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Fatty Liver - Types, Symptoms, Stages, and Treatment

Written by
Dr. Vasantha K S
and medically reviewed by Dr. Gokul Kruba Shanker

Published on Jun 09, 2018 and last reviewed on Jun 03, 2020   -  5 min read

Abstract

Abstract

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. In this article, read about the various grades of fatty changes that can take place in the liver and how they can be effectively managed.

Fatty Liver - Types, Symptoms, Stages, and Treatment

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. But due to various factors, excess fat can start accumulating in the liver. If more than 5 % 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 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 the liver function and the scaring increases the risk of liver cancer. It also increases the risk of heart and kidney disease, diabetes, etc.

Types:

  • Alcoholic fatty liver disease - It is the damage caused to the liver cells due to excess alcohol consumption.

  • Non-alcoholic fatty liver disease (NAFLD) - It is caused due to 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, there are no symptoms felt by the patient. But, there is a slight enlargement of liver detected during a physical examination. Later, once there is excessive inflammation, vague symptoms may develop such as:

  • Decreased appetite.

  • Drastic weight loss.

  • Fatigue.

  • Abdominal discomfort.

  • Pain in the upper right abdomen.

Further, it can progress to cirrhosis and give rise to the following symptoms:

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:

  1. Grade I - This is the mildest form. Here, the fat accumulates on the outside of the organ and does not affect its function.

  2. Grade II - It is a moderately severe form and requires medical intervention to prevent worsening.

  3. Grade III - It is the severe form of fatty liver, with the appearance of symptoms. Active treatments are required.

What Are the Causes of Fatty Liver?

  1. Alcoholism.

  2. Overeating as a habit.

  3. Medical conditions:

    1. Diabetes.

    2. Obesity.

    3. High triglycerides.

    4. High blood pressure (hypertension).

    5. PCOS (polycystic ovary syndrome).

    6. Sleep apnea.

    7. Hypothyroidism.

    8. Hypopituitarism.

  4. Certain medications (Aspirin, steroids, methotrexate, etc.)

  5. Rapid weight loss.

  6. Liver infections like hepatitis C.

Risk Factors:

  1. People with excess belly fat - individuals with too much fat around the belly are also called viscerally obese.

  2. Insulin resistance - high levels of insulin and its resistance increase the risk of fat deposition in the liver.

  3. Older adults.

  4. Consuming a diet rich in carbohydrates.

  5. More intake of sweetened beverages and soft drinks.

  6. Imbalance in gut bacteria.

Stages of Fatty Liver:

Fatty liver develops in the following stages:

  1. Steatosis - It is a relatively harmless accumulation of fat in the liver. It is accidentally diagnosed while trying to diagnose other conditions.

  2. Non-alcoholic steatohepatitis (NASH) - Here, the liver is inflamed.

  3. Fibrosis - Chronic inflammation of the liver results in scar tissues. Scars are around the liver and surrounding blood vessels, but the liver function is normal.

  4. 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 finding:

1) Blood tests - It includes -

  • Liver function test and liver enzymes.

  • Complete blood count.

  • Test for hepatitis.

  • Blood sugar levels.

  • Hemoglobin level.

  • Lipid profile.

2) Imaging tests - It includes -

  • Abdominal ultrasound.

  • CT or MRI.

  • Magnetic resonance elastography.

  • Transient elastography.

3) Liver biopsy - Here, a needle is inserted and a sample 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 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:

  • Avoid overeating.

  • Cut back on refined carbohydrates (you can try the Mediterranean diet).

  • Include monosaturated fats, whey protein, and soluble fiber.

3) Weight loss - If you 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, that is late-stage scarring of the liver, is the most concerning complication of fatty liver. Cirrhosis in turn can result in:

  1. Ascites - the buildup of fluid in the abdomen.

  2. Hepatic encephalopathy - it is when a severe liver disease affects brain function. The symptoms include confusion and slurred speech.

