Fatty Liver Disease: Understanding Its Types and Treatment

Fatty liver disease is a liver disorder marked by the accumulation of fat inside the liver. You'll be surprised to know that the estimated number of people who are affected by non-alcoholic fatty liver in the USA is about 100 million. It is also the most common form of liver disease in children, which has more than doubled over the past 20 years.

Gastroenterologists and hepatologists are the medical specialists that treat fatty liver disease. If you are looking for the best gastroenterologists with rich experience, you can opt for countries like UAE, India, Turkey, Thailand, and Germany.  

This blog is a complete guide on fatty liver disease. It will provide information about the disease's signs, symptoms, causes, and treatment. And most importantly, it will answer the question of the reversibility of fatty liver. 

What is a Fatty Liver Disease?

In layman's language, fatty liver is a disease in which fat gets stored in the liver. The liver is a significant body organ that serves the function of digesting food, removing toxins, and storing energy. When there is too much accumulation of fat in the liver, it causes inflammation and also reduces the liver's ability to perform its functions.

The disease progresses in four stages:

• Simple fatty liver: Marked by excess build-up of fat, simple fatty liver is mostly harmless if it does not progress further. 
• Steatohepatitis: When the liver becomes inflamed and damages the tissue, it is known as steatohepatitis. 
• Fibrosis: Due to long-term liver inflammation, the liver tissue gets scarred. This stage is known as fibrosis. 
• Cirrhosis: With extensive tissue scarring, the liver gets permanently damaged, and the condition becomes irreversible. Cirrhosis of the liver is the most severe stage of fatty liver in which the function of the liver is significantly reduced.

How is Fatty Liver Disease Diagnosed?

Various tests make the diagnosis of the fatty liver. These include:

• Physical Examination: Liver inflammation can be checked by pressing the abdomen. However, there may be inflammation in the liver without any liver enlargement. Therefore, other tests are done for the accurate diagnosis.
• Blood Tests: A liver function test or LFT is done to check the elevated levels of the liver enzymes. High levels of AST and ALT are suggestive of liver inflammation.
• Imaging Tests: CT scan, MRI scan, and ultrasound are the imaging techniques to find the amount of excess fat in the liver. 
• Liver Biopsy: It is the most accurate way of checking liver diseases. It helps in determining the severity of fatty liver disease and liver scarring. 

What Signs and Symptoms Does Fatty Liver Disease Show?

Fatty liver is a silent disease that does not show any prominent signs and symptoms until it progresses to severe stages. Some of the symptoms that you may observe with fatty liver disease are:

• Nausea, vomiting, Loss of appetite
• Extreme tiredness
• Weight loss
• Pain and swelling in the abdomen
• Weakness
• Edema of legs
• Yellow skin and eyes
• Dark-coloured urine and pale stools
• Enlargement of blood vessels underneath the skin
• Confusion

What are the Causes and Risk Factors of Fatty Liver Disease?

The consumption of too much alcohol causes alcoholic fatty liver disease (AFLD). The high amount of alcohol causes alteration in various metabolic processes in the liver. This leads to the formation of fat that gets accumulated in the liver.

In people who do not drink much, the cause of fatty liver disease is less known. In these people, the disease can be due to too much fat production by the body or improper metabolism of the fat.

The chances of developing fatty liver disease increase if:

• You are Asian or Hispanic
• Your periods have stopped (menopause)
• Have high levels of belly fat and obesity
• Have hypertension, diabetes, or hyperlipidemia
• Have obstructive sleep apnoea
• Are pregnant
• Are you suffering from infections like Hepatitis C
• You have PCOS (polycystic ovarian syndrome) 
• You are malnourished and losing weight rapidly
• You are taking certain medicines like steroids and synthetic estrogen 

How Many Different Types of Fatty Liver Disease Are There?

Fatty liver disease is of two types:

• Non-Alcoholic Fatty Liver Disease: NAFLD, or non-alcoholic fatty liver disease, affects about one in three people in the United States. It is not related to heavy alcohol consumption. NAFLD can be further divided into simple fatty liver and NASH (non-alcoholic steatohepatitis). NASH further leads to fibrosis and cirrhosis.  
• Alcoholic Fatty Liver Disease: AFLD, or alcoholic fatty liver disease, is caused by heavy consumption of alcohol. The liver performs the function of breaking down the alcohol. Certain harmful substances are generated in this process, which damage the liver cells. Alcoholic fatty liver disease leads to fibrosis and then cirrhosis. Cirrhosis ultimately causes liver failure. 

How is Fatty Liver Disease Treated?

No medicine yet has been approved to treat fatty liver disease. The early stages of the disease are managed mainly by making lifestyle changes. Managing weight helps in reducing the amount of fat in the liver. 

If the physician thinks a particular medicine is causing the fatty liver, you must stop taking the medication. Make sure to consult a specialist before doing so.

Abstaining from alcohol is vital for treating alcoholic fatty liver disease. If you are finding it difficult to stop consuming alcohol, you can try joining an alcohol recovery program.

Doctors also recommend taking vitamin E and thiazolidinediones for managing fatty liver, but more data is required to establish proven results of these drugs.

Alcoholic fatty liver disease and nonalcoholic steatohepatitis can progress to liver cirrhosis, which is treated using various medicines and medical procedures. If cirrhosis is not managed effectively, it will lead to complete liver failure. Liver failure will require a liver transplant.

Is it Possible to Reverse Fatty Liver?

Yes, fatty liver disease can be reversed in some cases. The liver has a unique ability to repair and rebuild itself. There are various ways in which you can reverse the damage to the liver and reduce the accumulated fat. Some of these are:

• Avoiding alcohol
• Reducing weight
• Following a nutrient-rich diet
• Keeping blood pressure and diabetes in control
• Exercising regularly for at least 30 minutes a day

What is the Cost of Fatty Liver Treatment?

The cost of fatty liver treatment depends on the stage at which it has been diagnosed. Simple fatty liver disease and early-stage fatty liver disease can be treated with a few lifestyle changes and medicines. These are relatively inexpensive treatments. However, once the disease has progressed to advanced stages like liver cirrhosis, it requires particular treatment.

The cost of liver cirrhosis treatment in India is INR 88,000 to INR 1,20,000. A liver transplant is required for treating end-stage fatty liver and costs around INR 22,00,000 to INR 30,00,000.

Countries like Germany, Turkey, Thailand, and the United Arab Emirates provide cost-efficient treatment for treating end-stage fatty liver, including liver cirrhosis and failure. They use a patient-centric approach and provide high-quality treatments.  

To Conclude

A fatty liver is a disease in which fat deposits are observed inside the organ. It does not show any significant signs and symptoms unless it has progressed to liver fibrosis and cirrhosis. Fatty liver disease is managed by lifestyle modifications like regular exercise, reducing alcohol consumption, maintaining weight, following a healthy diet, etc. The condition can be reversed when detected in early stages and managed adequately.