I recently had an ultrasound done because I was having slight abdominal pain. My doctor said the ultrasound showed fatty liver. I didn’t really understand everything he told me in the office. Should I be worried?
What exactly is fatty liver – and why don’t I have symptoms?
The incidence of fatty liver is increasing as more of the population in the Western world is overweight. Not all people who are overweight develop the condition, but being overweight significantly increases the risk of the disease. This liver disease is formally diagnosed when more than 5-10% of the liver is made up of fat. It is estimated that 75-100 million Americans have fatty liver. This condition is now the most common liver disease in the world.
There are typically no symptoms. Fatty liver disease is often diagnosed when blood work or imaging tests are done for another symptom or complaint. Once diagnosed, progression is monitored by following the level of specific liver enzymes in the blood, and obtaining periodic ultrasounds.
The medical term for fatty liver is non-alcoholic fatty liver disease (NAFLD). It is termed non-alcoholic because there is no significant consumption of alcohol leading to the liver damage. NAFLD is the first stage of this disease. Fatty liver disease can progress and cause serious liver damage. The second stage is called non-alcoholic steatohepatitis (NASH). At this stage the fat in the liver causes inflammation (hepatitis). During the third stage of the disease the liver cells become damaged, this is called fibrosis. Finally, liver cells stop functioning, and scarring of liver tissue results. This is considered cirrhosis. Cirrhosis can progress to the point where a liver transplant is needed.
How did I end up with fatty liver?
The specific reason some individuals develop fatty liver disease is unknown. It is known that it is most often seen in patients that are obese, have diabetes, and have high levels of fat in the blood (high levels of LDL, or “bad” cholesterol). There is ongoing research aimed at better understanding the causes of fatty liver disease. Two recently published, preliminary studies, have found new information. The first study suggested there may be a connection between too much unsaturated fat in the diet, which adversely affects metabolism. The second study suggested that changes in the bacterial growth in the gut may lead to liver inflammation. As research continues, new information will be available to better predict and prevent this disease.
As the incidence of obesity has increased in children and adolescents, fatty liver disease is increasing as well. Experts have predicted that in the next 10 years, it will be the largest cause of liver disease in children and adolescents in the western world.
There is no medication or treatment for fatty liver disease. However, lifestyle changes will halt progression of the disease. To prevent or control this disease, it is important to eat healthy, including fruits, vegetables, and protein and to restrict fat and sugar. It is also helpful to limit alcohol, to avoid any additional stress on the liver.
Fatty liver disease is a condition to be serious about. If you are diagnosed, it is important to make lifestyle choices that will prevent the disease from progressing. Without following a healthy diet the disease will progress over time, ultimately resulting in severe liver disease.
Our nine physicians are board certified in hepatology (the study of the liver) as well as gastroenterology. If you have questions about fatty liver disease, we would be happy to schedule an office visit to discuss this disease with you.