Know About Fatty Liver

Fatty liver is the accumulation of triglycerides and other fats in the liver cells. The amount of fatty acid in the liver depends on the balance between the processes of delivery and removal. While it is normal to have some fat in your liver, more than 5 to 10 percent of your liver weight is fat in the case of fatty liver.

In some patients, the excess fat can cause inflammation called steatohepatitis (steato=fat+hepar=liver +itis=inflammation), although there is no relationship between the amount of fat present and the potential for inflammation. Steatohepatitis can lead to cirrhosis (fibrosis, scarring and hardening of the liver). There is also an association with liver cancer (hepatocellular carcinoma).
Type of Fatty liver:
1. Alcoholic: Alcohol is a direct toxin to the liver and can cause inflammation.
2. Non-Alcoholic: Nonalcoholic fatty liver disease (NAFLD) and nonalcoholic related steatohepatitis (NASH) are markedly different illnesses and there are many potential causes that are linked to fat accumulation in the liver.

Some of the causes of Fatty liver include:
Diet: Consumption of excess calories in the diet
Diseases: Fatty liver is also associated with type II diabetes, obesity, and high triglyceride levels in the blood, celiac disease, and Wilson's disease.
Medical conditions: Rapid weight loss and malnutrition.
Medications: Medications such as tamoxifen (Soltamox), amiodarone injection (Nestorone), amiodarone oral (Cordarone, Pacerone), and methotrexate (Rheumatrex Dose Pack, Trexall)


Symptoms of Fatty liver:
It often has no symptoms and typically does not cause permanent damage.  You may experience fatigue or vague abdominal discomfort. Your liver may become slightly enlarged, and your doctor can detect this during a physical exam. Excess fat can cause liver inflammation. If your liver becomes inflamed you may have a poor appetite, weight loss, abdominal pain, weakness and confusion.

If steatohepatitis progresses to cirrhosis, symptoms of liver failure may develop. Symptoms of liver failure include:
- jaundice (because of the accumulation of bilirubin),
- ascites and edema (swelling of the body) due of decreased protein production by the liver,
- increased bruising, and
- associated mental confusion.

Diagnosis of Fatty liver:
Physical Exam and Medical History:
When concern exists for the presence of fatty liver disease, the health care practitioner will try to find the underlying cause and risk factors. Physical examination may reveal an enlarged liver that can be palpated or felt in the abdomen below the right rib margin. Otherwise, it may require the development of cirrhosis to elicit abnormalities on physical examination. These may initially include jaundice or a yellowish tinge to the skin and eyes, muscle wasting, hair thinning, abnormal skin blood vessels called spider angiomata, and splenomegaly (enlarged spleen).

Blood Tests
Blood tests may be helpful as screening tests for liver inflammation. Liver function studies such as serum transaminases  (AST, ALT),  alkaline phosphatase, bilirubin , Serum ferritin, cholesterol levels including triglycerides are often elevated.

Imaging Studies
Ultrasound of the liver can reveal patterns suggestive of fatty infiltration of the liver. CT Scan ANd MRI are also useful in the evaluation of fatty liver.

Liver Biopsy
The definitive diagnosis of fatty liver disease can only be confirmed by liver biopsy.

Treatment of fatty liver

There is no medication or surgery to treat fatty liver. Instead, doctors will offer recommendations to reduce your risk factors. These recommendations include limiting or avoiding alcoholic beverages, managing your cholesterol, losing weight and controlling your blood sugar.

If you have fatty liver because of obesity or unhealthy eating habits, doctors may also suggest that you increase physical activity and eliminate certain types of food from your diet. Choose healthier foods like fresh fruits, vegetables, and whole grains. Replace red meats with lean animal proteins like chicken and fish. In patients who are morbidity obese, bariatric surgery to promote weight loss is very effective in decreasing liver inflammation and NASH.

Protecting your liver is one of the best ways to prevent fatty liver. You should avoid drinking alcoholic beverages. Follow your doctor’s instructions and take medications for diabetes or high cholesterol as directed. Additionally, aim for at least 30 minutes of exercise most days of the week to maintain a healthy weight.

Patients with fatty liver disease should be seen routinely in follow-up visits to their health care practitioner in order to monitor their liver function and progression to more serious liver abnormalities. Since weight loss, diet, and physical activity are the most important tools in minimizing the risk of fatty liver disease, and are the most effective treatments, consultations with a dietician and a physical trainer may be appropriate.