Fatty liver disease, fatty hepatitis, liver steatosis – all these concepts reflect the same pathological condition that can develop as a result of exposure to a wide variety of factors.
What is bad for the liver?
Drinking regularly is harmful – anyone knows this, even a person far from medicine. And when it comes to diseases caused by excessive consumption of intoxicating drinks, as a rule, the first thing to remember is cirrhosis of the liver. Indeed, the doctor faces a difficult task when the patient comes to him with “ready” cirrhosis, manifested by a violation of the structure and function of the organ. It is possible to help at this stage, but nevertheless, the disease should not be brought to cirrhosis. It is much better for both the doctor and the patient when the liver changes are still minimal and reversible. We are talking about the so-called fatty hepatitis or, in other words, fatty liver.
What is Fatty Liver?
Fatty liver disease, fatty hepatitis, liver steatosis – all these concepts reflect the same pathological condition that can develop as a result of exposure to a wide variety of factors. At the same time, the literal translation of the English term “fatty liver” – “fatty liver” – attracts attention because it is understandable for both the doctor and the patient. Like an obese person, a “fatty liver” lies in wait for a whole range of diseases. However, in most cases, obesity of the liver is completely reversible, provided that the causes leading to its formation are eliminated. It is to this indisputable fact that the attention of both doctors and patients should first of all be drawn, since timely recognition of fatty hepatitis prevents the development of inflammation, which is much more difficult to treat.
What Causes Fatty Liver?
There are many reasons for the deposition of fat in the liver, but in 2/3 of patients it is still alcohol. In second, third and subsequent places are diabetes mellitus, obesity and hyperlipidemia (an increased content of some fractions of fat in the blood due to genetic reasons and corresponding dietary preferences). Some of the more rare causes of fatty liver development include certain medications, gastrointestinal surgery, and hereditary diseases. In addition, the listed factors can be combined.
Are alcohol and liver enemies?
So, back to alcohol. Fatty liver has become a frequent diagnosis of representatives of the high strata: politicians, businessmen, diplomats, artists. They are not alcoholics, they do not even abuse alcohol in the conventional sense. It’s just that these categories of citizens have a glass of cognac or vodka – either an indispensable attribute of buffets and presentations, or a means to relieve stress after a working day, and sometimes during. They feel great the next morning and are completely unaware of the need to cut back on alcohol. Such patients are very surprised when the examination reveals pathological changes in the liver. The reaction to alcohol is different for each person; this is due to genetically determined enzyme activity, gender, age, etc. So, in women, the hormonal background contributes to the strengthening of the damaging alcohol on the liver, and in half of the representatives of the Mongoloid race, the toxic decay products of ethyl alcohol are neutralized much more slowly than in Europeans. In addition, a person may have concomitant diseases that he does not even know about, for example, viral hepatitis or diabetes mellitus. At the same time, these diseases significantly increase the sensitivity of liver cells to alcohol. When talking about liver diseases, it should always be remembered that the liver is a very reliable, silent and patient organ, which often makes it known about its suffering when there are no more reserves for recovery. If you drink and do not eat, fatty liver will appear faster.
Why is fat stored in the liver?
The fact is that the liver bears the main load of fatty acid oxidation, as a result of which the body replenishes energy reserves. Alcohol damages the lining of the liver cells and disrupts the function of enzymes involved in the transport and oxidation of fatty acids. This leads to disruption of their normal metabolism and accumulation in the cell. In type 2 diabetes mellitus (typical for middle-aged and elderly people), obesity and hyperlipidemia, the ratio between the amount of fat that penetrates the hepatic cell and the cell’s ability to utilize it is also disturbed.
Why is fatty liver dangerous?
The main danger of this condition is that excess fat, under the influence of various factors, begins to oxidize with the formation of highly active compounds that additionally damage the cell. And this is the next stage of the disease – hepatitis, that is, inflammation of the liver. In this aspect, it is appropriate to compare fatty liver with a warehouse of fuels and lubricants, which should be guarded by an armed guard, since one spark is enough to start a fire. The progression of inflammation leads to the death of liver cells (hepatocytes), their replacement with skeletal connective tissue, and, as a result, impaired blood circulation in the liver and the development of liver failure. These, in fact, are the main manifestations of cirrhosis.
How does a fatty liver affect well-being?
Fatty liver is insidious in that it often does not manifest itself in any way. For some, a feeling of heaviness or dull pain in the right hypochondrium, nausea, and an unpleasant taste in the mouth lead to a doctor. Roughly imagining the location of the organs, patients believe that their liver hurts. But there is nothing to hurt in the liver, because there are no nerve endings, they are only in the capsule and bile ducts. Usually painful sensations are associated with impaired motor activity (dyskinesia) of the biliary tract. In the majority, the signs of a fatty liver are detected by chance during examination for some other reason. For example, a patient undergoes an ultrasound examination (ultrasound) of the abdominal organs or he or she turns to a doctor for any other disease (coronary heart disease, diabetes mellitus, etc.),
Is self-healing possible?
In this situation, it is very important that the patient see a specialist in liver disease. The point is not even that in a specialized clinic methods of laboratory and instrumental diagnostics are practiced that are inaccessible, for example, to a district clinic. There are well-equipped polyclinics in which any research is carried out, but they cannot correctly interpret their results due to a lack of relevant experience.
How to identify fatty liver?
Diagnosis of fatty liver and its complications is complex. An experienced physician always starts with a thorough history taking (memories of the patient’s life), paying particular attention to the dose and frequency of alcohol intake, as well as concomitant diseases. Then the patient is examined in order to identify external signs of damage to the liver and other organs, to determine the size of the liver and spleen. And only after that comes the stage of laboratory and instrumental methods. The latest method for diagnosing fatty liver disease is available in our clinic. This is a fibro scanning of the liver, when the doctor, right at the reception, can “look inside the liver” and make the correct diagnosis and develop a treatment program. A biochemical blood test provides valuable diagnostic information about the presence and nature of inflammation, impaired bile metabolism and functional reserves of the liver. A study for the presence of hepatitis viruses is mandatory: this is due both to the fact that viral hepatitis is the most common cause of liver damage in the world, and to the fact that, in particular, the hepatitis C virus can disrupt the metabolism of fat in the liver. Additional examination, including the determination of immunological parameters, computed tomography is prescribed if there are special indications.
How is fatty liver treated?
First of all, it is necessary to either exclude or minimize the effect of the factor that led to the deposition of fat in the liver. This is almost always possible in relation to alcohol, if we are not talking about the formation of addiction, when the help of a narcology’s is required. Patients with diabetes mellitus, obesity and hyperlipidemia should be monitored jointly by an endocrinologist and a cardiologist, respectively. All patients require a low carbohydrate diet and adequate daily physical activity.
When these measures are not enough, the doctor prescribes special medications that affect the metabolism of fat in the liver. Only an experienced doctor can establish what caused the changes in the liver in a particular patient and how pronounced they are. If you have any suspicions – seek advice from a gastroenterologist or Hepatology .
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