Fatty Liver Disease Or Hepatic SteatosisDr. Nitin Gupte
Kinds Of Fatty Liver Disease Or Hepatic Steatosis
Obese people have a greater risk of developing hypertension, diabetes or heart disease, than the slim people.
And most obese people know that they have these diseases.
But most obese people also have fatty liver disease, which is as dangerous a disease as any!
And few obese people know that they have this disease!
Most often fatty liver disease is diagnosed accidentally when an abdominal sonography is done for some other reason.
Fatty liver disease is also known as hepatic steatosis or fatty degeneration of liver.
It affects both alcoholics and nonalcoholics or those who drink very little.
Thus fatty liver disease is of two types, alcoholic fatty liver disease and nonalcoholic fatty liver disease or NAFLD.
Both diseases are characterised by build up of excess fat in the liver cells.
Nonalcoholic fatty liver disease or NAFLD is affecting increasingly greater number of people all over the world, more so in the Western world.
Some people suffering from Non Alcoholic Fatty Liver Disease or NAFLD develop nonalcoholic steatohepatitis or NASH.
Nonalcoholic steatohepatitis or NASH is a more aggressive form of fatty liver disease in which there is inflammation of the liver cells and it can progress to scarring of the liver tissue leading to liver cirrhosis and liver failure.
Thus the progression of nonalcoholic steatohepatitis or NASH could be similar to the severe alcoholic hepatitis seen amongst heavy alcoholics.
More than 90 per cent of heavy alcoholics develop fatty liver disease while 25 per cent develop the severe alcoholic hepatitis ending in liver cirrhosis and liver failure.
While children too suffer from non alcoholic fatty liver disease or NAFLD, older people, especially males, are affected much more often.
Experts do not yet know why some people develop non alcoholic fatty liver disease or NAFLD and why some of them progress to nonalcoholic steatohepatitis or NASH and develop liver cirrhosis and liver failure.
But both are linked to
Over weight or obesity, especially abdominal obesity
Hyperinsulinemia and insulin resistance
Hyperglycaemia or high blood sugar levels, pre diabetes or diabetes
Hypertriglyceridemia or high levels triglycerides or circulating fats in blood
These conditions could be helping build up of excess fat in the liver, causing NAFLD and in some this fat could be acting as a toxin to the liver cells and causing inflammation and scarring in them, causing NASH.
Signs and symptoms:
Non Alcoholic Fatty Liver Disease or NAFDL may have no symptoms but some times there can be fatigue and pain or discomfort in upper right hand area of the abdomen where the liver lies within the body.
Signs and symptoms of people with nonalcoholic steatohepatitis or NASH are the same as those of advance scarring and cirrhosis of liver seen in cirrhosis in severe alcoholic hepatitis:
Swelling of abdomen due to ascites or accumulation of fluid in abdominal cavity.
Enlarged blood vessels under the skin.
Yellowing of skin and eyes due to jaundice.
Other risk factors associated with development of NAFLD and NASH:
Hypercholesterolemia or high levels of cholesterol
Metabolic syndrome: Abdominal obesity, hypertension, high levels of blood sugar and triglycerides and low levels of HDL cholesterol
Type II diabetes
Under active thyroid gland
Under active pituitary gland
Complications or progression
The fatty liver disease can end up in development of inflammation and scarring resulting in liver cirrhosis.
Ascites or abdominal swelling due to fluid build up.
Swelling of veins in oesophagus or oesophageal varices, which can rupture causing bleeding
Confusion, drowsiness, slurred speech, delirium due to hepatic encephalitis
Complete liver failure meaning liver stops functioning altogether
Treatment and prevention:
Eating healthy, well balanced food
Losing and maintaining weight at a healthy level.