FATTY LIVER

Fatty liver, or steatosis, is a term that describes the buildup of fat in the liver. While it’s normal to have some fat in your liver, more than 5 to 10 percent of your liver weight is fat in the case of fatty liver.

Fatty liver is a reversible condition that can be resolved with changed behaviors. It often has no symptoms and typically does not cause permanent damage.

The liver is the second largest organ in the body. The liver’s function is to process everything we eat or drink and filter any harmful substances from the blood. This process is interrupted if too much fat is in the liver. The liver commonly repairs itself by rebuilding new liver cells when the old ones are damaged. When there’s repeated damage to the liver, permanent scarring takes place. This is called cirrhosis.

The most common cause of fatty liver is alcoholism and heavy drinking. In many cases, doctors don’t know what causes fatty liver in people who are not alcoholics.

Fatty liver develops when the body creates too much fat or cannot metabolize fat fast enough. The excess fat is stored in liver cells where it accumulates to form fatty liver disease. Eating a high-fat diet may not directly result in fatty liver.

Besides alcoholism, other common causes of fatty liver include:

  • obesity
  • hyperlipidemia, or high levels of fats in the blood
  • diabetes
  • genetic inheritance
  • rapid weight loss
  • side effect of certain medications, including aspirin, steroids, tamoxifen, and tetracycline

Fatty liver typically has no associated symptoms. You may experience fatigue or vague abdominal discomfort. Your liver may become slightly enlarged, and your doctor can detect this during a physical exam.

Excess fat can cause liver inflammation. If your liver becomes inflamed, you may have a poor appetite, weight loss, abdominal pain, weakness, and confusion.

There are four types of fatty liver:

Nonalcoholic Fatty Liver (NAFL) develops when the liver has difficulty breaking down fats, which causes a buildup in the liver tissue. The cause is not related to alcohol. NAFL is diagnosed when more than 10 percent of the liver is fat.

Alcoholic Fatty Liver is the earliest stage of alcohol-related liver disease. Heavy drinking damages the liver, and the liver cannot break down fats as a result. Abstaining from alcohol will likely cause the fatty liver to subside. Within six weeks of not drinking alcohol, the fat will disappear. However, if excessive alcohol use continues, cirrhosis may develop.

Nonalcoholic Steatohepatitis (NASH) – When the fat builds up enough, it will cause the liver to swell. If the original cause is not from alcohol, it’s called NASH, which can impair liver function. Symptoms include:

  • appetite loss
  • nausea
  • vomiting
  • abdominal pain
  • yellowing of the skin (jaundice)

If left untreated, NASH can progress to permanent scarring of the liver and eventual liver failure.

Acute Fatty Liver of Pregnancy – Acute fatty liver is a rare complication of pregnancy that can be life-threatening. Symptoms begin in the third trimester. These include:

  • persistent nausea and vomiting
  • pain in the upper-right abdomen
  • jaundice
  • general malaise

Pregnant women are screened for this condition. Most women improve after delivery and have no lasting effects.

DIAGNOSIS

Physical Exam

If your liver is inflamed, your doctor can detect it by examining your abdomen. Let your doctor know if you have been experiencing fatigue or loss of appetite. Also, tell your doctor about any history of alcohol, medication, and supplement use.

Blood Tests

Your doctor may find that liver enzymes are higher than normal on a routine blood test. This doesn’t confirm a diagnosis of fatty liver. Further analysis is necessary to find the cause of the inflammation.

Ultrasound

The fat on your liver will show up as a white area on the ultrasound image. Other imaging studies may also be done, such as CT or MRI scans. Imaging studies can detect fat in the liver, but they cannot help your doctor confirm any further damage.

Liver Biopsy

In a liver biopsy, your doctor will insert a needle into the liver to remove a piece of tissue for examination. Your doctor will give you a local anesthetic to lessen the pain. This is the only way to know for certain if you have fatty liver. The biopsy will also help your doctor determine the exact cause.

 

RECOMMENDED MEDICATIONS

There is no specific treatment. But you can improve your condition by managing your diabetes, if you have it.

If you have alcoholic liver disease and you are a heavy drinker, stopping your alcohol intake is the most important thing you can do. Talk to your doctor about how to get help. If you don’t stop drinking, you could develop serious complications like alcoholic hepatitis or cirrhosis.

Even if you have nonalcoholic fatty liver disease, it can help to avoid drinking. If you are overweight or obese, do what you can to gradually lose weight—no more than 1 or 2 pounds a week.

Eat a balanced and healthy diet and get regular exercise. Limit high-carb foods such as bread, grits, rice, potatoes, and corn. And cut down on drinks with lots of sugar like sports drinks and juice

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