What is fatty liver?
Fatty liver is also known as hepatic steatosis. It occurs when fat accumulates in the liver. Consuming small quantities of fat in the liver is normal, but too much can become a health problem. Your liver is the additional largest organ in your body. It helps process nutrients in food and drink and filters harmful substances from the blood.
Too much fat in the liver can cause inflammation of the liver, which can damage the liver and create scars. In severe cases, these scars can lead to liver failure. When fatty liver develops in somebody who drinks a lot of alcohol, it is recognized as alcoholic fatty liver disease (AFLD).
Symptoms of fatty liver disease
With ALD and NAFLD, there are usually no symptoms. Some people may have signs such as tiredness or pain in the upper right part of the abdomen, where the liver is. If you have NASH or cirrhosis, you may have symptoms such as:
- Swollen belly
- Enlarged blood vessels under the skin
- Larger than normal breasts in men
- Red palms
- Yellow skin and eyes due to a condition called jaundice.
Causes of fatty liver
For ALD, the cause is too much alcohol. You are even more likely to get it if:
- You drink a lot and
- Are obese
- They are malnourished
- You have chronic viral hepatitis, especially hepatitis C
- You have genes that make you more likely to get it
- Age: The older it is, the more likely it is to become
The reason why some people with NAFLD have simple fatty liver and others get NASH is not known. Genes may be a reason. NAFLD or NASH is more likely if:
- Are overweight or obese
- Your body does not respond to insulin the way it should (called insulin resistance) or if you have type 2 diabetes
- Have high levels of triglycerides or “bad” cholesterol (LDL), or low levels of “good” cholesterol (HDL)
- You’re older
- You have polycystic ovary syndrome
- You have sleep apnea
- You have an underactive thyroid (your doctor will call this hypothyroidism)
- You have an underactive pituitary gland (you will hear this called hypopituitarism)
- You are malnourished
- Has lost weight quickly
- You have been exposed to certain toxins and chemicals.
- You have metabolic syndrome. This is a combination of conditions that make you more prone to type 2 diabetes and heart disease.
With metabolic syndrome, you may have three of these conditions:
- Large waist size
- High triglycerides or LDL cholesterol
- Low levels of HDL (good) cholesterol
- High blood sugar level
There are also some less common reasons why you can get NAFLD or NASH. They include:
- Medical conditions that affect the way your body uses or stores fat
- Hepatitis C or other infections
- Rapid weight loss
- Taking convinced medications such as glucocorticoids, methotrexate (Rheumatrex, Trexall), a synthetic estrogen, tamoxifen (Nolvadex, Soltamox), and others
- Gallbladder removal. Some persons who have surgery to eliminate the gallbladder are more likely to have NAFLD.
A wide range of diseases and conditions can increase your risk for NAFLD, including:
- High cholesterol
- High levels of triglycerides in the blood
- Metabolic syndrome
- Obesity, particularly when fat is concentrated in the abdomen
- Polycystic ovary syndrome
- Sleep apnea
- Type 2 diabetes
- An underactive thyroid (hypothyroidism)
- Underactive pituitary (hypopituitarism)
NASH is more likely in these groups:
- Old people
- People with diabetes
- People with concentrated body fat in the abdomen
- It is problematic to distinguish NAFLD from NASH without further testing
To reduce your risk of NAFLD:
- Choose a healthy diet. Choose a healthy plant-based diet that is rich in fruits, vegetables, whole grains, and healthy fats.
- Keep a healthy weight. If you are overweight or obese, decrease the number of calories you eat each day and exercise more. If you are at a healthy weight, work to maintain it by choosing a healthy diet, and exercising.
- Exercise. Exercise most days of the week. Get your doctor’s approval first if you haven’t been exercising regularly.
The main complication of NAFLD and NASH is cirrhosis, which is late-stage scarring of the liver. Cirrhosis occurs in response to liver injury, such as inflammation in NASH. As the liver tries to stop inflammation, it produces areas of scarring (fibrosis). With ongoing inflammation, fibrosis spreads and occupies more and more liver tissue.
If the process is not interrupted, cirrhosis can lead to:
- Accumulation of fluid in the abdomen (ascites)
- Inflammation of the veins in the esophagus (esophageal varices), which can rupture and bleed
- Confusion, drowsiness, and trouble speaking (hepatic encephalopathy)
- Liver cancer
- End-stage liver failure, which means the liver has stopped working
- Among 5% and 12% of people with NASH will grow to cirrhosis.
How is the fatty liver (hepatosteatosis) diagnosed?
The most common imaging procedures used to diagnose hepatic steatosis include ultrasound, computed tomography, magnetic resonance imaging, fibroscan, and transient elastography. In inconclusive cases, a biopsy may be necessary.
How is fatty liver disease treated?
There is no specific medication for fatty liver disease. Instead, doctors focus on helping you control the factors that contribute to the condition. They also recommend making lifestyle changes that can meaningfully recover your health. Treatment includes:
- Avoiding alcohol
- Lose weight.
Take medicines to control diabetes, cholesterol, and triglycerides (blood fats). Take vitamin E and thiazolidinediones in specific cases.
Who gets fatty liver disease?
You have a higher chance of developing the fatty liver disease if:
- They are Hispanic or Asian.
- She is a postmenopausal woman (a woman whose periods have stopped).
- She is obese with a high level of abdominal fat.
- She has high blood pressure, diabetes, or high cholesterol.
- She has obstructive sleep apnea (a blocked airway that causes breathing to stop and start during sleep).
Why is fatty liver disease bad?
In most cases, the fatty liver disease does not cause any serious problems or prevent your liver from working normally. But in 7% to 30% of people with this condition, the fatty liver disease worsens over time. It progresses through three stages:
- Your liver becomes inflamed (swollen), damaging its tissue. This stage is called steatohepatitis.
- Scar tissue forms where your liver is injured. This process is called fibrosis.
- Extensive scar tissue replaces healthy tissue. At this point, he has cirrhosis of the liver.
- Liver cirrhosis
Cirrhosis of the liver is the result of severe damage to the liver. The hard scar tissue that replaces healthy liver tissue slows down the liver’s function. Eventually, it can block liver function completely. Cirrhosis can lead to liver failure and liver cancer.