MRI, or ultrasound scans.
• Liver Biopsy: A tissue from the liver is taken to determine the severity of the liver illness.
• Hepatic Elastography Fibroscan: This test measures the quantity of fat, the extent of liver damage, and the amount of scar tissue using a specialised ultrasound). As this is non-invasive, it is often used in alternation with liver biopsy.

Treatment

There is no specific fatty liver disease treatment. However, the doctor might suggest some change in lifestyle, which might often help reverse the fatty liver disease. For instance, a physician may recommend that you- 

• Refrain from alcohol
• Make dietary adjustments
• Engage in physical activity to reduce weight 
• Staying away from supplements and drugs that are harmful to your liver

You may be advised to abstain from alcohol entirely if you have AFLD. Additionally, if you are dealing with an alcohol use disorder, your doctor might recommend counselling and participation in a detoxification program.

Several viral diseases such as Hep A, B, and C might also damage and cause fatty liver disease. Hence, a doctor can recommend getting the hepatitis A and hepatitis B vaccines to protect the liver. Additionally, they could advise routine hepatitis C exams based on the condition of the patient. This helps the doctor chart a cure for fatty liver disease.

Fatty Liver Disease Risk Factors

According to research, males over the age of 10 to 12 who use 40–80 gm of alcohol per day and females over the same age who consume 20–40 gm of alcohol per day are more likely to develop severe alcoholic fatty liver disease. Other risk factors for AFLD besides excessive alcohol use are as follows: 

• Age
• Obesity
• Genetics
• Smoking
• Having a history of some illnesses, such as hepatitis C.

The following are the risk factors of nonalcoholic fatty liver disease -

• Type 2 diabetes 
• Insulin intolerance 
• Metabolic syndrome
• Being obese or overweight
• High cholesterol, triglycerides, and triglycerides

Here are some additional non alcoholic fatty liver disease risk factors -

• Sleep apnea 
• Sudden weight loss
• Obstructive sleeping
• Having a family history of liver disease
• Exposure to pollutants that might damage the liver
• Medical history of specific diseases, such as PCOS or hepatitis C
• Uncommon hereditary disorders, such as hypobetalipoproteinemia or Wilson disease
• Taking certain drugs, such as amiodarone (Pacerone), tamoxifen (Nolvadex), and methotrexate (Trexall)

It is important to consult a physician about preventative measures if you have one or more fatty liver disease symptoms of liver diseases, such as - abdominal swelling, itchy skin, yellow urination and eyes, red palms, nausea, weakness, etc. 

Prevention of Fatty Liver

It is important to maintain a healthy lifestyle and is essential to preventing fatty liver disease and any related complications. Several general guidelines for prevention consist of the following:

• Restricting or abstaining from alcohol
• Controlling your weight by consuming a diet high in nutrients and low in processed carbs, trans fat, and saturated fat
• Exercising for at least 30 minutes most days of the week while adhering to your doctor's suggested fatty liver treatment plan for diabetes and managing your blood sugar, triglyceride, and cholesterol levels

Apart from this, the healthcare provider might suggest some fatty liver disease medication that might help the liver reverse the damage, making it healthier and better. 

Conclusion

Fat accumulation in the liver leads to nonalcoholic fatty liver disease and alcoholic fatty liver disease, which causes the liver to malfunction. Fatigue, loss of appetite, and weight loss are some indicators a person must look out for, as these conditions do not usually have visible fatty liver disease symptoms. FLDs must be treated immediately, or they might develop into jaundice, itching, and swelling - which might cause liver cirrhosis and fibrosis. 

Although fatty liver disease is not easily treated, it might be prevented by eating a balanced diet, maintaining proper weight, exercising frequently, and refraining from consuming alcohol. Also, it is important to get a routine liver check to ensure the liver is healthy.

FAQs

1. Is fatty liver a serious problem?

Ans. Fatty liver might cause some severe problems, such as liver cirrhosis and cancer, if not treated early. 

2. What is a good diet to follow with SLD?

Ans. A good diet to follow with SLD is a balanced diet of lean proteins, fruits and vegetables, oatmeals, nuts and seeds, etc. 

3. Can a fatty liver go back to normal?

Ans. If proper preventive measures are taken to control fatty liver, the damage can be reversed, and the liver can go back to normal. 

4. How can I reduce my fatty liver?

Ans. Eating a healthy diet and exercising, in addition to cutting on alcohol, can help reduce fatty liver. 

5. What not to eat with fatty liver?

Ans. It is recommended not to eat fried food, meat, sugar, saturated fats, or any beverages that contain too much sugar. 

6. What to eat with fatty liver?

Ans. Doctors usually recommend eating foods like - nuts, whole grains, seafoods, legumes, vegetables, olive oil, etc. These foods help in reducing fatty liver. 

CARE Medical Team

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