Overview
It is typically the result of eating far more fats and sugars than the body can handle that liver fat develops. Adults with healthy body weights can also experience this, but it is more common among overweight or obese people. Fatty liver is characterized by fat building up over 5% of the liver. Fat accumulation in the liver may not immediately harm but cause inflammation and scarring later.
What is Fatty Liver Disease?
Fatty liver is a medical condition in which fat accumulates in the liver, leading to inflammation and possible organ scarring. It commonly affects 25-30% of adults worldwide.
The primary cause of fatty liver is excessive alcohol consumption. Over time, excessive alcohol intake can cause fat formation or accumulation in the liver leading to inflammation, scarring, and, ultimately, cirrhosis.
However, it’s important to note that fatty liver can occur without alcohol abuse. People who are overweight, obese, or have high cholesterol and type 2 diabetes are also at risk.
Fortunately, fatty liver can usually be reversed with lifestyle changes. Eating a healthy diet and regular exercise can help reduce fat in the liver, leading to decreased symptoms and an overall healthier liver. Cutting back on alcohol consumption and drinking in moderation is also key.
Fatty liver can be treated with medications like ursodeoxycholic acid (UDCA), which can help reduce liver inflammation and slow disease progression.
Talking to a doctor for early diagnosis and treatment is recommended to help stop the fatty liver from developing into something more serious.
Types of fatty liver disease
On the basis of cause, fatty liver disease is divided into the following types.
Non-Alcoholic Fatty Liver Disease( NAFLD)
NAFLD is a condition in which excess fat accumulates in the liver cells of non-alcoholics. The disease affects about 25% to 30% of US AND European citizens. NAFLD occurs when the liver is overloaded with fat, and you do not have a history of heavy alcohol use.
The condition is known as simple NAFLD if there is no inflammation or other complications. Imaging tests (such as abdominal ultrasounds, CT scans, and MRIs) often help make the right diagnosis.
Diabetes and obesity are common conditions that raise the risk of NAFLD. Additionally, it increases cardiovascular disease risk. The causes and consequences of the disease are still unclear.
NAFLD is further divided into two groups:
- Simple fatty liver or non-alcoholic fatty liver (NAFL)
- Non-alcoholic steatohepatitis (NASH).
It is essential to distinguish between simple fatty livers and NASH. You might wonder why? Most people do not suffer from liver ailments caused by simple fatty liver, whereas those with NASH suffer from inflammation and damage to their liver cells due to liver inflammation. Consequently, it leads to more serious conditions like fibrosis (scarring) of the liver, cirrhosis, and even liver cancer in the future. In the next year or so, it is estimated that NASH cirrhosis will be the leading cause of liver transplants owing to its severity and early onset.
Alcoholic fatty liver disease (AFLD)
It is well known that drinking excessive amounts of alcohol harms the liver. AFLD, also known as alcohol-induced fatty liver disease, is the earliest indication that alcohol-related liver disease has taken place. The condition is classified as simple alcoholic fatty liver if no inflammation or other complications are associated.
There are several types of AFLD, including alcoholic steatohepatitis (ASH). In other words, it results from a buildup of excess fat in the liver accompanied by inflammation, also known as alcoholic hepatitis. When a doctor diagnoses ASH, they will consider the following factors:
- In your liver, you have excess fat that needs to be removed
- There is inflammation in your liver.
- It appears that you are a heavy drinker.
There is a risk of liver fibrosis if ASH is not treated properly. Severe scarring of the liver (cirrhosis) can lead to the failure of the liver.
Acute Fatty Liver Disease of Pregnancy
Acute fatty liver during pregnancy (AFLP) is a type of fatty liver that develops during the last three months of pregnancy.
It is often difficult to diagnose AFLP early because AFLP symptoms are non-specific and can be confused with other conditions. There are several symptoms in women associated with AFLP, including:
- Vomiting and nausea
- Appetite loss
- Pain in the abdomen and indigestion
- Feeling unwell (malaise) without any specific cause
- Fatigue (excessive tiredness)
- Jaundice
- A thirsty feeling
If left untreated, acute fatty liver in pregnancy can cause rapid liver failure and be life-threatening for the mother and baby.
