Fatty liver

Fatty liver is the collection of excessive amounts of triglycerides, a form of fat stored by the body and used for energy and new cell formation, and other fats inside liver cells. Also called steatosis, fatty liver can be a temporary or long-term condition, which is not harmful itself, but may indicate some other type of problem. Left untreated, it can contribute to other illnesses. It is usually reversible once the cause of the problem is diagnosed and corrected. The liver changes fats eaten in the diet to types of fat that can bestored and used by the body. The break down of fats in the liver can be disrupted by alcoholism, malnutrition, pregnancy, or poisoning. In fatty liver, large droplets of fat, containing mostly triglycerides, collect within cells of the liver. The condition is generally not painful and may go unnoticed for a long time. In severe cases, the liver can increase to over three times its normal size and may be painful and tender.

The most common cause of fatty liver in the United States is alcoholism. In alcoholic fatty liver, over consumption of alcohol changes the way that the liver breaks down and stores fats. Often, people with chronic alcoholism also suffer from malnutrition by eating irregularly and not having a balanced diet.Other forms of malnutrition (especially when there is not enough protein inthe diet), obesity, diabetes mellitus, and Reye's syndrome in children can also cause fatty liver. Pregnancy can cause a rare, but serious, form of fattyliver that starts late in pregnancy and may be associated with jaundice and liver failure. Some drug overdoses or toxic chemical poisonings, such as carbon tetrachloride, can also cause fatty liver. Often, fatty liver has no symptoms. If there are symptoms, they can include pain under the rib cage on the right side of the body, swelling of the abdomen, jaundice, and fever. Symptomsthat occur less often in alcoholic fatty liver, but more often in pregnancy related fatty liver, are nausea, vomiting, loss of appetite, and abdominal pain. Fatty liver is diagnosed by a physical examination, when a doctor notices that the liver is enlarged and tender when the abdomen is examined; through blood tests to determine if the liver is functioning properly; and through a liver biopsy, where a small sample of liver tissue removed witha long needle or though a very small incision is examined. In pregnant women,fatty liver is usually associated with another serious complication, pre-eclampsia or eclampsia. In this condition, the mother has seriously high blood pressure, swelling, and possibly, seizures.

Treatment involves correcting the condition that caused fatty liver and providing supportive care. In fatty liver caused by alcoholism, the treatment is to give up drinking alcohol and to eat a healthy, well-balanced diet. In fattyliver associated with pregnancy, the recommended treatment is to deliver thebaby, if the pregnancy is far enough along. Vitamin and mineral supplementsalong with nutritional support may be useful. Fatty liver is usually reversible if recognized and treated. There may be some long-term tendency toward other types of liver problems depending on how long and how severe the fatty liver condition was. In pregnant women, the situation can be life threatening for both the mother and the infant. Left untreated, there is a high risk of death for both. Severe liver damage that may require a liver transplant can occur in the mother if the condition is not recognized early. Prevention consistsof maintaining a well-balanced diet and healthy lifestyle with moderate or no alcohol consumption. Pregnant women require good prenatal care so that symptoms can be recognized and treated as early as possible.

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