All about fatty liver disease

Dr Maxwell Adeyemi

FATTY LIVER disease is a common condition caused by the storage of extra fat in the liver. Most people have no symptoms and it does not cause serious problems for them. In some cases, though, it can lead to liver damage. The good news is you can often prevent or even reverse fatty liver disease with lifestyle changes.

The liver is an essential organ with multiple life-supporting functions:

* Produces bile, which helps with digestion

* Makes proteins for the body

* Stores iron

* Converts nutrients into energy

* Creates substances that help your blood clot (stick together to heal wounds)

* Helps you resist infections by making immune factors and removing bacteria and toxins (substances that can harm your body) from your blood

Fatty liver disease (steatosis) is a common condition caused by having too much fat build up in your liver. A healthy liver contains a small amount of fat. It becomes a problem when fat reaches five per cent to ten per cent of your liver’s weight.

In most cases, fatty liver disease doesn’t cause any serious problems or prevent your liver from functioning normally. But for seven per cent to 30 per cent of people with the condition, fatty liver disease gets worse over time. It progresses through three stages:

1. The liver becomes inflamed (swollen), which damages its tissue. This stage is called steatohepatitis.

2. Scar tissue forms where the liver is damaged. This process is called fibrosis.

3. Extensive scar tissue replaces healthy tissue. At this point there is cirrhosis of the liver.

Cirrhosis of the liver

Cirrhosis of the liver is a result of severe damage to the liver. The hard scar tissue that replaces healthy liver tissue slows down the liver’s functioning. Eventually, it can block liver function entirely. Cirrhosis can lead to liver failure and liver cancer.

Types of fatty liver disease

There are two main forms of fatty liver disease:

Alcohol-induced fatty liver disease

Alcohol-induced fatty liver disease is caused by regular alcohol consumption. About five per cent of people with fatty liver have this form of liver disease.

Non-alcohol-related fatty liver disease

Non-alcohol-related fatty liver disease (NAFLD) isn't related to alcohol consumption. Researchers have not found the exact cause of non-alcohol-related fatty liver disease. Several factors, such as obesity and diabetes, can increase your risk.

Risk factors

You have a greater chance of developing fatty liver disease if you:

* Are of Hispanic or Asian descent

* Have completed menopause (your periods have stopped)

* Have obesity with a high level of belly fat

* Have high blood pressure, diabetes or high cholesterol

* Have obstructive sleep apnea (a blocked airway that causes breathing to stop and start during sleep)

Causes of fatty liver disease

Some people get fatty liver disease without having any pre-existing conditions. But these risk factors make you more likely to develop it:

* Being overweight or obese

* Having Type 2 diabetes or insulin resistance

* Having metabolic syndrome (insulin resistance, high blood pressure, high cholesterol and high triglyceride levels)

* Taking certain prescription medications, such as amiodarone, diltiazem, tamoxifen or steroids

Symptoms of fatty liver disease

People with fatty liver disease often have no symptoms until the disease progresses to cirrhosis of the liver. Symptoms may include:

* Abdominal pain or a feeling of fullness in the upper right side of the abdomen (belly)

* Nausea, loss of appetite or weight loss

* Yellowish skin and whites of the eyes (jaundice)

* Swollen abdomen and legs (edema)

* Extreme tiredness or mental confusion

* Weakness

Diagnosis

Because fatty liver disease often has no symptoms, the doctor may be the first one to spot it. Higher levels of liver enzymes (elevated liver enzymes) that turn up in a blood test for other conditions may raise a red flag. Elevated liver enzymes are a sign your liver is injured.

To make a diagnosis, other tests that may be ordered include:

* Ultrasound or computed tomography (CT scan) to get a picture of the liver

* Liver biopsy (tissue sample) to determine how far advanced liver disease has progressed

* Fibro Scan, a specialised ultrasound sometimes used instead of a liver biopsy to find out the amount of fat and scar tissue in the liver

Treatment

There’s no medication specifically for fatty liver disease. Instead, doctors focus on helping you manage factors that contribute to the condition. They also recommend making lifestyle changes that can significantly improve your health. Treatment includes:

* Avoiding alcohol

* Losing weight

* Taking medications to manage diabetes, cholesterol and triglycerides

* Taking vitamin E

Preventing fatty liver disease

The best way to avoid fatty liver disease is to do the things that maintain overall health:

* Stay at a healthy weight. If you are overweight/obese, lose weight gradually

* Exercise regularly

* Limit your alcohol consumption

* Take medications as prescribed

The liver has an amazing ability to repair itself. If you avoid alcohol or lose weight, it’s possible to reduce liver fat and inflammation and reverse early liver damage.

Fatty liver disease doesn’t cause major problems for most people. However, it can turn into a more serious problem if it progresses into cirrhosis of the liver. Untreated cirrhosis of the liver eventually leads to liver failure or liver cancer.

Dietary adjustment

Follow a balanced diet to lose weight slowly but steadily. Rapid weight loss can actually make fatty liver disease worse. The Mediterranean diet is highly recommended, which is high in vegetables, fruits and good fats. A nutritionist's advice on healthy weight loss techniques will also be beneficial.

Ginger supplementation exerted an important beneficial effect on liver function and insulin resistance for non-alcoholic fatty liver disease.

The fundamental role of insulin resistance is found in fat accumulation of liver, and the increase in insulin sensitivity is very promising against non-alcoholic fatty liver disease.

The beneficial effect of ginger supplementation on non-alcoholic fatty liver disease is because ginger has substantial ability to improve insulin sensitivity to body fat and transformation of cholesterol to bile acids.

Garlic powder may potentially lead to significant reductions in LDL (bad) cholesterol, triglyceride levels, and the severity of liver fat accumulation. These nutritional adjustments or additions, with other interventions like weight loss and physical activity, can result in significant improvement in liver function.

Contact Dr Maxwell on 3631807 or 7575411