The rising incidence of fatty liver disease and what you can do to avoid it
“How did I get fat in my liver?” This is often the first question patients ask when I try to explain the cause of their liver disease. Recently, I have had this conversation more frequently, especially with my South Asian patients. The liver is the second largest organ in the body after the skin. It is located in the right side of the abdomen under the rib cage. It is responsible for a number of important functions such as clearing toxins from the blood and producing proteins such as clotting factors.
Fatty liver disease involves the accumulation of fat within the liver. It is typically due to either drinking excessive amounts of alcohol or a condition called nonalcoholic fatty liver disease (NAFLD). The exact cause of NAFLD is not known but has been closely associated with being obese and having diabetes, high cholesterol and high blood pressure. NAFLD has become increasingly more common as obesity becomes more common.
It is now one of the most common causes of liver disease and affects 20-35% of the world’s population. It is usually seen in adults between 40-60 years of age but can be seen even in young children. Most cases of NAFLD do not lead to any significant complications. However, in some people, the accumulation of fat in the liver can lead to inflammation and scar tissue which can ultimately lead to cirrhosis and liver failure, often resulting in early death. Unfortunately, many patients have no symptoms until the disease is advanced and they develop jaundice (yellowing of eyes and skin), confusion, and swelling of the abdomen and legs. As a result, it is often only detected when liver blood tests are found to be elevated or imaging tests of the abdomen are obtained for other reasons. Evaluation of this disease typically involves additional blood tests to exclude other causes of liver disease. Some may even need to have a liver biopsy where a needle is inserted through the skin to obtain a sample of liver tissue that is examined with a microscope. Currently, there is no cure for this disease but NAFLD is reversible if found in its early stages. Treatment is focused on controlling the conditions that led to the disease. Weight loss is essential and is achieved with diet and exercise. Aim for 30 minutes of exercise most days of the week and avoid items such as ghee, sugar and soda. Weight loss should be gradual as rapid weight loss can actually lead to worsening of the disease. Loss of 1-2 pounds per week is a reasonable goal. Good control of diabetes and cholesterol is also critical and may involve adjusting existing medications or addition of new medications. With these changes, it is possible to stop progression of the disease and even reverse it. If you are at risk for fatty liver disease, please see your primary care physician or gastroenterologist for further evaluation.
This column was guest written by Dr. Amil Patel, M.D., a board certified gastroenterologist who completed his residency at Emory University and GI fellowship at Duke University.
Gulshan Harjee, M.D., is a board certified internist in private practice with an emphasis on prevention. Please email your health and medical questions for consideration in this column to: gharjee@comcast.net. The material in this column is of a general nature, and must not be construed as specific medical advice. This column rotates monthly along with the Fitness Lifestyle column by Aarti Patel.
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