Re: fatty liver

Quite commonly people are told by their practioner that they have a fatty liver! Fatty liver is not a liver disease as such. It simply means there is more fat in the liver than normal. A person with a fatty liver is not necessarily ill.

Fatty liver can be caused by certain chemical compounds and by nutritional and endocrine disorders. Drugs or poisons that can cause fatty liver include alcohol, tetracycline, cortisone, phosphorus and carbon tetrachloride. Of these alcohol is by far the most common cause.

Nutritional causes of fatty liver are starvation, obesity, protein malnutrition and intestinal bypass operations for obesity. The endocrine disorder diabetes mellitus often leads to fatty liver. In juvenile diabetes the fat may be rapidly deposited leading to tenderness in the upper right of the abdomen. In all of these conditions the fatty deposits are occasionally accompanied by some inflammatory changes and scarring of the liver – so-called Non-Alcoholic SteatoHepatitis (NASH).

Fatty liver of pregnancy is a serious condition occurring near term. Premature termination of pregnancy may be necessary. Delivery of the baby by Caesarean section may be a life-saving measure.

Uncomplicated fatty liver does not usually produce symptoms because fat accumulates slowly. A doctor may be able to detect that the liver is enlarged by palpation (an examination by touch). When the fat content is increased rapidly the liver expands, stretching its covering, and pain results.

In fatty liver of pregnancy there may be nausea, vomiting, abdominal pain and jaundice.

Fat enters the liver from the intestines and from the tissues. Under normal conditions, fat from the diet is metabolized by the liver and other tissues. If the amount exceeds what is required by the body it is stored. In obesity some of the fat accumulates in the liver.

Fatty liver in people who drink too much alcohol is sometimes followed by more serious liver damage in the form of alcoholic hepatitis. Serious liver damage is less common in diabetes and obese people who don’t drink but if the fat has progressed to NASH then further progression to scarring and even cirrhosis can occur.

Treatment of fatty liver is related to the cause. Underlying conditions such as diabetes require treatment. Fat is decreased by removal of any drugs or other chemical compounds thought to be responsible. Nutritional causes are treated by altering the availability of fat coming into the liver. This is accomplished by providing available carbohydrates or by adding protein to overcome a complete or large deficiency in protein needed to make lipoproteins (proteins linked to fat and not capable of being dissolved in water).

To avoid fatty liver it is prudent not to drink to excess because alcohol can decrease the rate of metabolism and secretion of fat, leading to fatty liver.

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