Fatty Liver Disease

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• QHow can I manage my fatty liver disease on a daily basis?

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  A Sigma Nursing answered

  Fatty liver disease, whether caused by alcohol consumption or not, is managed by eliminating alcohol use and following your doctor’s or nutritionist’s guidelines for medication, weight loss, and proper diet. Abstaining from alcohol is crucial to restoring the liver to good health, provided the damage to the liver is not too great. If alcohol is an issue, your doctor or a counselor may help, as well as a recovery program. You will also need to follow a nutrition program that helps achieve and maintain a healthy weight and healthy cholesterol levels; limiting salt and sugar is important. If you have diabetes, it will need to be controlled. Regular exercise is also considered important. Make sure to take any medications as prescribed. Finally, make sure your doctor knows about all over-the-counter medications and supplements you are taking, as some can cause liver damage.

• QHow can I improve my child's diet if he has fatty liver disease?

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  A Dr. Joel E. Lavine, MD , Pediatric Gastroenterology, answered on behalf of Columbia University Department of Surgery

  Talk to your pediatrician for diet tips that pertain specifically to your child. Many children who have fatty liver disease are overweight or obese. If this is true for your child, losing even 5% to 10% of total body weight can improve the condition of his liver, as well as his health overall. Here are ways you can help a child with fatty liver disease lose weight, and achieve and maintain a healthy body weight:

  • Get the whole family committed to healthier eating. It is easier for a child to change his eating habits if everyone in the family makes the same changes. 
  • Fill your house with healthy foods. Avoid buying high-fat, high salt and high-cholesterol foods. Make fresh vegetables, fruits, and whole-grain foods readily available to your child. 
  • Make sure that your child starts the day with a healthy breakfast.
  • Read the school lunch menu. If there are no low-fat options available for lunch, pack your child a healthy lunch to take with him. 
  • Make daily exercise a family routine. Do some physical activity (such as riding bikes or a family walk) when everyone is home after work and school. 

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• QCan I work with my child's school to help him manage fatty liver disease?

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  A Dr. Joel E. Lavine, MD , Pediatric Gastroenterology, answered on behalf of Columbia University Department of Surgery

  Managing fatty liver disease is easier if your child can eat well and exercise both at home and at school. Check your child's schedule and make sure that physical education is part of his curriculum. If it is not, talk to the guidance counselor or other school authority to see if there is a way to ensure that physical activity is built into his school day.
  
  Also make sure that both at work and at home, your child has access to healthy foods and isn't tempted to consume high-fat or high-cholesterol foods. See if you can get a copy of the lunch menus for the month, and if there are days when you feel your child cannot purchase a nutritious low-fat lunch at school, help him pack a lunch to take with him. 
• QCan eating sugar raise my risk of fatty liver disease?

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  A Dr. Julia J. Wattacheril, MD , Hepatology, answered on behalf of Columbia University Department of Surgery

  Eating excessive amounts of sugar in your diet may raise your risk of fatty liver disease for a couple of reasons. Consuming too much sugar may cause you to become overweight or even obese, and obesity is a risk factor for fatty liver disease. Excess sugar in the diet can also be converted into fat in the body. Fat can be deposited in your liver, just as it can in your muscle and fat tissue, ultimately leading to fatty liver disease and diabetes.
• QIs pediatric fatty liver disease on the rise?

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  A Dr. Joel E. Lavine, MD , Pediatric Gastroenterology, answered on behalf of Columbia University Department of Surgery

  Rates of fatty liver disease in children have gone up as obesity rates in children have also risen. Obesity increases the risk of fatty liver disease, a condition in which the liver contains excessive amounts of fat, which can affect normal liver functioning. About 10% of American children have fatty liver disease, according to some research. 
• QHow is fatty liver disease diagnosed?

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  A Parkland Medical Center answered

  Blood tests are the usual method used to determine if you have fatty liver disease (FLD). Various types of blood tests will look for irregularity in the liver, including enlargement. Accumulation of fat in the liver can be identified through technology including ultrasound, CT scans, or MRIs; however, these tests cannot determine whether other characteristics of fatty liver are present, such as enlargement of the liver. A biopsy of the liver, obtained through insertion of a needle into the organ, can not only identify fatty liver but also give information about its causes and severity.

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• QCan fatty liver disease affect children?

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  A Parkland Medical Center answered

  About 5 percent of children are estimated to have nonalcoholic fatty liver disease (NAFLD), commonly associated with obesity in children and adults.  Fatty liver is thought to effect up to half of all obese children. Children with fatty liver disease may experience abdominal pain or fatigue.

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• QDo all people with fatty liver disease need a liver biopsy?

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  A Dr. Joanna Yeh, MD , Pediatric Gastroenterology, answered on behalf of UCLA Health

  Not all people with fatty liver disease need a liver biopsy. A lot of people fall into the category of having fatty liver disease, but if there is just simple steatosis but no inflammation then they will be evaluated and treated, and a liver biopsy will not be needed. However, if advanced scarring or advanced fibrosis is suspected, doctors need to know the extent of liver damage, so a liver biopsy is necessary. Liver biopsy is also useful when doctors are not 100 percent sure of the diagnosis of fatty liver disease and need to rule out other causes of liver disease.
• QWhat does a clinical workup for pediatric fatty liver disease involve?

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  A Dr. Joanna Yeh, MD , Pediatric Gastroenterology, answered on behalf of UCLA Health

  As part of a clinical workup for pediatric fatty liver disease, the child's pediatrician or gastroenterologist will screen for comorbid conditions, such as diabetes, cholesterol problems, thyroid dysfunction, vitamin D deficiency and sleep apnea. Sometimes, for example, correction of sleep apnea improves liver health, so it's very important that doctors screen for comorbid conditions. In addition, doctors may test for hepatitis B, hepatitis C, autoimmune hepatitis, Wilson's disease, alpha-1 antitrypsin deficiency, celiac disease, and other metabolic problems that can lead to elevated levels of the enzyme alanine transaminase (ALT), which might masquerade as fatty liver.
• QWhat are the two main types of fatty liver disease?

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  A Univ. of Nev. School of Medicine, Family Medicine answered

  The two main types of fatty liver disease are nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH). Fatty liver disease is a process where fat infiltrates into normal liver tissue. In NAFLD, the fat hasn't caused any damage to the function of the liver. In NASH, there is fat in the liver plus signs of inflammation and liver cell damage.