  3. Esophageal varices - the veins in the esophagus swells. This vein can rupture and bleed at any time.

  4. Liver cancer.

  5. End-stage liver failure.

Prevention:

  • Healthy diet.

  • Healthy weight.

  • Exercise.

To know more about fatty liver, talk to our specialist through phone or video consultation now!

 

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Frequently Asked Questions


1.

How Serious Is a Fatty Liver?

The fatty liver condition is dangerous because it can cause inflammation and severe damage to the liver. Once the damage has occurred, the changes become irreversible. Severe scarring of the liver is known as cirrhosis. The severity of cirrhosis can increase the risk of liver cancer.

2.

How Can I Reduce My Fatty Liver?

- The main cause of fatty liver is obesity. Check your BMI and maintain it at the healthy levels.
- Reduce your cholesterol level.
- Do exercise regularly. It can help you overcome a sedentary lifestyle.
- Control your diabetes.
- Choose a balanced and healthy diet. Avoid junk foods.

3.

What Can I Drink to Flush My Liver?

Citric fruits like oranges, limes, grapes, oranges, and lemons help in boosting the function of the liver. It also increases the cleansing ability. Consuming citrus fruits as such also has health benefits like detoxification of enzymes that can flush out the pollutants.

4.

How much time does it take to reverse fatty liver?

All the cases of fatty liver cannot be reversed. If fatty liver is caused by alcohol, then you should definitely stop drinking. Other worst habits, such as substance abuse, should also be stopped. Within a few weeks’ time, the fat that is around the liver might vanish. The important thing is staying away from alcohol as it might cause recurrence.

5.

Can Stress Cause Fatty Liver Directly?

Stress does not cause fatty liver directly. But it is known to be a risk factor because of its indirect effects. Stress is a contributor to unhealthy and poor behaviors like alcohol abuse, smoking, and poor diet patterns. In some cases, stress is known to be associated with non-alcoholic fatty liver disease.

6.

How Do You Detoxify Your Liver?

Detoxification of the liver involves the following:
- Avoiding certain foods that are rich in alcohol.
- Choose a liver-friendly diet.
- Use supplements to flush toxins out of the liver.
- Clean the colon and gut through the use of enemas.
- Juice fasting.

7.

How Do I Detox My Liver Naturally?

The ideal ways for detoxing the liver are:
- Drink huge quantities of water.
- Focus on getting sound sleep.
- Limit the usage of alcohol. If that is the reason for fatty liver, you should completely stop the habit.
- Reduce your intake of processed foods and sugar.
- Eat foods high in prebiotics.
- Eat antioxidant-rich foods.
- Get active.
- Decrease your salt intake.

8.

Is Fasting Good for the Liver?

There is a common belief that fasting will help you to treat liver disease. Like most of the detoxifying methods, a liver cleanse has specific steps. You may have to fast or only to drink juices or other liquids for several days. You might need to take herbal or restricted diet or dietary supplements.

9.

Is a Fatty Liver Painful?

In most of the cases, the fatty liver does not have any symptoms. A certain degree of pain and discomfort is seen on the abdomen. In severe cases, cirrhosis can occur and lead to scarring. Diagnosing at an early stage and terminating the cause can help you feel better. This is the only way to avoid pain in fatty liver condition.

10.

Does Apple Cider Vinegar Clean Your Liver?

Apple cider vinegar helps in promoting circulation. It also detoxifies the liver. The acid in this apple cider vinegar can also bind to toxins. This can aid in the removal of toxins from the body. It is also rich in potassium content. This quality makes it capable of breaking the mucus in the body. They also contribute to clearing the toxins in the lymph nodes.

11.

Is Turmeric Bad for Your Liver?

The turmeric antioxidant effect appears to be very powerful that prevents your liver from being damaged by toxins. It could be useful for people who take strong medications for diabetes or other health conditions, which might hurt their liver with long-term use.

Last reviewed at:
03 Jun 2020  -  5 min read

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Related Questions & Answers


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