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Let's talk a bit about Fatty Liver

Fatty liver

 

The fatty liver is defined as an excessive accumulation of fat (lipids) in the liver cells.

 

 

 

Symptoms

The fatty liver rarely causes symptoms. It rarely produces jaundice, nausea, vomiting or abdominal hypersensitivity.

Sometimes tiredness and pain or discomfort may appear in the upper right quadrant of the abdomen. Other possible manifestations are: loss of appetite, nausea and vomiting, jaundice, fever, ascites (distention of the abdomen by accumulation of fluid). The last three already correspond to advanced forms of the disease, with injury and inflammation of the liver.

 

 

 

Enlarged liver

When an enlarged liver is found on physical exploration without any other symptoms, the possibility of a fatty liver is suggested , the diagnosis of which can be confirmed by practicing a biopsy. For this, a long hollow needle is used to obtain a small sample of tissue for analysis under a microscope.  

 

Diagnosis

The most common techniques are abdominal ultrasound, which reveals a larger liver. This disease can also be suspected by altering blood tests, which detect an increase in liver enzymes (transaminases) in obese, diabetic and / or dyslipidemic patients. Biopsy is the test that allows you to confirm your diagnosis and also assess your degree of inflammation.

 

 

 

Hepatical cirrhosis

The mere presence of excess fat in the liver does not represent a serious problem, it can be a simple situation, which does not cause liver damage. The treatment aims to suppress the cause or alleviate the underlying change. Or it can progress to inflammation of the liver tissue due to repeated aggressions, caused by toxic substances, such as alcohol, can transform a fatty liver into liver cirrhosis.



 

Cause

 The accumulation of fat in the liver results from its excess intake, to the point that the body is unable to process it. There is talk of fatty liver when the fat corresponds to 5% to 10% of the mass of the liver.

But sometimes the cause of the fatty liver is unknown, especially in newborns.

In general, the known causes correspond to lesions of the liver. 

One of the major causes of fatty liver is alcohol consumption. 



 

However, this picture also appears in people who do not drink, being called non-alcoholic fatty liver. This condition is prevalent in patients with overweight / obesity, diabetes and with an increase in cholesterol and / or triglycerides.

Other, more rare, causes of fatty liver are: medications (amiodarone, estrogens, corticosteroids, tamoxifen, antiretrovirals, tetracyclines), certain genetic metabolic diseases, rapid weight loss, artificial forms of nutrition, intake of toxins (chemicals and mushrooms). There may still be some inherited predisposition for the occurrence of this pathology.

The fat that is ingested is metabolized in the liver and other tissues. If it is excessive, it is stored in the adipose tissue. From there it can be transferred to other places and also to the liver. In other cases, fat accumulates in this organ which is unable to transform it to be eliminated.

About 80% of alcohol consumers develop this pathology because alcohol allows a rapid accumulation of fatty acids in the liver.



 

Known causes of fatty liver

  • obesity
  • diabetes
  • chemicals and drugs (alcohol, corticosteroids, tetracyclines, valproic acid, methotrexate, carbon tetrachloride and yellow phosphorus).
  • malnutrition and poor protein diet
  • pregnancy
  • hypervitaminosis A
  • derivative surgery of the small intestine
  • cystic fibrosis (very often accompanied by malnutrition)
  • hereditary defects in glycogen, galactose, tyrosine or homocystine metabolism
  • medium-chain arylhydrogenase deficiency
  • cholesterol esterase deficiency
  • phytic acid deposit disease (Refsum's disease)
  • abetalipoproteinemia
  • reye syndrome




 

Treatment

There is no specific treatment or effective medication in this situation. Lifestyle changes and weight loss are key aspects. Therefore, diet and exercise are very important. 

 

 

It is also necessary to avoid the consumption of alcoholic beverages and to properly control associated diseases, such as diabetes and changes in cholesterol and triglycerides. It is worth emphasizing that, in its initial stages, the fatty liver is reversible.

What are the complications associated with fatty liver?

Although most cases have a benign evolution, it is now known that the evolution to cirrhosis is possible. This risk is greater in older patients, diabetics and those who already have inflammation of the liver (called non-alcoholic steatohepatitis).

 

 

 

Prevention

The choice for a healthy lifestyle, the prevention of obesity, the practice of physical exercise, are important aspects for this prevention. Such as a diet low in saturated fats, high in fiber and a moderate consumption of alcohol. Fish and lean meats should also be preferred over red meats and pork. It is also useful to supplement the diet with substances capable of preventing this disease and improving liver function, such as: vitamin E and C, selenium, omega-3 and ginseng, among others.




Based on: Merck Family Health Manual and https://www.cuf.pt/saude-az/figado-gordo



 

Catarina Vilela - Nurse