Fatty liver is a reversible condition caused by the accumulation of fats in and around the liver cells or hepatic cells. Fatty liver is also known as steatosis. Fatty infiltration of the liver is due to faulty fat metabolism of the liver and mobilization of fatty acids that can lead to inflammation called steatohepatitis. Fatty livery is commonly linked to metabolic syndrome or alcohol.
The causes of fatty liver include the following:
- Diabetes mellitus (type 2)
- Elevated triglyceride (lipid) levels (hyperlipidemia)
- Too much alcohol intake
- Malnutrion (Protein-calorie malnutrition)
- Long-term medication: e.g. prednisolon, amiodarone, methotrexate, tamoxifen
- Metabolic syndrome - when there is the occurrence of hypertension, diabetes, dyslipidemia and obesity
- Hepatitis C
- Inflammatory Bowel Disease
- Jejuno-ileal bypass
- TPN (total parenteral nutrition)
- Metabolic diseases: e.g. Wilson's disease, Abetalipoproteinaemia, Weber-Christian disease, Homocystinuria, Glycogen storage disorders
Many people with fatty liver are asymptomatic. The following are the symptoms of fatty liver:
- Abdominal discomfort or pain - right upper quadrant of the abdomen
- Body malaise
- Black or dark stool
- Disorientation, poor memory or confusion
- Pruritus (itchy skin)
- Easily bruised
- Vomiting blood
Initially the doctor will ask questions regarding medications, medical history and alcohol consumption. Next is a complete physical examination to assess the body for any abnormalities, especially the abdomen. Also, there are different tests or methods in diagnosing fatty liver such as:
- Complete blood count - the most common and typical finding is asymptomatic elevation of the Alanine Aminotransferase (ALT) and Aspartate Aminotransferase (AST).
- Percutaneous biopsy or Liver biopsy - The definitive test in confirming the diagnosis of fatty liver disease. The procedure is performed by inserting a fine needle into the abdomen where the liver is located and extracting a small tissue for analysis.
- Magnetic resonance imaging (MRI scan), Computerized tomography (CT scan) and ultrasound - can be used to confirm excessive fat in the liver.
Fatty liver can be treated since it is a reversible disease. The treatments for fatty liver are aimed at removing the underlying cause of infiltration. This includes, but not limited to, weight loss, glucose control, no alcohol intake, following a healthy diet, and improving cholesterol and triglyceride levels. Bariatric surgery may be done to help with weight loss.
The prognosis for people with fatty liver will depend on the extent of the disease. Fatty liver is treatable and the progression of the complication is preventable.
People living with fatty liver should have a routine visit to the doctor and closely monitor the liver function for any complications. The condition is treatable as long as you avoid drinking alcohol, maintain a healthy weight, eat a balanced diet, and exercise.
Researchers discovered that Vitamin E helps improve the liver function in people with advanced fatty liver disease .There were several studies conducted in patients with steatosis-related liver injury who were given Vitamin E. The results showed a remarkable development in their liver function. The researchers believed that Vitamin E can alter the fat metabolism that slows the occurrence of fatty liver disease, especially Alpha-tocopherol (fat soluble vitamin E), which disrupts the lipid preoxidation response that generates free radicals from deprivation of fatty molecules.