How dreadful is fatty liver?
How serious is fatty liver disease?
There are no medicines that can treat fatty liver disease, but certain lifestyle changes can reverse or abort its progress.
After our annual medical exam, I was told by our physician that I have mild fatty liver. Isn’t it normal to have fat in the liver? What is fatty liver? Is it a serious condition?—inday_alias@yahoo.com
You’re right. It is normal for your liver to contain some fat. However, if more than five to 10 percent of your liver’s weight is fat, then you have fatty liver disease or hepatic steatosis.
Fatty liver disease, per se, is a generally benign condition that is reversible if its causative agent is eliminated or certain lifestyle changes are adopted. However, in many instances, fatty liver progresses to inflammation of the liver (hepatitis), which if unabated leads to liver cirrhosis—severe scarring of the liver that is irreversible and usually progressive. Cirrhosis gives rise to fatal complications such as liver insufficiency and bleeding in the esophagus. It also predisposes to the development of liver cancer. In fact, 80 percent of all liver cancers are preceded by cirrhosis.
Types of fatty liver disease
There are two main types of fatty liver disease: alcoholic fatty liver disease and nonalcoholic fatty liver disease (NAFLD).
Needless to say, alcoholic liver disease is caused by excessive intake of alcohol. Fatty liver is a universal finding among heavy drinkers, while up to 40 percent of moderate drinkers (10 to 80 mg per day) also have the condition. But only one in five drinkers with fatty liver develop alcoholic hepatitis and only one in four of those who develop alcoholic hepatitis will progress to cirrhosis.
NAFLD, on the other, is a type of fatty liver disease that is not related to alcohol use. It is a very common condition, more common than alcoholic fatty liver in fact. About 25 percent of people in the world have NAFLD, but most of them have simple fatty liver, which typically does not get bad enough to cause liver damage. Only a small number, about 20 percent, have hepatitis (non-alcoholic steatohepatitis or NASH) and only about 11 percent of those with NASH develop cirrhosis.
What brings about non-alcoholic fatty liver disease (NAFLD)?
We do not know the cause of nonalcoholic fatty liver (NAFLD), but we know that it primarily affects middle aged or older people. We also know some risk factors for the disease including obesity, type two diabetes and prediabetes, high blood levels of cholesterol and triglycerides, hypertension, metabolic syndrome, sleep apnea, malnutrition, rapid weight loss, intake of certain drugs such as corticosteroids, underactive thyroid (hypothyroidism), underactive pituitary gland (hypopituitarism), and polycystic ovary syndrome.
Manifestations of fatty liver disease
Both NAFLD and alcoholic fatty liver disease are silent diseases that have no symptoms except for occasional fatigue and pain or discomfort in the upper right abdomen. As in your case, they are often incidental findings during comprehensive medical exams that include liver function tests or ultrasound of the liver.
However, when cirrhosis has set in, signs and symptoms appear including an enlarged liver, enlarged spleen, jaundice or yellowing of the skin and eyes, abdominal distention (ascites), enlarged blood vessels just beneath the skin’s surface, and red palms.
Treatments and prevention of fatty liver disease
There are no medicines that can treat fatty liver disease, but certain lifestyle changes can reverse or abort its progress. In as much as you simply have mild fatty liver disease, the following measures will certainly contribute largely to reversing your disorder:
• Abstain from alcohol. •Adopt a healthy diet—Choose a plant-based diet that’s rich in fruits, vegetables, whole grains and healthy fats, and limit your intake of salt and sugar.
• Maintain a healthy weight—If you are overweight or obese, reduce the number of calories you eat each day and get more exercise. Weight loss can reduce fat in the liver, inflammation, and scarring. If you have a healthy weight, work to maintain it by choosing a healthy diet and exercising.
• Exercise regularly—This will help you maintain a healthy weight and reduce fat in the liver
• Keep your blood sugar and blood pressure within normal levels by diet, exercise and if needed, doctor-prescribed medications.