Fatty Liver Disease

Considering the number of functions the liver performs, which is greater than 500, It would not be wrong to say that our survival revolves around the healthy functioning of the liver! Unlike the heart and other major organs, the liver can heal itself in case of any infections that cause minor damage. However, the liver’s ability is limited as it cannot handle repeated abuse or injuries caused by alcohol or other abuse. One such condition that causes severe liver damage is fatty liver disease.

Fatty liver and its causes

The liver, the largest organ in the human body, helps digest food, store energy, and remove poisons. Fatty liver disease is when fat deposits on the walls of the liver. There are two classifications of fatty liver disease:

  • Non-alcoholic fatty liver disease (NAFLD) 
  • Alcoholic fatty liver disease (AFLD)

Non-alcoholic fatty liver disease (NAFLD)

NAFLD is unrelated to heavy alcohol use. There are two kinds: 

Simple fatty liver: The fat in your liver does not cause inflammation or liver cell damage. The simple fatty liver rarely gets bad enough to cause liver damage or complications. 

Non-alcoholic steatohepatitis (NASH): The fat on the liver leads to inflammation and cell damage, causing fibrosis, or scarring, of the liver walls leading to liver cirrhosis or cancer 

Alcoholic fatty liver disease (AFLD)

Alcoholic fatty liver disease is because of heavy alcohol abuse. Your liver metabolises most of the alcohol you drink to eliminate it from the body. But this process can generate harmful by-products. These by-products cause damage to the liver cells, promote inflammation of the liver, and hinder your body’s immunity. Alcohol intake is the major contributor to liver damage. Alcoholic fatty liver disease is the primary stage of alcohol-related liver disease. When left untreated, this condition leads to alcohol-related hepatitis and liver cirrhosis.

Risks of contracting the fatty liver disease? 

Even today, the causes of non-alcoholic fatty liver disease (NAFLD) remain unknown to medical experts. Researchers know that it is more common in people with: 

  • Type 2 diabetes and prediabetes 
  • Obesity 
  • Middle-aged or older (children are also at risk of contracting) 
  • Hispanic and non-Hispanic whites. It is uncommon amongst African Americans. 
  • Fat concentration in the blood as cholesterol and triglycerides 
  • High blood pressure 
  • Drug dependencies, such as corticosteroids and some cancer drugs 
  • Certain metabolic disorders, including metabolic syndrome 
  • Rapid weight loss 
  • Certain infections, such as hepatitis C 
  • Exposure to toxins that cause hepatic diseases

NAFLD affects around 25% of the global population. With the increase in the growth rate of type 2 diabetes and high cholesterol levels among individuals in the United States, the rate of NAFLD has skyrocketed. In the United States, NAFLD is the most common chronic liver disorder. 

Alcoholic fatty liver disease affects heavy drinkers, especially those drinking for long. Female heavy drinkers, obese people and people with genetic mutations are at a higher risk of NAFLD.

What are the symptoms of fatty liver disease? 

NAFLD and AFLD are silent diseases with few or no symptoms in the initial stages. The few visible symptoms would include fatigue or discomfort in the upper right side of the abdomen.

How is a fatty liver disease diagnosed? 

The lack of symptoms makes it difficult to detect fatty liver disease. Your doctor might suspect that you have the condition if the liver test reports show abnormalities in the counts. For a clear understanding of the condition, your doctor would need: 

  • Your medical history 
  • A physical exam 
  • Various tests, including blood and imaging tests, and sometimes a biopsy 

To know your medical history, your doctor would ask about alcohol intake and histories of alcohol abuse to determine whether fat in your liver is a sign of alcoholic fatty liver disease or non-alcoholic fatty liver (NAFLD). They will also ask which medicines you take to determine whether a medication is a reason behind your NAFLD. 

As a part of the physical exam, your doctor will examine your body and monitor your height and weight. Your doctor will try to find any signs of fatty liver disease, such as 

  • An enlarged liver 
  • Symptoms of cirrhosis 
  • Jaundice (yellowness of the skin and eyes)

You will have to undergo blood tests, liver function tests and complete blood count (CBC) tests. If needed, you might have to go through imaging tests that check for fat deposits in the liver and the stiffness of the organ. Liver stiffness is a symptom of fibrosis (scarring of the liver). It may be necessary for the doctors to perform a liver biopsy to confirm the diagnosis and assess the extent of liver damage before starting liver damage treatment.

What are the treatments for fatty liver disease? 

Most doctors recommend weight loss to cure a case of NAFLD. Weight loss helps to reduce fat in the liver, inflammation, and fibrosis. If your doctor thinks that a particular drug is a reason behind your NAFLD, you must stop the intake of that medicine. But a medical consultation is a must before stopping the medication. You may need to get off the treatment gradually, and you might need to switch to another medicine instead. 

There are no approved medicines for treating NAFLD to date. Studies are investigating whether a particular diabetes medicine or Vitamin E can help, but more studies are needed. 

The most crucial part of treating AFLD is to quit alcohol intake. To help you with the addiction, see a therapist or reach out to an alcohol recovery program. Some medicines can help, either by reducing your cravings or making you feel sick if you drink alcohol. 

Both AFLD and NAFLD lead to liver cirrhosis. Doctors can help you with the health problems caused by cirrhosis with the help of medicines, operations, and other medical procedures. If cirrhosis is unattended and leads to liver failure, you may need a Liver transplant Surgery

What are some lifestyle changes that can help with fatty liver disease? 

In the case of both AFLD and NAFLD, some lifestyle changes can help to reverse the damage caused to the liver: 

  • Eat a healthy and balanced diet with little salt and sugars, fruits, vegetables and whole grains.
  • Get vaccinated against hepatitis A and B, the flu and pneumococcal disease. If you contract the hepatitis A or B virus and fatty liver disease, it increases the probability of liver failure. People with chronic liver disease are more prone to infections, so the other two vaccinations are also necessary. 
  • Get regular exercise, which helps you lose weight and reduce fat in the liver. 
  • Consult your doctor before using dietary supplements, such as vitamins, complementary or alternative medicines or medical practices. Some herbal remedies can damage your liver.

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