What Is Fatty Liver Disease?

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Fatty liver disease refers to deposition of fat in the liver and we're seeing a virtual epidemic of it because of the obesity epidemic, so with two out three Americans being overweight, and one out of every three Americans being obese, we're seeing a corresponding, rapid increase in Fatty Liver Disease, 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 fibers 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 enzyme 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, pre-diabetic and your 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 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 these other factors are excluded then the overwhelming likely hood 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 non invasive test where sound waves are used to look at the liver and the fat has a very characteristic appearance both on ultra sound and on other types of imaging like Cat scan or MRI.

So we can generally make a diagnosis again based on your histories, abnormal liver enzymes, and the imaging study. The next step is really to the 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 is 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 might have progression, that's generally the next step, and what we're looking for again is evidence of inflammation, and 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 are 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.