Hepatic Steatosis / Fatty Liver: symptoms, causes, diagnosis, treatments

You will find in this article and in this Youtube video :

- The liver: roles in the body

- Alcoholic hepatic steatosis

- Non-alcoholic fatty liver

- Causes of hepatic steatosis

- Symptoms of hepatic steatosis

- How serious is fatty liver?

- Diagnosis of fatty liver

- How is fatty liver treated?

- How long does it take to recover from fatty liver?

- Treatments for hepatic steatosis

Hepatic steatosis is a disease that affects the liver, it is also called fatty liver.

It affects people who drink alcohol, but it can also affect people who do not drink alcohol.

Before starting, I'll give you a little reminder about the liver, a very important organ for the proper functioning of our body.

The liver is located in the abdomen on the right side at the upper level, it allows the metabolism (transformation) of lipids and carbohydrates.

The liver is the place where glycogen is stored (a molecule formed by the linking of many glucose molecules). Glycogen is the carbohydrate reserve of our body to produce energy.

It is also in the liver that certain fat-soluble vitamins (attracted to fats) such as vitamin A and vitamin D are stored.

The liver is our detox organ. It filters the blood and degrades substances that are potentially toxic to our body, such as alcohol and drugs or their metabolites (molecules resulting from their transformation).

The liver produces bile, a substance that is stored in the gallbladder (a small organ near the liver). Bile has a very important role in digestion.

This organ is also involved in the production of certain proteins such as fibrogen, which plays a role in blood clotting (a set of reactions that take place to stop a hemorrhage).

Hepatic steatosis or fatty liver is the fact of having an excess of fatty mass in the liver. Lipids (mainly triglycerides) accumulate inside the liver cells called hepatocytes.

There are 2 types of hepatic steatosis: alcoholic hepatic steatosis due to excessive alcohol consumption and non-alcoholic hepatic steatosis, which is not associated with alcohol consumption, but rather with overweight or obesity.

Excessive alcohol consumption interferes with the proper functioning of the liver and the accomplishment of its metabolisms. This leads to an increase in the synthesis of triglycerides and their accumulation in this organ.

This liver disorder does not cause any particular symptoms, except for a slight fatigue and stomach ache sometimes.

It is usually diagnosed during a clinical examination (palpation of the abdomen), the doctor observes an increase in the volume of the liver. Blood tests show an increase in the level of liver enzymes (molecules that activate chemical reactions) called ALT and ASAT. These enzymes are the markers of the liver's functioning.

An ultrasound and/or liver biopsy may be ordered by the physician to: find the cause of the fatty liver, confirm the diagnosis and observe the severity of the liver damage. The liver biopsy is done under local anesthesia.

The main causes of hepatic steatosis are alcohol consumption, a metabolic disease (overweight, obesity), an excess of lipids in the blood, insulin-resistant diabetes (the cells become resistant to insulin which can no longer act properly to bring blood glucose into the cell to produce energy).

Metabolic syndrome is the term that combines overweight, insulin resistance and increased lipids such as cholesterol and triglycerides.

This accumulation of fat is due to the fact that the intake and production of fat within the person's body is greater than its elimination. Excess fats are found in the liver where they are stored.

I would like to point out that a diet rich in fats is not the only cause of this disorder, it can encourage its appearance, but there is already a metabolic disorder in the person who suffers from it.

This disorder can also appear during pregnancy, when taking certain treatments such as high-dose corticosteroids over a long period of time or anti-cancer chemotherapy.

Hepatic steatosis can promote inflammation of the liver, in this case, it is called steatohepatitis.

If the cause of fatty liver is alcohol consumption, the condition can disappear within 6 weeks after stopping alcohol intake altogether.

In order to treat fatty liver effectively, it is imperative to find the cause and correct it before the damage to the liver becomes too severe.

If the liver steatosis is caused by a drug, the doctor can ask the patient to stop taking it.

In the case of a metabolic disorder, it is advisable to reduce the triglyceride level with an adapted diet associated or not with hypolipidemic drugs (reduce the lipid level) and to lose weight.

Indeed, weight loss allows to directly reduce the fat mass in the liver.

The treatment requires a change in the patient's lifestyle (a balanced diet, regular and appropriate physical activity, and stopping the consumption of alcohol).

It is interesting to know that the liver can keep its functionality even if it is largely deteriorated. Stopping drinking alcohol allows the liver to recover a large part of its functionality.

On the other hand, if the person continues to drink, while the liver is deteriorated, the recovery will be really difficult, because it will already be too degraded.

Some treatments can be prescribed by a hepatologist (liver specialist), but there is no specific medication for this disease yet. The most important thing in this pathology is to find the cause and to remedy it quickly.

Dr. Noura Marashi (doctor of pharmacy, health youtuber, creator of the health and well-being application Pharmaquiz),

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