Fatty liver disease - (other common names include; non-alcoholic fatty liver disease
(NAFLD), hepatic steatosis or simply fatty liver). Fatty liver disease is a condition
of the liver in which the organ accumulates large fat deposits. This occurs as a
result of a process known as "steatosis”, which means that the body retains abnormal
amounts of lipids (i.e., fats) within cells, especially in the liver. The condition
is chronic, reversible, and normally not considered seriously threatening to health,
although its underlying causes may be.
Causes
The two main causes are either alcohol abuse or obesity;
Alcoholic fatty liver - of the two types of fatty liver, alcoholic FLD is the least
severe and most easily treated. In most cases it may just be a case of excessive
drinking in which the treatment is to stop or decrease your alcohol consumption.
If left untreated i.e. if you don't stop drinking, the disease will progress to alcoholic
hepatitis and finally cirrhosis of the liver. Once you have cirrhosis, the liver
tissue may be irreparably damaged if the cause is not managed.
Obesity - it's no surprise that obesity, often accompanied by diabetes, is one of
leading causes of fatty liver disease. It is also one of the highest growing contributors
to the disease due to the ever-increasing obesity epidemic here in the states. Excess
body fat is stored in the liver causing swelling and sometimes inflammation of the
liver which severely impedes liver function. This form of FLD is difficult to treat
because it involves a large change of lifestyle and can take a long time and much
dedication to influence a positive rate of recovery. Continued below....
There are a few lesser known contributing factor to the disease such as other illness
which affect the metabolizing of fats. There may also be a hereditary factor or factors,
as the condition tends to run in families.
Symptoms
Normally, fatty liver disease has very few symptoms. In the early stages especially,
it is considered asymptomatic. On rare occasions, however, some patients experience
long-term chronic pain in the upper right quadrant of the torso, over the location
of the liver. Other possible symptoms are fatigue, loss of appetite, weight loss,
and chronic weakness. If symptoms do occur, a more serious condition may be indicated
and the symptoms may actually arise from an underlying causative condition rather
than from fatty liver disease itself.
If left untreated, the disease can progress to alcoholic hepatitis, or non-alcoholic
steatohepatitis (NASH) for those affected by the obesity related version. Symptoms
may include yellowing of the skin and abdominal pain.
Diagnosis
The disease is usually diagnosed not from symptoms but from the results of tests
which are usually taken to diagnose something else. These can include blood testing
showing elevated liver enzymes, or medical scanning using ultrasound, MRI, etc. If
fatty liver is found, a next step in diagnosis is to assess the patient's intake
of alcohol. More than two drinks per day of alcohol intake indicates a diagnosis
of alcoholic fatty liver, while lower or no alcohol consumption indicates fatty liver
from another cause. The two forms of fatty liver are quite similar in effect but
indicate different treatment options.
In the event of a positive diagnosis, a liver biopsy may be suggested to assess the
extent of the progression of the disease/damage. A biopsy is a relatively minor surgery
where a small sample of the liver tissue is removed for more thorough examination.
Treatment
As a rule, except in rare cases, no treatment is recommended for fatty liver disease
beyond what applies to treating the causes. Alcohol abuse, diabetes, obesity, and
other causes of fatty liver disease can pose other health problems beyond just fatty
liver, and obviously any of these is a cause for concern and for treatment. There
are some complications to fatty liver disease that can on rare occasions arise. The
most serious complication is hepatocellular carcinoma, which is a cancer of the liver.
As many as ten percent of patients with alcoholic fatty liver develop hepatocellular
carcinoma. It is also associated with non-alcoholic fatty liver, although the incidence
has not been quantified. It's been argued that fatty liver disease carries an increased
danger of cardiovascular disease. However, it's difficult to confirm this, as many
of the causes of fatty liver (alcoholism, obesity, diabetes) definitely do carry
this increased risk, and determining what portion of the increase is due to fatty
liver and what comes from the underlying condition is not easy. For treatment purposes
it's arguably not very important, either, as treatment of the underlying condition
is the usual prescription. Fatty liver disease is an early-stage indicator of other,
more serious liver conditions, such as liver fibrosis, or even cirrhosis of the liver,
a very serious and potentially fatal disease that requires close monitoring and may,
if it progresses to advanced stages, require a liver transplant. Because of this,
fatty liver disease is always a cause of some concern even when (as is usually the
case) it is not particularly dangerous in itself.
Diet
Fatty liver disease often is improved by changes in diet and lifestyle. In the case
of alcoholic fatty liver, obviously a reduction (or elimination) of alcohol consumption
should improve the condition. In non-alcoholic fatty liver disease, a dietary regimen
high in fiber and low in fat, and leading to gradual weight loss, can cause the condition
to reverse. Such diets are of course frequently indicated for obesity or diabetes,
both of which are common underlying causes of fatty liver. In almost all cases, fatty
liver is a reversible condition and can be treated with lifestyle changes.
