Fatty liver, or steatosis hepatis, is also known in medical terminology as steatosis hepatis and is a very common occurrence due to eating habits in Western industrialized countries. This occurs whenever the body is supplied with more fats than it can break down.
What is a fatty liver?
Infographic on the anatomy and structure of the liver. Click to enlarge. Fatty liver is a very common disease in industrialized countries. It is referred to when fats are stored in the cells of the liver – these are so-called neutral fats. Basically, there are three types of fatty liver: mild, moderate and severe. If fatty deposits are present in one third of all liver cells, the condition is referred to as mild fatty liver. In moderate fatty liver, in turn, deposits are found in about two-thirds of the cells, and in severe fatty liver, deposits are found in more than two-thirds of the organ. Pregnancy-related fatty liver represents a special form of fatty liver.
Causes
Obesity, the disease diabetes, and alcoholism are considered the most common triggers of fatty liver in Western industrialized countries. Alcohol is the cause of fatty liver in about 50 percent of all cases. In contrast to a high-fat diet, however, malnutrition can certainly trigger fatty liver, and certain toxins can also cause it. In malnutrition, especially protein deficiency plays a crucial role, which is common both in developing countries, but also in the presence of anorexia. Wilson’s disease, a disorder of copper metabolism is another cause of fatty liver, although less common.
Symptoms, complaints, and signs
Fatty liver does not always cause symptoms. Before the first symptoms appear, elevated blood pressure may be noted. As the disease progresses, blood lipid levels also increase, and in individual cases, blood glucose levels also become unbalanced as the disease progresses. In many cases, those affected suffer from insulin resistance and are overweight. In addition, fatty liver often occurs in conjunction with an unhealthy lifestyle. The fatty liver itself sometimes manifests itself through problems with food utilization. Some sufferers experience a slight feeling of pressure or fullness in the right upper abdomen. In the second stage of the disease, fatty liver is also manifested by loss of appetite, nausea and vomiting, and diarrhea. Fever may also be present. Parallel to this, signs of jaundice appear, for example a conspicuous yellow skin, severe abdominal pain and high fever. If the disease is caused by alcohol, the typical symptoms of alcoholism appear as the disease progresses, i.e., symptoms of mental deficits, irritability, and changes in personality. Externally, alcoholism can be recognized by a reddened face, sunken skin and dark circles under the eyes. When these symptoms and complaints occur, a fatty liver can be inferred.
Course
The course of the disease or the extent of the symptoms depends on what stage of fatty liver it is. If the liver is only slightly fatty, patients usually feel only a slight sensation of pressure, while severe fatty liver can lead to severe pain. These usually affect the right upper abdomen. This pain is due to a severe enlargement of the liver – often the organ can even be felt through the abdominal wall. In the worst case, however, fatty liver can develop into more serious diseases. Liver cirrhosis, for example, is a disease that is often accompanied by the complete loss of all liver functions. If patients do not stop drinking alcohol at this stage of the disease, the mortality rate is as high as 60 percent.
Complications
Fatty liver can lead to serious complications. Acutely, fatty liver triggers vomiting and nausea and leads to loss of appetite and weight. In addition, there is fatigue and typical fever symptoms, which continue to increase as the disease progresses. Later, there are strong feelings of pressure in the upper abdomen and the formation of a water belly. The damaged liver can lead to the development of other diseases and symptoms. Typical secondary diseases include cirrhosis of the liver and fatty liver disease.In fatty liver inflammation, the liver cells die within a short time and inflammatory reactions occur in the liver tissue. This can limit organ function and cause jaundice, among other symptoms. Cirrhosis of the liver can disrupt brain function and limit mental performance. It can also cause mood swings, anxiety and a severe decrease in well-being. Physically, a shrinking liver causes bleeding of the esophagus, abdominal dropsy or liver cancer, among other symptoms. In the final stage, the condition eventually leads to liver failure. The risk of cirrhosis is particularly high in the case of chronic fatty liver. If the underlying disease is not treated promptly, the severe liver damage leads to various secondary symptoms and ultimately to the death of the patient.
When should you see a doctor?
In the early stages, fatty liver does not necessarily need to be treated by a doctor yet, and affected people can first change their diet and lifestyle. However, if they consistently suffer from a feeling of pressure in the liver area and a feeling of fullness, they should definitely seek medical attention. The fatty liver should also be monitored regularly if the cholesterol level is highly elevated. This is especially true for people addicted to alcohol, but they often lack insight into their addiction problem and the resulting health problems. It also makes sense for people who are severely overweight to see a doctor so that they can follow a diet under medical supervision to reduce weight and improve liver health. If fatty liver is not yet known, symptoms such as a feeling of pressure in the liver, fever, nausea, symptoms of jaundice, or severe weight loss with no apparent cause may indicate fatty liver. It is important to get clarification as early as possible to determine if hepatitis disease or liver cancer is the cause of the symptoms. If left untreated, a fatty liver can develop into a life-threatening inflammation. Those who are prone to fatty liver should consult with their doctor about how best to change their diet to relieve stress on the liver and prevent complications.
