Fatty Liver Disease: Symptoms, Causes, Types, Diagnosis, Prevention, and Treatment.

 

Fatty liver.

Fatty Liver Disease:

The liver is one of the biggest internal organs in our body. It is the second biggest organ of the body. It helps in digesting food and storing energy in our bodies. It helps process nutrients from food and beverages and filters harmful substances from the blood. Fatty liver occurs when a large amount of fat is made in the cells of the liver. Although it is normal to have a very small amount of fat in these cells, the liver is considered a fatty liver if it contains more than 5% fat. Fatty liver is also widely known as hepatic steatosis. Too much fat in the liver can cause inflammation of the liver which can damage the liver and create sores and subsequently make the liver dysfunctional. This condition is called fatty liver disease.

 

Symptoms of fatty liver:

There are several symptoms of fatty liver, although all of them may not be present. Some symptoms of fatty liver:

• Fatigue and weakness,
• Slight pain or fullness in the right or center abdomen,
• Liver enzymes levels including AST and ALT will be high,
• High levels of insulin,
• High levels of triglyceride,
• Loss of appetite,
• Nausea and vomiting,
• Moderate to severe abdominal pain, 
• Yellowing of skin and eyes,
• Weight loss,
• Bleeding through the nose,
• Itchy skin,
• Swelling in the abdomen,
• Swollen feet,
• Increased breast size in men than normal,
• Confusion.

Causes of fatty liver:

Many factors can cause a fatty liver. Some causes are:

• Obesity: Obesity is associated with inflammation and stimulates the liver to store fat.
• Excess belly fat: People who have normal Bodyweight but carry too much fat around their Waist may develop fatty liver.
• Insulin resistance: Insulin resistance and high insulin levels can increase liver fat storage in people who are suffering from type-2 diabetes and metabolic disorder.
• Refined carbs intake: when overweight or insulin-resistant individuals consume high amounts of refined carbs or frequently intake refined carbs then it promotes liver fat storage.
• Consumption of sugary beverages: Sugar-sweetened beverages such as soda and energy drinks contain high fructose that drives liver fat accumulation.
• Impaired gut health: A study has shown that an imbalance in gut bacteria or other gut health issues can contribute to developing non-alcoholic fatty liver disease.

Other less common causes are:

• Pregnancy,
• Rapid weight loss,
• Some types of infection like hepatitis C,
• Exposure to the certain toxin,
• Side effects of some types of medications like amiodarone, tamoxifen, and valproic acid, etc.

Types of fatty liver disease:

Fatty liver disease are mainly two types:

• Nonalcoholic fatty liver disease, and 
• Alcoholic fatty liver disease.

Nonalcoholic fatty liver disease:

This types of fatty liver disease are not related to heavy alcohol consumption. Nonalcoholic fatty liver disease may be two kinds:

Simple fatty liver: Simple fatty liver includes those who have small amount of fat in their liver, no inflammation, and no liver cell damage. Generally, simple fatty liver  never get bad enough to cause liver  complications or cirrhosis.

Nonalcoholic steatohepatitis: This type includes those who have fat in their liver, have inflammation, and liver cell damage. Inflammation and liver cell damage may cause fibrosis or scarring of the liver. Nonalcoholic steatohepatitis can lead to liver cirrhosis or cancer.

Alcoholic fatty liver disease:

Alcoholic fatty liver disease occur due to heavy alcohol consumption. Liver breaks down most of the alcohol and generate harmful substances.These harmful substances can increase inflammation, weaken  body's immunity, and damage the liver cells. Alcoholic fatty liver disease is the primary stage of alcohol-related liver disease and alcoholic hepatitis and cirrhosis are the next stage.

Diagnosis of fatty liver disease:

In order to diagnose fatty liver disease the following ways can be helpful:

Medical history:

Doctor can ask the following questions:

• Family medical history about any kind of liver disease.
• Alcohol consumption and other lifestyle habits.
• Medical conditions.
• Running medications.
• Recent health changes.
• Fatigue experience.
• loss of appetite, etc.

Physical examination:

For liver inflammation check doctor press on abdomen and try to find out If liver is enlarged or not.

Blood tests:

Fatty liver disease in many cases is diagnosed after blood tests. In these cases the test result show elevated liver enzymes. Doctor may suggest the alanine aminotransferase test (ALT) and aspartate aminotransferase test (AST) to check the liver enzymes.

Imaging studies:

To check for excess fat or any other problems in the liver doctor can use one or more of the following imaging tests :

Ultrasound,

CT scan,

MRI scan, 

Vibration-controlled transient elastography (VCTE, FibroScan).In order to measure liver stiffness this test uses low-frequency sound waves . It helps to check for scarring.

Liver biopsy:

Liver biopsy is the best way to determine the severity of the liver disease.During a liver biopsy, doctor insert a needle into the liver and remove a piece of tissue for test.

This test will help to determine if you have fatty liver disease, as well as liver scarring.

Prevention of fatty liver disease:

To prevent fatty liver disease and its potential complications, it is important to maintain a healthy lifestyle.

• Drink enough pure drinking water everyday.
• Limit or avoid alcohol consumption.
• Keep your body weight healthy.
• Take medication that is recommended by your doctor.
• Keep a nutrient-rich diet on your daily menu that is low in trans fats, saturated fats, and refined carbohydrates.
• Keep your blood sugar levels, triglyceride levels, and cholesterol levels control.
• If you have diabetes, follow the treatment plan that is recommended by your doctor.
• Exercise five days a week for at least 30 minutes every day.

Treatment of fatty liver disease:

Depending on the type of disease, fatty liver disease is treated as follows:

Non-alcoholic fatty liver disease:

There is no specific drug for non-alcoholic steatohepatitis (NASH) or non-alcoholic fatty liver disease (NAFLD). Those who have symptoms are advised to lose weight. Losing weight helps to reduce fat deposits in the liver, reduces inflammation and fibrosis. Physical activity helps to reduce overall body fat, including liver fat. Research shows that being active alone has an effective effect on NAFLD, even if the level of activity is below the recommended level. The doctor may evaluate the medications you are taking and ask you to change or stop certain medications. Do not stop taking any medicine on your own without your doctor's approval as it can lead to other complications and can be dangerous to your health. It is important to understand that there are no approved medications for the treatment of NAFLD but there is growing evidence that suggests that certain drugs used for treating diabetes and vitamins can help in the condition. However, more research is needed before making any decision.   

Alcoholic Fatty Liver Disease:

One of the most important factors in treating alcoholic fatty liver disease is the complete abstinence from alcohol. Therapy may be recommended for people who have problems with stopping taking alcohol. Some medications help to reduce alcohol cravings by reducing the craving for alcohol or by making you feel sick if you drink alcohol.

Lifestyle Management:

If you are diagnosed with fatty liver disease, then some lifestyle changes can help to improve the condition effectively. These include:

• Keep more fresh vegetables and fruits   in your diet. Avoid taking too much sugar and salt and choose whole grains instead of processed foods.
• Reduce saturated fat and trans fats and replace them with monosaturated fats and polyunsaturated fats, especially omega-3 fatty acids, which reduce the risk of heart diseases associated with NAFLD.  
• Exercise regularly to control your weight and reduce the fat stored in the liver. 
• If you take vitamin, or alternative herbal supplements, it is important to talk to your doctor and seek his advice. Some herbal medicines can cause damage to your liver.
• People with damaged liver are more prone to a few infections and pneumococcal disease. It is important that people with fatty liver get vaccinated against hepatitis A and B, the flu, and pneumococcal diseases. Hepatitis can be extremely dangerous for people with fatty liver and can even lead to liver failure.