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Monday, September 20, 2021

Fatty liver (Steatosis)

By Faozat Aragbaiye

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Fatty liver disease (steatosis) is a common condition caused by having too much fat build up in the liver. A healthy liver contains a small amount of fat. It becomes a problem when fat reaches 5% to 10% of your liver’s weight.
■Types of fatty liver disease
There are two types of fatty liver disease — nonalcoholic fatty liver disease (NAFLD) and alcoholic fatty liver disease.
Nonalcoholic fatty liver disease (NAFLD)
The main form of the disease is NAFLD. Two separate conditions fall under the umbrella of NAFLD: simple fatty liver, or nonalcoholic fatty liver (NAFL), and nonalcoholicsteatohepatitis (NASH).
Simple fatty liver does not typically develop into a more severe medical condition.
NASH :A person who has developed NASH has inflammation and damaged liver cells, as well as fat in the liver. NASH can progress into a more serious condition, such as liver cancer or cirrhosis.
Alcoholic fatty liver disease
People drink alcohol excessively may develop alcoholic fatty liver disease. As the liver breaks down the excess alcohol, it can generate harmful substances. This can result in liver cell damage and inflammation. This is the first stage of alcohol-related liver disease, and if a person stops using alcohol, they may be able to reverse it.
Alcoholic fatty liver disease can develop into alcoholic hepatitis or cirrhosis.
■Causes and risk factors
Eating excess calories causes fat to build up in the liver. When the liver does not process and break down fats as it normally should, too much fat will accumulate. The excess fat is stored in liver cells, where it accumulates and causes fatty liver disease.
People tend to develop fatty liver if they have certain other conditions, such as obesity, diabetes or high triglycerides.
Alcohol abuse, rapid weight loss and malnutrition may also lead to fatty liver. However, some people develop fatty liver even if they have none of the above conditions.
This build-up of fat can be caused by a variety of things. In people who don’t drink a lot of alcohol, the cause of fatty liver disease is less clear.
One or more of the following factors may play a role:
obesity
high blood sugar
insulin resistance
high levels of fat, especially triglycerides, in your blood
Less common causes include:
pregnancy
rapid weight loss
some types of infections, such as hepatitis C
side effects from some types of medications, such as methotrexate (Trexall), tamoxifen (Nolvadex), amiodorone (Pacerone), and valproic acid (Depakote)
exposure to certain toxins
Certain genes may also raise your risk of developing fatty liver.
■Symptoms
Fatty liver disease is being referred to as a silent disease. This is because a person might not experience any symptoms, even as the disease progresses. However, fatty liver disease can enlarge the liver. When this occurs , it may cause pain or discomfort in the upper right side of the abdomen.
Early symptoms can include:
loss of appetite
feeling sick or vomiting
weight loss
tiredness
This occurs when there is fat in the liver, but little or no damage to liver cells.
■Diagnosis
Diagnosing fatty liver, the doctor will do the followings:
Medical history
Physical exam
Blood tests. In many cases, fatty liver disease is diagnosed after blood tests show elevated liver enzymes.
Imaging studies:imaging tests are used to check for excess fat or other problems with the liver. Tests include:
ultrasound exam
CT scan
MRI scan
Vibration-controlled transient elastography (VCTE, FibroScan).
■Treatment
There are currently no medications to treat NAFLD. Depending on the stage of the disease, however, some people can reverse it.
Gradually reducing body weight by at least 7–10% can improve disease activity. However, losing weight too quickly can make NAFLD worse. A healthful way to lose weight gradually is with a balanced diet and regular exercise.
People who have alcoholic fatty liver disease may be able to reverse liver damage and inflammation or prevent it from getting worse by not consuming alcohol. However, this will not reverse cirrhosis.
Some people might find giving up alcohol extremely difficult, but a doctor can advise on how to do so in a safe and supported way.
Making lifestyle changes is essential in treating fatty liver disease.
Lifestyle changes may include:
abstaining from alcohol
eating a balanced diet
doing regular exercise
Eating a balanced diet and more modest portions may help a person maintain a moderate weight.
Foods that may help prevent the development of NAFLD include garlic, coffee, leeks, asparagus, and probiotics. Eat whole grains a wide range of fruits and vegetables.
Avoid foods that are high in saturated fats, refined carbohydrates, or sugar.
According to researchersTrusted Source, simple sugars, red meat, processed food, and foods that are low in fiber may lead to the development of NAFLD.
■Keeping your liver healthy
For people diagnosed with fatty liver disease, it is important to keep the liver as healthy as possible and avoid anything that can damage the liver further. Here are some important things to do:
Don’t drink too much alcohol. How much is too much remains controversial, but it’s probably best to avoid alcohol completely.
Make sure that none of the medications, herbs, and supplements are toxic to the liver; crosscheck the list with this LiverTox Even acetaminophen (the generic ingredient in Tylenol and some cold medicines) may be harmful if it’s taken for too long, especially for those that have liver disease or drink alcohol heavily.
Get vaccinated to protect against liver viruses hepatitis A and B.
Control other health conditions that might also affect the liver, and check with the doctor if there are underlying, treatable diseases contributing to your fatty liver.
Get regular screening tests for liver cancer if cirrhosis of the liver is diagnosed.

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