Fatty liver is a condition where excess fat is deposited on this organ. Also called as steatosis, this condition happens when more than 5- 10 percent of the weight of the liver is made up of fat.

Fatty liver is a common condition among people. A study from coastal regions of India found ~ 25% of healthy persons had patients had fatty liver on ultrasound.

It can occur at all ages including childhood, highest prevalence is in 40 50 year age group. Prevalence more in patient who are obese and in diabetic patients.

Types of Fatty Liver

1 Alcoholic fatty liver: This condition occurs when there is a heavy consumption of alcohol. Gastroenterologists recommend abstention from alcohol for this condition to subside. If the patient continues to consume alcohol, then liver cirrhosis may develop.

2 Non alcoholic fatty liver (NAFL): One may develop a fatty liver even if one is not an alcoholic. The liver in some cases is unable to process the fat in cells causing them to build-up on the organ.

When more than 10% of the liver is made of fat then this condition is called Non Alcoholic Fatty Liver (NAFL).

Non alcoholic steatohepatitis (NASH): When fatty liver is associated with inflammation in liver patient is said to be having Non alcoholic steatohepatitis. NASH is a more advanced stage of NAFLD, and has a higher risk of progressing to liver cirrhosis or hepatocellular carcinoma (HCC). These condition display symptoms like jaundice, vomiting, nausea, loss of appetite and abdominal pain. Blood test (LFT) shows raised enzymes level. Approx 5-8% of the Indian population has NASH. Consult a doctor if you are experiencing any of these symptoms.

3 Fatty liver during pregnancy: Occurring mainly in the third trimester, the symptoms of this condition are vomiting, nausea, pain the right part of the abdomen and jaundice.

Symptoms

During the early stages (fatty liver) of the disease, patients usually have no symptoms directly related to liver disease. However, people may experience a vague abdominal discomfort. If their liver is inflamed (NASH) then they may display symptoms of poor appetite, weight loss, pain in the abdomen and disorientation.

What causes fatty liver?

The most common cause of fatty liver is alcoholism. When the human liver is unable to metabolize fat fast enough or when there is an excess accumulation of fat on the liver cells then the liver becomes fatty. However, intake of high-fat foods may not result in a fatty liver.

Predisposing factor:

1 Diabetes mellitus

2 Obesity or being overweight

3 Hyperlipidemia or the condition where there are high levels of fat in the blood

4 Genetic reasons

5 Rapid loss of weight

6 Drugs: Aspirin, steroids, tamoxifen, tetracycline etc. cause side effects which also leads to fatty liver

7 Nutritional status (eg, overnutrition, severe malnutrition, total parenteral nutrition [TPN], or starvation diet)

8 Other health problems (eg, Hepatitis C infection, celiac sprue and Wilson disease)

Know More About Fatty Liver!

In general, fatty liver is considered synonymous with alcoholic liver disease. However, in reality it is not so. Fatty liver just indicates the presence of fat in the liver. It may or may not be harmful for the patient. Fatty liver is harmful only when it starts to damage the liver cells. Simple fatty liver does not cause inflammation, but when it starts doing so, it does not remain a simple fatty liver anymore.

Types of Fatty Liver Disease

There are two types of Fatty liver disease: Alcohol Related Fatty Liver Disease and Non-alcoholic Fatty Liver Disease.

Alcohol Related Fatty Liver Disease

Fatty liver does not always beget symptoms, although the liver may be enlarged. One may also feel discomfort or pain in the upper right quadrant of the abdomen. However, one can prevent alcoholic liver disease, since fatty liver owing to alcohol consumption usually gets better after stopping alcohol abuse. However, if a person doesn t do that, ALD can progress to more serious stages, like alcoholic hepatitis and alcoholic cirrhosis.

Alcoholic Cirrhosis
Alcoholic Cirrhosis occurs when there is formation of scar tissue in the liver. It can cause symptoms like bleeding, confusion, changes in mood and enlargement of spleen. Scar tissue formation can even lead to fatal liver failure.

