Fatty liver: Symptoms, Causes & Treatment

21 October 2017

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A fatty liver occurs when the body makes more fat or gets fed through the food when he can break down or carry away from the liver. There may different causes give.

The common form of fatty liver is the non-alcoholic fatty liver disease (Engl. Non-alcoholic fatty liver disease, short NAFLD). It arises almost always (in 90 percent of cases) as a result of the so-called metabolic syndrome. This metabolic disorder manifests itself among others in obesity, hypertension, elevated blood lipid levels and a permanently increased blood sugar levels. Metabolic syndrome, in turn, is usually the consequence of a unhealthy eating and a Lack of exercise. When the body gets fed more calories than they can burn, it deposits a the excess energy as fat - not only in the fat tissue under the skin, but also in the liver. This damages the one hand, the liver itself, on the other hand, the entire body. Because fatty change in the liver (and muscles) are among the main causes of diabetes mellitus Type II. Incidentally, there are not only the high-fat foods, which burden the liver: studies suggest that above all a sugar-rich diet may favor a non-alcohol-related fatty liver disease.

Also, people who drink too much alcohol can suffer from fatty liver; in this case speak of a medical alcoholic fatty liver disease (Engl. Alcoholic fatty liver disease, short AFLD). Much of the alcohol consumed enters the liver, where it certain enzymes degrade. Among other things, the so-called acetyl coenzyme A, short-acetyl-CoA is produced. For this substance the cells can say (more precisely, the mitochondria, so the "power plants" of the cells) normally gain energy. However, it seems the liver too much alcohol, so its degradation disturbs the work of the mitochondria. These can then only a portion of the acetyl-CoA metabolize - from the rest of the cells build new fatty acids. At the same time still produced during decomposition of alcohol, a substance, namely acetaldehyde. you damages the liver cells and prevents them to make fats into the blood. The fats so do not migrate to energy-requiring organ or fatty tissue, as would happen in a healthy body, but accumulate in the liver.

A fatty liver may also arise when there on the body protein lacking (So-called. Marasmus or kwashiorkor). If you eat protein-rich foods, such as meat, fish, cheese, egg, tofu or beans, the body breaks down the proteins and builds new proteins, which can then perform important functions in metabolism. These proteins also include To transport fats from the liver cells enzymes that are responsible for. However, the food contains too little protein, the body can not enough of these enzymes form. The liver cells then divorced no longer the fats, but store them. This form of fatty liver disease in this country is relatively rare. Sometimes it arises as a result of an eating disorder. but more often suffer from them, people in developing countries.

Rarely cause certain medicines (E.g., glucocorticoids, aspirin, tetracyclines, amiodarone, synthetic estrogens, tamoxifen, diltiazem and some anti-retroviral drugs) or poisons (E.g., phosphorus) a fatty liver. Also one chemotherapy can damage the liver and affect their function so strong that it intercalates too much fat.

Sometimes also suffer some pregnant woman on a fatty liver. the so-called acute fatty liver of pregnancy usually occurs after the 28th week of pregnancy and goes with a very strong liver injury associated. Debt is probably a hereditary defect of a certain enzyme, which is involved in the breakdown of fatty acids (the so-called 3-hydroxyacyl-CoA dehydrogenase, short LCHAD). However, this disease is not very common. Estimates of the frequency range from 1: 7,000 to 1: 20,000, that is: In a 7,000 pregnancies (or from 20,000 pregnancies) an acute fatty liver of pregnancy occurs.

Finally, there are a number of Diseases that can cause fatty liver. These include inflammatory bowel disease, celiac disease, the polycystic ovary syndrome, and called Reye's syndrome in children (under 15 years).

The doctor asked the patient usually beginning after his medical history and existing medical conditions (so-called. Anamnesis). He then examined under a ultrasound (Sonography) the condition of the liver. A fatty liver is evident from the fact that they increased in the ultrasound image and appear unusually bright. This is because adipose liver tissue denser and thus "hyperechoic" is - that is, it reflects the sound waves stronger. 

In general, the doctor also takes the patient from blood. Does this one high amount of certain liver enzymes, the so-called transaminases, this may also indicate a fatty liver. Among the transaminases include alanine aminotransferase (ALT) and aspartate aminotransferase (AST). If the patient is under a non-alcoholic fatty liver inflammation suffers, are his ALT levels increased more than his AST. Alcoholic fatty liver situation is reversed.

To determine the causes and extent of fatty liver, the doctor can be a Tissue sample from the liver examine (so-called. liver biopsy). For this purpose, a liver biopsy is necessary - that is, the physician pierces under local anesthesia with a special needle through the skin into the liver and takes a sample.

At the tissue sample can also be seen whether the liver has already inflamed and the inflammation have already damaged tissue. If this is about hardened and shrunk, it may be that the fatty liver has a so-called cirrhosis has progressed. Cirrhosis speaking doctors, if the Läppchen- and vascular structure of the liver is completely destroyed. This usually has the consequence that the organ can no longer fulfill his duties and failed.

As the disease develops and how well the chances of recovery depend on the age, sex and the genetics of the patient - but especially of the cause of obesity.

Good chances People who are suffering from fatty liver due to an unbalanced diet. If they improve their lifestyle habits and achieve a healthy body weight, abnormal fat deposits usually disappear again. at about a quarter of patients with non-alcoholic fatty liver advances the disease, however, so far away that the liver inflamed. Within this group, suffer less than 5 100 a Liver cirrhosis.

Also one alcohol-related fatty liver can regress again. This requires that the parties concerned refrain from alcohol. they drink more drinks, then the liver inflamed. This happens at about 10 to 30 out of 100 concerned. The alcoholic fatty liver inflammation leads significantly more likely to cirrhosis than non-alcoholic liver inflammation. In industrialized countries, more than half of all liver cirrhosis can be attributed to excessive alcohol consumption. 

People who are suffering from alcoholic liver cirrhosis, feel cut off, losing their physical and mental performance, prone to bleeding and store water in the legs one. The consequences of liver cirrhosis it include also:

The destruction processes in the liver can still be stopped by a complete alcohol withdrawal times. However, if the body is too badly damaged, it can also lead to death. In order to estimate the chances of survival, doctors divide the liver cirrhosis based on certain criteria (the so-called Child-Pugh criteria) in three levels of severity (Child A to C) on:

one dietary, non-alcoholic Fatty liver can be combined with a healthy diet and prevent adequate exercise. diabetic can prevent by setting their blood sugar well (leave) a fatty liver.

one alcoholic Fatty liver disease you can prevent by avoiding alcohol or drinking in moderation. The liver healthy women seems every day about 12 grams of pure alcohol to cope, Men should no more than 24 grams take pure alcohol. As an example: 0.33 liter of beer corresponding to about 13 grams of alcohol, 0.2 liters of wine about 18 grams of alcohol. note here, however, that this dose is not exactly defined, but is based on estimates and in individual cases can be higher or lower. People with compromised liver should completely abstain from alcohol.


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