Liver diseases

Fatty liver disease

Liver diseases
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Fatty liver disease
foto de Fernando Martínez Sáez
Written by

Fernando Martínez Sáez
Medically reviewed by our Medical staff

Last update: 13-07-2021

How else can it be called?

  • Hepatic steatosis

  • Steatohepatitis

  • CIE-9: 571.8

  • CIE-10: K76.0

What is fatty liver disease?

Fatty liver disease is the accumulation of excessive amounts of triglycerides and other types of fats inside liver cells.

The liver is the organ responsible to transform ingested fats into other types of fats that can be stored and used later.

In fatty liver disease, large droplets of fat containing mostly triglycerides are stored in the liver and thus the liver increases in size.

Fatty liver is not a worrying condition by itself, but if not treated properly, it may lead to other diseases. It is estimated that 15% of people with fatty liver disease may have cirrhosis in the next 15 years.

Fatty liver disease can be a temporary or a long-term condition. It is reversible when the underlying cause is diagnosed and treated.

Normally, fatty liver disease may go unnoticed since it is not painful. On the other hand, in severe cases, the liver can increase three times its normal size and be painful.

What can cause fatty liver disease?

The most common cause of fatty liver is alcoholism. When the amount of alcohol consumed is high, the liver changes the way it breaks down and stores fats.

Other conditions that may cause fatty liver disease are:

  • Metabolic syndrome
  • Obesity
  • Diabetes Mellitus
  • Type 2 diabetes
  • Dyslipidemia
  • Malnutrition or increased weight loss in short periods of time
  • Reye’s syndrome in children
  • Drug overdose, such as corticosteroids, amiodarone, diltiazem, tamoxifen, irinotecan, oxaliplatin or toxic chemical poisonings (like carbon tetrachloride or yellow phosphorus).

Pregnancy may cause a rare but sometimes severe form of acute fatty liver. It usually starts during late pregnancy (between weeks 28 and 40) and is often associated with jaundice and liver failure.

What incidence does it have?

Fatty liver disease can affect more than a third of adults in Western countries and 10% of children or adolescents.

During pregnancy, the disease has an approximate incidence of 5 cases per 100,000 pregnancies and is more common in case of twin pregnancy or when the mother is underweight.

What are the main symptoms?

Often, fatty liver does not show any symptoms. If they are present, the most frequent symptoms are:

  • Pain or swelling on the right side of the abdomen under the rib cage
  • Fatigue and exhaustion
  • Jaundice (yellow color of the skin and eyes)
  • Fever

In case of fatty liver during pregnancy, it is frequent to suffer:

  • Nausea
  • Vomiting
  • Loss of appetite

How can it be diagnosed?

Fatty liver may be suspected during a physical examination by noticing that the liver is enlarged and tender. It can be confirmed with a liver biopsy, where a small sample of liver tissue is removed with a needle through a small incision.

In a blood test, people with fatty liver disease usually have high levels of SGOT (AST) and SGPT (ALT) transaminases. In many cases, the alkaline phosphatase (ALP) is also elevated as a consequence of cholestasis (decreased flow of bile from the liver to the duodenum).

What is the recommended treatment?

Treatment for fatty liver is focused on correcting the underlying cause and providing supportive care.

General measures, such as losing weight and do regular exercise are helpful in people with obesity.

If alcoholism is the main cause, alcohol consumption should be stopped. Following a healthy and balanced diet is also recommended.

If fatty liver occurs during pregnancy, it is advisable to deliver the baby as soon as the appropriate conditions are met.

Medically reviewed by our Medical staff on 13-07-2021

Bibliography

  • The Gale Encyclopedia of medicine. Second Edition. Jacqueline L. Longe. Vol 2. pag 1298. ISBN 0-7876-5491-4
  • Liver and Biliary Disease. Nichola J. Talley. 2010. ISBN: 9781405182751 Pag 224.
  • Textbook of Clinical Gastroenterology and Hepatology. 2º edition. C. J. Hawkey, Jaime Bosch, Joel E. Richter, Guadalupe Garcia-Tsao, Francis K. L. Chan. 2012. ISBN-13: 978-1-4051-9182-1 Pag 658.

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