Fatty liver refers to the abnormal build-up of fat in the liver cells. Fatty liver disease covers a range of conditions including simple fatty liver (called hepatic steatosis), which is common, and steatohepatitis, which is associated inflammation of the liver that may lead to the serious condition of cirrhosis (scarring of the liver).
Excessive intake of alcohol is a common cause but it is becoming increasingly common in people who are overweight or obese. As type 2 diabetes becomes more common in our community, so does the incidence of fatty liver disease. The causes can be summarized as follows:
The big three
Others
The combination of being overweight and drinking too much alcohol makes people very prone to developing a fatty liver. This also increases their risk of developing diabetes, which perpetuates the problem.
Contrary to popular opinion, fatty liver is not necessarily caused by eating too much fatty food.
This modern epidemic facing the Western world is directly related to the global increase in obesity. It is the most common cause of abnormal liver function
In normal conditions, fat from our diet is processed by the liver and any excess is stored in the body tissues. In some people, especially people who are overweight or obese, some of the excess fat accumulates in the liver.
A person with a fatty liver is not necessarily ill. Usually there are no symptoms because the fat accumulates slowly. Some people complain of vague tiredness or a lack of energy. Your doctor may be able to feel an enlarged liver.
Blood tests of the liver may or may not show abnormalities but special tests, such as an ultrasound or CT scan, may show up fatty liver.
The commonest method to diagnose fatty liver disease is by a specialist ultrasound termed FibroScan. In rare instances, a biopsy of the liver may be required.
Simple fatty liver usually causes no problems and rarely progresses to the serious problem of liver cirrhosis (scarring). Depending on the cause, a fatty liver may be helped if the patient stops drinking alcohol, loses weight and improves control of diabetes.
This is a rare but very serious condition of unknown cause that develops close to term in the pregnant woman. It causes several uncomfortable symptoms including jaundice, nausea, vomiting, headache and abdominal pain. It has a high death rate and urgent delivery by caesarean section is required.
There is no proven cure but it is important to treat causes, such as diabetes and obesity. Avoiding alcohol and drugs that may affect the liver is also important. The treatment of steatohepatitis is avoidance of alcohol and achieving ideal weight (if applicable). Talk to your doctor about this if you are concerned.
Prevention is based on following a healthy lifestyle.