The liver is the largest internal organ of the human body. It is located on the upper-right side of the abdomen. It’s main functions are to remove toxins and also process food nutrients. Blood from the digestive system filters through the liver before travelling anywhere else in the body. What then is fatty liver disease?
Fatty liver disease is a build-up of fat in the liver. It is normal for the liver to contain some fat, but if fat accounts for more than 10 per cent of the liver’s weight, then you have fatty liver. You may even develop more serious complications.
For most people, it causes no symptoms and no problems but in some people, the fat damages the liver cells and affects how well their liver works. There are two types of fatty liver disease:
- Non-alcoholic fatty liver disease (NAFLD)
- Alcoholic fatty liver disease, also called alcoholic steatohepatitis
Non-alcoholic fatty liver disease (NAFLD)
Non-alcoholic fatty liver disease (NAFLD) is the build up of extra fat in liver cells that is not caused by alcohol. Nonalcoholic steatohepatitis, a potentially serious form of fatty liver disease. It is marked by liver inflammation, which may progress to scarring and irreversible damage. This damage is similar to the damage caused by heavy alcohol use. At its most severe, nonalcoholic steatohepatitis can progress to cirrhosis and liver failure.
It’s a common liver complaint in Western countries and affects about one in every 10 people. Non-alcoholic fatty liver occurs in every age group but especially in people in their 40s and 50s. This is because they are at high risk of heart diseases such risk factors as obesity and type 2 diabetes.
Possible causes are:
- metabolic syndrome which is the combination of having high cholesterol, diabetes mellitus and hypertension (high blood pressure)
- polycystic ovarian syndrome
- protein malnutrition (too less protein in the diet)
- starvation or rapid weight loss (loosing too much weight too quickly)
- some medicines.
- sleep apnea
Alcohol-related fatty liver disease
Alcoholic fatty liver disease is due to heavy alcohol use. Your liver breaks down most of the alcohol you drink, so it can be removed from your body. But the process of breaking it down can generate harmful substances.
However, these substances can damage liver cells, promote inflammation, and also weaken your body’s natural defenses. The more alcohol that you drink, the more you damage your liver. Fatty liver develops in 46 to 90% of heavy alcohol users. In some people, 5 to 10 standard drinks per week may be enough to cause liver disease.
You may have no symptoms in the early stages. Most people who have fatty liver disease feel fine and don’t know that they have it. Some people may get symptoms such as:
- feeling weak and tired all the time
- enlarged liver
- weight loss
- yellowing of the eyes
- a pain or discomfort in the upper right part of your stomach.
- bruising easily
- dark urine
- swelling of the lower tummy area (ascites)
- vomiting blood
- dark black tarry faeces
- periods of confusion or poor memory
- itching skin
It can be hard to diagnose, especially when the disease is still in its early stages. Your doctor may be able to suspect it after examining your symptoms and medical history.
During the physical exam, your doctor will examine your body and check your weight and height. Your doctor will look for signs, such as:
- An enlarged liver
- Signs of cirrhosis, such as jaundice, a condition that causes your skin and whites of your eyes to turn yellow.
Diagnosis is usually confirmed through tests such as:
- blood tests such as liver function test, cholesterol test and fasting glucose test
- ultrasound of the liver
- liver biopsy.
Treatment of fatty liver disease
The treatment of fatty liver will depend on the cause and the diagnosis. Your doctor may recommend that you receive vaccinations against hepatitis A and hepatitis B. This help to protect you from viruses that may cause further liver damage.
For those who have cirrhosis due to non-alcoholic steatohepatitis, liver transplantation may be an option. Outcomes of liver transplant in this population group are generally very good.
- In alcohol-related fatty liver disease, alcohol abstinence is the main treatment option.
- In non-alcoholic steatohepatitis, the main treatment are lifestyle changes such as: