Fatty Liver Disease: Nonalcoholic, Alcoholic Symptoms and Treatment

Fatty liver disease is more common than you might realize.

Fatty Liver Disease Is Common

When excess fat is stored in the liver, it may lead to fatty liver disease. This condition impairs the liver's ability to function. It is reversible in the early stages. However, if it progresses to cirrhosis, which is scarring of the liver, it is not reversible.

Fatty liver disease is very common and it affects approximately 1 out of 4 people. Many people who have fatty liver disease do not know they have the condition. There are two kinds of fatty liver disease: nonalcoholic fatty liver disease and alcoholic fatty liver disease.

Accumulation of fat in the liver may lead to fatty liver disease and may compromise liver function.

What Is Fatty Liver Disease?

Fatty liver disease is an abnormal accumulation of fat in the liver that may compromise the liver's ability to function. There are two types of fatty liver disease. One is associated with alcohol use (alcoholic fatty liver disease) and one is not (nonalcoholic fatty liver disease). Another name for alcoholic fatty liver disease is alcoholic steatohepatitis. Accumulation of excess fat in the liver may hinder the liver's ability to filter out toxins. This, in turn, may make people feel sick.

Fatty liver disease nonalcoholic is the more common form and may lead to cirrhosis.

Nonalcoholic Fatty Liver Disease

Nonalcoholic fatty liver disease (NAFLD) usually does not cause any symptoms. Most people do not know that they have it. But if the condition worsens it damages the liver from inflammation and may lead to scarring (cirrhosis). This is known as nonalcoholic steatohepatitis (NASH). People who suffer from diabetes or who are overweight or obese are more likely to suffer from NASH.

People who are overweight or obese or who have high blood pressure are more likely to get NAFLD.

Who Gets NAFLD?

Certain conditions increase the risk of NAFLD. People who are overweight or obese are more likely to get it than those who are normal weight. In one study, 90 percent of those undergoing bariatric surgery had NAFLD. High blood pressure and type 2 diabetes increase the risk of NAFLD. Even children can develop NAFLD. Approximately 10 percent of kids in the U.S. have the condition.

Ethnicity is related to risk as well. NAFLD is more common in people who are Hispanic and Caucasian and it is less common in people who are African American. People who are Asian American are more likely to develop NAFLD compared to those of other ethnicities when they are at a normal weight.

Women who are overweight or obese and drink heavily are at increased risk of alcoholic fatty liver disease.

Alcoholic Fatty Liver Disease

Alcoholic fatty liver disease occurs in long-term heavy drinkers. People who are obese, female, and those who have certain gene mutations are more likely to get it, too. The disease may be silent and not cause any symptoms. Others may experience fatigue or abdominal discomfort in the area of the liver. People who have the condition and continue drinking increase their risk of future cirrhosis, alcoholic hepatitis, liver failure and liver cancer.

Fatty liver disease symptoms may include abdominal pain, pressure, fatigue, and weight loss.

Fatty Liver Symptoms

Many people who suffer from fatty liver do not know they have it because they don't experience any symptoms. When people do experience symptoms, they may include loss of appetite, weight loss, abdominal fullness, abdominal pain, fatigue, confusion, weakness, and nausea. Signs of fatty liver that may be apparent to others include a yellowing of the skin and eyes (jaundice) and swelling of the legs and abdomen (edema).

The doctor may use ultrasound and other tests in order to diagnose fatty liver.

Diagnosis of Fatty Liver

Fatty liver disease may be hard to diagnose because many people do not have any symptoms. Tests the doctor may order if they suspect a patient has fatty liver include blood tests to monitor for elevated liver enzymes, ultrasound, and computed tomography (CT) scan. Elastography is a test that helps assess the level of fat and scarring in the liver. In some cases, the doctor may want to take a sample of liver tissue (liver biopsy) to diagnose fatty liver disease.

Fatty liver disease treatment may involve diet and lifestyle changes.

Fatty Liver Treatment

There's a lot patients can do with diet and lifestyle changes to treat a fatty liver. Losing weight if they are overweight or obese may help the liver. Losing as little as 1 to 2 pounds can help. The doctor can also prescribe certain medications to treat inflammation and help keep blood sugar under control, if patients need them.

