what-is-fatty-liver-and-are-you-at-risk-

WELLNESS / What is Fatty Liver and Are You at Risk?

What is Fatty Liver and Are You at Risk?

Fatty liver disease is an increasingly common health concern across the globe. The liver, located on the upper-right side of the abdomen, plays a crucial role in processing nutrients, removing toxins, and filtering blood. When this vital organ begins to store excessive fat, it can lead to a range of health complications.

What is Fatty Liver?
Fatty liver, or hepatic steatosis, is characterized by excess fat accumulation in liver cells [more than 5 % of liver weight]. Fat build-up can impede liver function and may be associated with various factors.

Types of Fatty Liver Disease
There are two types of fatty liver disease, including:
1. Alcoholic Fatty Liver Disease: It is the result of excessive drinking of alcohol. Your liver breaks down most of the alcohol that you drink, but in the process, it gets damaged. The more alcohol you drink, the more damaged your liver becomes. It is the earliest stage of other alcohol-related liver diseases.

2. Non-Alcoholic Fatty Liver Disease: It is not related to alcohol. A person is said to have non-alcoholic fatty liver disease if 5 % or more of their liver's weight is fat. It is most common in obese middle-aged people and diabetics.

Fatty Liver Disease Symptoms
Both alcoholic and non-alcoholic fatty liver diseases are often asymptomatic, meaning they typically do not show noticeable symptoms. Occasionally reported symptoms include mild discomfort in the upper right abdomen and fatigue. Due to the lack of prominent symptoms, diagnosing fatty liver disease can be challenging.

Fatty Liver Disease Causes And Risk Factors
Fatty liver disease can arise from various causes and is influenced by several risk factors, including:

- Obesity: Being overweight or obese, especially with central fat distribution, increases the risk of developing non-alcoholic fatty liver disease (NAFLD).
- Insulin resistance: Insulin resistance, often associated with conditions like type-2 diabetes, contributes to fat accumulation in the liver.
- High blood sugar: Elevated levels of blood sugar, as seen in diabetes, are linked to an increased risk of fatty liver disease.
- High levels of fat in the blood: Conditions such as high triglycerides or dyslipidemia can contribute to fat accumulation in the liver.
- Rapid weight loss: Quick and significant weight loss, as seen in certain medical conditions or crash diets, may lead to fatty liver disease.
- Certain medications: Some medications, such as corticosteroids, tamoxifen, and certain anti-retroviral drugs, may contribute to liver fat accumulation.
- Genetics: Genetic factors can play a role in the development of fatty liver disease.
- Poor diet: Diets high in refined carbohydrates and sugars, as well as low in essential nutrients, can contribute to fat build-up in the liver.
- Metabolic syndrome: Conditions associated with metabolic syndrome, including high blood pressure and abnormal cholesterol levels, are linked to an increased risk.

Fatty Liver Diagnosis
Fatty liver disease is diagnosed through a combination of medical history review, physical examination, blood tests, imaging studies, and sometimes, liver biopsy.

Medical History And Questions
In diagnosing fatty liver, your liver doctor initiates the process by obtaining the individual's medical history, performing a physical examination, and prescribing relevant tests. If there is suspicion of fatty liver, the patient may be queried about their family's medical history, encompassing any instances of liver disease, alcohol consumption, lifestyle habits, existing medical conditions, medications, and recent health changes. Any unexplained symptoms like fatigue or loss of appetite should be communicated.

Physical Examination
Physicians may conduct palpation on the patient's abdomen to assess enlargement of liver. However, it's crucial to note that liver inflammation can exist without observable enlargement, rendering a standalone physical examination insufficient.

Blood Tests
Diagnosis of fatty liver often follows blood tests indicating elevated liver enzymes. Tests such as alanine aminotransferase (ALT) and aspartate aminotransferase (AST) are commonly ordered to assess liver enzymes. High levels suggest inflammation, with fatty liver disease being a potential cause among others. In alcoholic fatty liver, the Gamma-Glutamyl Transferase (GGT) is typically raised, and AST is more than ALT values. Positive results will prompt further tests to pinpoint the specific cause of inflammation.

Imaging Studies
Various imaging tests, including ultrasound exams, CT scans, and MRI scans, may be employed to identify excess fat or other liver issues. Vibration-controlled transient elastography (VCTE or FibroScan) is another diagnostic tool utilising sound waves to measure liver stiffness, aiding in the detection of scarring.

Liver Biopsy
The most accurate method for assessing liver disease severity is a liver biopsy, which involves extracting tissue from the liver for examination using a needle insertion. Local anaesthesia is administered to minimise discomfort. This procedure is sometimes used in determining the presence of fatty liver disease and evaluating the extent of liver scarring.

Fatty Liver Treatment
Treatment for fatty liver disease primarily focuses on addressing its underlying causes and risk factors, as there are no specific medications approved solely for this condition. Here's a general approach to fatty liver disease treatments.

Lifestyle Modifications
- Weight loss: For overweight or obese individuals, reducing body weight through diet and exercise is the most effective way to decrease fat in the liver. A weight loss of 5-10% of body weight can significantly reduce liver fat.
- Healthy diet: Adopting a balanced diet rich in fruits, vegetables, whole grains, and lean proteins. It's advised to reduce the intake of saturated fats, trans fats, refined carbohydrates, and sugars.
- Regular exercise: Regular physical activity helps burn triglycerides and reduce liver fat. Aim for at least 150 minutes of moderate-intensity aerobic exercise per week.
Management Of Underlying Conditions
- Controlling diabetes: Effective management of blood sugar levels through medication and lifestyle changes.
Reducing cholesterol and triglycerides: Medications, dietary adjustments, and physical activity can help manage abnormal lipid levels.
- Avoiding alcohol: Reducing or eliminating alcohol consumption is crucial, especially in alcoholic fatty liver disease.
- Regular Monitoring: Regular follow-ups with healthcare providers to monitor liver function and the progression of the disease.

Advanced Treatments
In severe cases, such as when liver cirrhosis develops the patient should be seen by a liver specialist (Hepatologist) who can guide further in the management of such advanced cases.
Sometimes, advanced cirrhosis can lead to liver cancer and liver failure, where liver transplantation is the only definitive treatment.

Fatty liver disease can be tricky to handle because it comes in different forms and can be caused by various factors. Getting the proper treatment is important.