Insight into Fatty Liver Disease

Many of you might have noticed the words “fatty liver” on an ultrasound scan report of the abdomen, generally reported as Fatty Liver Grade 1 or 2. Fatty liver is a very common incidental finding during an ultrasound scan of the abdomen done to evaluate some other abnormality. Fatty liver occurs when fat globules accumulate in liver cells. Most people with fatty liver do not have any symptoms, while some may have pain in the right upper area of the abdomen, generalized weakness and body discomfort.

There are two main types of fatty liver disease:

1: Non-alcoholic fatty liver disease (NAFLD) is a very common cause of mild derangements in liver function tests including AST (aspartate transaminase), ALT (alanine transaminase), GGTP (gamma-glutamyl transpeptidase), alkaline phosphatase and serum bilirubin levels. It shows microvesicular (small vacuoles) fatty deposits that you would find in alcoholic fatty liver, but without the history of alcoholism as the name says.

This disorder is associated with:

• Sedentary lifestyle
• Obesity
• Diabetes
• Hyperlipidemia
• Corticosteroid use

2: In Alcoholic fatty liver disease (AFLD) the alcohol abuse is the factor behind liver enlargement. The affected person on careful questioning would generally accept its use. This diagnosis is made when all other causes have been ruled out with tests. Alcohol causes a greater elevation in AST compared to ALT.

The most accurate test to differentiate between the above two types of fatty liver disease is a liver biopsy. The degree of liver dysfunction is usually mild in case of any fatty liver disease. An important issue in these cases is to exclude other serious liver disorders like autoimmune diseases and drug induced liver disorder.

Both types of fatty liver disease are managed by correcting the underlying causative factors. If the cause is not eliminated, it may slowly progress from this reversible stage to irreversible stage of damage known as cirrhosis of liver.

Though there are many medicines under study, there is none available that will reverse fatty liver.

 It is only LFM (lifestyle modifications) that can be attempted to bring in reversal of the fatty changes in the liver. It is good to discuss all your concerns with your doctor while keeping the causes at bay.