The liver is the second largest organ in the body. It is responsible for a wide variety of functions, including processing everything we eat and drink, and filtering harmful substances from the blood.
Non alcoholic fatty liver disease is an umbrella term for a range of liver conditions affecting people who are non alcoholic. Fatty liver or Hepatic steatosis is the deposition of fat globules in the liver cells. Fat is present in a normal liver, but too much can be a health problem.
Incidence of non alcoholic fatty liver is on the rise due to poor lifestyle choices across the world and is now the most common chronic liver disease.
There are four stages of non alcoholic fatty liver disease-
- Simple fatty liver or steatosis
- Non-alcoholic steatohepatitis (NASH)
Nonalcoholic steatohepatitis, a potentially serious form of the disease, and 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. In severe conditions, nonalcoholic steatohepatitis can progress to cirrhosis and liver failure.
Causes of fatty liver disease
The exact cause of why excess fat gets deposited in the liver cells is not known.
Similarly, there is limited understanding of why some fatty livers develop inflammation that progresses to cirrhosis.
The most common causes are-
- hyperlipidemia, or high levels of triglycerides in blood
- High sugar diet
- Low physical activity
- Metabolic disorders
These health issue causes excess deposition of fat into the liver cells.In some cases this excess deposition of fat can lead to inflammation and scar tissue known as Non alcoholic steatohepatitis.
Who are at risk?
Factors that may increase the risk of Non alcoholic fatty liver disease are-
- Being overweight/obese
- Metabolic syndromes
- Consuming more than the recommended doses of certain over-the-counter medications, such as acetaminophen
- High cholesterol/high fat diet
- Type 2 diabetes
- Polycystic ovarian disease
- Sleep apnoea
Nonalcoholic steatohepatitis is more likely in these groups:
- Older people
- Type II diabetes
- People with high abdominal fat
Symptoms of Non alcoholic fatty liver disease
Non alcoholic fatty liver disease is not associated with the symptoms but with excess fat deposition in your liver.
In Non alcoholic steatohepatitis, Liver becomes inflamed due to advanced disease and excess deposition of fat, you may have
- weight loss
- abdominal pain
- physical weakness
- Poor appetite
- Abdominal swelling (ascites)
- Enlarged blood vessels just beneath the skin’s surface
- Enlarged spleen
- Red palms
- Yellowing of the skin and eyes (jaundice)
It can further advance to cirrhosis and liver failure.
How is Non alcoholic fatty liver disease diagnosed?
Because nonalcoholic fatty liver disease causes no symptoms in most cases, it frequently comes to medical attention when tests done for other reasons point to a liver problem.
Your doctor will order some tests and will perform a physical examination.He may be able to detect it by examining your abdomen for an enlarged liver. However, your liver can be inflamed without being enlarged. Let your doctor know, if you have been experiencing fatigue,abdominal pain or loss of appetite. Also, tell your doctor about history of any other illness.
Your doctor will order-
Blood tests-In some cases, liver enzymes are higher than normal during a routine blood test. This doesn’t confirm a diagnosis of fatty liver, but it does relate to liver inflammation. Further analysis is necessary to find the cause of the inflammation.
Imaging-Ultrasound abdomen may be able to detect fat in your liver and liver enlargement if any.
Imaging studies can detect fat in the liver, but extent of damage cannot be confirmed.
Liver biopsy-It is needed in the advanced stages when there is liver enlargement and inflammation.
The first line recommendations for the treatment of Non alcoholic fatty liver disease is reduction of risk factors.Ideally, a loss of 7-10 percent of body weight is desirable, but improvement in risk factors can become apparent if you lose even three to five percent of your starting weight.
The lifestyle changes recommended are-
- managing your cholesterol and reducing the intake of saturated fats
- losing weight
- controlling your blood sugar
- Increase in physical activity
- Choose a balanced diet with healthier foods like fresh fruits, green leafy vegetables, whole grains, and healthy fats like those in nuts,fish and avocados. Try to replace red meat with lean proteins such as chicken and fish. Avoid sugary drinks, juices, and sodas.
- You may be advised to get vaccination for hepatitis A and B to help protect you from viruses that may cause further liver damage.
For those who have cirrhosis due to nonalcoholic steatohepatitis, liver transplantation may be an option.
Most cases of non alcoholic fatty liver disease do not progress further as liver repairs itself if you take the necessary steps and reduce the risk.
So, following a better lifestyle and being active is the key to protect your liver from non alcoholic fatty liver disease and its complications. A step by step change in your lifestyle will keep your liver healthy and free from disease.
-Dr Prerna gaur