A fatty liver disease diet helps promote weight loss.

Weight Loss

Fatty liver that is not related to alcohol use is mainly caused by obesity. The doctor will recommend weight loss for patients with fatty liver who are overweight or obese. Even losing as little as 1 to 2 pounds can help. Depending on a patient's weight, weight loss of approximately 10 percent is desirable. The doctor or nutritionist can recommend the best fatty liver disease diet. Those who are very obese may need weight loss surgery, which can help fatty liver as well.

Moderate exercise can help decrease the amount of fat in your liver.

Exercise

Patients may be able to treat and reverse fatty liver with the help of diet and lifestyle changes, including weight loss. Exercising for at least 30 minutes for five days a week can help people lose weight. Even moderate activities like walking at a brisk pace count towards this goal. People who have not exercised in a while or who are starting to exercise for the first time should get their doctor's okay first.

One way to manage alcoholic fatty liver is to refrain from drinking alcohol.

Avoid Alcohol

People who suffer from fatty liver disease from alcohol should not drink alcohol. This may be easier said than done. In 2018, almost 15 million people in the U.S. suffered from an alcohol use disorder. They may drink to excess and feel as if they have no control over how much they drink. And this excess alcohol consumption may lead to fatty liver disease.

Can fatty liver be reversed? The answer is yes, especially if the disease process is diagnosed early. Avoiding alcohol is part of the recovery process. Patients with fatty liver who suspect they have an alcohol abuse problem should talk to their doctors. There are treatments that can help. .

Attend to medical conditions like diabetes and high cholesterol to help fatty liver.

Go to Checkups

Fatty liver may increase the risk of type 2 diabetes. Having both conditions can make fatty liver worse if type 2 diabetes is not well controlled. Patients who have type 2 diabetes should make sure it is well controlled. People with fatty liver should keep blood lipids, like triglycerides and so-called “bad” LDL cholesterol, in check. Controlling high blood pressure and losing weight also helps take strain off of the liver. They should also avoid drinking alcohol.

People with fatty liver should attend regular doctor checkups to stay on top of their health. The doctor may order an ultrasound to monitor a patient's liver along with regular blood tests to monitor liver function.

Doctors may recommend that patients with fatty liver receive several vaccines to help protect the liver.

Protect the Liver

People who suffer from fatty liver disease can potentially develop a more serious condition if they become ill with hepatitis A, hepatitis B, pneumonia, or the flu. That's why it is important to receive vaccinations against these diseases to decrease the risk of other potential complications.

The liver filters everything we eat, drink, and take; this includes herbs, vitamins, supplements, and medications (over-the-counter and prescription drugs). Patients who suffer from fatty liver or other condition that compromises liver function should talk to their doctors about everything they take. Patients may need to stop taking certain substances or switch to different medications that do not harm the liver.

The best treatment for fatty liver disease is prevention.

Prevent Fatty Liver

Prevention is the name of the game when it comes to fatty liver disease. Ask the doctor about the best diets for fatty liver disease prevention. Keep weight down by eating a sensible diet and exercising regularly, with the doctor's knowledge and permission, of course. Avoid or limit alcohol intake. Review all over-the-counter medications, prescription medications, supplements, vitamins, and herbs with the doctor to make sure they aren't harming the liver. Living a healthy lifestyle keeps weight, blood pressure, blood lipids, stress, diabetes, and heart disease risk low. It's also good for the liver.

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REFERENCES:

  • Harvard Health Publishing: “Fatty Liver Disease: What It Is and What to Do About It.”
  • Gastroenterology & Hepatology: “Vaccinating Patients with Chronic Liver Disease.”
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  • National Institute of Diabetes and Digestive and Kidney Diseases: "Definition & Facts of NAFLD & NASH," "Treatment for NAFLD & NASH," "Diabetes, Heart Disease, and Stroke."
  • American Diabetes Association: "Statistics About Diabetes."
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  • Mayo Clinic: “Diabetes: How Do I Help Protect My Liver?” "Nonalcoholic fatty liver disease."
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