Wednesday, November 7, 2012

Fatty Liver Disease Affects 6 Million in US

Fatty Liver Disease or Non-Alcoholic Fatty Deposits in the Liver

Associate Medical Director
Department Head, Section of Gastroenterology
The liver is our most noble organ and has several vital functions including being one of the filters of toxins that our body generates. 
Metabolic syndrome is a group of conditions that are a consequence of insulin resistance or in other words, the inability of insulin to work transferring sugars (energy) to our body cells. Fatty liver disease is a consequence of this malfunction, along with diabetes, heart disease and high blood pressure. 

More than one-third of adult Americans suffer from fatty liver disease that is unrelated to alcohol consumption. Unfortunately, fatty liver produces no symptoms on its own, so people often only learn about this problem when they go and see their physicians for a routine exam. 

Excessive alcohol consumption can also cause fatty deposits in the liver, causing what is known alcoholic liver disease and alcoholic hepatitis. 

Non-alcoholic fatty liver disease (NAFLD) is a term used to describe the accumulation of fat in the liver of people who drink little or no alcohol.

NAFLD not only affects adults and more than 6 million children in this country who have excessive fat deposits in the liver,  which are most common in Asian and Hispanic children.  While NAFLD affects all age groups, the risk of developing cirrhosis and liver failure is greatest in people over forty-five who are affected by obesity, diabetes, or both. Those who have elevated cholesterol and triglyceride levels are also at higher risk. The fatty deposition in the liver causes inflammation leading to cirrhosis and scarring. 

With the increasing incidence of diabetes and obesity in Western countries, the high prevalence of NAFLD came to the forefront in the 1990s, and has become a serious concern among health care professionals. 

During my training, we used to see patients with clinical presentations that were classical for alcoholic liver disease but they swore they never drank alcohol. It was really puzzling until a few decades ago when the correlation between insulin resistance, fat deposition and inflammation of the liver was proven. 

While a high percentage of people with NAFLD will not develop serious liver problems, without treatment these conditions can progress to cirrhosis, liver failure, and death.

As mentioned previously, fatty liver disease can go unnoticed for years. Early sign and symptoms include fatigue, drowsiness, dull abdominal discomfort in the upper abdomen and skin discoloration. If the disease progresses to cirrhosis, you can develop fluid retention, abdominal distention and jaundice.

There is no specific treatment at this time for fatty liver disease; however, getting treatment for any underlying disease, such as diabetes, is essential. 
  • You MUST limit your intake of alcohol, drugs and any unnecessary medication. The analogy I tell my patients is, if your liver is considered to be your home and it has caught on fire, pouring alcohol into it is like spraying gas all over your house.
  • If you are overweight or obese, do what you can to gradually lose weight, but no more than 1 or 2 pounds a week. A recent study showed that weight loss of at least 9% over a period of months can help reverse non-alcoholic fatty liver disease. Even less weight loss than this can help lessen buildup of fat in the liver.
  • Also, exercise is of serious importance in reversing fatty liver disease. Exercise strengthens the muscles and redistributes body fat.
  • Recent studies have shown that Vitamin E alone or in combination with an oral hypoglycemic (a diabetic pill) can reverse the liver inflammation caused by fatty deposition.
What we do know is that lifestyle changes, increased in physical activity and avoiding meals high in carbohydrates are by far, more effective than any medical therapy available.

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