Fatty liver disease condition caused by the deposition of excess fat in the liver. It’s asymptomatic in most people, and it doesn’t cause any harm to them. However, in few patients, it can result in liver inflammation causing damage. The implications of fatty liver disease are preventable with lifestyle changes.  

 

How do we define Fatty Liver Disease? 

Fatty liver disease (steatosis) is a condition caused by the deposition of excess fat in the liver. A healthy liver contains negligible fat. When fat reaches 5% to 10% of the liver’s weight it’s defined as fatty liver disease and it may lead to its associated complications if not resolved. 

Why is fatty liver disease harmful? 

It’s asymptomatic in most people, and it doesn’t cause any harm to them. However, in few patients, it can result in liver inflammation causing damage. It has three stages: 

1. The liver becomes inflamed (swollen), which damages the liver. This stage is called steatohepatitis. 
2. Persistent inflammation caused repeated liver damage and can result in the formation of scar tissue. This stage is called fibrosis. 
3. Continuation of the inflammation results in formation of more and more scar tissue which ultimately replaces normal healthy liver tissue. This stage is called Cirrhosis of the liver. 

Cirrhosis of the liver 

The replacement of healthy liver tissue by scar tissue results in cirrhosis of the liver. This will result in impaired liver function and ultimately may shut down liver function completely. This may lead to liver failure and even liver cancer. 

What are the types of fatty liver disease? 

There are two main forms of fatty liver disease: 

1. Alcoholic Liver Disease –  Alcoholic fatty liver is the deposition of fat in the liver due to high amounts of alcohol consumption.  (More than one drink a day for women and up to two to three drinks per day for men.)
2. Nonalcoholic Fatty Liver Disease –  Non-alcoholic fatty liver disease is the deposition of fat in the liver in people who don’t have high amounts of alcohol consumption. Experts don’t know the exact cause of non-alcoholic fatty liver disease. Several factors, such as obesity and diabetes, can increase the risk. 

 

SYMPTOMS AND CAUSES 

 

Risk factors of Fatty Liver Disease? 

1. Postmenopausal woman  
2. Obesity with a high level of central obesity 
3. Dyslipidemia ( High cholesterol and Triglceridelvels) 
4. Hypertension Diabetes 
5. Insulin Resistance 
6. Long-term use of certain drugs like steroids of OCPs. 

What are the symptoms of Fatty Liver Disease?

It’s asymptomatic in most people, and it doesn’t cause any harm to them. However, in few patients, it can result in liver inflammation causing damage. Symptoms if present may include :  

1. Right upper quadrant discomfort or pain 
2. Loss of appetite, the fullness of abdomen, or bloating 
3. Nausea  
4. Weakness and lethargy 
5. In advanced stages when it results in liver cirrhosis it may result in Jaundice( Yellow eyes and urine), Ascites ( Water in the abdomen), UGI bleed ( Vomiting of blood), etc. 

 

DIAGNOSIS AND TESTS 

How is Fatty Liver Disease diagnosed? 

As most patients are symptomatic or minimally symptomatic fatty liver disease is usually detected incidentally on a routine ultrasound or after an abnormal LFT which shows raised liver enzymes. . To make a diagnosis, the following tests may be done : 

1. Ultrasound of the abdomen to look at the liver 
2. Fibroscan is a specialized ultrasound to assess the amount of fat and scar tissue in the liver. 
3. Few more tests are required to look for the risk factors 
4. Fasting blood sugar and HBA1C, Fasting lipid profile 

 

MANAGEMENT AND TREATMENT 

Treatment of Fatty Liver Disease  

The most important role in the management of fatty liver disease is lifestyle modification. Drugs have a limited role and have only a supporting role. Treatment includes: 

1. Stopping alcohol. 
2. Weight loss through a combination of adoption of healthy eating habits and maintaining an active life. 
3. Treatment of diabetes and high cholesterol and triglyceride with drugs.  
4. Vitamin E  

 

Prevention of Fatty Liver Disease  

1. Exercise regularly. 
2. Limit alcohol consumption. 
3. If Risk factors like diabetes and dyslipidemia are present one should strive towards maintaining optimum weight.  
4. Reduce weight if obese