What is fatty liver disease?
Fatty liver disease is deposition of fat in the liver; the obesity epidemic has created a rapid increase in this condition. Watch as integrative gastroenterologist Robynne Chutkan, MD, discusses basic information and symptoms of fatty liver disease.
ROBYNNE CHUTKAN (VOICEOVER): Fatty liver disease refers to deposition of fat in the liver. And we are seeing a virtual epidemic of it because
of the obesity epidemic. So with two out of three Americans being overweight, and one out of every three Americans being obese,
we're seeing a corresponding rapid increase in fatty liver disease. [MUSIC PLAYING]
So with fatty liver disease in the early stages, we see a lot of extra fat being deposited in the liver. And this can cause the liver to become enlarged.
It can cause pain in the right upper quadrant where the liver is located because the fibrous capsule around the liver stretches as the liver gets bigger.
And it most commonly causes an abnormality in the liver function testing, a blood test we do to liver enzymes called
the AST and the ALT. So the combination of being overweight, particularly if you have what we call central obesity, where you
tend to put on most of your weight around your middle, or if you also have elevated blood pressure, high cholesterol, if you're diabetic or pre-diabetic,
and you have these elevated liver enzymes, there's a strong likelihood that you might have fatty liver disease. Now, the first thing that we do is exclude other causes
of liver disease, like viral hepatitis, hepatitis C, or hepatitis B, like alcoholic liver disease.
So we take a careful history to try and figure out how much alcohol you're drinking and see whether that could be contributing. We look at other medications you might be taking
that can also damage the liver. Once those other factors are excluded, then the overwhelming likelihood is that it's fatty liver disease.
The next thing we might do would be an imaging test of the liver so that we can actually see the fat. And what's usually done is an ultrasound exam.
It's a noninvasive test where sound waves are used to look at the liver. And the fat has a very characteristic appearance,
both on ultrasound and on other types of imaging, like CAT scan or MRI. So we can generally make a diagnosis, again,
based on your history, the abnormal liver enzymes, and the imaging study. The next step is really to see whether you
have early fatty liver disease, where you just have fat deposited in the liver and an enlarged liver, or whether you might have progression of that to a stage
where there's actually inflammation of the liver, or even end stage liver disease, something we call cirrhosis. And that's usually done by doing a liver biopsy.
We don't do liver biopsies in everyone with fatty liver disease. But if we suspect that you have progression, that's generally the next step.
And what we're looking for, again, is evidence of inflammation as sort of the second step or scarring, which is the third step.
Now, the good news is that the early stages of fatty liver disease are reversible by changing your diet and losing weight.
But unfortunately, the end stage, cirrhosis, which can progress and can be fatal, is not reversible. So it's very important if you think
you're at risk to seek help from a medical professional, get some testing done, and find out, A, if you have it,
and, B, if you do have it, where in the progression you might be. --
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