Fatty Liver

Fatty liver is one of the most common liver diseases and has a global presence. It can affect persons at any age but most often starts in the thirties and forties. It can be considered as a ‘life style disease’

What is fatty liver?

Fatty liver is due to accumulation of fat in the liver cells (hepatocytes).This process is otherwise called steatosis.The accumulated fat can produce injury to hepatocytes in certain cases and leads to hepatitis (Steatohepatitis)

What are the causes of fatty liver ?

Alcoholism is the leading cause of fatty liver.In fact almost all the alcoholics develops fatty liver.

Other causes of fatty liver – Non Alcoholic Steatohepatitis (NASH)

• Diabetes Mellitus
• Obesity
• Impaired cholesterol metabolism in the body
• Sedentary life style
• Sudden weight loss
• Hepatitis B and Hepatitis C infections
• Certain drugs like steroids

What are the symptoms of fatty liver?

Fatty liver does not produce any specific symptoms. It is often detected during casual health check ups when somebody is worked up further for abnormal Liver Function Tests (LFT).Rarely it produces heaviness and dragging sensation in the upper abdomen. Some people will be having excessive fatigue.

How do you diagnose fatty liver?

Physical examination might reveal enlarged liver.LFT shows mild elevation of liver enzymes – mainly SGOT and SGPT.The simplest investigation is ultrasound abdomen which reveals a bright liver.All other known causes of elevation of liver enzymes should be excluded before making a diagnosis of fatty liver.The confirmation is by doing a liver biopsy which clearly demonstrates the presence of fat globules in the hepatocytes.But it is an invasive procedure with its own inherent complications. So biopsy is seldom needed to establish the diagnosis

What is the natural history of fatty liver?

Fatty liver is largely a benign, reversible situation particularly if the cause can be identified and rectified. If there is inflammation that can progress to fibrosis and ultimately to cirrhosis. The calculated risk is about 5-8%.

What is the treatment?

There is no specific treatment for fatty liver per se. Look for any correctable or modifiable causes and then work on it. Alcoholics should stop drinking. Diabetes should be tightly controlled. Diet and exercise is the cornerstone of therapy. If there is inflammation in the liver certain liver protective medicines might help

Author

Dr. Benoy Sebastian,

Consultant – Gastroenterologist

KIMS Oman Hospital, Muscat

Dr. Benoy comes with 13 years of experience, 7 years of which has been with the Medical Trust Hospital, Kerala, India as Consultant Gastroenterologist. He qualified his MD (Internal Medicine) and DM (Gastroenterology) from Medical College, Kottayam, India and Medical College, Trivandrum, India respectively.