Fatty Liver: Symptoms, Causes, and Treatment

Fatty liver disease is characterized by excessive accumulation of fat in the liver. Discover its symptoms, causes, and treatment.
Fatty Liver: Symptoms, Causes, and Treatment
Diego Pereira

Reviewed and approved by el médico Diego Pereira.

Last update: 09 February, 2023

As its name indicates, fatty liver or fatty liver disease is characterized by excess fat in the liver. There are two types: Non-alcoholic fatty liver disease (NAFLD) and alcoholic fatty liver disease (AFLD). Today, we’ll go over its symptoms, causes, and treatment options according to specialists.

As the liver has the ability to repair itself, most episodes of this condition can be reversed. This, at least, during its early stages, as when the damage is very advanced the patient runs the risk of developing liver failure. It’s estimated that up to 30% of the world’s population suffers from NAFLD.

Symptoms of fatty liver

Fatty liver disease usually has no symptoms in its early stages. The patient may look and feel healthy, although the first signs may alert them to a health problem.

Doctors often refer to it as silent liver disease, as it can take years for its first signs to be detected. Below, we’ll tell you about its clinical manifestations according to Johns Hopkins Medicine :

  • Weakness
  • Spider-shaped blood vessels in the skin (spider veins or telangiectasias)
  • Yellowing of the skin and mucous membranes (jaundice)
  • Itching on the surface of the skin (pruritus)
  • Weightloss

The most severe cases, those in which the liver begins to suffer, are characterized by signs such as muscle breakdown, confusion, fluid retention, and bleeding. These episodes can lead to liver enlargement (hepatomegaly), cirrhosis, and liver failure. Despite this, it’s fair to say that most patients develop the condition in mild stages.

The causes of fatty liver

There are two types of fatty liver: Alcohol-related (AFLD) and non-alcohol-related (NAFLD). As the experts warn, and despite the similarities between these, they’re conditions that are different from one another. Among other things, they have different triggers.

Causes of the AFLD

Fatty liver caused by alcohol consumption.
One of the consequences of alcohol-associated fatty liver is the possibility of advancing to cirrhosis and liver failure over the years.

Researchers estimate that up to 3.8% of deaths worldwide are related to alcohol use. The most frequent health complications due to its intake are alcoholic liver disease, cardiovascular diseases, and cancer. These arise in the case of chronic intake of alcohol or alcohol consumption disorder.

In the process of metabolizing alcohol, highly toxic chemical elements (such as aldehydes) are generated as residues. These activate inflammatory processes that deteriorate the health of the liver, thus interfering with its functioning. Keep in mind that up to 90% of the alcohol consumed is metabolized exclusively in the liver.

Therefore, uncontrolled patterns of alcohol intake can lead to AFLD. In general, low or moderate intake doesn’t have this effect, although it all depends on the habits and health of the person. In any case, if the patient drinks regularly, this should be considered as the probable source of increased fat concentrations in the liver.

Causes of NAFLD

As experts point out, the causes of non-alcoholic fatty liver disease are very heterogeneous. The reasons why it’s triggered aren’t fully known, although of course there are several candidates among the suspects. Therefore, we’ll point out the most common catalysts of the condition:

  • Obesity
  • Severe weight loss
  • Feedback syndrome
  • Total parent nutrition
  • Malnutrition
  • Dependence on certain medications (or exposure to toxins and chemicals)
  • Celiac disease
  • Hepatitis C
  • Inflammatory bowel disease
  • HIV
  • Genetic predispositions
  • Removal of the gallbladder
  • Type 2 diabetes
  • Metabolic syndrome
  • Heart diseases
  • Hypopituitarism
  • Hypothyroidism
  • Polycystic ovarian syndrome
  • Insulin resistance

This is just a selection of the alterations that can trigger NAFLD. For all these reasons, researchers point out that NAFLD is related to a deterioration in the quality of life in general. Sometimes a specific cause can’t be found, as it responds to a confluence of many of them.

Diagnosis of fatty liver disease

Fatty liver is diagnosed by ultrasound.
There are many imaging-based diagnostic methods to diagnose fatty liver. Ultrasound is inexpensive and doesn’t emit radiation.

As most patients don’t develop symptoms, the diagnosis of fatty liver disease can be delayed for several years. It’s usually discovered accidentally in other medical evaluations, or when the signs alert the patient of an alteration in their health.

Among other tests, the specialist will choose to do a physical examination, blood tests, imaging tests, and liver biopsy (only in severe cases). Medical history, family history, eating habits, and alcohol consumption habits will also be taken into account. Experts diagnose the condition when the concentration of fat in the liver exceeds 5% of the total weight of the organ.

Treatment options

There are no drugs approved to treat fatty liver disease, despite the fact that there are at least a dozen in clinical trials in this regard. The roadmap depends on the type of disease; that is, if its causes are related to alcohol or not. As expected in the first case, the patient must abandon said harmful habit, so many will require a detoxification program.

Quitting alcohol won’t only prevent the condition from getting worse, but may even reverse the deterioration of the liver. NAFLD episodes are treated with lifestyle changes and controlling the underlying disease. The typical plan in these cases is the following:

  • Lose weight
  • Control daily caloric intake (as well as dietary fat)
  • Exercise regularly
  • Replace medications or supplements (if the specialist deems it prudent)

Morbidly obese patients can undergo bariatric surgery if conventional alternatives aren’t working. Severe cases may require a liver transplant, although this is reserved for only a small percentage of patients. A change in lifestyle and reducing alcohol intake is the first line in dealing with fatty liver disease.

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