Fatty liver disease — The Downey Patriot
Did you know that the liver is the second largest organ in our body? As blood leaves our stomach and intestines, it passes through the liver. The liver processes this blood; breaks it down, balances it, creates nutrients, and metabolizes drugs into more usable forms. Fatty liver disease occurs when fat builds up in the liver. It is also known as fatty liver and is a common condition. What should you know about fatty liver disease?
It is normal for the liver to contain fat, but too much leads to inflammation, which can cause damage and scarring. In severe cases, this scarring can lead to liver failure. Fatty liver disease in those who drink a lot of alcohol is called alcoholic fatty liver disease (AFLD), and in others it is called non-alcoholic fatty liver disease (NAFLD).
NAFLD is the most common chronic liver disease here in the United States. About 55% to 75% of obese people probably have some degree of NAFLD. Perhaps 20% of people with AFLD will progress to cirrhosis, and they account for about 50% of cirrhosis deaths worldwide. For people with NAFLD, perhaps 5-12% progress to cirrhosis. Fatty liver disease is the most common cause of liver transplantation.
NAFLD and AFLD have four typical stages:
· Stage 1: Simple fatty liver. There is an accumulation of excess fat. Simple fatty liver disease is usually not harmful if it does not progress. For many, there are no symptoms.
Stage 2: Steatohepatitis. In addition to excess fat, there is inflammation.
Stage 3: Fibrosis. Persistent inflammation leads to scarring. However, the liver can still function normally.
Stage 4: Cirrhosis. The scarring has become widespread, impairing the ability of the liver to function. This is the most serious phase, potentially fatal and irreversible.
Cirrhosis has a number of really terrible symptoms, including abdominal pain, loss of appetite, weight loss, weakness, nausea, itchy skin, yellowing of the skin and eyes (jaundice), easy bruising or bleeding, dark-colored urine, pale stools, fluid accumulation in the abdomen, swelling of the legs, clumps of blood vessels under the skin, breast enlargement, and even confusion. And, of course, it can lead to liver failure. In addition, steatohepatitis and cirrhosis are risk factors for hepatocellular carcinoma, the most common form of liver cancer.
The cause of AFLD is simple: drinking too much alcohol. Alcohol can impair certain metabolic processes in the liver, and when the products combine with fatty acids, there is an excessive accumulation of fat. The Centers for Disease Control and Prevention define heavy drinking as 15 or more drinks per week for men and eight or more drinks per week for women.
Causes of NAFLD include obesity, type 2 diabetes, and high cholesterol, as well as pregnancy, certain medications, hepatitis C, and some rare genetic diseases.
The diagnosis of fatty liver disease is usually made when blood tests show elevated liver enzymes, which indicates inflammation. It appears on ultrasound, CT or MRI. A liver biopsy will indicate its severity.
If you are diagnosed with this condition, even if you are not yet experiencing symptoms or liver function problems, it is essential to take steps to stop or reverse it. There is no medicine to treat fatty liver disease. However, in most cases, lifestyle changes can manage it and even reverse the damage. The key steps are to quit drinking alcohol, lose weight, change your diet, exercise, and avoid drugs or supplements that are harsh on the liver.
I encourage you to consider a diagnosis of fatty liver disease as an early warning sign. Use this advice to avoid life-threatening cirrhosis or liver cancer. As always, talk to your doctor and work out a plan together.
Dr. Alan Frischer is former chief of staff and former chief of medicine at Downey Regional Medical Center. Write to him care of this journal at 8301 E. Florence Ave., Suite 100, Downey, CA 90240.