Fatty liver disease occurs when too much fat builds up in the liver. This is called nonalcoholic fatty liver disease, or NAFL. It often is found during a regular checkup when a doctor looks at lab results or does a scan such as an ultrasound or CT. If results show liver problems, the patient will be referred to a gastroenterologist. Many people do not experience symptoms, so they may not know they have fatty liver disease. If the liver has fat and becomes inflamed, it is called nonalcoholic steatohepatitis or NASH. This can lead to scarring, called cirrhosis, and even liver cancer if not treated.
Dr. Andrew Canning, a gastroenterologist with Prisma Health Gastroenterology, says this is becoming a big problem. “It’s becoming one of the more common causes, if not the leading cause, of liver disease in the United States,” he said. “A lot of our patients think that alcohol causes liver disease, but fatty liver disease often begins with poorly controlled diabetes, being overweight, high cholesterol and those kinds of risk factors.” Around 30 percent of people in the United States have fatty liver disease. Some may feel pain or swelling in their stomach area. Others may have yellow skin or eyes, or feel tired. In some cases, people may not feel anything different at all.
There aren’t many medicines that treat fatty liver disease right now. The best way to treat this disease often is through weight loss. Losing even a small amount of weight, about 5 to 10 percent, can help the liver heal. In some cases, weight loss surgery also may help. “Typically, the treatment strategy that we give to patients for fatty liver disease is weight loss,” said Canning. “We also like to make sure our patients don’t drink alcohol and are not taking any medicines or supplements that could hurt the liver.”
Doctors check liver health with special blood tests every few months. These tests help watch for scarring or signs that the liver is getting worse, and how well the liver is working. “Not every patient who has fatty liver disease progresses to cancer,” said Canning. “It’s kind of a spectrum of illness – there’s fatty liver, there’s fatty liver associated with inflammation, and then there’s fatty liver associated with scarring of the liver, or cirrhosis.” Based on these tests, doctors can make informed decisions about treatments and lifestyle changes to prevent the condition from getting worse.
Only about 5 percent of people with fatty liver get cirrhosis. But, if there is inflammation, that number can go up to 20 percent. People who have NASH should see a liver specialist, called a gastroenterologist. The good news is that fatty liver disease can be reversed. With help from doctors and by making healthy changes, many people can stop the disease from getting worse.
For more information or to schedule an appointment with Prisma Health Gastroenterology, visit blountmemorial.org or call 865-980-5060.
