FATTY LIVER DISEASE

Fatty liver is otherwise called as the fatty liver disease (FLD). This is a reversible condition which is caused by the triglyceride fat accumulation in liver cells. It is seen world wide and it has multiple causes which mainly includes excessive alcohol intake.
Progressive inflammation of the liver occurs in accumulation of fat and it is called steatohepatitis. Contribution of this condition by alcohol is called alcoholic steatosis. Fatty liver is commonly caused either by alcohol or metabolic diseases (ex.diabetes, obesity) and other causes include nutritional, drugs and toxins, and other causes.

Metabolic: glycogen storage disease, lipodystrophy and wolman disease.
Nutritional: Malnutrition, gastric bypass and total parenteral nutrition.
Drugs and toxins: Amiodarone, diltiazem and tamoxifen.
Other: Inflammatory bowel disease and Hepatitis C.


Fatty change represents the intra-cytoplasmic accumulation of triglyceride. In the beginning stage the hepatocytes present small fat vacuoles around the nucleus. In the later stage liver cells are filled with multiple fat droplets that do not displace the centrally located nucleus. In the later stages, the size of the vacuoles increases pushing the nucleus to the periphery of the cell giving characteristic signet ring appearance and it is called macrovesicular fatty change.
Inflammation is accompanied in severe fatty liver disease and this condition is called the steatohepatititis. Most of the affected individuals are asymptomatic. The fatty liver is noticed while undergoing incidental check ups and by abnormal liver function tests or the hepatomegaly is noted in unrelated medical condtions. There are cases where elevated liver biochemistry is found, this is applicable in 50% of patients with simple steatosis. Ultrasonography reveals a bright liver with increased echogenicity. Histological diagnosis by liver biopsy is sought when assessment of severity is indicated.
The treatment is based on treating the underlying causes and it depends on what is causing it. The process of steatosis is able to be reversed if implemented at an early stage. Fatty liver disease, unlike other diseases, it proceeds in a gradual and harmful way. In fact, fatty liver symptoms are very larger than other diseases. Recognizing the fatty liver disease is easier when it is known to them.
Fatty liver symptoms:
1. Fatty liver diseases in most of the cases experience no symptoms and especially in the early stage of the disease.
2. Mild form of fatty liver symptoms and its damage is not revealed in the liver tests. But, even a mild form of fatty liver disease affects two things which are dependent on the liver. One is the metabolism and another one is the drug clearing systems.
3. Several diseases are generated or manifested by the fatty liver diseases. They are such as diabetes, high cholesterol, obesity and it is due to low metabolism as well. Fatty liver symptoms and the disease may also cause frequent cold, rashes and allergies due to immune system deregulation.
4. The delicate or minute fatty liver symptoms are many as said earlier and they are very broad. Fatty liver disease symptoms include dizziness, coated tongue, (first fatty liver symptoms in most of the cases), tiredness, and the formation of circles under the eyes, a feel of bloating, headaches. The liver is enlarged in some cases. The enlarged liver may felt by pressing on the abdomen and by palpating. This enlarged liver is smooth normally during the earlier stages and it does not have any pain or tenderness.
5. Generally, when excessive alcohol intake is not stopped, or the underlying causes are not identified earlier, the liver gets changed, the liver can progress and lead to the development of other liver related diseases. These include alcoholic liver cirrhosis and alcoholic hepatitis.
6. Alcoholic liver cirrhosis is in its advanced stage, the liver becomes scarred, hardens and shrinked. In alcoholic hepatitis, the liver is inflamed and necrosis of liver tissue occurs due to alcohol. It is the fact that alcoholic cirrhosis and alcoholic hepatitis may occur together at the same time.
7. In the above disease, the skin and eyes become yellow in color, poor appetite, fatigue, weight loss and weakness appears. Pain originates from the right upper side of the stomach. In some cases bleeding occur, bruising, leg swelling (edema), swelling in abdomen (ascites) appears.
8. Portal hypertension is another symptom (increased blood pressure in the abdomen) and it causes the veins of the esophagus to swell. These swelling may result in burst and internal hemorrhage. The liver damage in severe cases causes failure to filter toxins from the blood resulting in brain damage called hepatic encephalopathy.
9. Advanced liver disease complications end in liver failure and kidney failure which are life threatening symptoms and in very rare cases liver cancer is caused.

(courtesey)