All you need to know about fatty liver

Fatty liver, or steatosis, is a term that describes the buildup of fat in the liver. While it is normal to have some fat in your liver, more than 5 to 10 percent of your liver weight is fat in the case of fatty liver. Fatty liver is a reversible condition that can be resolved with changed behaviours.

It often has no symptoms and typically does not cause permanent damage. Around 10 to 20 percent of people have too much fat in their liver, but no inflammation or damage is present. Most cases of fatty liver are detected in people between ages 40 and 60. When fatty liver is caused by an underlying condition, it can become harmful to the liver if the cause is not recognised and treated.

Symptoms of fatty liver

Fatty liver typically has no associated symptoms. You may experience fatigue or vague abdominal discomfort. Your liver may become slightly enlarged, and your doctor can detect this during a physical exam. Excess fat can cause liver inflammation. If your liver becomes inflamed you may have a poor appetite, weight loss, abdominal pain, weakness and confusion.

Causes of fatty liver

The most common cause of fatty liver is alcoholism and heavy drinking.

Fatty liver develops when the body creates too much fat or cannot metabolise fat fast enough. The excess fat is stored in liver cells where it accumulates to form fatty liver disease. Besides alcoholism, other common causes of fatty liver include obesity, high levels of fats in the blood, diabetes, genetic inheritance, rapid weight loss and side effect of certain medications, including aspirin, steroids and tetracycline.

Who are at risk for fatty liver?

It is more likely to develop if you are overweight or obese. Having type 2 diabetes also may increase your risk for fatty liver. Fat accumulation in the liver has been linked to insulin resistance, which is the most common cause of type 2 diabetes. Other factors that may increase your risk for fatty liver are excessive alcohol use, taking more than the recommended doses of certain over-the-counter medications like paracetamol, pregnancy, high cholesterol, high triglyceride levels, malnutrition and metabolic syndrome.

Diagnosis of fatty liver

Your doctor may find that liver enzymes are higher than normal on a routine blood test. This does not confirm a diagnosis of fatty liver. Further analysis is necessary to find the cause of the inflammation. Liver biopsy is the only way to know for certain if you have fatty liver. The biopsy will also help the doctor determine the exact cause.

Treatment of fatty liver

There is no medication or surgery to treat fatty liver. Instead, doctors will offer recommendations to reduce your risk factors. These recommendations include limiting or avoiding alcoholic beverages, managing your cholesterol, losing weight and controlling your blood sugar.

If you have fatty liver because of obesity or unhealthy eating habits, doctors may also suggest that you increase physical activity and eliminate certain types of food from your diet. Choose healthier foods like fresh fruits, vegetables, and whole grains. Replace red meats with lean animal proteins like chicken and fish.

Protecting your liver is one of the best ways to prevent fatty liver. You should avoid drinking alcoholic beverages. Follow your doctor's instructions and take medications for diabetes or high cholesterol as directed. Additionally, aim for at least 30 minutes of exercise most days of the week to maintain a healthy weight.

The writer is an Assistant Professor of Medicine at Z H Sikder Women's Medical College and Hospital, Dhaka.