Fatty liver disease is one of the most common causes of liver damage. It happens when fat builds up in the liver cells and causes the liver to swell, leading to inflammation or cell death. Fatty liver can be caused by several factors, including obesity, high blood pressure, diabetes, excessive alcohol consumption, an overproduction of fatty acids, medicines that interfere with insulin function (such as anabolic steroids ), or disorders that affect how substances are produced or removed from the body (such as hemochromatosis ).
Symptoms: If you have fatty liver disease, you may not have any symptoms at first. But if scarring develops in your liver, you could experience fever, nausea, pain in your abdomen or muscles, swelling of your lower legs and feet, weakness, weight loss, itching, or a yellowing of your skin and the whites of your eyes ( jaundice ).
Treatment: The treatment for the fatty liver disease usually focuses on relieving symptoms until the disease goes away. In some cases, medication may be used to treat high cholesterol levels. Your doctor may monitor you for signs of scarring in your liver by performing blood tests that check for certain enzymes or proteins that are released into your blood when liver cells are injured or dying. If scarring is detected early enough, medications might help prevent the further progression of the disease.
In most cases, however, treatments focus on managing any underlying conditions that caused the fatty liver. For example:
- if you are overweight or obese, you will likely be advised to lose weight through dietary changes, increased physical activity, and sometimes surgery.
- if you have high blood pressure, your doctor may recommend lifestyle changes, such as eating a healthy diet and losing weight. Medications to control your blood pressure may also be used.
- if diabetes is the underlying cause of fatty liver disease, you will need treatment for that condition, which could include medication or insulin therapy. Your doctor might also advise you to make significant changes in your lifestyle that can help keep your blood sugar within a normal range, such as exercising regularly and following a nutritious diet.
- If alcohol use was the primary cause of fatty liver disease, quitting drinking may improve liver inflammation and scarring. Your doctor may recommend that you enroll in a support program to help you stop drinking or attend an alcohol abuse treatment program.
- If your hepatitis virus was the cause of fatty liver disease, your doctor may advise you to avoid activities that can spread this condition to others (such as sharing needles for drug use) and will work with you to prescribe medication and other treatments as needed.
If you have ever had hepatitis B or C, it is important to tell your doctor before having any medical tests that might reveal fatty liver diseases, such as an ultrasound or a blood test called the alanine aminotransferase (ALT) level.
To help reduce the risk of early scarring in your liver, ask your doctor whether you should limit alcohol use and which medications you should avoid if necessary.
Liver Transplant: A liver transplant may be considered for people who develop cirrhosis. However, chronic hepatitis B or C infection before liver transplantation predisposes recipients to recurrence of hepatitis after transplantation. To prevent this complication, antiviral drugs are recommended for all patients with underlying chronic hepatitis B or C virus infection who are undergoing liver transplantation, regardless of the severity of underlying hepatitis.
The prognosis (outlook) for fatty liver disease varies depending on what caused it. For example:
- Symptoms associated with the alcoholic fatty liver disease usually disappear after you stop drinking, but permanent scarring may remain.
- Nonalcoholic fatty liver disease is not always reversible because it can progress to cirrhosis (permanent scarring ). But in many cases, significant weight loss and other changes in your diet and lifestyle can help halt this progression by reducing insulin resistance and helping you control blood sugar levels.