Fatty liver disease

Summary about Disease


Fatty liver disease is a condition where there is an excessive buildup of fat in the liver. There are two main types: Non-alcoholic fatty liver disease (NAFLD), which is not caused by heavy alcohol use, and Alcoholic fatty liver disease (ALD), which is caused by heavy alcohol use. NAFLD is often associated with obesity, diabetes, high cholesterol, and high triglycerides. In some cases, fatty liver disease can progress to more severe liver damage, including inflammation (steatohepatitis), scarring (fibrosis), and cirrhosis.

Symptoms


Many people with fatty liver disease have no symptoms, especially in the early stages. When symptoms do occur, they may include:

Fatigue

Abdominal pain or discomfort, usually in the upper right abdomen

Weakness

Loss of appetite

Nausea

Jaundice (yellowing of the skin and eyes) - less common, usually indicates more advanced liver damage.

Swollen abdomen and legs (edema) - usually indicates more advanced liver damage.

Causes


NAFLD:

Obesity

Insulin resistance

High blood sugar (hyperglycemia), indicating prediabetes or type 2 diabetes

High levels of fats, particularly triglycerides, in the blood

Metabolic syndrome (a cluster of conditions including increased blood pressure, high insulin levels, excess body fat around the waist, and abnormal cholesterol levels)

ALD:

Heavy alcohol consumption

Medicine Used


There is no specific medication approved solely for treating NAFLD. Treatment focuses on managing underlying conditions and lifestyle changes. Medications may be used to treat:

Diabetes: Metformin, Insulin sensitizers

High cholesterol: Statins, Fibrates

High blood pressure: Antihypertensives

Vitamin E: Sometimes used, but consult with a doctor

Emerging Therapies: Several new drugs are in clinical trials for NAFLD/NASH.

ALD: Medication to treat alcohol dependence or withdrawal. Consult a doctor before taking any medicine.

Is Communicable


No, fatty liver disease is not communicable. It is not caused by an infectious agent and cannot be spread from person to person.

Precautions


Maintain a healthy weight: If overweight or obese, lose weight gradually.

Eat a healthy diet: Focus on fruits, vegetables, and whole grains. Limit saturated and trans fats, added sugars, and processed foods.

Exercise regularly: Aim for at least 30 minutes of moderate-intensity exercise most days of the week.

Control diabetes: Manage blood sugar levels through diet, exercise, and medication if necessary.

Lower cholesterol: Follow a healthy diet and take medication if prescribed.

Avoid alcohol (NAFLD): or limit it drastically.

Stop drinking alcohol (ALD): Complete abstinence is essential.

Talk to your doctor about medications: Some medications can damage the liver.

How long does an outbreak last?


Fatty liver disease is not an "outbreak." It's a chronic condition that develops over time. The duration of the condition depends on factors like the underlying cause, lifestyle changes, and the presence of other medical conditions. Progression can be halted or even reversed with lifestyle changes and proper medical management, but without intervention, it can persist for years and potentially lead to cirrhosis.

How is it diagnosed?


Blood tests: Liver function tests (ALT, AST) can be elevated.

Imaging tests:

Ultrasound

CT scan

MRI

FibroScan (a specialized ultrasound to assess liver stiffness)

Liver biopsy: A small sample of liver tissue is removed and examined under a microscope. This is the most accurate way to diagnose and stage the disease, but it's not always necessary.

Timeline of Symptoms


The timeline of symptoms can vary greatly.

Early stages: Often asymptomatic.

Progression to steatohepatitis (NASH/ASH): Fatigue, abdominal discomfort may develop gradually.

Advanced liver disease (cirrhosis): Jaundice, edema, ascites, internal bleeding, mental confusion (hepatic encephalopathy) may appear over months to years. Progression speed depends on factors like diet, alcohol consumption and concurrent illness.

Important Considerations


Fatty liver disease is often linked to other health problems, such as diabetes, heart disease, and kidney disease.

Early diagnosis and treatment are crucial to prevent serious complications.

Lifestyle changes are the cornerstone of treatment, particularly for NAFLD.

ALD requires complete abstinence from alcohol.

Regular monitoring by a doctor is essential to track the progression of the disease and adjust treatment as needed.

Weight loss surgery may be considered in selected individuals with severe obesity and NAFLD.