Fatty Liver Disease can occur for a number of reasons; however, physicians generally split Fatty Liver Disease into two categories: Alcoholic and Non Alcoholic. Alcoholic Fatty Liver Disease is caused by alcoholism whereas Non Alcoholic Fatty Liver Disease is caused by obesity and metabolic syndrome. Both diseases can be asymptomatic at first and may only be discovered by lab tests or other tests to scan the liver for fat globules, or after progression to hepatitis or cirrhosis.

Signs and Symptoms

Pain

Most of the time, fatty liver disease is asymptomatic until it has progressed farther. Sometimes, however, there are some symptoms, including pain or discomfort. If you experience pain or discomfort in your right upper quadrant (RUQ), you may have Fatty Liver Disease.

Enlarged Liver

During a regular physical exam, a physician or nurse will generally palpate, or feel your liver through your abdomen. If it feels larger than it should, this is diagnosed as “hepatomegaly”, or enlarged liver, and may be another sign that you have a fatty liver. You may also feel some tenderness when the physician or nurse presses in that area.

Fatigue, Nausea, Vomiting, Digestion Issues or Weight loss are not commonly symptoms of Fatty Liver Disease. These symptoms generally occur when the disease has progressed to hepatitis or cirrhosis, which is generally several decades later. At this point, irreversible liver damage has already occurred.

Elevated LFTs

If you have Fatty Liver Disease, you usually will have an abnormal laboratory test called “Elevated LFTs” or Elevated Liver Function Tests. This includes AST and ALT which are enzymes usually contained in your liver. When they are elevated, this means your liver has some damage to it, which lets these enzymes out into the bloodstream. Physicians also may use an AST to ALT ratio in order to tell how advanced your liver disease is. Your Triglycerides (abbreviated TG or TAG) may also be elevated.

Diagnosis

Non Alcoholic Fatty Liver Disease is generally diagnosed by excluding other liver diseases. Thus, if your physician suspects you have Non Alcoholic Fatty Liver disease, he or she will likely test for hepatitis, autoimmune disease, and screen for drugs that may have caused liver damage in order to rule those possibilities out. If all of this is negative and you have risk factors for Non Alcoholic Fatty Liver Disease such as obesity, elevated triglycerides, diabetes, and/or metabolic syndrome, you may be given this diagnosis. It is also possible that your physician may perform an ultrasound, CT scan, or MRI of the liver. In severe cases, you may require a liver biopsy.

Alcoholic Fatty Liver disease is generally diagnosed through social history in addition to the medical tests above. If you have a fatty liver, and you or your family states that you drink often, alcoholic fatty liver disease is diagnosed. Alcoholism is very damaging to your liver and other organs, so if you have a problem with alcohol you should seek help immediately.

Treatment

The treatment for Non Alcoholic Fatty Liver Disease is generally weight loss and correction of any lipid abnormalities such as elevated cholesterol or triglycerides. If you have diabetes, it will also help if it is well controlled and your blood sugars are consistently below 150 mg/dl. There are also some experimental treatments such as Vitamin E therapy that may help. Make sure that you check with your doctor before starting a supplement regimen, however, and never go over the daily Upper Limit established for any vitamin or mineral.

Abstaining from alcohol is the treatment for Alcoholic Fatty Liver Disease. If this treatment is successful, the liver damage can usually be entirely reversed before it leads to more severe irreversible liver damage.

Progression of Liver Disease

In Alcoholic Liver Disease, the disease progresses quickly, depending on the severity of alcoholism. The disease starts with Fatty Liver, then becomes Alcoholic Hepatitis which is inflammation of the liver. This may be the beginning of necrosis, or death of the liver tissue. If alcoholism continues, this can progress to liver cirrhosis, or End Stage Liver disease (ESLD). This condition is irreversible. It can causeĀ  jaundice, or yellowing of the skin and eyes, fluid retention in the abdominal area, encephalopathy or swelling of the brain causing confusion, and eventually death.

Non Alcoholic Fatty Liver Disease progresses more slowly. It progresses first to Non Alcoholic Steatohepatitis, or NASH, which is an inflamed, enlarged liver. In some cases, it will also lead to cirrhosis or ESLD. If this occurs, it usually happens by the 5th or 6th decade of
life.

Conclusion

If you are suspected of having Non Alcoholic Fatty Liver Disease or Alcoholic Fatty Liver Disease, the best thing you can do is prevent whatever is causing it. In the former, the cause is generally an unhealthy lifestyle causing obesity and metabolic syndrome. If you lose weight and become more healthy, it is likely that this condition will resolve on its own.

The same can be said for Alcoholic Fatty Liver Disease. If you abstain from alcohol and get help for your addiction, your condition can also be entirely reversed. Don’t wait until you have progressed to hepatitis or cirrhosis in order to do something about it. At that point, it may be too late.

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