Fatty Liver Disease: Types, Signs and Symptoms, Causes, Risks, Complications, Diagnosis, Treatment, Prevention and Prognosis

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Fatty Liver Disease

1Overview

Also dubbed as hepatic steatosis, fatty liver is a condition affecting the liver, one of the largest organs in the body. Fatty liver disease is a condition wherein the fat in the liver is more than 5 to 10 percent of the organ’s weight.

Fatty liver is a reversible condition that can be cured through lifestyle and diet changes. Normally, this condition has no symptoms and do not cause permanent damage. However, it could predispose a person to other medical conditions.

The liver is the second largest organ in the body, next to the skin. It works by processing everything a person eats, drinks or consumers. The normal function of the liver is disrupted when there is too much fat in it. Usually, the liver can repair itself by rebuilding new cells when the old ones are already damaged. However, when this process goes on in cycles, permanent scarring may take place leading to a serious condition called liver cirrhosis.

About 10 to 20 percent of all Americans have fatty liver disease. Most cases are detected in people who are between the ages of 40 and 60.

2Types Of Fatty Liver Disease

Alcoholic Liver Disease (ALD)

Alcoholic liver disease is the first stage of an alcohol-related liver disease. This is caused by heavy drinking. It damages the liver, and as a result, it can’t break down fats like it used to. However, within just six weeks of abstaining from alcohol consumption, the fat will disappear on its own. If heavy drinking is not controlled, it may lead to severe liver disease – cirrhosis and eventually liver damage.

Non-Alcoholic Fatty Liver Disease (NAFLD)

A non-alcoholic fatty liver disease (NAFLD) is the term used to describe the disorders caused by the collection of fat in the liver. Overweight and obese people are at a higher risk of having a fatty liver.

NAFLD do not cause serious harm to the liver. However, prolonged periods with fat buildup may cause liver damage, called cirrhosis. Having a fatty liver may also increase the risk of other diseases such as heart attacks, strokes, and diabetes.

Acute Fatty Liver of Pregnancy

During pregnancy, fat may accumulate in the liver, leading to a condition called acute fatty liver of gestation. This condition is rare and will eventually disappear as soon as the mother delivers. However, it might lead to serious complications like liver or kidney failure.

3Signs and Symptoms

Usually, there are no symptoms associated with fatty liver. However, you may experience a vague abdominal discomfort and fatigue.

However, when there is liver inflammation, there are symptoms like lack of appetite, abdominal pain, weakness and unexplained weight loss.

When liver cirrhosis develops, during the most advanced stage of fatty liver disease, severe symptoms might emerge which include jaundice or yellowish color of the skin and eyes, skin itchiness, swelling in the legs or ascites (fluid accumulation in the abdomen).

4Causes

Fatty liver disease is a common illness in people who are obese. Obesity is the number one cause of fatty liver disease. About 75 percent of obese people are at a higher risk of developing fatty liver, while 23 percent are at a heightened risk of developing fatty liver with inflammation.

Other causes of fatty liver disease include:

  • Protein malnutrition
  • Starvation
  • Long-term use of total parenteral nutrition (a feeding procedure in patients wherein the nutrients are given directly into the bloodstream).
  • Rapid weight loss
  • Intestinal bypass procedure for obese people

Some medical conditions may lead to having a fatty liver disease like diabetes mellitus, insulin resistance, hypertension and elevated lipids in the blood.

5Risk factors

Some people are at a heightened risk of developing fatty liver disease. The risk factors for the disease include:

  • Long-term use of total parenteral nutrition (a feeding procedure in patients wherein the nutrients are given directly into the bloodstream).
  • Rapid weight loss
  • Intestinal bypass procedure for obese people
  • Obesity
  • Pregnancy
  • Use of drugs like corticosteroids and some chemotherapy drugs

6Complications

Fatty liver may lead to a serious disease, liver cirrhosis. It results from the scarring of the liver as a result of continuous damage. In fact, about 20 percent of people with NAFLD will lead to liver cirrhosis. Cirrhosis happens as a response to injury like inflammation. As the liver tries to stop inflammation and repair liver cells, scarring occurs.

