Patient Education: Fatty Liver

Today's discussion: Fatty liver!

Fatty liver is one of the most common diagnoses these days. Many people are often told they have fatty liver but aren't told exactly what it is or the potential complications of it.

To break it down, fatty liver is simply when fat cells in the body start to invade the liver. That's all it truly is. In a majority of cases fatty liver is almost always lifestyle induced and is usually linked to either being overweight or by excessive alcohol consumption. As our general population's weight has increased the prevalence of fatty liver has increased proportionally as well. In an overwhelming majority of patients, they will experience no symptoms from fatty liver in the beginning stages. There's no changes in liver function, no pain, and most only know about it because it showed up on routine screening probably while looking for something else. For this reason it can be easily overlooked and is poorly discussed.

The truth is a bit more nuanced, uncomplicated fatty liver can and does progress to different versions. The first progression is known as Steatohepatitis, which is essentially when the invasion of fat cells results in inflammation in the liver which can cause severe abdominal pain, abnormal liver function and a variety of other symptoms. Another version is when the fat cells cause damage to the liver which can lead to fibrosis or cirrhosis of the liver. Ultimately, it can lead to liver failure. Most patients will not experience the complications of fatty liver I just described but the potential and risk to progress is there for all of them.

The good news is since this is primarily a lifestyle induced disease, in the early stages of uncomplicated fatty liver (and even into the stages of steatohepatitis), in most cases it is completely reversible by simply losing weight and quitting alcohol. By burning off the fat cells and getting down to a healthy weight it is possible to go into full remission of fatty liver and thereby avoid all of the potential complications. Unfortunately, the bad news is there is almost no other treatment for fatty liver. With few exceptions, for most patients there are no medications, no surgeries, or anything other than lifestyle modification to treat fatty liver unless there are other associated conditions. Suffice to say if you have it, most of the time almost nothing can be done for it by your doctor and it all hinges on you to make major lifestyle changes.

If you or anyone you know has ever been diagnosed with fatty liver and thought or even been told it was nothing. I encourage you to think of it as what it truly is, a warning. It's a chance to start making life long healthy choices and can help give you the motivation to do so.

If you have any questions please feel free to reach out!