Fatty Liver: Alcohol is Not the Only Cause

Fatty liver is primarily associated with alcohol, but metabolic diseases, poor diet or medication can also cause fatty liver. Since symptoms usually only become apparent when liver function is already impaired, a fatty liver often goes unnoticed for a long time. But early action is important: a fatty liver can become inflamed and lead to cirrhosis. This also increases the risk of liver cancer. If, on the other hand, the changes in the liver are detected in time, a change in lifestyle is usually enough to cure a fatty liver.

Causes and development of fatty liver

Fatty liver (steatosis hepatis) is said to occur when more than half of all liver cells have stored fat (triglycerides). Depending on the cause, a distinction is made between two forms:

In alcoholic fatty liver, the increased detoxification of alcohol in the liver produces certain substances that inhibit the breakdown of fatty acids and promote fat production. With permanently increased alcohol consumption, this leads to an increasing storage of fat in the liver cells. Non-alcoholic fatty liver may be due to a variety of causes:

  • Improper diet with too much fat and sugar leads to obesity and promotes the reformation and accumulation of fat in the liver cells.
  • Lipid metabolism disorders can be genetic or occur as a result of other diseases. In this case, increased blood fat levels lead to increased uptake of fatty acids into the liver.
  • In diabetes mellitus, sugar can not be broken down due to insufficient effect or lack of production of the hormone insulin and is increasingly converted to fat and stored in the liver.
  • Autoimmune diseases, viral infections and medications such as certain antibiotics, chemotherapeutic agents and cortisone can damage the liver and thus disrupt fat breakdown.
  • In cases of extreme malnutrition, certain transport proteins can no longer be produced, which means that fat can no longer be removed and accumulates in the liver.
  • During pregnancy, hormonal changes can lead to an increase in fatty acids in the blood and disruption of fatty acid breakdown in the liver.

Fatty liver: symptoms

Fatty liver is a gradual process and initially causes no symptoms. In an advanced stage, there may be nonspecific symptoms such as fatigue, loss of appetite, decreased performance, as well as bloating, nausea and a feeling of pressure in the right upper abdomen.

Diagnosis of fatty liver

In most cases, fatty liver is only discovered by chance during a screening examination because of the lack of symptoms. The enlargement of the organ associated with fatty liver can be detected by palpation of the abdomen or during an ultrasound examination. In addition, liver values are determined as part of a blood test: Damage to the liver is indicated by an increase in the enzymes GOT, GPT, gGT and AP in the blood. The reason for the change in blood values is the death of liver cells, whereby enzymes are released into the blood that are mainly found in the cells of the liver. However, since these values say nothing about the cause of the liver damage, the doctor also takes a tissue sample to confirm the diagnosis: under the microscope, the fat droplets in the liver cells can usually be identified without a doubt.

Possible consequences of a fatty liver

In about one-third of cases, a fatty liver can become inflamed and progress into what is known as steatohepatitis. The increased death of tissue caused by the inflammation leads to “scarring.” In this process, destroyed liver cells are replaced by connective tissue (fibrosis), which can ultimately lead to liver cirrhosis (shrunken liver). In this final stage of liver damage, the changes to the organ are already irreversible: The tissue and vascular structure is increasingly destroyed, liver function declines and, in the worst case, liver failure can occur. In addition, the remodeling processes involved in this process increase the risk of developing liver cancer.

Fatty liver therapy: lifestyle modification.

If fatty liver is the result of another disease, such as diabetes, in most cases the fatty degeneration of the liver can be reversed by treating the underlying disease alone.If, on the other hand, fatty liver is caused by alcohol or a poor diet, the only therapeutic option is a change in lifestyle, because there are no drugs to treat fatty liver. However, through dietary changes and a healthy lifestyle, the liver can recover completely in most cases. Specifically, this means:

  • Consistently abstain from alcohol!
  • Prefer in the diet whole grain products and vegetable oils.
  • Limit the consumption of fat and sugar.
  • Reduce existing excess weight slowly: losing weight too quickly puts stress on the liver due to the sudden increase in fatty acids released into the blood.
  • Exercise regularly and build exercise into your daily routine.