Introduction
The feature picture [1] shows a celebration of beer and food. The intended message is alcohol and fatty food taken in excess can lead to fatty liver disease and cirrhosis and end stage liver disease. The progression of liver damage to end stage liver disease goes through the stages of fatty liver disease (steatosis and hepatosteatosis), liver fibrosis, and cirrhosis. See Figure 2 [2].
Definition of fatty liver disease
What is fatty liver disease? It is a common condition caused by having too much fat deposition in the liver. This becomes a problem when the fat amounts to 5 to 10% of the liver’s weight. There are two main forms of fatty liver disease: Alcohol-induced fatty liver disease, and non-alcoholic fatty liver disease (NAFLD) (Cleveland Clinic, 2022).[3]
Risk factors of fatty liver disease
(1) Alcohol-induced fatty liver disease
Alcohol-induced fatty liver disease is caused by drinking of alcohol beyond moderate drinking. Moderate drinking is defined as one drink a day for a woman and two drinks a day for a man. Drinking alcohol should not exceed these moderate drinking limits.
(2) Nonalcoholic fatty liver disease (NAFLD)
Nonalcoholic fatty liver disease (NAFLD) has two main risk factors — obesity, and diabetes.
Stages of fatty liver disease
- 1-Steatosis and steatohepatosis- Fatty liver disease begins with the stage of accumulation of fat in the liver — due to either excessive alcohol intake (alcoholic fatty liver disease) or excessive intake of carbohydrates, or the consequence of uncontrolled diabetes mellitus; and if left unchecked, this reversible stage progresses to steatohepatosis which if it is not due to alcohol is called non-alcoholic steatohepatitis (NASH); and if left unchecked this reversible stage progresses to the next reversible stage of
- 2-Liver fibrosis, which if still unchecked, now progresses to the irreversible stage of
- 3-Liver cirrhosis, and eventually to
- 4-End-stage chronic liver disease, liver failure, and death. (Wikipedia, 2022).[2]
Diagnosis
In early stages, there will be no symptoms and the only abnormalities are elevated liver enzyme levels and slight liver enlargement. Confirmation of the diagnosis at this stage can be made by:
- Ultrasound or CT scan of the liver – where the fatty deposits can be seen.
- FibroScan — which is a specialised ultrasound, is used to find out the amount of fat and scar tissue in the liver.
- Liver biopsy may be done to see how far advanced is the fatty liver disease.
Treatment of fatty liver disease
Lifestyle changes are of paramount importance:
- Avoid alcohol — might be prudent to stop drinking.
- Lose weight — 10% of body weight in 6 months is an often health education advice.
- Controlling diabetes, and taking medications to lower cholesterol and triglycerides will help.
- Exercise regularly.
- Take medications to reduce cholesterol
- Follow a balanced diet to lose weight steadily. Note that rapid weight loss can actually make fatty liver disease worse.
- Take a Mediterranean diet — which is high in vegetables, fruits, and unsaturated fats.
- Go for regular check ups to screen for cancer of the liver.
Take home messages
1-Know the risk factors of alcohol-induced fatty liver disease and non-alcohol induced fatty liver disease (NAFLD)
2-Lifestyle changes are of paramount importance.
3-Go for regular checkups to screen for cancer of the liver.
Acknowledgment — Anon. Unsplash picture of celebration of beer and food.
References
- Anon. Feature picture of celebration with beer and food.
- Wikipedia. Fatty liver disease. URL. https://en.wikipedia.org/wiki/Fatty_liver_disease Accessed 2022 Sep 30.
- Staff writers. Fatty Liver Diseases. Cleveland Clinic. 2020 Jul 31. URL. https://my.clevelandclinic.org/health/diseases/15831-fatty-liver-disease Accessed 2022 Sep 22. Accessed 2022 Sep 22.
- Staff writers. Mayo Clinic. Non-alcoholic fatty liver disease. Symptoms and causes. 2021 Sep 22. URL. https://www.mayoclinic.org/diseases-conditions/nonalcoholic-fatty-liver-disease/symptoms-causes/syc-20354567 Accessed 2022 Sep 22.
- Staff writers. Mayo Clinic. Non-alcoholic fatty liver disease. Diagnosis and treatment 2021 Sep 22. URL. https://www.mayoclinic.org/diseases-conditions/nonalcoholic-fatty-liver-disease/diagnosis-treatment/drc-20354573 Accessed 2022 Sep 22.