What is fatty liver disease

Fatty Liver: All you need to know about it!
What is fatty liver disease?
Fatty Liver or Steatosis is a medical conditiaon where the fat builds up in the liver. It is normal to have some fat in the liver; however, if it is more than 5-10% of the weight of the liver, you could be suffering from Fatty Liver disease. This is a reversible condition and can often be resolved by medication and small changes in the daily behaviors.
In case of fatty liver, the liver cells accumulate excessive amount of fat in them, slowing down the metabolism. The main cause for this is alcohol; however, fatty liver is a condition that can be developed in the absence of alcohol as well.
Fatty Liver Disease is mainly of two types:
  • Alcoholic Fatty Liver disease: This happens to heavy drinkers and is an early stage of alcohol related liver disease. Excessive drinking causes damage to the liver and as a result, the fat in the liver does not break down.
  • Non Alcoholic Fatty Liver disease: This happens when there is difficulty in breaking down the fats in the liver, causing fat to build up in the liver. The reason for this kind of fatty liver disease is not alcohol. Some causes for non-alcoholic fatty liver disease could be sudden weight loss, inherited liver disease, malnutrition, viral hepatitis or medications.
Liver is the main organ that is responsible for the metabolism of fat. Liver makes and regulates fat to all parts of the body. Non alcoholic fatty liver disease is a medical condition where the liver is unable to conduct the metabolism in the regular mannerism because of abnormal accumulation of fat in the liver cells.
Non alcoholic fatty liver disease could be classified as two conditions, namely, isolated fatty liver disease and NASH (Non Alcoholic Steato Hepatitis). In case of isolated fatty liver, there is only excessive fat accumulation in the liver, however, in case of NASH; there is inflammation in the liver cells along with fat accumulation. There is also a risk of liver damage in case of NASH.
Acute Fatty Liver of Pregnancy
This is a rare complication that pregnant women may come across; however, this can be fatal to both the mother and the baby. This can cause kidney or liver failure, serious infection or bleeding to both the mother and the child. The symptoms of this complication usually begin in the third trimester of the pregnancy and could include jaundice, general malaise, upper right abdomen pain, nausea and vomiting.
The reason for fatty liver during pregnancy could be hormonal changes; however, the exact cause is still unknown. Usually, once fatty liver is diagnosed during pregnancy, the baby is delivered as soon as possible.
Why is it important to know about fatty liver disease?
Fatty liver disease is a condition found in many people these days and the cases are on the high. Since there are no clear symptoms of the disease, it goes without notice until it advances to cirrhosis or other major complications. Since liver is the main organ responsible for the metabolism of fat across different parts of the body, it is important to keep it healthy. Fatty liver disease not only causes damage to the liver but, once developed to cirrhosis, other complications such as cardiovascular diseases, stroke and even mental changes occur as a result. Early diagnosis and treatment can help prevent worsening of the condition.
Non alcoholic fatty liver disease is also present in children. Since more and more children these days have obesity, they have a risk to non alcoholic fatty liver disease. If a child with obesity is suspected of fatty liver disease, it is recommended that they get a liver biopsy done. As preventive measures, obese children should take special care of their diet and physical exercise.
What are the causes of Non Alcoholic Fatty Liver disease?
Exact cause for non alcoholic fatty liver disease is not yet known. Some of the main reasons someone is usually diagnosed with fatty liver disease are diabetes and obesity. The presence of large amounts of fat in the body triggers production of some hormones and proteins that are released into the blood. These affect cells throughout the body; one of the many effects being, making them insulin resistant.
Insulin is a hormone that regulates the amount of glucose in blood. Insulin resistance is when the cells of the body do not properly respond to insulin that is responsible to promote glucose in the blood cells. Gradually, the pancreas decreases the amount of insulin produced, in turn, leaving the blood cells deficient of glucose. This results in excessive sugar in blood, causing the condition called diabetes.
Apart from proteins and hormones, the fat cells also release something called fatty acids. The release of these fatty acids along with the proteins and hormones affects cells in different parts of the body. Liver cells, like other cells of the body, become insulin resistant. The fatty acids in the liver become storage fats and start to accumulate.
Some other causes for fatty liver could be:
  • Hepatitis C
  • Excessive alcohol consumption
  • Starvation
  • Abetalipoproteinemia
  • Wilson’s disease
  • Lipodystrophy
  • Intravenous nutrition
  • Intake of several drugs
Symptoms of Fatty Liver
There are no clear symptoms of fatty liver disease and mostly it is difficult to notice until the condition is in an advanced stage. Fatty liver disease is usually detected or found out in one of the following ways:
  • Enlarged liver in a physical examination
  • Abnormal liver in routine blood tests
  • Fat in the liver seen in an ultrasonography
When the condition advances to advanced stages, patient starts to show signs and symptoms of cirrhosis. Some symptoms are as follows:
  • Liver unable to eliminate bilirubin from blood, causing jaundice
  • Liver unable to make a blood protein called albumin
  • Gastrointestinal bleeding
  • Liver unable to make blood clotting protein, causing excessive bleeding
  • Coma or mental changes due to liver’s inability to destroy chemicals that are toxic to the brain
  • Liver cancer
Non-alcoholic Fatty Liver Disease: Diagnosis
