Fatty liver should not be taken lightly

Dear Dr. Roach: I have been suffering from fatty liver for the past 10 years. Is there any medication to reverse it?

A.A.

Answer: Fatty liver is a very common finding that refers to the accumulation of excess fat in the liver cells. The most common cause, in people who do not drink excess alcohol, is being overweight, which eventually leads to insulin resistance. Although you asked about medication treatment, the primary treatment for people who are overweight with fatty liver is losing weight.

Ideally, this is accomplished through healthy dietary changes and increased exercise; however, bariatric surgery is worth considering in people who continue to have fatty liver despite their best efforts on diet and exercise.

Fatty liver should not be taken lightly. It may progress to inflammation of the liver, fibrosis and eventually cirrhosis of the liver.

Drug therapy is more often used to help the underlying and accompanying conditions than it is for treatment of the fatty liver itself. For people who have fatty liver without diabetes, the use of vitamin E appears to be of modest benefit, although there are conflicting data. Vitamin E should not be used in people with diabetes for the treatment of fatty liver. Most experts will not use vitamin E in men with a history of prostate cancer, since vitamin E increases the risk of prostate cancer about 17%.

Dear Dr. Roach: I read your response to the guy with itching ears in a recent column. I have that problem. I asked a pharmacist what to use, and he recommended 1% hydrocortisone on a cotton swab. This solved my problem.

D.C.

Answer: Hydrocortisone is an effective but nonspecific treatment for itching on the skin. If it doesn’t work, the ear canal needs an exam.

I am also cautious about using cotton swabs in the ears.

For applying medicine near the outside of the canal, a swab should be safe, but you should be very careful with any instrument inserted into the ear.

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