Treatment and therapy
Treatment of fatty liver generally depends on how far it is already advanced. In the most favorable case, it is already sufficient to fundamentally change one’s dietary habits to counteract the symptoms of fatty liver. In order to clearly establish the diagnosis of fatty liver, the attending physician will first perform a thorough physical examination and usually also take a close look at the abdomen with the help of an ultrasound examination. Liver puncture, on the other hand, is used to determine the exact causes of fatty liver on the basis of tissue samples. Under local anesthesia, the physician punctures the abdominal wall with a needle to gain access to the liver. The advantage of this examination is that other diseases such as liver cirrhosis can also be detected. Analysis of the blood, in turn, is used to examine liver enzymes. Fatty liver itself is not usually treated with medication, but other dangerous diseases such as cirrhosis can develop from fatty liver. In the case of fatty liver, the therapy usually consists solely of changing one’s diet or abstaining from alcohol as much as possible.
Outlook and prognosis
The prognosis of fatty liver depends on the diagnosis, the present cause, and the start of treatment. Patients with alcohol-induced fatty liver have a poor prognosis. In these cases, the disease developed because of liver cirrhosis and is associated with liver cell death. If the course of the disease is severe, the patient is at risk of liver failure and premature death. Only rarely can a cure be achieved with immediate as well as permanent abstinence from alcohol and the transplantation of a donor organ. Since the liver is one of the organs of the human organism whose ability is a regenerative process, patients who receive an early diagnosis and immediately address the causes can achieve a regression of the symptoms. However, the more liver cells are damaged or dead, the less likely recovery is. Patients suffering from obesity are encouraged to change their lifestyle for a good prognosis. They must lose weight and eat a healthy diet from now on. With a strict diet, they have a good chance of improving their health.If a relapse occurs, the prognosis worsens. The organism is weakened, as health stresses have usually occurred over many years. The likelihood of developing liver cancer is increased in these patients and may lead to further complications.
Prevention
The best way to prevent fatty liver is to avoid alcohol. Of course, the one or other glass of red wine is certainly allowed at a party, but alcohol consumption should not become a daily habit. Also a healthy and above all balanced nutrition is important for the avoidance of the illness fat liver – just like sufficient movement by the way. If diabetes is known to be the trigger for fatty liver, affected patients should have their blood sugar checked carefully and adjusted correctly. In this way, the incipient fatty degeneration of the liver can usually be stopped quickly.
Follow-up care
The best aftercare is adherence to preventive measures. These are usually carried out by the patient independently. A physician, on the other hand, accompanies the course of the disease according to plan only in severe cases. Suitable examinations include determining liver values in the blood and taking a tissue sample, known as a liver biopsy. An ultrasound examination also provides clarity about the extent of fatty liver disease. Medications can help cure fatty liver. These are usually prescribed for diabetes and lipid metabolism disorders that cause disease. Fatty liver once cured can recur again and again. No immunity develops, which is why preventive measures accompany the rest of the patient’s life. If symptoms can be traced back to alcohol abuse, long-term abstinence is essential. If necessary, those affected undergo withdrawal in a closed facility. Especially in the event of a relapse, addicts should seek help quickly. An unbalanced diet and obesity also cause fatty liver. With the help of therapists, patients can achieve a balanced diet and reach their normal weight. Those who manage to eliminate the causes have good prospects of recovery. In most cases, the liver regenerates. In older people, however, the body’s healing power is significantly limited.
What you can do yourself
To date, there are no effective medications for fatty liver. This makes a conscious lifestyle all the more important after diagnosis. By eating a healthy, balanced diet and avoiding the original trigger (such as alcohol or certain medications), affected individuals can at least partially reverse fatty liver disease. Overweight people suffering from non-alcoholic fatty liver should take steps to normalize their body weight. A combination of diet and exercise is ideal. In the case of alcoholic fatty liver, alcohol should be completely avoided. Accompanying therapeutic measures are recommended. The doctor in charge will usually prescribe the patient various medications to counteract the withdrawal symptoms and, in the further course of treatment, refer him to a self-help group. Which measures are appropriate in detail depends on the severity of the fatty liver and the individual symptoms. Therefore, the rule is to always consult with the doctor and inform him or her of any unusual symptoms. If medication is suspected as the cause of the fatty liver, a change in medication should be discussed with the doctor. If the fatty liver is steroid-related, the preparations must be discontinued immediately. If symptoms are severe, hospitalization is advised.
