Fatty liver (hepatic steatosis; steatohepatitis)

• What is Fatty Liver (steatosis, steatohepatitis)
• Statistics on Fatty Liver (steatosis, steatohepatitis)
• Risk Factors for Fatty Liver (steatosis, steatohepatitis)
• Progression of Fatty Liver (steatosis, steatohepatitis)
• Symptoms of Fatty Liver (steatosis, steatohepatitis)
• Clinical Examination of Fatty Liver (steatosis, steatohepatitis)
• How is Fatty Liver (steatosis, steatohepatitis) Diagnosed?
• Prognosis of Fatty Liver (steatosis, steatohepatitis)
• How is Fatty Liver (steatosis, steatohepatitis) Treated?
• Fatty Liver (steatosis, steatohepatitis) References

What is Fatty Liver (steatosis, steatohepatitis)

Fatty liver is also known as NASH, which stands for Non-Alcoholic Steatorrhoeic Hepatosis or Non-Alcoholic-Fatty-Liver-Disease (NAFLD). Fatty liver is due to excessive accumulation of fatty material in the hepatocytes (liver cells), which is the most common response of the liver to injury.

Statistics on Fatty Liver (steatosis, steatohepatitis)

In countries where obesity is becoming a serious health issue, Fatty liver is predicted to affect approximately 25% of the general population. Fatty liver or NASH, is very common in overweight persons over the age of 30. The liver is invaded by an excessive amount of fat and a normal healthy liver tissue is partially replaced with areas of unhealthy fats. In such a liver, the liver cells and the spaces in the liver are filled with fat so the liver becomes slightly enlarged and heavier.

Risk Factors for Fatty Liver (steatosis, steatohepatitis)

Chemical Causes: Drugs or chemical compounds that can cause fatty liver include alcohol, tetracyclines, cortisone, phosphorous and carbon tetrachloride. Of the aforementioned compounds, alcohol is by far the most damaging in regards to fatty liver. Inflammation usually accompanies exposure to these toxins and is responsible for the associated symptoms of fever, fatigue and jaundice. Nutritional causes: Nutritional causes of fat in the liver result from starvation, obesity, protein malnutrition and intestinal bypass operation for obesity. When considering obesity, the fatty deposits are often associated with some inflammation and possible liver scarring. The endocrine causes: The endocrine causes of fatty liver include diabetes mellitus and fatty liver of pregnancy. In both these circumstances cases, a large amount of fat can be rapidly deposited in the liver leading to expansion of the liver with associated tenderness in the upper right portion of the abdomen. Only juvenile diabetics will suffer from this. Fatty liver during pregnancy occurs near term and may result in premature termination of the pregnancy.

How is Fatty Liver (steatosis, steatohepatitis) Diagnosed?

In diagnosing fatty liver, the physician will first eliminate the other possible causes of chronic liver disease, especially alcohol abuse. Images of the liver obtained by an ultrasound test, a CT, or an MRI scan, can suggest the presence of a fatty liver. In the ultrasound test, a fatty liver will produce a bright image in a ripple pattern. A CT, will show a liver that is less dense than normal.

Prognosis of Fatty Liver (steatosis, steatohepatitis)

Fatty liver can be considered reversible up to a point, by removing/reducing chemical and nutritional factors for the disease and treating any underlying endocrine cause.

How is Fatty Liver (steatosis, steatohepatitis) Treated?

Fatty liver treatment is related to its cause. Fat intake can be decreased by removing chemical compounds or drugs. Nutritional based causes are treated by simply altering ones diet to decrease liver fat intake. This can also be accomplished by providing available carbohydrates or by adding protein to overcome a complete or large deficiency in protein needed to make lipoproteins (proteins not capable of being dissolved in water).

Fatty Liver (steatosis, steatohepatitis) References

1. Bacon BR, Farahvash MJ, Janney CG: Nonalcoholic steatohepatitis: an expanded clinical entity. Gastroenterology 1994 Oct; 107(4): 1103-9
2. James O, Day C: Non-alcoholic steatohepatitis: another disease of affluence. Lancet 1999 May 15; 353(9165): 1634-6
3. Liver Foundation US
4. Ludwig J, Viggiano TR, McGill DB: Nonalcoholic steatohepatitis: Mayo Clinic experiences with a hitherto unnamed disease. Mayo Clin Proc 1980 Jul; 55(7): 434-8
5. The Merck Manual of Diagnosis and Therapy. Section 4. Hepatic And Biliary Disorders, Chapter 39. Fatty Liver. www.merck.com