Fatty liver: what it is, symptoms, causes and treatment

  • Fatty liver is a very common disease, more common than you think.
  • Although it is normal to have a certain amount of fat in the liver, when it exceeds 10% it becomes a health problem.
  • It is not usually a serious disease, unless it is accompanied by steatohepatitis (inflammation of the liver caused by the presence of fat), which may evolve into cirrhosis and / or liver cancer.

Index

  • What is it
  • Main causes
  • symptom
  • Evolution
  • Treatment

The fatty liver, known medically as hepatic steatosis, is a generally benign liver disease characterized by the accumulation of fatty acids and triglycerides in the liver cells.

It is characterized by being one of the most common liver diseases, and one of the fastest growing in recent years.

The symptoms of hepatic steatosis They are usually pain in the upper right alcohol of the abdomen, malaise, chronic fatigue, and heavy feeling, especially after meals.

Some years ago it was related to drinking alcohol in large quantities, although at present many doctors associate it with the increase in obesity (1), and cholesterol and triglyceride levels. That is why it has been called medically as Non-Alcoholic Liver Disease (NAFLD) (2).

Although today it is considered a very common disease, it can progress to steatohepatitis (3) and fibrosis, and if not treated in time it can end in cirrhosis and / or liver cancer (4).

What is nonalcoholic fatty liver (NAFLD)?

It is normal for our liver to have fat, but only a small amount.

Usually and normally, our liver has small amounts of fat. However, when this deposit is excessive, it is when we are faced with a hepatic steatosis, known medically as non-alcoholic hepatic steatosis.

As its name indicates, fatty liver consists of the excessive deposit of fat in your cells.

Basically the liver is unable to eliminate fatty acids and triglycerides, accumulating little by little in their cells.

In fact, hepatic steatosis is considered serious when it causes hepatomegaly and hepatitis (steatohepatitis), affecting not only the liver function itself, but causing the enlargement and inflammation of the liver.

Moreover, in most cases, doctors are faced with a mild hepatic steatosis, known as Grade 1 hepatic steatosis or 2, which usually does not give complications or progress to more serious stages, or cause symptoms.

... And the fatty alcoholic liver?

This time is due to an accumulation of fat produced directly by the regular intake of a high level of alcohol over time.

However, as many studies have shown, it is not necessary that the consumption of alcohol be excessive for the accumulation of fat in the liver.

However, a reduction in fat has been observed when alcohol is stopped. That is, if you stop drinking alcohol it is a reversible condition.

The presence of alcoholic fatty liver also tends to be closely related to the alcoholic hepatitis. Its symptoms are: jaundice, hepatomegaly, low fever, anorexia and ascites. Being able to advance, as we shall see, to liver cirrhosis.

In fact, in most cases this disease is usually a direct cause of liver transplantation. But it tends to produce no symptoms until the excessive presence of fat has caused liver damage.

Causes of fatty liver

Until recently it was thought that it was due to habitual and excessive consumption of alcoholic beverages. However, it has been discovered in people who do not ingest it, and may be closely related to what is known as metabolic syndrome.

Its causes are:

  • Overweight and obesity: We must bear in mind that hepatic steatosis occurs especially in people who are overweight. In fact, many medical specialists agree that the higher that excess weight is, the higher the risk.
  • Weightloss: Unlike what is thought, excess weight is not the only cause of steatosis. Did you know that it can also occur as a result of rapid weight loss? In turn, it may appear due to malnutrition.
  • Alcohol consumption: It is one of the most common causes. It would be a fatty liver secondary to alcohol consumption.
  • Mellitus diabetes: Both type 2 diabetes and insulin resistance They are two related causes.
  • High cholesterol: When there is high cholesterol, and above all triglycerides, we also have a directly related cause.
  • Consumption of certain medications: As is the case of estrogen, corticoids, antiretrovirals, Tamoxifen or Diltiazen.
  • Pregnancy (Acute fatty liver of pregnancy, AFLP): Although not common, it usually presents acutely. In fact, specialists do not know why it occurs, although they suspect that it may be due to an inherited problem related to the way in which the liver breaks down fats.

Although it is a benign disease in most cases, if not treated properly it can cause the appearance of cirrhosis (5) and / or liver cancer.

What symptoms can fatty liver cause?

There are several symptoms of fatty liver, although it is also true that not all patients have symptoms. As a general rule, the most common are the following:

  • Pain in the upper right part of the abdomen.
  • General discomfort.
  • Fatigue.
  • Chronic fatigue
  • Weightloss.
  • Heaviness sensation
  • On some occasions, jaundice.

In severe cases, it is possible to observe some symptoms such as severe pain in the upper abdomen and possibility of it developing acute liver failure.

However, not having associated symptoms does not mean that you can not be suffering from fatty liver. It is estimated that around 30% of patients with this disease have no symptoms.

As it is a condition that usually does not cause symptoms, it is common for fatty liver to be discovered when an abdominal ultrasound is done, or for an exploration of the abdomen (if there is an enlargement).

Or after checking in a blood test that liver enzymes are elevated. In some cases high bilirubin may also appear.

Evolution of fatty liver

If not treated, fatty liver can progress to cirrhosis and / or liver cancer.

It is usually a benign pathology that tends not to evolve into more serious stages.

When the doctor detects it, it is necessary to take the appropriate measures to treat it, and prevent it from evolving to steatohepatitis, which consists of the presence of inflamed liver, and from there to a possible cirrhosis and / or cancer.

