Fatty Liver

Fatty liver or hepatic steatosis is a condition when the liver organ stores too much fat. This condition can cause disturbances in liver function and increase the risk of many liver diseases later in life.

The liver is an organ that has many important functions for the body, one of which is to break down fat from food to be converted into energy for the body. Therefore, it is normal for there to be a small amount of fat in the liver.

Fatty liver is generally cured by making lifestyle changes. However, in some cases, fatty liver can trigger the formation of scar tissue in the damaged part of the liver (fibrosis). This condition can lead to cirrhosis which can increase the risk of liver cancer and liver failure.

Causes of Fatty Liver

Based on the cause, fatty liver can be classified into alcohol-related and non-alcohol-related fatty liver. Here is the explanation:

Alcohol-related fatty liver

Fatty liver related to alcohol occurs due to the habit of consuming alcoholic beverages excessively. The following is the limit of the intake of alcoholic beverages that can be accepted by the heart:

If the alcohol received by the body exceeds the above limit, the liver has to work harder to break down the alcohol so that it can be removed from the body.

The process of breaking down alcohol in the liver can cause disturbances in the metabolism of hepatocytes, which are the main cells that build liver tissue. This can cause a decrease in the function of the liver in breaking down fat and even increase the function of the liver in storing fat.

Non-alcoholic fatty liver disease

Fatty liver can also occur without alcohol addiction or excessive consumption of alcoholic beverages. The exact cause of this condition is more difficult to know, but metabolic syndrome is suspected to have a large role in the process of this disease.

Metabolic syndrome includes several conditions, among which are:

• Obesity, especially centered on abdominal fat ( waist circumference exceeding the normal limit)
• High triglycerides
• HDL cholesterol (good cholesterol) is low
• Hyperglycemia
• Hypertension (> 130/85 mmHg)

The above conditions are often caused by an unhealthy diet and lifestyle. However, it should also be known that consuming high-fat foods alone does not immediately cause fatty liver.

In addition, there are several other conditions that can also trigger the occurrence of fatty liver that is not related to alcohol, namely:

• Consumption of certain drugs for a long time or with high doses, for example corticosteroids , synthetic estrogen, methotrexate , and tamoxifen
• Exposure to toxic substances
• Certain medical conditions, such as hepatitis C
• Malnutrition
• Weight loss drastically
• Pregnancy

Fatty liver that is not related to alcohol can be divided into simple fatty liver (steatosis) and nonalcoholic steatohepatitis. In steatosis, there is no inflammation in the hepatocytes so the liver is not susceptible to complications.

On the other hand, hepatocytes in nonalcoholic steatohepatitis experience inflammation and damage. This can cause fibrosis or scar tissue formation in the liver. As a result, the risk of complications from cirrhosis (extensive scar tissue) or liver cancer becomes higher.

Symptoms of Fatty Liver

Fatty liver generally does not cause symptoms. However, some sufferers may experience discomfort in the stomach or fatigue. More obvious symptoms usually appear when the liver begins to experience inflammation. The condition is characterized by:

• Pain or swelling in the upper right part of the abdomen
• Nausea
• Loss of appetite
• Weight loss
• The body feels weak

Fatty liver that occurs during pregnancy usually appears in the third trimester. Symptoms of this condition can be nausea and vomiting, stomach pain, and yellow skin.

When should you go to the doctor?

Check with your doctor if you experience the symptoms as mentioned above, especially if they do not improve. Diagnosis and treatment as early as possible can prevent fatty liver complications.

If you have a condition that can increase the risk of fatty liver, such as obesity, type II diabetes, and high triglycerides or cholesterol, it is recommended to have a liver examination at least once a year.

Consult a doctor if you have an alcohol addiction . The doctor can help you in managing the habit of consuming alcoholic beverages in order to maintain your body's health.

Fatty Liver Diagnosis

The diagnosis process begins by asking questions and answers related to the symptoms experienced, lifestyle, as well as the patient's and family's medical history. After that, the doctor will perform a physical examination by measuring body weight and observing signs of liver problems, such as yellow skin or enlarged liver organs.

In order to confirm the diagnosis, the doctor will perform supporting examinations, such as:

• Blood tests, to check liver function
• Scanning with USG , CT scan, or MRI, to detect the presence of fat in the liver
• Liver biopsy, to see the condition of the liver tissue directly, also to see if there is a potential for inflammation

Fatty Liver Treatment

Fatty liver treatment aims to control or deal with the cause of this disease. For that purpose, the doctor will usually advise the sufferer to live a healthy lifestyle, such as:

1. Change the eating pattern

Dietary changes to lose weight are the most recommended treatment methods for all types of fatty liver. Weight loss of 3–5%, especially from abdominal fat, can lower the amount of fat in the liver. However, losing weight should be done slowly.

In addition, patients also need to control blood sugar and cholesterol levels by maintaining a healthy diet, such as:

• Consume foods high in fiber, such as vegetables and fruits
• Limit the consumption of foods high in calories and trans fats, such as fast food, fried foods, and pastries
• Limit the consumption of simple carbohydrates, such as white rice or white bread, and prioritize the consumption of complex carbohydrates , such as red rice or yams
• Consume healthy fats, such as fish, olive oil , and avocados
• Consuming chicken and fish as a substitute for red meat which tends to be high in fat
• Avoid drinks with high sugar content, especially packaged drinks

2. Stop drinking alcoholic beverages

Both for alcohol-related and non-alcohol-related fatty liver, patients are strongly advised to stop alcohol consumption . If the patient has difficulty in stopping the habit, the patient can consult a therapist or follow a special alcohol addiction recovery program.

3. Live a healthy lifestyle

Living a healthy lifestyle can help cure fatty liver and reduce the risk of liver inflammation and complications. The trick is to exercise regularly for at least 30 minutes a day.

All types of sports can help improve the condition of the heart. In addition, quitting smoking can also help lower the risk of complications due to fatty liver.

4. Consuming medicines

Certain medications can make the liver work harder. Therefore, consume medicines according to the needs and recommendations of the doctor, including herbal medicines.

As previously explained, fatty liver can be caused by certain conditions such as hyperglycemia and high cholesterol. Patients who suffer from the condition need to take medicine from the doctor to control it.

In addition, vitamin E and pioglitazone (a drug to deal with diabetes) are thought to be able to improve fatty liver conditions, even in patients who do not suffer from diabetes. However, the use of the drug still requires further research.

Complications of Fatty Liver

Untreated fatty liver can lead to cirrhosis. As a result, sufferers will experience liver dysfunction, which is marked by the following complaints:

• Yellow skin and eyes
• Edema or swelling of the limbs or the whole body
• Ascites
• Vomiting blood due to rupture of esophageal varices
• Confusion and fatigue
• Bleeding easily
• Palms are red
• Gynecomastia
• Enlargement of blood vessels under the surface of the skin

Cirrhosis can also increase the risk of liver cancer, especially if there is inflammation or hepatitis.

It is important to remember that a liver that has already suffered from cirrhosis cannot return to normal. The only treatment that can be done to improve this condition is a liver transplant .

Prevention of Fatty Liver

Prevention of fatty liver depends on the type. To prevent fatty liver related to alcohol, things that can be done are:

• Limit the consumption of alcoholic beverages
• Preventing hepatitis C by avoiding risk factors, such as unsafe sex and sharing the use of personal items such as toothbrushes, razors, and nail clippers
• Avoiding the consumption of alcohol while taking drugs, especially drugs such as paracetamol

While for fatty liver that is not related to alcohol, prevention methods include:

• Consume healthy food
• Maintain an ideal weight
• Exercise regularly