Fatty liver or hepatic steatosis occurs when fat builds up in your liver and causes liver inflammation.
Normally, having small amounts of fat in your liver is normal, however, too much of it can cause a number of medical conditions.
Your liver is the second largest organ in the body that helps to process nutrients from food and drinks and filters harmful substances from the blood.
If your fat intake is more than the usual intake then this can cause liver inflammation. This can cause scarring and damage to your liver.
In severe cases, this scarring on the liver can be very fatal and can lead to liver failure.
If a person drinks a lot of alcohol, the fatty liver develops, and this is known as alcoholic fatty liver disease, AFLD.
If someone doesn’t drink a lot of alcohol this condition is known as non-alcoholic fatty liver disease, NAFLD.
Let’s discuss the causes, symptoms, types, and treatment as follows.
Fatty liver Symptoms
In most cases, the fatty liver disease causes no noticeable symptoms.
However, you may feel tired and experience discomfort or pain in the upper side of your abdomen.
Some people with fatty liver disease may develop complications including scarring of the liver.
In case you have liver scarring it is liver fibrosis. However, if it is severe then it is known as cirrhosis.
Cirrhosis can cause symptoms like:
Weight loss, loss of appetite, nose bleeds, fatigue, weakness, yellow eyes, and skin
Moreover, its symptoms include itchy skin, breast enlargement in men, abdominal swelling, and confusion.
Additionally, Cirrhosis is a life-threatening condition.
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Causes of Fatty liver
Fatty liver develops when your body produces too much fat or does not metabolize fat in an efficient way.
Your liver cells stores excess fat, where it accumulates and causes fatty liver disease.
This build-up of fat can be due to a number of things.
For instance, individuals who drink too much alcohol can suffer from fatty liver diseases. This is the first stage of alcohol-related liver disease.
However, for those individuals who do not drink a lot of alcohol, the causes of fatty liver are often unclear.
It is important to note that one of the following factors can play a role:
On the other hand, less common causes of fatty liver are:
Pregnancy, rapid weight loss, certain infections like hepatitis C, side effects of medications like methotrexate, tamoxifen, amiodarone, and valproic acid.
Moreover, certain genes can also raise your risk of developing a fatty liver.
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Types of Fatty Liver Disease
There are 2 main types of fatty liver diseases: nonalcoholic and alcoholic.
Nonalcoholic fatty liver diseases or NAFLD include simple non-alcoholic fatty liver, nonalcoholic steatohepatitis, NASH, and acute fatty liver of pregnancy, AFLP.
Alcoholic fatty liver disease AFLD includes simple AFLD, and alcoholic steatohepatitis, ASH.
Let’s discuss NAFLD and NASH as follows:
Non-Alcoholic Fatty Liver Disease, NAFLD
NAFLD occurs when fat build-ups in the liver. It occurs in your body when you do not drink a lot of alcohol.
If you have excess fat in your liver and there is no history of alcohol use, then your doctor will diagnose you with NAFLD.
If there is no inflammation or other complications along with the build-up of fat, the condition is termed Simple Non-alcoholic fatty liver.
Nonalcoholic Steatohepatitis, NASH
NASH is a type of NAFLD and occurs when the build-up of fat in the liver develops along with liver inflammation.
In case there is excess liver in your fat, and there is inflammation as well as no history of heavy alcohol use, your doctor will diagnose you with NASH.
When you do not get treatment for NASH, it can cause scarring of your liver and in severe cases can lead to cirrhosis and liver failure.
Let’s discuss other types of fatty liver disease.
Acute Fatty liver of Pregnancy, AFLP
Acute fatty liver of pregnancy or AFLP is a rare condition, however, a serious complication of pregnancy. The exact cause of this condition is unknown.
When AFLP develops, it usually appears in the third trimester of pregnancy.
If you do not get treatment, it can pose serious health risks to both you and the growing baby.
However, if your doctor diagnoses you with AFLP, they will want to deliver the baby as soon as possible.
You will need to receive follow-up care for several days after you deliver the baby.
Moreover, your liver will likely return to normal within a few weeks of giving birth.
Alcoholic Fatty Liver Disease, ALFD
Drinking a lot of alcohol damages your liver and when it is damaged, the liver is unable to break down fat properly.
This can cause fat to build up which is known as alcoholic fatty liver.
ALFD is the earliest stage of alcohol-related liver disease.
If there is no inflammation or other complications along with the build-up of fat. the condition is termed as simple alcoholic fatty liver.
Alcoholic Steatophepatitis, ASH
This one is a type of AFLD and occurs when there is an excess build-up of fat in your liver along with liver inflammation.
It is also termed alcoholic hepatitis.
If there is excess fat in your liver, inflammation in the liver, and you drink a lot of alcohol, your doctor will diagnose you with it.
In case you do not get treatment for this condition, ASH can cause scarring of your liver, and severe liver scarring or Cirrhosis can lead to liver failure.
To treat this condition, it is crucial that you avoid alcohol.
Thus, if you have alcoholism or alcohol use disorder, your docotr may recommend counseling or other treatment.
Diagnosing Fatty Liver
To diagnose fatty liver, your doctor will take your medical history, conduct a physical exam, and will also order some additional tests as well.
