Understanding fatty liver disease

Penned By: Rtr. Zeeniya Hassan (RAC RIC)

The daily rush of life often makes it easy to ignore the growing discomfort within our bodies and the need to care for the organs that work tirelessly to keep us healthy.It’s often hard to fully comprehend the wonders our organs perform for the functioning of our bodies on a daily basis. For instance, the liver is the only human organ capable of completely regenerating itself even if up to 75% of it is removed! In this blog, we will explore fatty liver disease, a condition that threatens the health of this remarkable organ. The liver, which holds paramount importance in performing vital functions such as digestion, detoxification, and nutrient storage, when compromised, can inturn majorly affect one’s health if left untreated. We will discuss the causes, stages, and symptoms of fatty liver, as well as how you can protect your liver for a healthier life.

What is fatty liver?

Fatty liver disease, also known as hepatic steatosis, is a growing global condition where excess fat builds up in the liver cells affecting people of all ages.This fat accumulation can happen due to various reasons, including obesity, insulin resistance, type 2 diabetes, high blood fats, or excessive alcohol consumption. If left untreated, this can later turn into a chronic liver disease causing permanent scarring on the liver, disrupting the livers ability to function properly, progressing into cirrhosis, leading to serious complications and, in advanced cases, liver failure. The common mistake of self-diagnosing and generalizing symptoms based on loosely gathered information from the internet, often reduces the possibility of timely detection and receiving the correct diagnosis which are critical for effective management and better health outcomes

The stages of fatty liver disease :

 Fatty Liver (Hepatic Steatosis)

Excess fat accumulation in liver cells

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Steatohepatitis (NASH or ASH)

Fat + inflammation causing liver cell injury

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Fibrosis

Scarring and stiffening of liver tissue

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Cirrhosis

Severe scarring, liver function impaired

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Liver Failure and Complications

Liver unable to perform vital functions

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Death

Due to liver failure, liver cancer, or related complications

Types and causes of fatty liver :

Fatty liver disease can be broadly categorized into five main types, each with distinct causes and characteristics. 

-        Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD)

MASLD is the most common form of fatty liver disease globally. It is closely linked to metabolic conditions such as obesity, especially abdominal obesity, type 2 diabetes, and insulin resistance. Currently, about 30.2% of people worldwide have MASLD, with prevalence soaring to 57.5% among adults with obesity.

-         Metabolic Dysfunction-Associated Steatohepatitis (MASH).

 MASH is basically a progress from MASLD to a more severe form involving liver inflammation and damage. This progression is often worsened by factors such as a high intake of refined carbohydrates and sugary drinks, as well as a sedentary lifestyle. The global prevalence of nonalcoholic fatty liver disease (NAFLD), which includes MASLD and MASH, is expected to rise sharply, reaching 55.7% by 2040, a threefold increase since 1990. This increase will affect all adult age groups, with similar rates projected for those younger than 50 and older adults (56.7% vs. 61.5%). Among youths and young adults (aged 15–39), NAFLD cases have also risen steadily, with the burden projected to increase further by 2035, signaling a growing health concern even in younger populations.however it is to be noted that NAFLD is not caused by alcohol and is increasingly common due to lifestyle factors.

-        Metabolic Dysfunction-Associated Alcohol-Related Liver Disease (MetALD)

MetALD is a type of fatty liver disease influenced by both metabolic dysfunction and alcohol consumption. It represents a combination of metabolic risk factors and alcohol-related liver damage.

-        Alcohol-Related Fatty Liver Disease (ALD)

ALD is caused primarily by excessive alcohol abuse and intake. It is important to distinguish ALD from NAFLD, as the underlying causes and management strategies differ significantly.

-        Genetic Fatty Liver Disease

Fatty liver disease can also be caused purely by genetic factors. Certain genetic predispositions influence fat metabolism and liver inflammation, making some individuals more susceptible to developing fatty liver disease regardless of lifestyle.

Symptoms and diagnosis

While fatty liver disease is known to escalate into a life-altering chronic liver condition, it can also be emotionally, mentally, and physically challenging as it silently creeps into one’s life and progresses, causing reversible damage.  Fatty liver progression often starts with no or minimal symptoms, ranging from mild fatigue to discomfort in the upper right abdomen, but can eventually become fatal by quickly progressing to cirrhosis. Cirrhosis may lead to complications such as jaundice, easy bruising, dark urine, pale stools, abdominal swelling, vomiting blood, black stools, and persistent itching. Timely and accurate diagnosis can be achieved through blood tests, imaging techniques (ultrasound, CT, MRI), and sometimes liver biopsy, alongside concurrent lifestyle improvements

Prevention and management.

The good news is that Fatty liver disease is often reversible, especially if caught early.

It is commonly known that maintaining a healthy weight is crucial for patients with fatty liver disease. Losing approximately 7–10% of one’s body weight can significantly reduce liver fat and inflammation, helping to manage underlying conditions. This can be achieved by following a healthy diet, ideally planned by a dietitian, which includes limiting processed foods, sugar, and red meat. Regular exercise and lifestyle changes also contribute to improving overall health. Furthermore, abstaining from alcohol even in cases of non-alcoholic fatty liver disease supports the regeneration of liver cells and helps combat fatty liver. Contrary to popular myth, fatty liver can be reversed with lifestyle changes, especially if detected early and managed with appropriate medical care. In advanced cases, a liver transplant may be necessary to save a patient’s life. While medications are not the primary treatment for fatty liver disease, several promising research studies are currently underway.

Support strategies for patients suffering from fatty liver and its progression include providing clear information about the disease, prognosis, and treatment options to reduce anxiety and reassure them about the potential for reversibility or effective symptom management. Furthermore, offering psychological support such as counseling or helping patients join support groups can assist them in coping with stress, fear, and lifestyle adjustments. Motivating patients to adopt healthier diets, engage in regular exercise, and moderate alcohol consumption can empower them and improve health outcomes. Regular monitoring and open communication help build a trusting relationship between healthcare providers and patients, making patients feel supported and engaged in their care.

Your Liver, Your Health: Make Every Choice Count.

The liver is a remarkable organ that works tirelessly to keep us healthy, yet it often goes unnoticed until problems arise. Fatty liver disease is a growing global health concern, but it doesn’t have to be a life sentence. With increased awareness, timely diagnosis, and proactive lifestyle changes, you can protect your liver and improve your overall well-being.If you experience symptoms such as unexplained fatigue, abdominal discomfort, or have risk factors like obesity or diabetes, consult your healthcare provider for evaluation. Remember, early intervention can make all the difference.

Stay informed, stay proactive, and give your liver the care it deserves!