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.
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.