Fatty Liver Disease-by Dr harold Gunatillake

“Non-alcoholic fatty liver disease (NAFLD) is a very common disorder and refers to a group of conditions where there is an accumulation of excess fat in the liver of people who drink little or no alcohol. The most common form of NAFLD is a non-serious condition called fatty liver”.

Transcript:

Let us discuss today- fatty livers.

It is normal for the liver to contain some fat, but if fat accounts for more than 10 per cent of the liver’s weight, you have fatty liver and may develop more serious complications. Fatty liver may cause no damage, but sometimes the excess fat leads to inflammation of the liver. In inflammation, the liver swells and becomes damaged.

It is a silent disease like high blood pressure until the symptoms start appearing one day. If you are overweight, have metabolic syndrome or type 2 diabetes, you are most likely to have the disease.

Early stages, it is referred to as non-alcoholic fatty liver disease or NAFLD, and with the progress of the disease, we call it non-alcoholic steatohepatitis or NASH when there is inflammation and liver damage along with fat in your liver.

How do doctors diagnose non-alcoholic fatty liver disease?

The medical history of your lifestyle, physical examination for an enlarged liver, blood tests, imaging tests and liver biopsy are the methods available to clinch a diagnosis.

This way, one could diagnose whether you are having the early stage, i.e., non-alcoholic fatty disease or late non-alcoholic steatohepatitis.

Fatty liver can also be brought about due to excessive drinking habits.

Alcohol and fatty foods, eating too many added sugars and beverages with corn syrup, consumed in excess can cause alcoholic fatty liver disease. When the condition is due to alcohol we call it alcoholic fatty liver, and in the non-alcoholic situation, it is called a non-
 

alcoholic fatty liver or steatosis and when it is severe, we call it non-alcoholic steatohepatitis (NASH), as mentioned earlier.

If left untreated can lead to cirrhosis and liver failure.

The prevalence of NAFLD among adults in Sri Lanka is high. In a large population-based study from urban Sri Lanka, among 2,985 adults (aged 35-64 years), 974 (32.6%) were found to have NAFLD on ultrasonography.

White rice and its unrefined form, brown rice, contain numerous compounds that are beneficial to human health, but the starch content of rice can contribute to obesity, the main risk factor for nonalcoholic fatty liver disease

Brown rice endosperm protein slows the progression of fatty liver and diabetic nephropathy in rat studies (ref: Kubota M et.al Br J Nutr 2016)

Fatty liver is one of the most common causes of liver disease in the US. It affects more than 25% of the US. population.

The condition is common in obesity, metabolic derangements, and diabetes-related to high carb and high-fat diets.

How does the liver build up fat?

Your liver has a great capacity to detoxify and buffer a lot of things that come into your body. It also makes a lot of things that help you digest food, clot properly, maintain healthy blood pressure and carry out many other functions.

However, as cells start to get hurt from the accumulation of fat, inflammation in the tissue increases and this can lead to the death of cells and scar formation in the liver, which can then progress to advanced liver disease. In these cases, the liver is not able to fully carry out its regular functions and many other organ systems in the body can be affected.

Eating excess calories from carbs and fatty foods can cause the build-up of fat in the liver. The liver does not break down the fats as it normally should, too much fat will accumulate. As mentioned earlier, if you are obese and have type 2 diabetes you probably have a high chance of fat accumulating in your liver.

You need to have a blood test during the early stages to diagnose the disease. Your enzymes produced by your liver will be high, which indicates inflammation or damage to cells in the liver.

Inflamed or injured liver cells leak higher than normal amounts of certain chemicals, including liver enzymes, into the bloodstream, elevating liver enzymes on blood tests. The elevated liver enzymes most found are:

Alanine transaminase (ALT) Aspartate transaminase (AST) Alkaline phosphatase (ALP)

Gamma-glutamyl transpeptidase (GGT)

Elevated liver enzymes might be discovered during routine blood testing. In most cases, liver enzyme levels are only mildly and temporarily elevated. Most of the time, elevated liver enzymes don’t signal a chronic, serious liver problem.

When you are diagnosed having non-alcoholic fatty liver disease, what treatments are available for you.

Doctors recommend weight loss if you are overweight to treat nonalcoholic fatty liver disease, which is either nonalcoholic fatty liver or nonalcoholic steatohepatitis.

Weight loss can reduce fat, inflammation, and fibrosis in the liver. No medicines have been approved to treat NAFLD or NASH.

Diet-wise, you need to eat a healthy diet and maintain a healthy weight.

If you neglect your disease you may end up with Cirrhosis in which your liver is scarred and permanently damaged. Scar tissue replaces healthy liver tissue and prevents your liver from working normally. As cirrhosis gets worse, your liver begins to fail.

When you get to cirrhosis, the symptoms are fatigue and severe itchy skin.

Doctors diagnose cirrhosis based on your medical history, a physical exam, and the results of tests. Tests include blood tests such as liver function tests and tests for viral infections, imaging tests, and liver biopsy.

A few people who get cirrhosis of the liver develop liver cancer. Also, people who get fatty liver have an increased risk of heart attack and stroke.

Can fatty liver be prevented?

Eating a healthy diet that is rich in fruit and vegetables, whole grains and healthy fats, maintaining a healthy weight, being physically active on most days of the week, and if you are a diabetic need to control your blood sugar levels.

Hope this video presentation was useful. Stay safe and goodbye for now.

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