The Dangers of a Fatty Liver

The Dangers of a Fatty Liver

It may show no signs but a fatty liver means trouble if untreated.

 

The liver is the largest organ in the body, apart from the skin. It is found in the right upper abdomen. It is a vital organ with many functions:

  • Storing energy in the form of sugar (glucose)
  • Storing vitamins, iron, and other minerals
  • Making proteins, including blood clotting factors
  • Making bile which is needed for food digestion
  • Metabolising or breaking down many chemicals, medications and alcohol

Fatty liver means the accumulation of fat in the liver cells. Most people with this condition will not develop serious liver problems. In others, fatty liver (steatosis, which means the abnormal retention of reduction of high blood triglycerides, good control lipids in the cells) may lead to inflammation of the liver called steatohepatitis or NASH. It is typically a chronic condition (i.e. it persists for many years). This condition may lead to progressive scarring of the liver (fibrosis) and hardening of the liver (liver cirrhosis). About a third of patients with NASH may progress to fibrosis and about 20% will develop cirrhosis over a period of 9 to 10 years. Liver cirrhosis is a serious condition that can lead to multiple complications. Unfortunately, it is difficult to predict the natural course of fatty liver and NASH in individual patients.
It is known that fat accumulates in the liver in a number of conditions. The most common is obesity. Fatty liver is also associated with diabetes mellitus,
high blood triglycerides, and the heavy consumption of alcohol. It may occur with other conditions such as malnutrition, bypass surgery for obesity, or the use of certain drugs. Sometimes fatty liver may occur as a complication of pregnancy.

SYMPTOMS AND DIAGNOSIS

There are usually no symptoms that are noticeable to the patient and fatty liver is often discovered during a routine health screening. There may be a rise in certain enzymes found in the blood test, and occasionally slightly enlarged during physical examination. An ultrasound scan of the abdomen will show increased echogenicity of the liver which is consistent with fat accumulation in the liver. Fibroscan or liver biopsy may be recommended to evaluate the extent of the liver damage or liver fibrosis.

TREATMENT

Treatment of fatty liver and steatohepatitis requires control of the underlying conditions. This may include reduction of high blood triglycerides, good control of diabetes, abstinence from alcohol and weight reduction. Since being overweight is by far the most critical factor, weight loss is the most important factor. This is especially necessary if damage to the liver is occurring, and early signs of scarring (fibrosis) are present on biopsy.

Diet associated with improvement of fatty liver must be low in rapidly absorbed carbohydrates and high in protein-to-calorie ratio. Weight loss should be gradual, moderate, and controlled. Multiple studies have shown that exercise added to diet appears to improve results of fatty liver.

Preventing from getting fatty liver

  • Choose a healthy diet that is rich in fruits, vegetables, whole grains and healthy fats and avoid “fast food diet”.
  • Maintain a healthy weight. If you are overweight or obese, reduce the calories intake and get more exercise. If you have a healthy weight, maintain it by choosing a healthy diet and regular exercise.
  • Eliminate alcohol from your diet.
  • Get other medical conditions such as diabetes, hypertension, high cholesterol and triglycerides treated. Inform your doctor about your regular medication.

 Published in This Quarterly July 2011

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