What You Should Know About Fatty Liver Disease

November 28, 2021

Your liver is one of the most essential organs in the body, and it is the epicenter for regulating chemicals in the blood and the production of bile, which carries waste away from the liver. The liver is also responsible for cholesterol production, hemoglobin processing, regulation of blood clotting, and the metabolization of drugs and other nutrients to be available to the rest of the body.

These are but a few of the liver’s functions, so keeping the liver in good health is wise. Fatty liver occurs when there is too much fat buildup in the liver. There are two types of FLD: alcohol-associated FLD, and NAFLD, or nonalcoholic fatty liver disease. Read on to learn about both forms of FLD, its symptoms, and how it is diagnosed and treated.

Because fatty liver disease often has no symptoms, it is first noticed by your healthcare provider after a routine blood test.

What Is Fatty Liver Disease (Alcohol-Associated)?

Those who have AUD (alcohol use disorder) or drink heavily have a predisposition to developing alcohol-associated fatty liver disease over time. It is estimated that 7.4 percent of the United States population abuses alcohol, so this group is at risk for developing alcoholic liver disease (ALD). Fatty liver is often a universal finding if one drinks daily and heavily, while alcoholic hepatitis or cirrhosis is not as prevalent, even in heavy drinkers. However, other factors contribute to the development of ALD and other alcohol-related liver diseases, such as genetics.

There often aren’t signs and symptoms associated with ALD, and it may only become noticeable to a healthcare provider when a patient comes in for their annual physical or a different type of blood test. Quite often, liver enzymes are checked (AST:ALT ratio among other values), and a high number indicates to the practitioner that there is fatty liver disease present. However, in more severe cases, there are associated symptoms with ALD, some of which include:

  • Jaundice (yellowing of the skin or eyes)
  • Decreased body hair
  • Muscle wasting or atrophy
  • Confusion and stupor

The best treatment for alcohol-associated fatty liver disease is abstinence from alcohol. If NAFLD is ruled out and it is determined that the patient’s fatty liver disease was alcohol-related, the liver will revert back to its normal state over time with prolonged abstinence. There is also a good chance of recovery if one is diagnosed with alcoholic hepatitis. The one condition that the liver cannot recover from is cirrhosis or scarring of the liver. This occurs with continued heavy drinking and fatty liver. Scars form on the liver, and these are not reversible. Quite often, cirrhosis can be deadly, although symptoms can be managed with abstinence. 

What Is Fatty Liver Disease (NAFLD)?

Nonalcoholic fatty liver disease is very similar to alcohol-associated fatty liver disease in that there is an excess of fat buildup in the liver, which interferes with its ability to function properly. However, in the case of NAFLD, alcohol is not a factor. There are two types of NAFLD: NAFL (nonalcoholic fatty liver) and NASH (nonalcoholic steatohepatitis). HASH is more serious than NAFL, and NAFL can later become NASH if the condition goes untreated. 

NAFL refers to an excess buildup of fat on the liver but no associated inflammation. Your liver may be enlarged, and you may feel discomfort and pain, but typically, you will not experience liver damage. With NASH, there is both fat buildup and inflammation of the liver, which can cause liver damage. NASH can lead to cirrhosis, and potentially even liver cancer, if the disease is not arrested. 

What Are the Signs of NAFLD?

Both NAFL and NASH fall under the umbrella term of NAFLD. NAFLD symptoms and signs can include:

  • Jaundice (yellowing of the skin and eyes)
  • Unexplained weight loss
  • Pain in the upper right quadrant of the abdomen
  • Unexplained fatigue and/or weakness
  • Fluid and swelling in the legs and stomach

If you have one or more of these symptoms, particularly jaundice, it’s good to make an appointment with your gastroenterologist or healthcare provider as soon as possible to determine the cause of your symptoms. 

What Are the Causes of Fatty Liver?

When it comes to ALD, the cause is clear—excessive alcohol consumption. However, the causes of NAFLD are different but not well understood by scientists and researchers. There are certain risk factors associated with NAFLD, and many of these are associated with lifestyle choices, just not the consumption of alcohol. Risk factors for NAFLD include:

  • A diet high in fructose (sugar)
  • An unhealthy microbiome (gut)
  • High triglyceride levels
  • High cholesterol

In addition to these risk factors, genetic predisposition can also play a role in developing NAFLD. 

How Is Fatty Liver Disease Diagnosed?

Because fatty liver disease often has no symptoms, it is first noticed by your healthcare provider after a routine blood test. If your liver enzymes are elevated, your physician will likely order other tests to diagnose you with FLD or rule out other more concerning conditions, such as cirrhosis, liver cancer, or alcoholic hepatitis. Generally, your doctor will order a typical ultrasound or a transient elastography ultrasound, which measures the stiffness of the liver. If your physician is still unable to provide a concrete diagnosis, they may order a biopsy of the liver for evaluation. 

Is Fatty Liver Disease Treatable?

All forms of FLD are treatable because of the elasticity of the liver. However, in both cases (ALD and NAFLD), the patient will have to make lifestyle adjustments and changes as a part of their course of treatment. In the case of alcohol-associated fatty liver disease, the patient must abstain from alcohol so that the liver can heal. In the case of NAFLD, your physician may instruct you to make changes to your diet, lifestyle, or routine. Your doctor may advise you to:

  • Begin an exercise regimen to lose weight
  • Avoid alcohol (even in the case of NAFLD)
  • Limiting added sugars and unhealthy fats
  • Adhere to a fatty liver disease diet

What Does a Fatty Liver Disease Diet Consist Of?

You can be very proactive in your own recovery from NAFLD by adjusting your diet to help heal the liver. While you should stay away from processed foods, foods with added sugars, foods high in cholesterol, and foods with unhealthy fats, there is a list of foods that you should eat as well. Some of these foods include:

  • Coffee (studies suggest those who drink coffee can lower the amount of abnormal liver enzymes)
  • Fish high in Omega-3s, such as salmon, tuna, sardines, and trout. This can reduce inflammation and lower liver fat levels. 
  • Garlic powder has been shown to help reduce overall weight in those who have FLD
  • Sunflower seeds are high in vitamin E, which is helpful for liver health 
  • Milk (an animal study correlated less liver damage in those with FLD)
  • Walnuts are also a food high in vitamin E
  • Greens, such as Brussels sprouts, kale, broccoli, and spinach, are associated with general weight loss and the prevention of fat buildup in the liver 

Overall, a balanced diet and an exercise regimen can help you lose weight, which will help the liver recover from NAFLD more quickly.

Talk to a GI Doctor in the Tampa Bay Area.

If you need more information about NAFLD, Fatty Liver Disease or would like to be seen by a Gastroenterologist in Clearwater, Florida, Gastro Florida can help. Contact us today to make an appointment at one of our 20+ locations and learn about our quality, comprehensive care of all types of gastrointestinal disorders.