Fatty Liver Disease (Hepatic Steatosis)

June 15, 2023 / Article

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A fatty liver disease means you have an abnormal fat in your liver. Such condition is medically known as Hepatic Steatosis.

Heavy alcohol consumption is the primary reason to develop a fatty liver. High alcohol levels in your body, tends to build up fat inside your liver cells. However, this may prevent the liver from functioning properly. In some case, you can get fatty liver disease even if you’re not an alcoholic.

Fatty liver disease can be categorised into two categories:

  1. Non-alcoholic fatty liver disease
  2. Alcoholic fatty liver disease

Non-alcoholic fatty liver disease (NAFLD)

NAFLD are of two types:

  • Simple fatty liver – This condition means you have a fatty liver, however there isn’t any damage to your liver cells. It is of low-risk and doesn’t cause any serious health problems. 80% of people with NAFLD have simple fatty liver.
  • Non-alcoholic steatohepatitis (NASH) – It is a serious condition than that of a simple fatty liver. NASH causes inflammation and liver cell damage that can cause serious health problems such as fibrosis and cirrhosis. About 20% of people with NAFLD have non-alcoholic steatohepatitis.

Alcohol-related fatty liver disease (ALD)

A condition of ALD is preventable. It is caused due to high consumption of alcohol. However, it usually gets better when you stop drinking. ALD can cause serious health problems, such as:

  • Enlarged liver – There aren’t any actual symptoms for this condition, however, you may feel discomfort or have pain on the upper side of your belly.
  • Alcoholic hepatitis – This is a swelling in the liver that can cause fever, nausea, vomiting, belly pain and jaundice.
  • Alcoholic cirrhosis – This condition builds up a scar tissue in the liver. The symptoms for this condition are similar to hepatitis, however it can cause additional symptoms like: High blood pressure in liver, bleeding in your body, changes in behaviour, enlarged spleen and advanced stage of liver failure.

Alcoholic hepatitis is an advanced stage of alcohol-related fatty liver disease. By time, it may also turn into alcoholic cirrhosis. Make sure to talk to your doctor if you drink heavily and start experiencing such symptoms. Your physician may help you to control drinking and keep you on track.

Symptoms of fatty liver disease

There are no direct symptoms for both ALD and NAFLD conditions. You may just experience tiredness or discomfort in the upper part of your belly. In case you are suffering from NASH or cirrhosis, you may have symptoms such as:

  • Swollen belly
  • Enlarged blood vessels
  • Enlarged breasts in men
  • Jaundice
  • Red palms

Causes and Risk Factors

You have a greater chance of developing fatty liver disease if you:

  • Are Hispanic or Asian
  • Are a postmenopausal woman (a woman whose periods have stopped early)
  • Have obesity
  • Have high blood pressure, diabetes, or high cholesterol
  • Have obstructive sleep apnea (a blocked airway that causes breathing to stop and start during sleep).

Some people get fatty liver disease without having any pre-existing conditions. But the following risk factors make you more likely to develop it:

  • Being obese or overweight
  • Having Type 2 diabetes or insulin resistance
  • Having metabolic syndrome (insulin resistance, high blood pressure, high cholesterol and high triglyceride levels)
  • Taking certain prescription medications, such as amiodarone(Cordarone®), diltiazem (Cardizem®), tamoxifen (Nolvadex®) or steroids.

Diagnosis

Most people with fatty liver disease may not have symptoms. However, it’s not that easy to diagnose. However, you doctor may think of other methods to diagnose this condition. This may include:

  1. Health history– Your doctor may want to know about your drinking habits. Providing this information can help your doctor determine whether you have ALD or NAFLD, so be honest. Additionally, they will ask you about the medications you take, how you eat, and whether you have any health conditions.
  2. Physical exam– If you have jaundice or an enlarged liver, your doctor will weigh you and check your body for signs of liver problems.
  3. Blood tests – An elevated level of liver enzymes, such as alanine aminotransferase (ALT) or aspartate aminotransferase (AST), can be detected. If this is the case, you might have a liver problem.
  4. Imaging tests– MRIs, CT scans, or ultrasounds may be performed. These tests can help determine whether your liver contains fat. Unfortunately, they cannot tell if you have NASH or simple fatty liver.
  5. Liver biopsy– NAFLD patients do not always need to undergo a liver biopsy. If you’re at risk for NASH or cirrhosis or other complications associated with NASH, your doctor may recommend it. During an exam, your doctor will take a sample of liver tissue and send it to a lab to determine if you have inflammation or damage. An outpatient surgery center or hospital can perform this procedure for you. Medicine will be given to you prior to the procedure to help you relax or control your pain. During the biopsy, your doctor will numb the area before taking a small sample of liver tissue. NASH can only be diagnosed through a liver biopsy.

Treatment

There are no medications for NAFLD, though some are undergoing clinical research. However, the first point of treatment is to lose weight. It helps reduce fat in your liver. You can also try other methods like weight loss surgery if you have a lot to lose.

You’ll must stop drinking. It’s the only way you can hold the liver back from deteriorating. Talk to your primary care physician concerning how you can find support. You might require a therapeutically regulated detox program to securely stop drinking and oversee withdrawal manifestations.

Assuming you have difficulties because of NASH like cirrhosis, you might have to have a liver transplant. Studies show individuals with NASH who get a liver transplant do quite well.

Conclusion

The good news is that it is possible to reverse fatty liver disease through certain lifestyle changes, such as reducing alcohol intake, managing weight, and adjusting diet. Such changes could prevent further liver damage and scarring.

For patients with AFLD, it is crucial not to drink alcohol at all. For those who need help quitting drinking, consier attending a detoxification program and counseling.

Generally, the outlook for fatty liver disease is more favorable when treatment begins in the early stages, before fibrosis and cirrhosis. You need to follow your doctor’s recommended treatment plan and follow an overall healthy routine.


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