The liver's primary functions are to remove toxins and process food nutrients. Before circulating throughout the body, blood from the digestive system goes through the liver filtration process.
Fatty liver disease (Steatohepatitis) affects about 1 in every 10 people. Having some fat in the liver is normal, but if the amount exceeds 10% of the liver's weight, it is considered a fatty liver. This condition may lead to more severe complications.
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What is Fatty Liver?
The accumulation of fat cells in the liver, accounting for more than 5-10% of the liver, causes fatty liver. The fatty liver cells, when accumulated in the liver, can lead to inflammation in the liver and destroy the surrounding tissues.
Watch Saiful Islam from Bangladesh talk about his successful fatty liver treatment in India:
What are the Forms of Fatty Liver Disease?
The two main forms of fatty liver disease are:
- Alcohol-induced Fatty Liver Disease is caused by regular alcohol consumption.
- Non-alcohol Related Fatty Liver Disease (NAFLD) is unrelated to alcohol consumption. Several factors, such as obesity and diabetes, can increase your risk.
Mostly, fatty liver disease doesn't cause severe problems or prevent your liver from functioning normally. But fatty liver disease worsens over time for 7-30% of people with the condition. It progresses through three stages:
- Your liver becomes inflamed (swollen), which damages its tissue
- When your liver is damaged, scar tissue forms in that area (fibrosis)
- Extensive scar tissue replaces healthy tissue (cirrhosis of the liver).
How does Fatty Liver Occur?
When you consume too many calories, it leads to fat accumulation in the liver. Too much fat will accumulate when the liver does not process and break down fats as it usually should. If individuals have conditions such as obesity, diabetes, or high triglycerides, they are more likely to develop fatty liver.
The fatty liver can specifically develop due to insulin resistance (IR), which causes obesity. People with IR cannot normally respond to insulin, so the blood sugar moves into the bloodstream, increasing the risk of developing diabetes and cardiac disorders.
Fatty liver can be caused by rapid weight loss, alcohol abuse, and malnutrition. However, someone can develop fatty liver even without having any of these conditions.
What are the most Common Causes of Fatty Liver Disease?
Some of the most common reasons that lead to the development of fatty liver are listed below:
- Excessive alcohol consumption
- Obesity
- Hyperlipidemia (higher levels of triglycerides content in the blood)
- Diabetes
- Genetic
- Side effects of certain drugs like tamoxifen, amiodarone, valproic acid, methotrexate, etc.
What are the Signs Indicating Fatty Liver?
The mild stages of the fatty liver do not show many signs and symptoms. If the condition progresses to a later stage, the patient will start noticing the following symptoms:
- Weight loss
- Abdominal pain
- Physical weakness
- Poor appetite
- Fatigue
- Confusion
Further progression of the condition can be manifested as:
- Enlargement of abdomen
- Accumulation of fluid in the abdomen
- Growth of blood vessels beneath the blood vessels
- Abnormal bleeding
- Redness in the palms
- Splenomegaly
- Paleness in the skin and the eyes
- Enlargement of the breast in men
Pregnancy-Related Fatty Liver
This usually happens in the third trimester of pregnancy. It is a rare condition and can be fatal. The sign and symptoms include:
- Pain in the upper right abdomen
- Jaundice
- Headache
- Persistent nausea
- Vomiting
- Fatigue
- Decreased appetite
If consulted on time, the treatment is given based on treating complications and safer delivery. If timely treated, women do not suffer any post-delivery complications.
How is it Diagnosed?
Once you persistently experience the symptoms mentioned above for a few days, you must consult a hepatologist. The doctor will take a detailed medical history of your past illnesses and patterns of the changes in signs and symptoms. It is important to tell your doctor if you have any family history of liver disorders or habits like alcohol, smoking, etc. The following tests will follow this:
Physical Exam
The doctor will conduct a physical examination by palpating various abdomen regions. The physical exam describes any swelling or enlargement in the liver, spleen, or other area.
Blood Investigations
The blood samples are taken from the patient and sent to the laboratory to check:
- Complete blood count
- Liver enzyme and liver function test
- Chronic viral hepatitis (A and C)
- Celiac disease screening test
- Hemoglobin A1C
- Fasting blood sugar
- Lipid profile (including cholesterol and triglycerides)
Radio-Imaging Investigations
- Ultrasound: This is the primary investigation after the blood tests.
- CT (Computerized tomography) scan and MRI (Magnetic Resonance Imaging): They provide more details with precision than ultrasound. However, they cannot distinguish between alcoholic and non-alcoholic fatty liver.
- Transient Elastography: This is an enhanced form of MRI that detects the amount of stiffness in the liver. This helps to diagnose liver fibrosis or scarring.
- Magnetic Resonance Elastography: This combines magnetic resonance imaging and the patterns formed by sound waves that come from the liver to produce a vision. The image generated depicts the extent of stiffness throughout the liver.
- Liver Biopsy: The final test to detect the fatty liver and its further stages is a liver biopsy. This is a sure-shot investigation in which a tissue sample is extracted from the liver by inserting a small needle. The sample is sent to the diagnostic laboratory for detailed investigations. The biopsy looks out for the type of cells present in the liver. The microscopic examination of the fatty liver tissue reveals the appearance of hepatic macrovesicular steatosis and accumulation of lipids in the hepatocytes (fat cells).
How is Fatty Liver Cured?
The entire treatment for fatty liver disease is based upon lifestyle changes. The following changes must be made to reverse the condition:
- Weight loss: Gradual weight loss associated with dietary changes and regular exercise is a significant factor in normalizing the condition.
- Reduce alcohol consumption and smoking: It is imperative to stop or significantly reduce alcohol consumption and smoking. Continuing the habit can cause permanent damage to the liver leading to liver cirrhosis or liver failure.
- Management of blood sugar levels: Regular blood sugar levels should be monitored. This is because the patients tend to have high blood sugar levels due to insulin resistance. Avoid taking artificial sweeteners, preservative drinks, or processed foods.
- Lowering the cholesterol levels: The patients must consult the doctor and get themselves treated if they have hyperlipidemia which is high cholesterol levels. High levels of cholesterol make fatty liver even worse.
- Avoiding medications that might cause fatty liver
- Liver transplant: In the worst situations where a large part of the liver has been damaged permanently, the patient is advised to have a liver transplant. Liver transplant is available in some of the best hepatology hospitals in India at affordable costs.
What Foods Repair a Fatty Liver?
Try eating a combination of foods that help reduce fat in your liver, such as healthy fats, antioxidants, and complex carbohydrates. To maintain a healthy diet, it is recommended to include the following food items:
- Fish and seafood at least a couple of times a week
- Fruits
- Whole grains
- Nuts
- Olive oil
- Vegetables
- Avocados
- Beans and legumes
- Poultry, eggs, cheese, and yogurt in moderation
- Sweets and red meat for special occasions
Conclusion
Lifestyle changes and weight loss may be difficult, but the benefits are immense if you have a fatty liver, so give it your best effort. It is important to note that cardiovascular disease is still the most significant risk for people with fatty liver. These lifestyle changes can improve or resolve your fatty liver and help keep your heart healthy.
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