Fatty liver disease is normally suspected in patients with diabetes or obesity, if accompanies by other symptoms. As suggested earlier, fatty liver disease does not have specific symptoms of its own. Some of the main tests used to detect nonalcoholic fatty liver disease are CT (Computerized Tomography), Ultrasonography and MRI (Magnetic Resonance Imaging). Fatty liver disease is also diagnosed when patients develop liver complications like liver cancer, liver failure or cirrhosis.
In order to differentiate between fatty liver disease and NASH (Non Alcoholic Steato Hepatitis), a combination of different blood tests is dome along with a liver biopsy. Normally, patients with diabetes, obesity and/or metabolic syndrome are required to get a biopsy done.
What are the treatments for non alcoholic fatty liver disease?
Some of the treatments for fatty liver disease are as follows:
  • Change in the daily routine—exercise, balanced diet and weight control
  • Nutritional supplements or antioxidants
  • Medications
  • Omega 3 fatty acids
  • Liver transplant
  • Surgery
Fatty Liver Disease: Medications and Treatments
Here are some medications and some treatment options for nonalcoholic fatty liver disease:
  • Antioxidants: Vitamin E has effects that reduce fat in liver and works against inflammation. Vitamin E is said to be effective to be used on patients with NASH, however, not all patients can use vitamin E to treat NASH.
  • Insulin sensitizers: Drugs like Pioglitazone (Actos), Rosiglitazone (Avandia) and Metformin (Glucophage) are used to treat diabetes. These increase insulin sensitivity in cells by reducing insulin resistance which in turn causes nonalcoholic fatty liver disease and metabolic syndrome.
  • Omega 3 fatty acids: Omega 3 fatty acids are said to have reduced liver fat in non alcoholic fatty liver disease as per some studies. This is a good treatment option for people that have non alcoholic fatty liver disease or metabolic syndrome, as this reduces the risk to cardiovascular diseases like heart attacks.
  • Bariatric surgery: Bariatric surgery is a potential treatment for nonalcoholic fatty liver disease as it results in weight loss. This is a surgery of the gastrointestinal tract, which causes loss of weight and decrease in inflammation. Even though bariatric surgery is not a proven treatment for NASH, it has shown effects that help reduce fat and inflammation, which is beneficial in the treatment.
  • Liver transplantation: When the complications of the liver advance, sometimes the cirrhotic liver has to be removed and transplanted with a healthy liver. Non alcoholic Steato Hepatitis is one of the foremost reasons for liver transplantation these days. Due to the increase of diabetes and obesity among people, this is expected to be the main reason for transplantation in the coming times. There have been occurrences where the transplanted liver gets affected with NASH because of the presence of obesity and diabetes.
Fatty liver: diet, weight loss and exercise
An ideal diet for fatty liver disease should meet the following objectives:
  • Facilitate weight loss
  • Improve the functioning of insulin
  • Reduce fat in the liver
  • Prevent liver damage
The diet should essentially have the following foods:
  • Raw fruits and vegetables
  • Cooked vegetables except potatoes
  • First class protein diet
Following are the foods that fatty liver disease patient should not consume:
  • Candy or food with sugar content
  • Foods that have flour in it
  • Junk food like pizzas and fried take away foods
  • Foods that claim to be slimming
  • Biscuits or other snacks that contain flour
Since non alcoholic fatty liver disease is common in patients with obesity and diabetes, physical activity is very important along with other medication. Along with a balanced diet, exercise and weight loss is an important part of the treatment. Weight loss and exercise help reduce the fat in the liver and also helps reduce inflammation due to NASH.
Facts about non alcoholic fatty liver disease
Here are some facts about non alcoholic fatty liver disease:
  • Nonalcoholic fatty liver disease or NAFLD is a medical condition where of abnormal amounts of fat accumulate within the liver.
  • If untreated, NASH advances to scarring in the liver and eventually to  Some of the complications associated to cirrhosis are excessive bleeding, liver cancer or liver failure.
  • Nonalcoholic fatty liver disease can be of two types: isolated fatty liver and nonalcoholic steatohepatitis (NASH). In isolated fatty liver there is accumulation of fat alone and in case of NASH, there is inflammation along with fat and it causes damage to liver cells.
  • The main cause for a patient to develop non alcoholic fatty liver disease is presence of obesity or diabetes in the patient’s medical history.

  • There have been many scientific studies to determine the exact treatment of NASH; however, there hasn’t been a proven treatment method yet.

  • In most cases, isolated fatty liver disease advances to NASH or cirrhosis.

  • It is a myth that nonalcoholic fatty liver disease is only seen in adults; it affects young children as well.
  • Obesity, high blood pressure, diabetes, dyslipdemia etc. are some diseases associated with NASH. These must be treated to avoid further complications.
  • In the time to come, NASH will become the primary reason for liver transplantations.Preventive measures must be taken and people must be made aware of this in order to avoid such a situation.
  • A liver biopsy is the only test that helps differentiate between isolated fatty liver disease and NASH.

  • Some of the treatment measures widely used in cases of non alcoholic fatty liver disease is weight loss, physical exercise, diet, medications and bariatric surgery in some cases.

  • Since there are no specific symptoms of nonalcoholic fatty liver disease, it is normally detected incidentally. If left untreated, the complications of nonalcoholic fatty liver disease could be as bad as liver failure or liver cancer. This may also cause mental changes or excessive gastrointestinal bleeding in some cases.

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