Fatty Liver: Causes, Symptoms, Diagnosis, Treatment, and Prevention
A fatty liver is a common condition that affects about 1 in 3 adults and 1 in 10 children in Australia. Inflammation and scarring can result when too much fat accumulates in the liver. Various factors, including alcohol consumption, obesity, diabetes, and high cholesterol, can cause fatty liver. We will discuss the causes, symptoms, diagnosis, treatment, and prevention of fatty liver in this blog post.
What is the liver and what does it do?
The liver is the second largest organ in the body, after the skin. It is located in the upper right side of the abdomen, under the rib cage. The liver performs many vital functions, such as:
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Producing bile, which helps with digestion and absorption of fats and vitamins.
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Making proteins for the body, such as blood clotting factors and immune system components.
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Storing iron and vitamins.
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Converting nutrients into energy and regulating blood sugar levels.
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Detoxifying the blood by removing harmful substances, such as alcohol, drugs, and toxins.
What is fatty liver and how does it affect the liver?
Generally, the liver contains a small amount of fat, but when it exceeds 5% to 10% of its weight, it becomes problematic. A fatty liver, also known as hepatic steatosis, is a condition where excess fat builds up in the liver cells. When the liver becomes fatty, it can interfere with normal functions and cause inflammation, leading to liver damage. As a result, scarring (fibrosis) and hardening (cirrhosis) of the liver can impair its ability to perform its functions. Cirrhosis can also lead to liver cancer and failure of the liver.
What are the types of fatty liver?
There are two main types of fatty liver: alcoholic fatty liver disease (AFLD) and non-alcoholic fatty liver disease (NAFLD).
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AFLD is caused by regular and excessive consumption of alcohol. Alcohol can damage the liver cells and impair their ability to process fat. This leads to fat accumulation in the liver. AFLD affects about 5% of people in Australia.
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NAFLD is not related to alcohol consumption. It is associated with various risk factors, such as obesity, diabetes, high blood pressure, high cholesterol, metabolic syndrome, and certain medications. NAFLD affects about 30% of people in Australia.
There are also other rare causes of fatty liver, such as pregnancy, genetic disorders, infections, autoimmune diseases, and malnutrition.
What are the symptoms of fatty liver?
Fatty liver usually does not cause any noticeable symptoms in most cases. However, some people may experience:
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Fatigue or weakness.
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Discomfort or pain in the upper right side of the abdomen.
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Loss of appetite or weight loss.
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Nausea or vomiting.
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Itchy skin or yellowing of the skin and eyes (jaundice).
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Easy bruising or bleeding.
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Dark urine or pale stools.
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Swelling of the abdomen (ascites) or legs (edema).
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Confusion or mental changes.
The presence of any of these symptoms indicates that fatty liver has progressed to a more serious stage, such as steatohepatitis (inflammation), fibrosis (scarring), or cirrhosis (hardening).
How is fatty liver diagnosed?
Fatty liver can be diagnosed by various tests and examinations, such as:
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Your doctor will ask you about your symptoms, your medical history, your family history, your lifestyle habits, and the medications you take. They will also examine your abdomen for signs of liver enlargement or tenderness.
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In order to rule out other causes of liver disease, your doctor may order blood tests. Among these tests are liver enzymes (ALT and AST), bilirubin (a pigment produced by the breakdown of red blood cells), albumin (a protein produced by the liver), and prothrombin time (a measure of blood clotting ability).
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A doctor may use imaging tests to visualize your liver and determine its size and fat content. Ultrasound (sound waves), computed tomography (CT) scan (X-rays), magnetic resonance imaging (MRI) scan (magnetic fields), or transient elastography (FibroScan) scan (vibration waves) are examples of these tests.
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Using a needle inserted through your skin, your doctor may take a small sample of your liver tissue to confirm your diagnosis and assess the extent of your liver damage. Under a microscope, the sample is examined for signs of fat accumulation, inflammation, scarring, or cancer.
How is fatty liver treated?
