Fatty liver disease is also referred to as Nonalcoholic Fatty Liver Disease (NAFLD) or Nonalcoholic Steatohepatitis (NASH).
This is a group of conditions where there is accumulation of excess fat deposits over the liver. This fat deposit is also seen among alcoholics.
Non alcoholic fatty liver disease is seen in patients who drink little or no alcohol. The commonest form of Non alcoholic fatty liver disease is termed fatty liver.
Fatty liver is a very common disorder and up to 20 percent of adults and approximately 5 percent of children are affected.
One of the common risk factors for this condition is obesity. Nearly two thirds of obese adults and half of obese children are found to have fatty liver.
Nonalcoholic Steatohepatitis – the more severe form of fatty liver – is seen in is around 20% of the obese individuals.
With the rise of obesity over the last couple of decades, there has been a rise in number of individuals with fatty liver.
Having some amount of fats over the liver cells is normal and seldom causes damage to the liver. As the disease progresses to Nonalcoholic Steatohepatitis (NASH) there is presence of liver cell inflammation followed by formation scars within the liver tissues.
NASH may eventually lead to liver scarring and cirrhosis that leads to substantial damage to the liver and liver failure.
Some of the risk factors for fatty liver disease include:-
Commonly there are no symptoms. There may, however, be some amount of abdominal pain that may be concentrated in the central or right upper part of the abdomen.
There may be fatigue and tiredness in addition.
The liver may be enlarged in some children.
Some patients experience dark discoloration of the skin called acanthosis nigricans that occurs in the neck or in the underarm region.
Diagnosis is suspected in an obese individual. On blood tests there are mild elevations of the liver enzymes – Aspartate transaminase (AST) and Alanine transaminase (ALT). However, blood tests may also be normal in many cases.
An ultrasound of the abdomen, however, can show the fatty deposits over the liver and confirm the diagnosis.
A more confirmatory test is by taking a small sample of liver tissue from the affected liver. This is called a liver biopsy. The sample is stained appropriately and looked under the microscope. The abnormal fat deposits in the liver cells can be seen under the microscope.
Patients are advised to take a healthy balanced diet and regular exercise in order to lose weight and maintain a normal body weight.
They are advised to avoid alcohol and unnecessary medications.
Diabetics and those with other associated conditions like high blood cholesterol, high blood pressure etc. need to be treated individually for the same.
Fatty liver disease is also referred to as Nonalcoholic Fatty Liver Disease (NAFLD) or Nonalcoholic Steatohepatitis (NASH). This is a group of conditions where there is accumulation of excess fat deposits over the liver seen among individuals who take little or no alcohol. Fatty liver disease is most common among obese and overweight individuals.
The condition is similar to alcoholic liver disease but the risk factors are different. There are essentially four stages of Nonalcoholic Fatty Liver Disease or fatty liver.
Stage 1 is simple fatty liver and is also called steatosis. In this stage excess fat builds up in the liver cells. This is abnormal but does not cause harm. Usually there are no symptoms at this stage.
Fatty changes of the liver cells mean accumulation of neutral fats or triglycerides within the liver cells.
Initially the cytoplasm of the liver cells show small fat filled vacuoles or sacs around the nucleus. This is called microvesicular fatty change. Here the vacuoles containing fat are multiple but do not displace the centrally located nucleus.
As the condition progresses the vacuoles increase in size and push the nucleus to the sides of the cell. This is called a signet ring appearance and is due to macrovesicular fatty change. Many of the cells with large vacuoles join together, to form fatty cysts.
Stage 2 is termed non-alcoholic steatohepatitis (NASH). This is a more severe condition than simple fatty liver and there is cellular level inflammation at this stage.
The patients with non-alcoholic steatohepatitis may have some symptoms including a dull pain at the right upper side of the abdomen and may feel tired or fatigued easily.
Stage 3 is also termed stage of fibrosis. With non-alcoholic steatohepatitis and its inflammatory processes, there is scarring of the liver tissues. These fibrous scar tissues around the liver cells and the blood vessels lead to formations of fibrosis.
This fibrous tissue eventually replaces the healthy liver tissues to a great extent but the liver still continues to function.
Stage 4 is termed as stage of cirrhosis where there is extensive scarring of the liver tissues severely affecting liver functions. The liver shrinks and becomes deformed.
Cirrhosis usually occurs years after development of inflammation of the liver.
With time the liver damage caused by cirrhosis may lead to liver failure.
Fatty liver disease is also referred to as Nonalcoholic Fatty Liver Disease (NAFLD) or Nonalcoholic Steatohepatitis (NASH). This is a group of conditions where there is accumulation of excess fat deposits over the liver seen among patients who consume little or no alcohol.
Around 50 to 100% patients with fatty liver disease have no symptoms of the condition. Detection of the disease is more often than not an incidental finding on routine blood tests.
Some of the other symptoms that may be present include:-