What is Fatty Liver Disease?
This describes a range of conditions which lead to an accumulation of fat in the liver. The disease affects around 10-15% of Australians and is the most common cause of mildly abnormal liver function tests (a commonly performed blood test). It does not cause symptoms but can lead to ongoing inflammation and then scarring in the liver called cirrhosis. Cirrhosis can lead to signs and symptoms such as jaundice (yellow colouring of the whites of eyes or skin), easy bruising, fluid accumulation within the abdominal cavity, confusion or gastrointestinal bleeding.
What causes Fatty Liver Disease?
The most common cause of fatty liver is non-alcoholic fatty liver disease (or NAFLD). It is associated with the metabolic syndrome which is a constellation of metabolic health issues including obesity, heart disease, high cholesterol, diabetes and strokes. It can result in inflammation of the liver known as non-alcoholic steatohepatitis (or NASH) which can then eventually lead to cirrhosis.
Excess alcohol consumption is another cause of fatty liver disease. Less common causes of fatty liver include an underactive thyroid, certain medications, polycystic ovarian syndrome and sometimes as a complication of late pregnancy.
How is Fatty Liver diagnosed?
As fatty liver disease does not usually cause symptoms, many people are unaware that they have a problem until a routine blood test suggests a liver problem. People who are at risk of fatty liver disease, such as those with features of the metabolic syndrome or consume excess alcohol, should have their liver function tests checked.
If abnormal liver function tests are found, your doctor may order a liver ultrasound to check for fat or even evidence of cirrhosis. A specific type of ultrasound called a fibroscan may be ordered to check on the state of the liver at regular intervals. A fibroscan measures the stiffness of the liver. A healthy liver is very soft but as there is progressive inflammation and scarring, the liver will become stiffer which results in a higher fibroscan score.
How is Fatty Liver Disease treated?
There are no specific drug treatments for fatty liver disease but lifestyle changes are necessary to control the risk factors and also slow or halt the progression of the disease.
- Weight loss if overweight: gradual weight loss aiming at 0.25-0.5kg a week until you reach your ideal body weight.
- Exercise at least five days a week with both aerobic and resistance exercise.
- A healthy, low-fat diet. Aim for a high fibre, low calorie diet. You may wish to consult with a dietician to maximise the health benefits from a healthy diet. There are many fad diets that come and go but there are no specific diets that ‘cleanse’ the liver.
- Control your other metabolic risk factors such as high blood pressure, diabetes, high cholesterol etc. Your doctor may prescribe you medication to help with these issues.
- Avoid or minimise alcohol. If you have fatty liver disease from alcohol consumption, you must abstain from alcohol.
- Do not take any medications or supplements without clearance from your doctor beforehand.
- Regular check ups will be required to check on the progress of your lifestyle changes and its affect on the fatty liver disease.
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