What is Fatty Liver Disease?
Fatty liver is a condition in which the cells of the liver accumulate abnormally increased amounts of fat. While it is normal for the liver to contain some fat, if more than five to ten percent of the liver’s weight is fat, it is deemed a fatty liver (steatosis). Although excessive consumption of alcohol is a cause of fatty liver disease (called alcoholic fatty liver or ADL), there are other common forms of fatty liver disease.
One is termed nonalcoholic fatty liver disease (NAFLD), in which alcohol is not considered a cause of the condition. The more severe form of NAFLD is called nonalcoholic steatohepatitis (NASH). In addition to excess fat, NASH includes liver cell damage, caused by inflammation. In fact, NASH is one of the leading causes of cirrhosis.
Fatty liver disease is very common, and is also on the rise. Fatty liver and NASH can lead to cirrhosis and other complications from cirrhosis including bleeding, liver cancer and liver failure. In addition, fatty liver diseases are associated with other serious conditions, such as cardiovascular disease, heart disease, diabetes and strokes.
Causes of NAFLD and NASH
While some people may develop NAFLD and NASH without apparent cause, the causes below are commonly attributed to these diseases:
- High levels of fats in the blood (e.g., cholesterol, triglycerides)
- High blood pressure
- Metabolic disorders
- Insulin resistance
- Rapid weight loss
- Poor eating habits
- Hepatitis C
- Medications (e.g., corticosteroids, antidepressant/antipsychotics, tamoxifen, methotrexate)
Typically, fatty liver disease is asymptomatic (no symptoms). In fact, people can have NASH for years before symptoms emerge. When symptoms do occur, they may include:
- Weight loss
- Abdominal pain
- Poor appetite
- Jaundice (yellowing of the skin and eye)
- Edema (fluid build-up) in the legs and abdomen
No medications have proven effective for treating fatty liver disease. Therefore, as of now, there are no approved medical treatments for NAFLD/NASH. Treatment for NAFLD and NASH is lifestyle-oriented. The first line of nonalcoholic fatty liver disease treatment is usually weight loss through a combination of a healthy diet and exercise. Losing weight addresses the circumstances that contribute to nonalcoholic fatty liver disease. Ideally, a loss of 10 percent of body weight is desirable, but improvement in risk factors can become apparent with even 3 to 5% weight loss. Weight-loss surgery is also an option for those who need to lose a considerable amount of weight. Diabetes and cholesterol control are also important.
A healthcare professional may recommend vaccinations against hepatitis A and hepatitis B to help protect against further liver damage. In the case of cirrhosis due to nonalcoholic steatohepatitis, a liver transplant may be an option. Among those with nonalcoholic steatohepatitis liver transplant outcomes are generally very good.