Fatty Liver Disease

Background

The liver is a vital organ that performs many important roles. One of its most crucial functions is that of metabolism. The liver carries out metabolism of carbohydrates, fats and proteins. In other words, all the three macronutrients present in our diets are metabolised by this organ.

There can be a variety of afflictions of the liver, ranging from infection to malignancy. However, globally, one of the main causes of liver disease is the overconsumption of alcohol. Liver disease caused by alcohol develops gradually and progressively and leads to conditions such as fatty liver disease and liver cirrhosis. Beyond a certain point, alcohol damages the liver permanently.

What Is Fatty Liver Disease?

Normally, if you are healthy and you liver is healthy too, there may be no fat or only a small quantity of fat stored in the organ.

However, when the percentage of fat in the liver exceeds 5% of the organ’s total weight, the person is considered to be suffering from fatty liver disease.

In medical terms, this condition is known as hepatic steatosis.

This can be the outcome of excessive alcohol consumption or it may be entirely unrelated to alcohol.

The former type is known as alcoholic fatty liver disease and the former is known as non-alcoholic fatty liver disease. The non-alcoholic form is often related to obesity or even pregnancy.

Up to a certain point, fatty liver disease is reversible. However, if the conditions responsible for it are not actively rectified, it tends to give rise to liver cirrhosis and eventually permanent liver damage. In fact, fatty liver disease is acknowledged as one of the primary causes of liver cirrhosis. In extreme cases, patients may even die.

What Is Responsible For Fatty Liver Disease?

The main problem that leads to this form of disease is excessive deposition of fat within the liver itself.

Fatty liver disease is often associated with excessive alcohol consumption.

Alcohol alters the way that the liver normally processes fat, forcing it to store more than the normal quantities of fat.

It does not only inflict alcoholics or those with a severe addiction to alcohol. Those who regularly consume large quantities of alcohol, whether or not they are actually addicted to it, are liable to develop this disorder.

Insufficient or imbalanced nutritional intake can also precipitate this condition. For instance, if your diet is rich in cholesterol, there is a greater risk of developing fatty liver disease. A diet poor in nutritional value can also lead to fatty liver disease.

The following conditions may also contribute:

• Heredity
• Existing liver disease
• Inflammation of the liver due to autoimmune activity
• Being middle aged
• High blood cholesterol level
• Being obese or underweight
• Being pregnant
• Smoking
• Sleep apnea
• Side-effect of certain medications
• Having hypertension
• Insulin resistance
• Suffering from type 2 diabetes
• Other endocrine disorders such as hypothyroidism and hypopituitarism
• Hepatitis C
• Having polycystic ovary syndrome
• Metabolic syndrome
• Malnutrition
• Starvation and rapid weight loss

What Are The Identifying Features And Symptoms?

Fatty liver disease is often asymptomatic. In other words there may be no noticeable external signs of disease. However, having excess fat in your liver can lead to inflammation in the organ and symptoms more often arise as a result of this process. Patients who do experience symptoms typically complain of the following problems:

• Loss of appetite
• Distended abdomen
• Abdominal discomfort
• Vomiting
• Fatigue
• Confusion

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What Are The Different Types Of Fatty Liver Disease?

As we seen above in brief, the two main forms of fatty liver disease are the alcoholic and non-alcoholic types. Their causes and risk factors differ to some extent. Another form of fatty liver disease can develop in women during pregnancy. The causes for this are not well understood. The risks to maternal and foetal health are considerable. For instance, either of them may develop liver failure.

What Complications Can Fatty Liver Disease Lead To?

Usually, the liver is able to renew itself by replacing damaged cells. However, if the damage continues to occur and if unhealthy habits have not been rectified, the organ develops scarring. This is known as fibrosis. As the scarring gets worse it is irreversible. This condition is known as liver cirrhosis. In extreme cases, liver cirrhosis can lead to further complications such as liver cancer and liver failure.

In pregnant women suffering from fatty liver disease, there is a risk of liver failure or kidney damage in the mother as well as the foetus.

How Is It Diagnosed ?

Since a good number of patients tend to be asymptomatic, the condition is often detected incidentally. Usually, this happens when the liver appears abnormal upon conducting imaging tests. Earlier detection is associated with a greater likelihood of recovery. Based on an overview of your symptoms and dietary habits or medical history, your doctor may suspect fatty liver disease. In order to confirm the diagnosis, the following investigations may be required:

• Blood tests such as AST 
• Tests for viral hepatitis.
• Liver function tests.
• Lipid profile tests.
• Ultrasounds.
• Computerised tomography (CT).
• Elastography.
• Liver biopsy.

If detected early enough, fatty liver disease can be successfully resolved. The most effective way to do this is to reverse unhealthy diet patterns and lifestyle habits.

In case the patient is accustomed to consuming alcohol in excessive quantities, he or she will need to be supported in the process of overcoming this habit.

This can be hard to do and counseling may be required. Support groups can aid in the process of overcoming alcoholism.

Losing weight is a sound approach for non-alcoholic fatty liver disease.

However, if the condition has progressed too far and the patient has developed severe liver cirrhosis or even liver failure, the best option may be to undergo surgery for a liver transplant.

Treatment and Prevention

The treatment protocol followed for treating and managing this  condition focuses on minimizing liver damage. If the main cause is high-alcohol consumption, then the necessary abstinence methods need to be adopted. Similarly, if its diet or diabetes related, addressing unhealthy diet patterns or glucose control is the way to go. Weight control and increasing muscle mass in the body can help get rid of excess visceral fat deposition. It is important that the patient follows a strict cardio exercise routine. Cardio routine will not only help in losing weight and increasing body’s metabolism, but it will also control insulin resistance.

Treatment for fatty liver disease basically includes a complete lifestyle change. Including a healthy dietary pattern and physically active lifestyle will go a long way in improving the condition of the liver. Sugar and tobacco consumption should be refrained from. Drugs that faciltate cholesterol and triglyceride control are often prescribed to FLD patients. For extremely obese individuals, bariatric surgery might prove helpful. Regardless of the severity of this disease, it is advised to the patients to go for regular check-ups and follow-ups with the doctor.

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