Fatty Liver
Fatty liver, or steatosis, is a broad term that describes the buildup of fats in the liver. Having some fat in your liver is normal, but if more than five to 10 percent is fat, then it is called fatty liver disease. Fatty liver is usually a reversible condition and can go away if the inciting cause is corrected. Fatty liver often has no symptoms and may not cause any permanent damage unless the cause continues unabated.
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. If too much fat has accumulated in the liver then this process is interfered with. The liver commonly repairs itself by rebuilding new liver cells when the old ones are damaged. When there is repeated damage to the liver, permanent scarring takes place. This is called cirrhosis.
Symptoms
There are typically no symptoms of fatty liver. Some people experience fatigue or vague abdominal discomfort. The liver may become slightly enlarged—which may be detected by your doctor on a thorough physical exam, or by an ultrasound scan.
If the liver has become inflamed, there may be other symptoms, such as poor appetite, weight loss, and feeling extremely weak, tired, or sick.
The most common cause is alcoholism. Almost all heavy drinkers have fatty liver disease. Other causes are high blood cholesterol, obesity, and type 2 diabetes. It may also be caused by toxins, certain drugs (asprin, steroids), pregnancy, and inherited metabolic disorders. In many cases, the cause is not clear.
Fatty liver develops when the body ingests and/or creates too much fat and cannot metabolize it fast enough. As a result, the leftover is stored in liver cells where it accumulates to become fatty liver disease.
Types
Fatty liver may be seen in four common forms:
1. Nonalcoholic Fatty Liver Disease
Nonalcoholic fatty liver (NAFLD) develops when the liver has difficulty breaking down fats, which causes a buildup in the liver tissue. The cause is not related to alcohol. NAFLD is diagnosed when more than 10 percent of the liver is fat.
2. Alcoholic Fatty Liver
Alcoholic fatty liver is the earliest stage of alcohol-related liver disease. The liver is damaged by heavy drinking and inability to break down fats. If the patient abstains from alcohol, the fat in the liver will go away within six weeks of being alcohol-free. If excessive alcohol use continues, alcoholic hepatitis and later cirrhosis may develop.
3. Nonalcoholic Steatohepatitis (NASH)
With excessive build up of fat, the liver swells and gets inflamed. If the original cause is not alcohol, it is called NASH. This disease can impair liver function. Symptoms can be seen with this disease, such as loss of appetite, nausea, vomiting, abdominal pain, and yellowing of the skin. If left untreated, NASH can progress to permanent scarring of the liver, cirrhosis and eventual liver failure.
4. Acute Fatty Liver of Pregnancy
This is a rare complication of pregnancy that can be life threatening. Symptoms begin in the third trimester and include persistent nausea and vomiting, pain in the upper-right abdomen, jaundice, and general malaise. Women who are pregnant and become jaundiced should be screened for this condition. Most women improve after delivery and have no lasting effects.
Who is at Risk?
Since fatty liver is the buildup of extra fats in the liver, it is more likely to develop if you are overweight or obese. As described above, alcoholism, diabetes, high cholesterol and triglyceride levels and pregnancy can increase your risk of fatty liver.
Other factors that may increase the risk:
- excessive use of over-the-counter medication (taking more than the recommended doses of certain medications, such as acetaminophen)
- malnutrition
- metabolic syndrome
Diagnosis
Fatty liver can be diagnosed by:
- History of the risk factors as above
- A physical exam of the abdomen by your physician
- Blood Tests: Higher than normal liver enzymes may be found on a routine blood test
- Scans: Ultrasound will show the fat on your liver as a white area on the image. Other imaging studies may be done as well such as a CT (computed tomography) scan or MRI (magnetic resonance imaging).
- Liver Biopsy: A needle is inserted into the liver to remove a piece of tissue for examination (after giving a local anesthetic to lessen the pain). This is sometimes needed to help your doctor learn the exact cause of liver damage.
How is Fatty Liver treated and prevented?
Treatment focuses on the factors that may cause the disease. Common interventions center around:
- treatment of alcoholism
- cholesterol management
- weight loss
- blood sugar control
To reduce your risk of fatty liver, make healthy lifestyle choices, such as:
- Limit or avoid alcohol consumption.
- Choose a healthy, balanced diet.
- Maintain your ideal weight.
