Fatty Liver

What is Fatty Liver?

Fatty liver is a medical condition characterised by the accumulation of excess fat in the liver cells.

About 1 in 3 of the world population is suffering from fatty liver and most of the people with diabetes have this condition.

Irrespective of the consumption of alcohol, people can develop fatty liver. They are called alcoholic fatty liver and non-alcoholic fatty liver.

There are 4 grades in fatty liver, the final being cirrhosis. Around 10% of all the people with fatty liver and 20% of the people with both diabetes and fatty liver can progress to cirrhosis.

Fatty liver may progress to liver cancer in a minority. At the same time, the risk of people with fatty liver having cardiovascular diseases is also high, so that, most of the time the causes of death for these people are cardiovascular diseases like heart attacks.

There is no medication to reverse the condition once it has progressed to cirrhosis but can be fully controlled or reversed if treated before it progresses to cirrhosis. Hence, early detection and management are extremely important to stop the progression of fatty liver to cirrhosis.

What are the causes and risk factors of Fatty Liver?

1. Unsafe alcohol consumption (Males consuming alcohol > 14 units/week and females consuming alcohol > 7 units/week)
2. Diabetes
3. Sedentary lifestyle
4. High fructose, fatty, and refined diet
5. Family history

What are the symptoms of Fatty Liver?

• Fatty liver can last for a longer time without showing any symptoms. It is a dreadful risk as people can go unnoticed until they develop cirrhosis.
• They may complain of right-sided abdominal pain or a feeling of fullness in the upper right side of the abdomen.
• It is important to suspect fatty liver and investigate especially if you have risk factors for fatty liver like diabetes, obesity, or a positive family history of liver diseases.
• However, it is important to remember that non-obese people also can develop fatty liver.

Diagnosis and testing of Fatty Liver

Fatty liver is diagnosed by an ultrasound scan (USS) of the liver. They may have elevated liver enzymes like ALT and AST. The likelihood of progressing of fatty liver to cirrhosis can be measured by a ‘FibroScan’ assessment.

Is Fatty Liver treatable?

Yes. It is treatable or reversible if identified early.

What are the treatment options available for Fatty Liver?

• Treatment mainly involves stopping the risk factors, lifestyle modification, and management of underlying conditions that lead to fatty liver.
• The effects of medications on controlling fatty liver are limited, costly, and not freely available.

Main management steps include:

• Stopping alcohol, high fructose, and refined carbohydrate diets.
• 10% reduction of body weight and maintaining the ideal body weight for height.
• Exercise for a minimum of 30 minutes a day for 5 days a week.
• Taking accurate medical advice.
• There is no scientific evidence to prove the efficacy of herbal medications that are available to treat fatty liver.

How should the diet be changed?

What exercises should you do?

• Aerobic exercise for at least 30 minutes a day for 5 days a week.

What are the complications of Fatty Liver?

• Cirrhosis
• Hepatocellular carcinoma
• Cardiovascular disease like myocardial infarction

How to prevent Fatty Liver

Fatty liver can be prevented with lifestyle modification and sticking to a balanced healthy diet.

• Minimise or stop alcohol consumption
• Exercise regularly
• Maintain an ideal body mass index
• Optimal control of other metabolic risk factors like diabetes, high blood cholesterol levels, etc.
• Strict adherence to a good diet plan