Alcoholic Hepatitis
Alcoholic Hepatitis occurs when there is a swelling of the liver. It can precipitate nausea, fever, abdominal pain, vomiting, jaundice etc.

Non-Alcoholic Fatty Liver Disease

This is of two types: Simple Fatty Liver and Non-alcoholic Steatohepatitis.

Simple fatty liver just indicates the presence of fat in the liver without inflammation. On the other hand, Non-alcoholic steatohepatitis is a much worse form of fatty liver. This indicates that there is fat as well as inflammation in the liver. Even some of the liver cells may have become damaged. It can cause the following problems:

Formation of scar tissue in the liver, called fibrosis.

Severe fibrosis can lead to cirrhosis in advanced stages. Cirrhosis can lead to liver failure

Liver cancer

Causes of Fatty Liver

In alcoholic fatty liver disease, the prime cause is consuming too much alcohol. Alcohol may precipitate fatty liver by promoting obesity, malnourishment and even chronic hepatitis.

For non-alcoholic fatty liver disease there may be a number of factors:

Obesity

Insulin resistance

High levels of LDL cholesterol or low levels of HDL cholesterol

Diabetes

Conditions that may precipitate Type 2 diabetes 

High blood pressure

High blood sugar

Symptoms of Fatty Liver

There is hardly any symptom of fatty liver disease. At most, one can feel pain or tiredness in the right upper quadrant of the abdomen. However, if fatty liver has advanced to cirrhosis, fibrosis or hepatitis, there can be a number of symptoms. Some of these symptoms are:

Swollen abdomen

Enlarged blood vessels under the skin

Abnormal breast size in men

Redness in palms

Yellowing of skin and eyes.

Treatment

For alcoholic fatty liver disease, the best treatment is cessation of drinking when the fatty liver has still not progressed to more serious forms. For non-alcoholic fatty diseases, weight loss is an effective treatment. If there is Cirrhosis or Liver Failure, liver transplant is the only option.

As the treatment may vary from patient to patient, it is important that one should always consult a doctor before going for any option.

Fatty Liver - Types & Treatment Of It!

In healthy individuals, the liver contains little or no fat. In overweight or obese people, gradual fat accumulation leads to significant liver disease. Interestingly, these individuals may be consuming minimal to no alcohol. So, alcohol, which is the main cause for liver damage, does not have a significant role to play.

The non-alcoholic fatty liver disease (NAFLD) has 4 significant stages as outlined below. It is a chronically progressive disease and may take years to reach the final stages of cirrhosis and fibrosis.

1. Simple fatty liver (steatosis): This is usually identified when diagnostic tests are done for some other suspected conditions. There are usually no symptoms obvious in this stage, other than the buildup of fat in the liver.

2. Non-alcoholic steatohepatitis (NASH): The second stage where the liver is inflamed to a greater extent due to fat accumulation.

3. Fibrosis: The next degree of inflammation where blood vessels may be narrowed leading to scarring in the liver with impaired liver functions.

4. Cirrhosis: This is the most severe stage that occurs due to years of cumulative inflammation. The liver shrinks in size, is scarred, and liver functions are markedly impaired and can also result in liver cancer.

Risk factors for NAFLD: The exact reason why a person develops NAFLD is not established, but some of the risk factors include

1. Obesity, with more weight concentrated around the abdomen

2. Type 2 diabetes

3. High blood pressure

4. High cholesterol levels

5. Age greater than 50

6. Smoking

Symptoms: This will depend on the stage in which it is identified. While there are no symptoms in the early stages, in some people there could be a dull, aching below the ribs, unexplained weight loss, weakness, and extreme tiredness. As it progresses to cirrhosis, there could be jaundice, fluid accumulation in the abdomen and feet, and itching of the skin.

Management: While there is no treatment aimed at curing the disease per se, there are ways to manage the symptoms, as noted below.