It has been shown that when left untreated, it is possible that it may have cirrhosis and therefore increase the risk of liver cancer. But not in all cases.

How is fatty liver treated?

The medical treatment that is usually followed varies depending on the cause. If it is due to alcohol consumption, the key is to eliminate it completely. In these cases, avoiding its consumption reverses the disease.

With regard to non-alcoholic fatty liver, although for the moment there is no definitive medical treatment, the recommendations are: reduce weight and follow a healthy diet, low in fat and rich in fruits and vegetables.

The practice of exercise is always adequate, by helping our body to eliminate excess body fat. Moreover, when we also opt for the consumption of foods such as artichoke, or milk thistle capsules. These two foods help the liver to perform its functions and, in addition, renew the liver cells.

A good option is to go to a nutritionist who prescribes a proper diet, and control the weight that we lose. A rapid loss of weight is associated with greater damage to the liver.

Basically controlling the causes that have caused its appearance facilitates its healing.

Sometimes it is possible to administer drugs in order to treat the symptoms and thus not overload the liver.

Recent studies have found that some medications, such as the case of metformin (6), has proved useful for Decrease transaminases and fats in the liver.

But if the disease is not treated in time, the existence of nonalcoholic steatohepatitis may make liver transplantation necessary (7).

If you want to know more about what I did to cure my fatty liver, I recommend reading the following article: How to cure fatty liver.

Bibliography:

  1. Milić S, Lulić D, Štimac D. Non-alcoholic fatty liver disease and obesity: biochemical, metabolic and clinical presentations. World J Gastroenterol. 2014 Jul 28; 20 (28): 9330-7. doi: 10.3748 / wjg.v20.i28.9330.
  2. Sweet PH, Khoo T, Nguyen S. Nonalcoholic Fatty Liver Disease. Prim Care 2017 Dec; 44 (4): 599-607. doi: 10.1016 / j.pop.2017.07.003.
  3. Enomoto H, Bando Y, Nakamura H, Nishiguchi S, Koga M. Liver fibrosis markers of nonalcoholic steatohepatitis. World J Gastroenterol. 2015 Jun 28; 21 (24): 7427-35. doi: 10.3748 / wjg.v21.i24.7427.
  4. Charrez B, Qiao L, Hebbard L. Hepatocellular carcinoma and non-alcoholic steatohepatitis: The state of play. World J Gastroenterol. 2016 Feb 28; 22 (8): 2494-502. doi: 10.3748 / wjg.v22.i8.2494.
  5. Do Y, Kanda T, Sasaki R, Nakamura M, Nakamoto S, Yokosuka O. Nonalcoholic fatty liver disease and hepatic cirrhosis: Comparison with viral hepatitis-associated steatosis. World J Gastroenterol. 2015 Dec 14; 21 (46): 12989-95. doi: 10.3748 / wjg.v21.i46.12989.
  6. Kim EK, Lee SH, Jhun JY, Byun JK, Jeong JH, Lee SY, Kim JK, Choi JY, Cho ML.Metformin Prevents Fatty Liver and Improves Balance of White / Brown Adipose in an Obesity Mouse Model by Inducing FGF21. Mediators Inflamm. 2016; 2016: 5813030. doi: 10.1155 / 2016/5813030.
  7. Gitto S, Vukotic R, Vitale G, Pirillo M, Villa E, Andreone P. Non-alcoholic steatohepatitis and liver transplantation. Dig Liver Dis. 2016 Jun; 48 (6): 587-91. doi: 10.1016 / j.dld.2016.02.014.

Other references consulted:

  • David J. A. Jenkins, MD; Cyril W. C. Kendall, PhD; Augustine Marchie, BSc; et al. Effects of a Dietary Portfolio of Cholesterol-Lowering Foods vs. Lovastatin on Serum Lipids and C-Reactive Protein. JAMA 2003; 290 (4): 502-510. doi: 10.1001 / jama.290.4.502. Available at //www.ncbi.nlm.nih.gov/pubmed/12876093
  • Armstrong MJ, Haydon G, Syn WK. Beyond the liver in patients with non-alcoholic fatty liver disease (NAFLD) -cause for concern? Hepatobiliary Surg Nutr 2018; 7 (2): 138-142. doi: 10.21037 / hbsn.2018.01.09. Available at //hbsn.amegroups.com/article/view/18567/19176
  • Conjeevaram Selvakumar, P.K., Kabbany, M.N. & Alkhouri, N. Pediatr Drugs (2018) 20: 315. Nonalcoholic Fatty Liver Disease in Children: Not a Small Matter. Available at //www.ncbi.nlm.nih.gov/pubmed/29740791
  • Pang Y, Kartsonaki C, Turnbull I, Guo Y, Clarke R, Chen Y, Bragg F, Yang L, Bian Z, Millwood IY2, Hao J, Han X, Zang Y, Chen J, Li L, Holmes MV, Chen Z Diabetes, Plasma Glucose, and Incidence of Fatty Liver, Cirrhosis, and Liver Cancer: A Prospective Study of 0.5 Million People. Hepatology. 2018 Oct; 68 (4): 1308-1318. doi: 10.1002 / hep.30083. Available at //aasldpubs.onlinelibrary.wiley.com/doi/full/10.1002/hep.30083

Last revision 12/13/2018

This article is published for informational purposes only. It can not and should not replace the consultation with a Physician. We advise you to consult your Trusted Doctor. ThemesLiver diseases Liver

Fatty Liver Disease | Q&A (April 2021)