FATTY LIVER DISEASE

Picture show a healthy liver
Healthy liver

Introduction

It’s hard to ignore the fat that appears on the abdomen or the thigh. But what about a fatty liver that we cannot see or feel, and most people do not know it exists? The presence of a certain amount of fat in the liver is normal. But when fat constitutes more than 5% – 10% of the weight of the liver, it may mean that there is a fatty liver disease caused by drinking alcohol, or other factors.

Some cases of the fatty liver may develop serious complications.

Types of fatty liver diseases

There are two main types of fatty liver. They are:

1. Alcoholic liver disease (ALD )

Fatty liver can develop after drinking either small or large amounts of alcohol.

The disease may develop even after a short period of excessive consumption of alcoholic beverages.

2. Non-alcoholic fatty liver disease (NAFLD)

Some people who suffer from excess fat in the liver suffer from a disease called fatty liver. Indeed, this condition is not normal. But as long as it does not cause inflammation or damage to the liver, it remains a non-serious condition.

Other people suffer from a disease called inflammation and scarring of the liver (Steatohepatitis).

Although this disease is similar to liver disease caused by alcohol consumption, people with it consume only small amounts of alcohol or don’t consume alcohol at all.

This disease may cause irreversible damage to the liver. Plus, the liver may become solid, and, over time, the scars may replace the cells. This condition is called cirrhosis of the liver (liver cirrhosis).

Up to 20% of all adults are likely to develop fatty liver disease or inflammation and scarring of the liver not caused by alcohol consumption. Plus, more than six million children suffer from one of these two diseases, which are prevalent mainly among children of Asian or Hispanic origin.

Fatty liver during pregnancy

In very rare cases, fat accumulates in the liver of a pregnant woman. This phenomenon poses a serious threat to the life of both the mother and the fetus, as both may develop liver failure, severe infection, or bleeding.

It’s not clear why fatty liver develops during pregnancy. Perhaps, hormones are the main cause of the disease.

After confirming the disease via diagnosis in a pregnant woman, she may find herself obliged to give birth as soon as possible. In certain cases, the mother may need intensive care for a few days. But, in most cases, the liver returns to its normal functioning within a few weeks.

Symptoms of fatty liver

Generally, fatty liver disease is silent and has no symptoms, especially in its early stages. Its symptoms increase with the development of the disease.

General symptoms of fatty liver

In cases where the disease worsens, (a process that may take a few years, or even a few decades), the following symptoms may appear:

  1. Tiredness
  2. Weight loss
  3. Anorexia
  4. Weakness
  5. nausea
  6. jamming
  7. Inability to use the mind sensibly
  8. Inability to concentrate
  9. Pain in the center of the abdomen, or the upper right side of it
  10. Hepatomegaly
  11. Dark, uneven, and heterogeneous patches on the skin, especially on the neck and underarms.

In patients with alcoholic liver disease, symptoms may worsen after periods of heavy drinking. The nonalcoholic fatty liver disease may stop, reverse, or worsen.

Advanced fatty liver symptoms

In cases where cirrhosis progresses, the liver loses its ability to function and perform its role in the body.

As a result, the following symptoms may appear:

  1. fluid retention
  2. muscle atrophy
  3. internal bleeding
  4. jaundice
  5. Hepatic failure

Causes of fatty liver

Factors associated with alcohol consumption

Fat has started to accumulate
on the live
r

The causes of this disease vary according to which type it is. Among the most important factors that lead to the emergence of the disease are the following:

Genetics

Heredity plays a great role in causing liver disease associated with alcohol consumption. This happens in two ways:

  1. It may affect how much alcohol a person drinks and their likelihood of becoming an alcoholic.
  2. Genetic factors may influence levels of liver enzymes, which are involved in the process of alcohol breakdown and metabolism.

Other factors

Other factors that may influence the possibility of developing a liver disease caused by alcohol consumption include:

  1. jaundice;
  2. Iron overload in the body.
  3. Obesity.
  4. Diet.

There are other factors that influence the disease, but they are patient-specific and can be studied individually.

Factors not associated with alcohol consumption

The factors that cause nonalcoholic fatty liver disease are not entirely clear. There are many factors that increase the degree of risk. Yet, there are cases in which none of these risk factors are present.

Some of the most prominent factors are:

  1. Genetics.
  2. Young age.
  3. Obesity or overweight.
  4. High cholesterol levels or hypertriglyceridemia.
  5. Diabetes mellitus.
  6. Insulin resistance.
  7. Oxidative stress that causes damage to liver cells.
  8. Release of toxic and inflammatory proteins from fat cells, either from liver cells or from other cells.
  9. Programmed cell death (Apoptosis) in hepatocytes.
  10. Using some medicines
  11. Viral hepatitis.
  12. Liver disease that is hereditary, or caused by autoimmune diseases.
  13. Rapid weight loss.
  14. Improper nutrition.
  15. Bacteria overgrowth in the small intestine and other changes in the intestine are associated with nonalcoholic fatty liver disease.

