What is fatty liver disease?
Fatty liver disease (steatosis) is a common condition caused by having too much fat build up in your 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.
Why is fatty liver disease bad?
In most cases, fatty liver disease doesn’t cause any serious problems or prevent your liver from functioning normally. But for 7% to 30% of people with the condition, fatty liver disease gets worse over time. It progresses through three stages:
- Your liver becomes inflamed (swollen), which damages its tissue. This stage is called steatohepatitis.
- Scar tissue forms where your liver is damaged. This process is called fibrosis.
- Extensive scar tissue replaces healthy tissue. At this point, you have cirrhosis of the liver.
Cirrhosis of the liver is a result of severe damage to the liver. The hard scar tissue that replaces healthy liver tissue slows down the liver’s functioning. Eventually, it can block liver function entirely. Cirrhosis can lead to liver failure and liver cancer.
What are the forms of fatty liver disease?
There are two main forms of fatty liver disease:
- Alcohol-induced fatty liver disease is caused by heavy drinking. (Moderate drinking is defined as one drink a day for women and up to two drinks per day for men.) About 5% of people in the U.S. have this form of liver disease.
- Non-alcohol-related fatty liver disease (NAFLD) occurs in people who aren’t heavy drinkers. The condition affects one in three adults and one in 10 children in the United States. Researchers haven’t found the exact cause of non-alcohol-related steatosis. Several factors, such as obesity and diabetes, can increase your risk.
Who gets fatty liver disease?
You have a greater chance of developing steatosis if you:
- Are of Hispanic or Asian descent.
- Have completed menopause (your periods have stopped).
- Have obesity with a high level of belly fat.
- Have high blood pressure, diabetes, or high cholesterol.
- Have obstructive sleep apnea (a blocked airway that causes breathing to stop and start during sleep).
What causes fatty liver disease?
Some people get steatosis without having any pre-existing conditions. But these risk factors make you more likely to develop it:
- Having overweight/obesity.
- Having Type 2 diabetes or insulin resistance.
- Having metabolic syndrome (insulin resistance, high blood pressure, high cholesterol, and high triglyceride levels).
What are the symptoms of fatty liver disease?
People with steatosis often have no symptoms until the disease progresses to cirrhosis of the liver. If you do have symptoms, they may include:
- Abdominal pain or a feeling of fullness in the upper right side of the abdomen (belly).
- Nausea, loss of appetite, or weight loss.
- Yellowish skin and whites of the eyes (jaundice).
- Swollen abdomen and legs (edema).
- Extreme tiredness or mental confusion.
DIAGNOSIS AND TESTS
How is fatty liver disease diagnosed?
Because steatosis often has no symptoms, your doctor may be the first one to spot it. Higher levels of liver enzymes (elevated liver enzymes) that turn up on a blood test for other conditions may raise a red flag. Elevated liver enzymes are a sign your liver is injured. To make a diagnosis, your doctor may order:
- Ultrasound or computed tomography (CT scan) to get a picture of the liver.
- Liver biopsy (tissue sample) to determine how far advanced liver disease has progressed.
- FibroScan, a specialized ultrasound sometimes used instead of a liver biopsy to find out the amount of fat and scar tissue in the liver.
MANAGEMENT AND TREATMENT
How is fatty liver disease treated?
There’s no medication specifically for steatosis. Instead, doctors focus on helping you manage factors that contribute to the condition. They also recommend making lifestyle changes that can significantly improve your health.
- Avoiding alcohol.
- Losing weight.
- Taking medications to manage diabetes, cholesterol, and triglycerides (fat in the blood).
- Taking vitamin E and thiazolidinediones.
How can steatosis be prevented?
The best way to avoid steatosis is to do the things that maintain overall health:
- Stay at a healthy weight. If you have overweight/obesity, lose weight gradually.
- Exercise regularly.
- Limit your alcohol consumption.
- Take medications as prescribed.
OUTLOOK / PROGNOSIS
Can steatosis be reversed?
The liver has an amazing ability to repair itself. If you avoid alcohol or lose weight, it’s possible to reduce liver fat and inflammation and reverse early liver damage.
Will steatosis kill you?
steatosis doesn’t cause major problems for most people. However, it can turn into a more serious problem if it progresses into cirrhosis of the liver. Untreated cirrhosis of the liver eventually leads to liver failure or liver cancer. Your liver is an organ you can’t live without.
What is a good fatty liver diet?
Follow a balanced diet to lose weight slowly but steadily. Rapid weight loss can actually make steatosis worse. Doctors often recommend the Mediterranean diet, which is high in vegetables, fruits, and good fats. Ask your doctor or nutritionist for advice on healthy weight loss techniques.
What questions should I ask my doctor?
- Am I taking any medications that could contribute to fatty liver disease?
- How much damage does my liver have?
- How long will it take to reverse the liver damage?
- What is a healthy weight for me?
- Can I talk to a nutritionist or go to classes to learn about healthy eating?
- How can I get treatment for alcohol use disorder?
Consider steatosis an early warning sign to help you avoid a fatal liver condition, like cirrhosis or liver cancer. Even if you don’t have symptoms or any liver function problems at this point, it’s still important to take steps to stop or reverse fatty liver disease.