1. Weight loss: Reducing excess accumulated fat will help reverse symptoms and prevent further progression of the disease. A BMI of 18 to 26 is considered optimal.

2. Dietary changes: Modify your diet to a carbohydrates and protein rich and reduced fats and sugars. Increasing fiber through fruits and vegetables is highly recommended.

3. Exercise: Whatever your choice of workout, it will do wonders for NAFLD. Keep a target of an hour or two of moderate to intense exercise per day to reduce weight.

4. Smoking: This is another risk factor and can also help prevent other effects of NAFLD such as diabetes and heart disease.

NAFLD is highly controllable with these changes and other damages can be reversed too.

What is Nonalcoholic Fatty Liver Disease (NAFLD)?

Having some fat in your liver is legit. But, if you have too much of fat say more than 5%-10% of the organ's weight then you are at risk of getting fatty liver disease. At the onset, you can do one important thing to help your liver stop drinking. It causes fatty liver disease.

There are two main types of fatty liver disease

Alcoholic liver disease or ALD
Non-alcoholic fatty liver disease or NAFLD
If you are a woman who is pregnant, you can also get fatty liver disease.
Alcoholic Liver Disease (ALD)

You can get ALD from drinking lots of alcohol. ALD can also present itself after a short period of heavy drinking.
Genetics has a role to play in ALD. Genes can make you hit the bottle and increase your chances of becoming an alcoholic.
Genes can also impact the way your body breaks down the alcohol you drink.
Other root causes of ALD are:

Hep C doesn't cause ALD. it is one of the causes of fatty liver. 
Hep B is also a cause of fatty liver. There are certain medications which may be helpful from person to person besides lifestyle management.
Excess iron in your body
Obesity
Non-alcoholic Fatty Liver Disease (NAFLD)
The cause of NAFLD is not clear, but we know that it tends to run in families.
NAFLD is also more common in the middle-aged and the obese or, those who have high cholesterol and diabetes.

Other risk factors are:

Certain medicines
Viral hepatitis
Auto-immune or inherited liver disease
Gaining weight fast
Malnutrition
Acute Fatty Liver during Pregnancy
Fat can build up in your liver when you're pregnant, causing this kind of fatty liver disease.
It s a serious condition as it can be risky for both you and your baby. It can cause liver or kidney failure in you and your child, both.
Causes are unknown. But, hormones may play a role.
Symptoms of fatty liver disease
This disease can sometimes cause no symptoms for long. But, the things to look out for are-

Feeling tired all the time
Loss of appetite or weight
General weakness
Nausea
Confusion and trouble concentrating
Your liver can become larger
Pain in the centre or right upper part of your belly
In ALD, your symptoms get worse after bouts of heavy drinking. Fatty liver disease is diagnosed during routine exams when your doctor notices your enlarged liver. Ultrasound, blood tests to check for certain enzymes and biopsy of the liver are performed to confirm it.

Treatment

There is no specific treatment for the fatty liver disease.
You can manage it by managing your diabetes and giving up drinking. If you have ALD and you don t quit, you get complications like alcoholic hepatitis or cirrhosis.
Even if you have a non-alcoholic fatty liver disease, alcohol cessation helps.
Losing weight if you are overweight also helps to manage this disease and having a good balanced diet with exercise also shows benefits.

Fatty Liver Disease - Signs You Are Suffering From It!

Alcoholic liver disease or cirrhosis is one of the most common disorders of the liver. Since the liver performs a vital function in the body, it is essential to maintain its health. There can be several causes for the cirrhosis of the liver. Here are some of the factors that you need to watch out for if you want to steer clear of alcoholic liver disease.