The goal of treatment for fatty liver is to address the underlying cause and prevent further damage to the liver. Treatment options include:
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In order to prevent and treat fatty liver, lifestyle changes are the most important and effective method. Lifestyle changes include:
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If you are overweight or obese, aim for a gradual and sustainable weight loss of 5% to 10% of your body weight over six to 12 months. This will reduce liver fat and improve liver function.
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It is important to eat a diet high in fibre, fruits, vegetables, lean protein, and whole grains, and low in fat, sugar, and salt. Fried foods, pastries, cakes, biscuits, butter, margarine, and fatty meats, all contain saturated and trans fats. Choose foods that contain unsaturated fats, such as olive oil, nuts, seeds, avocados, and oily fish. Avoid alcohol, soft drinks, fruit juices, and energy drinks.
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Exercise regularly for at least 150 minutes a week of moderate-intensity physical activity, such as walking, cycling, swimming, or jogging. You can lose weight, burn calories, lower your blood sugar and cholesterol levels, and improve your blood circulation and liver function by doing this.
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You should quit smoking if you smoke. Smoking increases your risk of developing fatty liver, liver diseases, heart disease, stroke, lung cancer, and other health problems.
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Diabetes, high blood pressure, high cholesterol, and metabolic syndrome may be treated with medications to treat the underlying conditions that contribute to fatty liver. Metformin (a drug that lowers blood sugar levels), statins (drugs that lower cholesterol levels), or drugs that lower blood pressure include angiotensin-converting enzyme inhibitors (ACEs) and angiotensin receptor blockers (ARBs). You can reduce the risk of complications from fatty liver by taking these medications.
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To support your liver's health and function, your doctor may recommend supplements. Inflammation can be reduced with vitamin E (an antioxidant), omega-3 fatty acids (an unsaturated fat that lowers triglycerides and inflammation), milk thistle (an herb that protects liver cells from damage), or probiotics (beneficial bacteria that improve gut health and immunity). It is important to consult your doctor before taking any supplements, as they may interact with your medications or cause side effects. More research is needed to prove their effectiveness.
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People with end-stage liver disease due to fatty liver can consider liver transplantation as a last resort option. An individual replaces their damaged liver with a healthy one from a donor. You will also need to take immunosuppressive drugs for the rest of your life to prevent your body from rejecting your new liver. However, this is a major surgery that carries many risks and complications. In other words, this option is only considered when all other treatments have failed and your life expectancy is less than a year.
How can fatty liver be prevented?
The best way to prevent fatty liver is to adopt a healthy lifestyle that includes:
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Maintaining a healthy weight.
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Eating a balanced diet.
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Exercising regularly.
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Limiting alcohol intake.
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Quitting smoking.
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Managing chronic conditions.
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Avoiding unnecessary medications.
What is the outlook for people with fatty liver?
The outlook for people with fatty liver depends on several factors, such as:
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The type and cause of fatty liver.
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The stage and severity of liver damage.
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The presence of other health conditions or complications.
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The adherence to treatment and lifestyle changes.
When people with fatty liver follow their doctor's advice and make positive lifestyle changes, they usually have a good prognosis. Weight loss, diet modification, exercise, and medication can often reverse or improve fatty liver. However, some people may develop liver damage that leads to cirrhosis or cancer, which has a bad prognosis and may require a liver transplant.
Summary
The condition of fatty liver occurs when too much fat accumulates in the liver cells, and may be caused by a number of factors, including alcohol, obesity, diabetes, high cholesterol, and certain medications. Inflammation and scarring of the liver can occur over time with fatty liver, which can impair liver function and increase the risk of complications such as cirrhosis and cancer. It is possible to diagnose fatty liver through a medical history, a physical examination, blood tests, imaging tests, or a liver biopsy. To treat fatty liver, lifestyle changes are primarily recommended, including weight loss, healthy eating, regular exercise, alcohol restriction, and smoking cessation. Lifestyle changes include weight loss, healthy diet, regular exercise, alcohol limitation, and smoking cessation.