Symptoms of Fatty Liver Disease
The symptoms of AFLD and NAFLD are similar. In many cases, fatty liver causes no noticeable symptoms. However, some of the symptoms when fatty liver progresses to cirrhosis:
- Tiredness
- Discomfort
- Pain in the upper right side of your abdomen
- Nausea
- Loss of appetite
- Unexplained weight loss
- Jaundice
- Mental confusion
- Weakness
- Bleeding or bruising easily
- Dark-colored urine
- Pale stools
- Fluid accumulation in the abdomen (ascites)
- Web-like clusters of blood vessels under your skin
- In men, breast growth
Causes of Fatty Liver Disease
Fatty liver refers to fat accumulation within the liver cells (hepatocytes). Many factors play a role in fat accumulation within liver cells.
The consumption of too much alcohol can lead to AFLD. It has been shown that heavy alcohol consumption alters liver metabolism. As a result of these altered metabolic processes, some metabolites combine with fatty acids and form fat-type that accumulate in the liver.
Fatty liver disease has a less clear cause in people who do not drink much alcohol. It may be that their bodies produce too much fat or do not metabolize fat properly in these individuals.
Non-alcoholic fatty liver can develop from one or more of the following factors:
- Obesity
- Diabetes type II
- Insulin resistance ( insulin insensitivity )
- Having high serum TAG levels
- Metabolic syndrome
The following are other possible causes of fatty liver:
- Pregnancy
- Medication side effects
- Hepatitis C and certain types of infections
- Genetic conditions
Progression of Fatty Liver
In terms of fatty liver progression, there are four stages:
Simple fatty liver: Excess fat builds up in the liver. If it doesn’t progress, simple fatty liver is mostly harmless.
Steatohepatitis: Excess fat in the liver is accompanied by inflammation.
Fibrosis: Scarring occurs in the liver due to persistent inflammation. Still, the liver can generally function normally.
Cirrhosis: Liver scarring has become widespread, compromising its function. It is irreversible at this stage.
Fatty liver disease may lead to complications, such as liver scarring. Liver fibrosis is characterized by scarring of the liver. Cirrhosis is a life-threatening condition that damages the liver permanently that may be caused by severe liver fibrosis.
Fatty Liver Diagnosis
Your doctor will review your medical history and advise one or more tests to diagnose fatty liver. Your doctor will likely ask you questions about the following:
- Medical history of your family, including liver disease history
- How you consume alcohol and live your life.
- The underlying medical condition
- Medications you might be taking
- Recent health changes you noticed
Palpating or pressing on your abdomen can be used to check for liver inflammation. It may be possible to feel your enlarged liver.
Despite this, it is also possible to have an inflamed liver without an enlarged one. Touching your liver might not be enough for a doctor to determine whether it is inflamed. Therefore, the following tests are the most effective option for making the right diagnosis:
Blood tests
The diagnosis of fatty liver disease is often made after blood tests reveal elevated liver enzyme levels. To check your liver enzymes, your doctor may advise you to follow.
A doctor may recommend these tests if you develop liver disease symptoms or undergo routine blood tests.
It is a sign of liver inflammation that liver enzymes are elevated. Liver inflammation is often caused by fatty liver disease, but it’s not the only cause.
Additional tests will likely determine the cause of inflammation if your liver enzymes are elevated.
Imaging studies
Several imaging tests can be performed to determine whether your liver has excess fat or other problems:
- Ultrasound
- CT scan
- MRI scan
- Vibration-controlled transient elastography (VCTE, FibroScan).
Liver stiffness is measured using low-frequency sound waves. Scarring can be checked with this test.
Liver biopsy
The most effective way to diagnose liver disease is through a liver biopsy. A needle is inserted into your liver during a liver biopsy, and tissue is removed for examination. For your comfort, a local anesthetic will be administered. If you have liver scarring or fatty liver disease, this test can help determine the severity of the disease.