Let’s discuss them as follows:
In case your doctor suspects that you are suffering from fatty liver, they will ask the following questions:
Your family history, including the history of liver disease, alcohol consumptions, lifestyle habits, and medical conditions you might have.
Moreover, they will also ask you about medications you are currently taking, and recent changes in your health.
If you have recently experienced weight loss, loss of appetite, fatigue, or other unexplained symptoms, let your doctor know.
To check for liver inflammation, your doctor may palpate or press on your abdomen, and if it is enlarged, they will be able to feel it.
However, it is also possible for your liver to be inflamed without being enlarged.
Your doctor may be able to tell if your liver is inflamed by touch.
Blood Tests and Image Testing
In most cases, after the diagnosis of fatty liver, your doctor will order blood tests to show elevated liver enzymes.
For instance, your doctor may order the alanine aminotransferase test, ALT and aspartate aminotransferase test, AST to check your liver enzymes.
Most often, your doctor will recommend this if you are showing symptoms or signs of liver disease or as a part of routine blood work.
Elevated liver enzymes are a sign of liver inflammation and fatty liver diseases are one potential cause of liver inflammation but are not the only one.
However, if your test comes back positive, then your doctor will order other tests to identify the cause of the inflammation.
Your doctor may use an ultrasound exam, CT scan, or MRI scan to check for excess fat or other problems.
They might also order vibration-controlled transient elastography, VCTE, FibroScan that uses low-frequency sound waves to measure liver stiffness. It can help to check for scarring.
One of the best ways to determine the severity of liver disease is through liver biopsy.
During this procedure, your doctor will insert a needle into your liver and remove a piece of tissue for examination.
They will give you local anesthesia to reduce the pain or discomfort you will feel during the procedure.
This test can help determine if you have fatty liver disease as well as liver scarring.
Currently, there is no approved medication to treat fatty liver disease. More research is required to develop and test medications to treat this condition.
In most cases, certain lifestyle changes can help reverse fatty liver disease.
Your doctor will advise you to limit or avoid alcohol, take steps to lose weight, and make changes to your diet.
However, if there are complications, your doctor may recommend other treatments.
To treat cirrhosis, they may prescribe lifestyle changes, medications, or surgery.
It is important to note that cirrhosis can lead to liver failure and if you develop it, you might need a liver transplant.
The first line of treatment for fatty liver disease is lifestyle changes.
Depending on your current situation and lifestyle habits, it can help to lose weight, reduce alcohol intake, eat a healthy diet that is low in excess calories, saturated fat, and trans fat.
According to Mayi Clinic, some evidence suggests that Vitamin E supplements can help prevent or treat liver damage due to fatty liver disease.
However, more research is required, and there are certain health risks with consuming too much vitamin E.
It is always important to consult your doctor before you try a new supplement or natural remedy.
Some supplements or natural remedies can put stress on your liver or interact with the medications you are taking.
If you have fatty liver disease, your doctor will encourage you to adjust your diet to help treat the condition and lower your risk of complications.
For instance, they might advise you to:
Eat a diet that is rich in plant-based food like fruits, vegetables, legumes, and whole grains.
Limit your consumption of refined carbs, like sweets, white rice, white bread, and other refined grain products.
Reduce your consumption of saturated fats, found in red meat and other animal products, avoid trans fat present in snack foods and avoid alcohol.
Moreover, they will encourage you to cut calories from your diet to lose weight.
Drinking high amounts of alcohol puts you at an increased risk of developing fatty liver. Moreover, you may also be at high risk if you are:
Obese, insulin resistance, type 2 diabetes, polycystic ovary syndrome, conceiving, have a certain infection like hepatitis C.
Moreover, certain medications, high cholesterol levels, high triglyceride levels, high blood sugar levels, and metabolic syndrome can increase your risks.
However, if you have a family history o fatty liver disease, you are more likely to develop it yourself.
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Stages of Fatty Liver
Fatty liver can progress through 4 stages.
Simple Fatty liver: There is a build-up of excess fat in the liver.
Steatohepatitis: In addition to excess fat, there is inflammation in your liver.
Fibrosis: Inflammation in the liver, due to scarring.
Cirrhosis: Scarring in the liver that has become widespread.
Cirrhosis is a potentially life-threatening condition that can cause liver failure. This is why it is important to prevent it from developing.
To help stop it from progressing and causing complications, follow your doctor’s treatment plan.
To prevent fatty liver and its potential complications, it is important to avoid or limit alcohol intake.
Maintain a healthy lifestyle, eat a nutrient-rich diet, take steps to control blood sugar levels, triglycerides levels, and cholesterol levels.
Moreover, follow the recommendations of your doctor and take treatment for diabetes, if you have it.
Aim for at least 30 minutes of exercise most days of the week. Take steps to improve your overall health.
In most cases. reversing fatty liver with lifestyle changes is possible and these changes can help to prevent liver damage and scarring.
This condition can cause inflammation, damage to your liver, and potentially irreversible scarring, if you do not get treatment. Severe liver scarring or Cirrhosis can increase your risk of liver cancer and liver failure.
Moreover, it can be fatal. For best outcomes, follow the recommendations of your doctor, their treatment plan, and practice an overall healthy lifestyle.