What Does Fatty Liver Mean?
The liver is the largest gland in the body. Its primary function is to process the food and drinks we consume and filter out the harmful substances. A certain amount of fat is normal if present in the liver. However, due to various factors, excess fat can start accumulating in the liver. If more than 5 percent of the liver is fat, it is said to be fatty. Initially, there will not be any symptoms. But, it does not affect the efficiency of the liver functions. The body has some mechanisms in place to allow the liver cells to regenerate. But, repeated damage can cause permanent scarring in the form of cirrhosis.
The cause is not known in most cases, but in some, alcoholism plays an important role (alcoholic fatty liver). If the cause is not alcohol, then it is called a non-alcoholic fatty liver (NAFL). NAFL falls under the group of non-alcoholic liver disease (NAFLD), which is the most common type of liver disease. The initial stage of liver disease is the non-alcoholic fatty acid, which can be reversed but usually goes undiagnosed. If left untreated, it can progress to non-alcoholic steatohepatitis (NASH), which is a more serious liver condition.
The fat accumulated in the liver is more in NASH, and it can lead to inflammation of the liver and cell damage. This damage can cause liver cirrhosis or fibrosis. Continuous damage to the liver cells can impair liver function, and the scarring increases the risk of liver cancer. It also increases the risk of heart and kidney disease, diabetes, etc.
Types:
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Alcoholic Fatty Liver Disease - It is the damage caused to the liver cells due to excess alcohol consumption.
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Non-alcoholic Fatty Liver Disease (NAFLD) - It is caused by the other factors mentioned above in a person who does not consume too much alcohol.
What Are the Signs and Symptoms of Fatty Liver?
Initially, the patient feels no symptoms. However, there is a slight enlargement of the liver detected during a physical examination. Later, once there is excessive inflammation, vague symptoms may develop, such as:
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Decreased appetite.
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Drastic weight loss.
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Fatigue.
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Abdominal discomfort.
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Pain in the upper right abdomen.
Further, it can progress to cirrhosis and give rise to the following symptoms:
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Jaundice.
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Ascites (abdominal swelling).
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Edema.
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Confusion.
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Increased bleeding tendency.
The levels of liver enzymes (AST - Aspartate Aminotransferase and ALT - Alanine transaminase), insulin, and triglycerides are elevated.
Grades of Fatty Liver:
Based on the visual changes observed on the ultrasound, the fatty liver is graded into three:
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Grade I - This is the mildest form. Here, the fat accumulates on the outside of the organ and does not affect its function.
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Grade II - It is a moderately severe form and requires medical intervention to prevent worsening.
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Grade III - It is a severe form of fatty liver, with the appearance of symptoms. Active treatments are required.
What Are the Causes and Risk Factors of Fatty Liver?
Alcoholic fatty liver disease occurs mainly in people who drink heavily, especially over a long time. Women who drink heavily, those who are obese, or people with certain genetic changes have a higher risk. Some common causes and risk factors include the following.
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Alcoholism.
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Overeating as a habit.
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Medical conditions:
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Diabetes.
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High triglycerides.
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High blood pressure (hypertension).
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PCOS (polycystic ovary syndrome).
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Sleep apnea.
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Hypopituitarism.
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Certain medications (Aspirin, steroids, Methotrexate, and more).
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Liver infections like hepatitis C.
Risk Factors:
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People with excess belly fat (individuals with too much fat around the belly are also called viscerally obese). Having elevated levels of fats in the blood, such as cholesterol and triglycerides.
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Consuming a diet rich in carbohydrates.
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More intake of sweetened beverages and soft drinks.
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Imbalance in gut bacteria.
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Having type 2 diabetes or prediabetes. High levels of insulin and its resistance increase the risk of fat deposition in the liver.
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Being middle-aged or older (although it can also occur in children)
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Having elevated levels of fats in the blood, such as cholesterol and triglycerides.
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Having hypertension (high blood pressure)
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Undergoing rapid weight loss.
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Being exposed to certain toxins.
Stages of Fatty Liver:
Fatty liver develops in the following stages:
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Steatosis - It is a relatively harmless accumulation of fat in the liver. It is accidentally diagnosed while trying to diagnose other conditions.
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Non-alcoholic Steatohepatitis (NASH) - Here, the liver is inflamed.
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Fibrosis - Chronic inflammation of the liver results in scar tissue. Scars are around the liver and surrounding blood vessels, but the liver function is normal.
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Cirrhosis - It occurs gradually over the years and is the most severe stage. Here, the liver shrinks and looks scarred. This damage cannot be reversed.
Drastic lifestyle changes can prevent the development of cirrhosis or fibrosis.
How Does a Doctor Diagnose Fatty Liver?
In the early stages, as mentioned above, there are no symptoms. So, it is often diagnosed during routine blood tests. The doctor can palpate the abdomen area to feel for changes, and he/she may suggest tests such as the following to confirm his findings:
1. Blood Tests - It includes -
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Liver function test and liver enzymes.
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Complete blood count.
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Test for hepatitis.
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Blood sugar levels.
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Hemoglobin level.
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Lipid profile.
2. Imaging Tests - It includes -
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Abdominal ultrasound.
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CT or MRI.
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Magnetic resonance elastography.
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Transient elastography.
3. Liver Biopsy - Here, a needle is inserted, and a sample of tissue is taken out for testing. This is the most certain method to detect fatty liver.
Can Fatty Liver Be Treated?
Yes, if the liver has not altered or been scarred, fatty liver can be treated. The treatment options include:
1) Alcohol Abstinence - It is absolutely essential to stop drinking to prevent the progression of this disease.
2) Dietary Modifications:
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Avoid overeating.
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Cut back on refined carbohydrates (One can try the Mediterranean diet).
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Include mono-saturated fats, whey protein, and soluble fiber.
3) Weight Loss - If individuals are overweight or obese, lose weight with dietary modifications and exercise.
4) Diabetic Control - Diabetic patients should control their blood glucose levels with the help of dietary restrictions, anti-diabetic drugs or insulin, and exercise.
5) Triglyceride Control - People with high cholesterol or triglycerides should exercise and watch what they eat.
What Are the Possible Complications of Fatty Liver?
Cirrhosis, which is late-stage scarring of the liver, is the most concerning complication of fatty liver. Cirrhosis, in turn, can result in:
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Ascites (the buildup of fluid in the abdomen).
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Hepatic Encephalopathy - It is when a severe liver disease affects brain function. The symptoms include confusion and slurred speech.
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Esophageal Varices - The veins in the esophagus swell. This vein can rupture and bleed at any time.
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Liver cancer.
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End-stage liver failure.
What Lifestyle Changes Can Assist in Managing Fatty Liver Disease?
Some simple lifestyle changes that can help with fatty liver disease include:
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Eat a healthy diet by avoiding too much salt and sugar, and instead, eat plenty of fruits, vegetables, and whole grains.
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Make sure to get vaccinated for hepatitis A and B, the flu, and pneumococcal disease. Having these conditions along with fatty liver can increase the risk of liver failure.
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Individuals with long-term liver disease are more susceptible to infections, so these vaccinations are inevitable.
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Engage in regular exercise, as it can assist in weight loss and reducing fat in the liver.
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Before taking any dietary supplements, or vitamins, or trying alternative medicines or practices, discuss them with the doctor. Some herbal remedies might harm the liver.
Conclusion:
Depending on the seriousness of one's condition, they can potentially clear fatty liver and even some scarring. The liver is really good at fixing itself. If individuals stick to their doctor's treatment plan, they can lower liver fat and swelling. This helps stop the damage from getting worse and might even reverse some early liver damage.