Fatty Liver Prevention and Management
Nutritional Therapy
According to the Canadian Liver Foundation, diet is major in treating and preventing NAFLD. It is possible to build up fat in the liver by consuming too much sugar and saturated fat. While no specific liver-healthy diet exists, following these guidelines can ensure your liver functions optimally! Added sugar should not exceed 10% of adults and children’s daily energy intake, according to the World Health Organization (WHO). Per day, that’s less than 50 grams of added sugar!
Physical Activity
It is essential to recognize that physical activity differs from exercise if you want to live a more active life! Physical activity is anything that gets you moving and challenges you. Exercise is best done moderately to high intensity and with a structured routine. It would help if you reduced your time spent sedentary.
Sleep and Liver Health
Several health issues, including fatty liver, have been linked to insufficient sleep. You may experience changes in your metabolic rate (like insulin resistance) due to lack of sleep, which may affect how your liver converts nutrients from foods you eat, affecting your weight management efforts. During the day, it can also make you feel more tired and sleepy, affecting your overall activity level.
According to Health Canada, adults should sleep at least 7-9 hours per night to maintain their health. It is even more important for children to get enough sleep.
According to current guidelines :
- Children aged 5-13 should sleep 9 to 11 hours a night
- Children between 14 and 17 need 8 to 10 hours of sleep per night.
Maintaining a good sleep pattern is also important for achieving a healthy ‘sleep routine.’ It’s important to avoid interruptions to your sleep that might interfere.
Fatty Liver Treatment:
Treatment for NAFLD involves changing lifestyle habits, including losing weight. It is also possible to treat fatty liver disease with the following medications:
Insulin Sensitizers
In the development and progression of NAFLD, insulin resistance plays an important role. Research suggests that insulin sensitizers, also called thiazolidinediones (TZDs), are effective against NASH. Pioglitazone and rosiglitazone are common TZDs.
NASH is typically not treated with TZDs due to their possible side effects, including:
- Cardiovascular disease is more likely to occur
- Putting on weight
- Fluid retention (edema)
- Bone density loss
Lipid-Lowering Drugs
Inhibiting cholesterol production is one of the benefits of lipid-lowering drugs. Studies indicate that statins may help treat NAFLD due to their lipid-lowering properties. Healthcare professionals do not recommend statins for treating NAFLD or NASH until further research confirms their effectiveness.
Studies have also suggested that the lipid-lowering drug ezetimibe effectively treats fatty liver. It isn’t a standard treatment, though.
Pentoxifylline
NAFLD may be inhibited by pentoxifylline. The only downside is that it can make you nauseous and sick. It needs more research before doctors recommend it for fatty liver disease.
Angiotensin Receptor Blockers
Clinical trials have shown that angiotensin II type 1 blockers can slow NASH progression. Telmisartan, losartan, and valsartan are some of the common type 1 blockers.
The downside is that these blockers can lower blood pressure, so doctors don’t typically recommend them for fatty liver.
When to Consult a Doctor?
Fatty liver is a hidden killer that can progress to liver cirrhosis and liver failure.
In most cases, early symptoms are silent. If you still feel doubtful about the disease’s presence, consider consulting a medical expert immediately before it’s too late. You can get medical aid from Your Doctors Online, highly professional medical doctors who can help you with the early and right diagnosis and suggest the best treatment depending on the stage and severity of the disease.
FAQS about Fatty Liver Disease Answered By Your Doctors Online Team
A study found that people with nonalcoholic fatty liver disease who drank two or more cups of coffee daily had less liver damage than those who drank none or little. Although it’s not clear how coffee affects liver damage, some research suggests it may have anti-inflammatory properties.
Yes, it can, depending on the stage of the disease. If it has already progressed to cirrhosis, it can’t be normalized.
It is believed that vitamin E and other vitamins called antioxidants could protect the liver by reducing or neutralizing inflammation-induced damage. However, more research is needed. Evidence suggests vitamin E supplements can help people with nonalcoholic fatty liver disease. But vitamin E has been linked to death and prostate cancer in men.
Too much fat in your liver can cause inflammation, liver damage, and scarring. In severe cases, scarring can cause liver failure.