If left untreated, liver cirrhosis may lead to ascites, esophageal varices, confusion,
liver cancer, and end-stage liver failure.

7Diagnosis

Usually, the doctor will detect fatty liver when you get a routine checkup, and he might notice that your liver is larger than usual.

Some of the tests to confirm fatty liver disease are:

Blood Test

Imaging Tests

Ultrasound

This is the first test requested to confirm a fatty liver disease

Computed Scan and Magnetic resonance imaging

CT scan and MRI is a way to determine the severity of the condition. Moreover, these are used to distinguish the various types of fatty liver disease and other liver conditions.

Transient elastography

This is a condition that detects the elasticity and hardness of the liver. This can detect if there are scarring and damage.

Liver Tissue Examination (Biopsy)

If other tests do not give a definite diagnosis, a liver biopsy may be done to look for signs of inflammation and scarring. This is a painful procedure, and there are small risks involved. 

8Treatment

There is no specific treatment for fatty liver. However, you can improve the condition by managing underlying conditions such as diabetes, high cholesterol levels, and alcohol abuse.

If you have an alcoholic liver disease, abstaining from drinking alcohol is important to prevent further damage to the liver. Moreover, you can talk to your doctor about the ways on how to avoid drinking alcohol. If you do not stop heavy drinking, it might lead to serious conditions like cirrhosis, liver cancer, and hepatitis.

For obese and overweight individuals, gradual weight loss is recommended. The weight loss should range from 1 to 2 pounds a week. Abrupt and rapid weight loss might aggravate the condition.

Eating a well-balanced diet with regular exercise are good ways to reduce the fat in the liver. You should also limit your high-carbohydrate diet like bread, rice, potatoes, and corn, among others. Lessen the consumption of sugary drinks like juice, soda, and sports drinks.

In some patients, the doctor recommends that they receive vaccinations against hepatitis infections. These vaccines will protect them from viruses that can further damage the liver.

For those with liver cirrhosis and liver damage, a liver transplant is an option. Liver transplant outcomes are good.

There are some alternative treatments for fatty liver. New studies have been looking into various compounds that can help reverse fatty liver disease like:

Vitamin E – Vitamin E and other compounds that are considered antioxidants are helpful in the treatment of fatty liver disease.

Some studies have found that these antioxidants protect the liver by decreasing the damage caused by inflammation. Moreover, some studies have suggested that the vitamin E supplements help people with liver damage in some ways.

Coffee – In some studies, scientists have found that those who reported drinking coffee had lesser liver damage than those who drank a little or no coffee at all. There is still no clear explanation about this theory, but the researchers are still looking for answers.

At present, lifestyle modification, changes and practicing a healthy lifestyle are still the recommended treatment options for the fatty liver disease.

9Prevention

Self-management of Fatty Liver Disease

To reduce the risk of developing fatty liver disease, it is important to practice the following:

Eating a healthy diet

Choose a healthy diet, mostly composed of plant-based foods that are rich in vitamins and minerals. Choose vegetables, fruits, whole grains and healthy fats.

Avoid Processed and Junk Food

overeating salty, fatty and processed food may aggravate the condition and make you at a higher risk of developing fatty liver.

Maintain a healthy weight

If you are overweight or obese, losing weight is important. Reduce the number of calories consumed and get more exercise. If you have a healthy weight, make sure you maintain your weight by choosing a healthy diet and engaging in regular exercise.

Exercise

Moderate exercise, at least 150 minutes per week, is important to maintain a healthy weight and boost the body’s circulation.

10Prognosis

The non-alcoholic fatty liver disease is usually preventable and treatable, as long as you practice a healthy lifestyle. If you have a fatty liver, reducing the consumption of high caloric foods and unhealthy fats will eventually reverse the condition.

However, not doing anything to curb the situation may lead to a serious condition called liver cirrhosis. This may cause liver damage and in some cases, liver cancer.

For alcoholic liver disease sufferers, not stopping heavy drinking may lead to serious consequences. Continued alcohol intake may result in persistent and progressive liver damage.