Fatty liver is the accumulation of fat within the cells of the liver. About one in 10 Australians are affected by this condition.
Causes of fatty liver disease
Fatty liver disease is often caused by an excessive alcohol intake, but it is increasingly being found in people who do not drink to excess but who are obese or have diabetes.
Fatty liver disease can also occur, although far less commonly, with malnutrition, certain medicines and occasionally as a complication of pregnancy.
The major factor in the development of non-alcohol-related fatty liver disease is insulin resistance, a condition usually associated with obesity.
Normally, the hormone insulin tells the body’s cells to take up glucose (a type of sugar) from the bloodstream to use as fuel. In insulin resistance, however, the cells don’t respond properly to insulin. They cannot take up sufficient glucose and are therefore deprived of fuel. The blood does not have much glucose removed from it by the cells, so blood glucose levels rise.
Doctors have not yet discovered exactly how insulin resistance causes fat to be deposited within liver cells. However, it is clear that fatty liver disease is not necessarily caused by eating too much fat.
Fatty liver symptoms
Fatty liver disease usually does not cause any symptoms. Occasionally, people with the condition will complain of feeling tired or generally unwell, but this varies between individuals, and the degree of symptoms does not usually equate to the severity of the disease.
Diagnosis of fatty liver disease
Often fatty liver disease is diagnosed after finding an abnormality incidentally on blood tests or an abdominal ultrasound. Alternatively, your doctor may detect an enlarged liver while examining your abdomen.
A biopsy of your liver is the only test that can definitively diagnose fatty liver disease, but this is not always necessary, as other tests can be sufficiently suggestive to warrant treatment.
Originally, fatty liver disease was thought to be a harmless condition, but it is now known that it has the potential to progress to more serious liver conditions, such as liver cirrhosis.
Treatment of fatty liver disease
There is no proven cure for fatty liver disease, but active lifestyle changes can significantly improve the condition and perhaps even reverse it. These changes include:
- Avoiding alcohol and medicines that may affect your liver, such as some steroids. Do not take medicines that have not been prescribed by your doctor.
- Losing weight. This is not easy for many people with fatty liver disease, so having a well-designed management plan designed by a doctor or dietitian can be beneficial. Gradual weight loss is the key, as sudden, severe weight loss can actually make the condition worse.
- Eating certain foods. There are some foods that help fatty liver disease, such as oily fish, nuts and avocado.
- Exercising. Even if this does not result in weight loss, it is worthwhile as it can reduce the amount of fat around your abdominal organs.
- Controlling your blood sugar levels if you have diabetes.
- Treating high cholesterol.
There are a number of medicines that have been suggested for the treatment of fatty liver disease, although research into these is continuing. These are sometimes prescribed by doctors in particular cases.
By focusing on reversible factors associated with fatty liver disease, it may be possible to prevent progression of the disease.
- 1. Nonalcoholic fatty liver disease [revised September 2006]. In: eTG complete [Internet]. Melbourne: Therapeutic Guidelines Limited; 2009 Nov (Accessed 2009 Dec 11.) http://www.tg.org.au/
2. Gastroenterological Society of Australia (GESA) [website]. Fatty liver disease (2005). Available at: http://www.gesa.org.au/leaflets/fatty-liver.cfm (accessed 2009, Dec 11)