Liver & Biliary Surgery in Ahmedabad by Dr. Manish Gandhi.
Dr. Manish Shah performs the best Liver & Biliary Surgery in Ahmedabad. Some fat in the liver is normal. But if fat makes up more than 5%-10% of the weight of your liver, you may have alcoholic or nonalcoholic liver disease. In some cases, these diseases can lead to serious complications.
Alcoholic Liver Disease (ALD)
More than 15 million people in the U.S. abuse or overuse alcohol. Almost all of the 90% to 100% develop fatty livers. Fatty liver can occur after drinking moderate or large amounts of alcohol. It can even occur after a short period of heavy drinking (acute alcoholic liver disease).
Genetics or heredity (which passed down from parent to child) plays a role in alcoholic liver disease in two ways: It may influence how much alcohol you consume and your likelihood of developing alcoholism. And, it may also affect levels of liver enzymes involved in the breakdown (metabolism) of alcohol.
Other factors that may influence your chances of developing alcoholic fatty liver disease include:
- Hepatitis C (which can lead to liver inflammation)
- An overload of iron
Non-alcoholic fatty liver disease (NAFLD)
Nonalcoholic fatty liver disease is now the most common cause of chronic liver disease in the U.S. Some people with excess fat in the liver simply have what’s called a fatty liver. Although this is not normal, it is not serious if it doesn’t lead to inflammation or damage.
Others have what’s called nonalcoholic steatohepatitis (NASH). Although it is similar to alcoholic liver disease, people with this type of fatty liver disease drink little or no alcohol. NASH can lead to permanent liver damage. The liver may enlarge and, over time, liver cells replaced by scar tissue. It is cirrhosis. The liver can’t work right and you may develop liver failure, liver cancer, and liver-related death. NASH is one of the leading causes of cirrhosis.
Both types of NAFLD are becoming more common. Up to 20% of adults may have either fatty liver or NASH. And more than 6 million children have one of these conditions, which are most common in Asian and Hispanic children. Recent evidence indicates that NAFLD increases the risk of heart disease in children who are overweight or obese.
Causes of Nonalcoholic Fatty Liver Disease (NAFLD)
The cause of the nonalcoholic fatty liver disease is not clear. Certain factors tend to increase risk, but in some cases, no risk factors show up. However, NAFLD tends to run in families. It also shows up most often in people who are middle-aged and overweight or obese. These people often have high cholesterol or triglycerides and diabetes or prediabetes (insulin resistance), as well.
Other potential causes of fatty liver disease include:
- Viral hepatitis
- Autoimmune or inherited liver disease
- Rapid weight loss
Recent studies show that an overgrowth of bacteria in the small intestine and other changes in the intestine may be associated with nonalcoholic fatty liver disease. Some researchers now suspect this may play a role in the progression of NAFLD to NASH.
Symptoms of Fatty Liver Disease
Fatty liver disease is often silent, producing no symptoms, especially in the beginning. If the disease advances which is usually over a period of years, or even decades it can cause vague problems such as :
- Weight loss or loss of appetite
- Confusion, impaired judgment, or trouble concentrating
These symptoms may also be present:
- Pain in the center or right upper part of the abdomen
- An enlarged liver
- Patchy, dark skin discoloration, usually on the neck or underarm area
With alcoholic liver disease, symptoms may worsen after periods of heavy drinking. With NAFLD, the disease process can stop or reverse, or it may worsen. If cirrhosis develops, the liver loses its ability to function. This can cause signs and symptoms such as :
- Fluid retention
- Muscle wasting
- Internal bleeding
- Jaundice (yellowing of skin and eyes)
Diagnosis of Fatty Liver Disease
Often a fatty liver shows up during a routine checkup. Your doctor might notice that your liver is slightly enlarged or see signs of a fatty liver on a blood test. Or, your doctor may suspect a problem after taking a health history or doing a physical exam.
During routine blood tests, elevations in certain liver enzymes may show up. These might include alanine aminotransferase (ALT) or aspartate aminotransferase (AST).
A fatty liver may also show up on imaging tests, such as an abdominal ultrasound.
The only way to confirm a diagnosis of fatty liver disease is with a liver biopsy. This is usually done once other causes have been ruled out. After application of local anesthesia, the doctor inserts a needle through the skin to remove a tiny piece of liver. This is then examined under a microscope for signs of fat, inflammation, and damaged liver cells. If inflammation or damage is not present, the diagnosis is simply a fatty liver.
Treatment of Fatty Liver Disease
There is no specific treatment at this time for fatty liver disease. However, getting treatment for any underlying disease, such as diabetes, is essential. And you can take other steps to improve your condition.
If you have alcoholic liver disease and you are a heavy drinker, quitting drinking is the most important thing you can do. Find the support you need to be successful. With ALD, continued use of alcohol can lead to advanced disease, including alcoholic hepatitis or cirrhosis. Even for those with NAFLD, however, avoiding alcohol may help.
If you are overweight or obese, do what you can to gradually lose weight — no more than 1 or 2 pounds a week. A recent study showed that weight loss of at least 9% over a period of months can help reverse NASH. Even less weight loss than this can help lessen the buildup of fat in the liver.
Eat a balanced and healthy diet and increase your physical activity. In addition to limiting calories, avoid diets rich in refined, rapidly digested carbohydrates. This includes limiting foods such as bread, grits, rice, potatoes, corn, and concentrated sugar that is found in sports drinks and juice.
Avoiding unnecessary medications can also help slow or reverse the disease. Clinical trials are also looking at the effectiveness of certain antioxidants and newer diabetes medications in treating fatty liver disease (because of the disease’s link to oxidative stress and diabetes).
- Vitamin E
Note that even vitamins and minerals can lead to health problems. The best way to get their benefits is through food sources that contain them.
New findings of the role of bacteria in the development of the fatty liver disease may lead to still other options for treatment, such as by counteracting unbalanced diets with probiotics. These are dietary supplements containing healthy live bacteria or yeasts.
If cirrhosis becomes severe, a liver transplant may be needed. A surgeon removes the damaged liver and replaces it with a healthy one.