Some researchers today suspect that the last factor likely plays a role in the progression of nonalcoholic fatty liver disease into inflammatory disease and the scarring of the nonalcoholic liver.

Complications of fatty liver

Picture of a liver that has reached a cirrhosis state
Cirrhotic liver

There are many complications resulting from fatty liver, which, are, linked to both types of liver diseases. They can be summed up as follows:

  1. Fluid retention within the abdominal cavity (Ascites).
  2. Liver Cancer.
  3. Kidney failure.
  4. Liver cirrhosis.
  5. Hepatic encephalopathy.
  6. Bleeding results in anemia.
  7. Vulnerability to infection.

Diagnosis of fatty liver

Routine examinations often help to discover the fatty liver disease. Your doctor may notice that your liver is slightly enlarged, or he may see signs of a fatty liver in blood tests.

The most important diagnostic tests that can help discover fatty liver are:

Blood tests

In routine blood tests, elevated levels of certain enzymes in the liver may appear.

These enzymes can be alanine aminotransferase (ALTalanine aminotransferase), or aspartate aminotransferase (ASTaspartate aminotransferase).

Imaging examinations

Fatty liver can also be seen in imaging tests, such as X-ray imaging or ultrasound imaging.

Liver biopsy

The only way to confirm a diagnosis of fatty liver is a liver biopsy. A biopsy is usually performed after the exclusion of other factors.

Under local anesthesia, the doctor inserts a needle through the skin and takes a small sample from the liver. The sample is examined under a microscope for signs of fat, inflammation, or infection in the liver cells.

If there are no signs of inflammation or injury to the liver cells, the diagnosis will be fatty liver.

Fatty liver treatment

Up to now, there is no cure for fatty liver. But it is so important to treat any other health trouble that may be related to this disease, such as diabetes.

Still, some measures or steps can be taken to decrease the effects of fatty liver. Below, you will find the most important ones of these measures:

Refraining from drinking alcohol

Disease of a fatty liver

In case of liver disease caused by alcohol consumption, the patient should stop drinking alcohol, especially if he is an excessive drinker. If necessary, we must give him any support or assistance to help to quit alcohol. One should understand that continued alcohol consumption may lead to disease exacerbation, like alcohol-induced jaundice or cirrhosis of the liver.

As for patients with nonalcoholic fatty liver disease, stopping drinking alcohol can be helpful.

Loss of excess weight

People who are obese or overweight should do everything they can to gradually lose weight from half a kilo up to one kilogram per week.

A study showed that losing weight within a few months can help reverse the course of inflammation and scarring of the liver that is not caused by alcohol consumption. Plus, losing weight in small percentages can help reduce the accumulation of fat in the liver.

Following a healthy diet along with physical activity

In addition to reducing the number of calories in your body via exercising, you should avoid foods rich in refined carbohydrates (purified carbohydrates), which are quickly digested. That is, you should reduce the consumption of foods like white bread, white rice, and refined sugar.

Refraining from taking unnecessary medications

This can help slow the disease or reverse its course.

Checking the use of antioxidants and some medications

In clinical trials, health professionals check the effectiveness of certain antioxidants and some modern diabetes medications in treating fatty liver disease, as there is a relationship between this disease, oxidative stress, and diabetes. Checking can include:

  1. Vitamin E
  2. Selenium element
  3. Metformin
  4. Rosiglitazone (Rosiglitazone)
  5. Pioglitazone

Taking probiotics

New findings on the role of bacteria in the development of fatty liver disease may lead to other therapeutic methods, and approaching the unbalanced diet with probiotics.

Probiotic is a general name given to food additives that contain good bacteria or active and good yeasts.

Liver transplant

In cases where cirrhosis is exacerbated, a liver transplant is sometimes needed. In this operation, the surgeon removes the diseased liver and transplants a healthy liver in its place.

Prevention of fatty liver

Fatty liver infection can be prevented by following these tips:

  1. Ensure that you enjoy a healthy and ideal weight. If you suffer from obesity,  try to get rid of it.
  2. Play sports and stay active periodically.
  3. Do not drink alcohol excessively.
  4. Make sure to take the medication as prescribed by the doctor.
  5. Follow a healthy and balanced diet. Eat vegetables, fruits, grains, healthy fats, and the like.
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