Excess alcohol consumption: While limited alcohol consumption does not cause major health issues, you need to understand how much is too much. Drinking too much for a prolonged period of time will cause damage to the liver cells, which will lead to alcoholic liver disease. So, if you are a heavy drinker, stop immediately or at least try to cut down on the amount that you ingest each day. More than three drinks per day for men and two drinks per day for women for 5 years will substantially increase the chances of the disease.
Beer Consumption: People who drink beer are at a greater risk of suffering from alcoholic liver disease than people who consume wine or other alcoholic beverages. The exact reason for this is not known, but if you are a wine drinker, you would be happy to know that you have lesser chances of damaging your liver.
Gender: Research has indicated that women take longer to metabolize the alcohol that they consume than men. This is why such drinks have a deeper impact on women s bodies. For instance, even if a man and a woman drink the same amount of alcohol, it will cause more damage to the body of the woman than it will to the body of the man.
Obesity: Excess body weight can cause a host of harmful medical conditions, one of which is alcoholic liver disease. Maintaining an ideal body weight can go a long way in preventing the liver condition. Excess weight is a risk factor for both men and women. Pay attention to your diet and also ensure that you work out every day. Not only will such a lifestyle help you achieve a better liver, but it will also enhance your overall health.
If alcoholic liver disease is left untreated, it can progress to Hepatitis A or cirrhosis. Therefore, it is essential that you seek treatment as soon as you are diagnosed with the condition, in order to limit the damage to your health.

The 4 Most Common Risk Factors For Alcoholic Liver Disease!

The term cirrhosis refers to liver scarring due to various diseases and conditions such as chronic alcoholism and hepatitis. Each time the liver gets injured, it tries to repair itself, resulting in the formation of the scar tissue. With the progression of cirrhosis, a number of tissues generate making the task of liver difficult. Since the liver is an important organ of the body due to its functionalities such as detoxification and nutrient generation, reduced function of liver poses a serious threat to the body.

Symptoms of liver cirrhosis:
Unfortunately, cirrhosis doesn t portray any conspicuous symptoms that can be easily identified until the scarring has reached a level of threat. Some of the common signs and symptoms of this disease include fatigue, nausea, itchy skin, drowsiness, enlarged breasts, testicular atrophy, fluid in the abdomen, bleeding from the mouth, leg swelling, redness in palms etc.

Causes of liver cirrhosis:
There could be an array of reasons for the occurrence of liver cirrhosis. The major causes include an accumulation of fat in the liver, chronic alcoholism and chronic hepatitis. Some of the other reasons include cystic fibrosis, bile duct deformation, Wilson s disease, hemochromatosis, schistosomiasis, continuous consumption of medicines such as methotrexate, a disease involving glycogen storage and Aalagille syndrome.

Complications involved in liver Cirrhosis:

High blood pressure: Cirrhosis results in slow blood movement through the passage of the liver resulting in an increased pressure on the vein that is responsible for carrying blood from the intestine to the liver. This increases the blood pressure in the body.
Swelling of abdomen and legs: Portal hypertension can result in accumulation of fluid in the leg and the abdomen due to the liver s inability to producing an important protein known as the albumin.
Spleen enlargement: Portal hypertension is responsible for changing the shape of the spleen. Decreased count of WBC and the platelets indicate towards portal hypertension and cirrhosis.
Bleeding: Portal hypertension doesn t let the blood flow in its normal path. It directs the blood to flow through smaller veins. The veins, in turn, swell and burst to cause a massive amount of bleeding.
Apart from these some of the other complications involve jaundice, liver cancer, infections, bone diseases and liver failure.

Diagnosis:
Liver cirrhosis doesn t get detected easily. It is often diagnosed with a routine blood test. Some of the lab tests that can help to identify cirrhosis include blood work to check organ function of liver and kidney. Your doctor might suggest other tests such as MRI scan, CT scan or liver biopsy.

Treatment:
Treatment for the underlying cause of liver cirrhosis is done to keep the disease under control. A doctor might treat you for weight loss, alcohol dependency, complications related to hepatitis, portal hypertension and hepatic encephalopathy. For advanced cases where the liver stops functioning, a doctor might suggest a patient go for a liver transplant.

Liver Cirrhosis - What You Must Know About It?

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