The liver is the largest organ in your body. The liver helps your body digest food, store energy, and remove food toxins before food ingredients are assimilated in the body. When we eat more sugar or fatty food than what we need, our body stores this excess sugar or fat in the form of fat in the liver.
Over last few decades, life has become more stressful and the effects of these lifestyle changes are visible in the form many health problems. Non-alcoholic fatty liver disease affects about 25% of the world's population. In India, the proportion is growing rapidly. Alcoholic fatty liver disease only occurs in people who drink heavily, especially those who have been drinking for a long time. Women who drink heavily, are more likely to be obese or have some genetic mutations and suffer from fatty liver disease.
There are two types of this disease: Non-alcoholic fatty liver disease (NAFLD) and Alcoholic fatty liver disease, also called alcoholic steatohepatitis (inflammation of the liver)
Non-Alcoholic Fatty Liver
Non-Alcoholic Fatty Liver means increased liver fat in non-alcoholic individuals. There are two types:
A. Simple fatty liver disease, in which there is accumulation of fat in your liver but does not damage liver cells.
B. Non-alcoholic steatohepatitis (NASH), which involves damage to liver cells, causes a number of changes in the liver. This can lead to liver fibrosis or destruction of liver cells. NASH can further lead to cirrhosis or liver cancer.
Alcoholic Fatty Liver
Alcoholic Fatty Liver is caused by excessive alcohol consumption. Your liver processes alcohol in the body and removes it from your body. The energy produced by alcohol is stored in the liver in the form of fat. But doing so produces harmful substances. These substances damage the liver cells. This also weakens your body's natural immune system. More you drink, more your liver deteriorates. Alcoholic fatty liver disease (liver fat) is an early stage of alcoholic liver disease. The next stages are alcoholic hepatitis and cirrhosis.
When the fat in your diet is not properly digested, fat accumulates in the liver. This is due to too much sugar or fat in the diet and less of exercise / movement. Obesity, diabetes, thyroid and other endocrine deficiencies, gastric bypass surgery and high blood cholesterol / triglyceride levels increase the amount of fat in the liver.
Who is at risk?
People with the following disorders/profile are more likely to develop fatty liver disease.
Middle-aged or elderly
High levels of fat in the blood, such as cholesterol and triglycerides
High blood pressure
Corticosteroids and some cancer drugs
Metabolic syndrome and metabolic disorders
Rapid weight loss
Diseases like Hepatitis C.
Fatty liver disease is graded in four types: Grade 1 is minor disease with minimal or no changes in liver parenchyma. Grade 4 means severe damage to liver. Most people have Grade 1 fatty liver disease. Grade 1 does not cause any problems and has no symptoms. But some people may feel tired or have a mild inflammation in the upper right side of their abdomen. But if the disease is severe, the liver may become enlarged, swollen and jaundiced.
Tests that help diagnose fatty liver disease include: sonography, blood tests, elastography, and sometimes biopsy. Diagnosis of increased fat is made by examination such as ultrasonography, CT scan or MRI. Blood detects presence of jaundice.
If liver enlargement persists, a biopsy should be performed. Some of the enzymes in the blood (GGT) are increased if the fat in the liver causes the destruction of the liver cells. Destruction of liver cells can cause the liver to become firmer and stiff. Liver stiffness can mean fibrosis. It can later be transformed into cirrhosis.
Weight loss is recommended for non-alcoholic fatty liver. Some medications can increase fat in liver, so these should be stopped after consulting your doctor. Certain diabetes medications and vitamin E can help reduce fat in liver.
The most important part of treating alcohol-related liver fat disease is to stop drinking. Cirrhosis can be caused by either alcoholic fatty liver disease or non-alcoholic fatty liver disease (non-alcoholic steatohepatitis).
Following lifestyle changes can help you combat the problem:
Eat balanced diet, include more fruits and vegetable, limit salt and sugar intake
Vaccinate for hepatitis A and B, flu and pneumococcal disease
Exercise regularly, which will help you lose weight and liver fat
Talk to your doctor before taking vitamins, supplements or alternative medications or specific diets
(Dr Avinash Supe, former dean KEM hospital and Director - Clinical Governance & Head, Hinduja Hospital, Khar)