Fatty liver
J
What is fatty liver?
Fatty liver is not a disease, but a pathological finding. A more
appropriate term is fatty filtration of the liver.
What causes fatty liver?
Fatty liver can be caused by certain chemical compounds, nutritional, or
endocrine disorders. Drugs or chemical compounds that can cause fatty
liver include alcohol, tetracycline, cortisone, phosphorous and carbon
tetrachloride. Of these alcohol is by far the most common cause.
Inflammation usually accompanies exposure to these toxins and is
responsible for the associated symptoms of fever, fatigue and jaundice.
Nutritional causes of fat in the liver result from starvation, obesity,
protein malnutrition and intestinal bypass operation for obesity. In
obesity, the fatty deposits are accompanied by some inflammatory changes
and mild scarring of the liver.
The endocrine causes of fatty liver include diabetes mellitus and fatty
liver of pregnancy. In both cases, a large amount of fat can be rapidly
deposited in the liver leading to expansion of the liver with tenderness
in the upper right part of the abdomen. In diabetes this occurs only in
juveniles. Fatty liver during pregnancy occurs near term and may result
in premature termination of the pregnancy.
Can fatty liver easily be identified?
Fat in the liver does not often produce any symptoms because it is
usually deposited slowly. When the fat content is increased rapidly, the
liver expands and the covering is stretched and pain results.
How does fat get into the liver?
Fat enters the liver through diet and from fat stored in the fatty
tissue. Under normal conditions, fat from the diet is usually
metabolized by the liver and other tissues. If the amount exceeds what
is required by the body it is stored in the fatty tissue. Eating fatty
foods does not produce a fatty liver.
Can fatty liver lead to other liver diseases?
Fatty liver can be present in patients with alcoholic hepatitis and
cirrhosis or may be an isolated finding. Present evidence shows that
while fatty liver is usually present in excessive alcohol intake, it
probably does not lead to the development of alcoholic hepatitis or
cirrhosis. In fact, most individuals with alcoholic fatty liver do not
develop the more serious forms of liver disease. However, continued
alcohol ingestion has been known to cause alcoholic hepatitis and
cirrhosis.
How is fatty liver treated?
Treatment of fatty liver is related to the cause. Fat is decreased by
removal of the chemical compound or drug. Nutritional causes are treated
by altering the availability of fat coming into the liver. This is
accomplished by providing available carbohydrates or by adding protein
to overcome a complete or large deficiency in protein needed to make
lipoproteins (proteins not capable of being dissolved in water).
How can I avoid fatty liver?
Some recommendations on avoiding fatty liver are listed below. This
listing is by no means complete. There may be certain activities you
should avoid which pertain to your circumstances directly. Always
consult your physician if you are in doubt.
Do not drink to excess: Alcohol can decrease the rate of metabolism and
secretion of fat, leading to fatty liver.
Watch your diet: Obesity is a common cause of fatty liver and weight
reduction to a normal body weight should be encouraged. Although less
common in Canada, starvation and protein malnutrition can result in fat
build-up in the liver.
Seek medical advice: Your physician can advise on appropriate diets to
follow.
J
First I can't figure out how I'd have that, and second, they never did a
biopsy, so it's" guess or by golly" diagnostics here.
Why do I mention this?
Well, my ex-landlady was told 4? years back that she had that. She kept
bloating up.
then she developed diarrhea, they did a colonoscopy and said she had UC.
(which I don't have)
Two years later, she was dx'd with tumors in her colon/bowel.
They removed them, but she'll have to have rechecks every 3 months now.
Apparently people with chronic diarrhea (or UC?) are prone to bowel cancer.
J
What is NAFLD/NASH? (Nonalcoholic Fatty Liver Disease/Nonalcoholic
Steatohepatitis)
What is fatty liver?
In fatty liver, fat accumulates in the liver cells. Simple fatty liver
usually does not damage the liver, but is a condition that can be identified
by taking a sample of liver tissue (liver biopsy) and examining it under a
microscope.
What causes fatty liver?
Fat may accumulate in the liver with extreme weight gain or diabetes
mellitus. Fatty liver can also occur with poor diet and certain illnesses,
such as tuberculosis, intestinal bypass surgery for obesity, and certain
drugs such as corticosteroids, or in the setting of heavy alcohol use. A
patient has fatty liver when the fat makes up at least 10% of the liver.
Eating fatty food by itself does not produce a fatty liver.
Simple fatty liver is not associated with any other liver abnormalities such
as scarring or inflammation. It is a common finding in patients who are very
overweight or have diabetes mellitus.
Alcoholism could also result in inflammation of the liver (alcoholic
hepatitis) and/or scarring (alcoholic cirrhosis) and needs to be
differentiated from NASH by patient history.
Possible explanations for fatty liver include the transfer of fat from other
parts of the body, or an increase in the extraction of fat presented to the
liver from the intestine. Another explanation is that the fat accumulates
because the liver is unable to change it into a form that can be eliminated.
How is fatty liver diagnosed?
Fatty liver is usually suspected in a patient with the diseases or
conditions described above. The patient may have an enlarged liver or minor
elevation of liver enzyme tests. Several studies show that fatty liver is
one of the most common causes of isolated minor elevation of liver enzymes
found in routine blood screening.
In diagnosing fatty liver, the physician will first eliminate the other
possible causes of chronic liver disease, especially alcohol abuse. Images
of the liver obtained by an ultrasound test, a computed tomography (CT)
scan, or a magnetic resonance imaging (MRI) scan, can suggest the presence
of a fatty liver. In the ultrasound test, a fatty liver will produce a
bright image in a ripple pattern. A CT scan will show a liver that is less
dense than normal.
The diagnosis must be confirmed by a liver biopsy, a procedure where the
physician inserts a needle into the liver and extracts a sample of tissue,
which is examined under a microscope.
How is fatty liver treated?
The treatment of fatty liver is related to the cause. It is important to
remember that simple fatty liver does not require treatment, since it does
not result in damage to liver cells. Obese patients with fatty liver will
have reduction or loss of excess fat in liver cells, as well as in other
cells in the body, if substantial weight loss can be achieved. Good control
of diabetes mellitus with diet, drugs, or insulin also decreases the fat
content in the liver.
What is nonalcoholic steatohepatitis?
Nonalcoholic steatohepatitis (NASH) is described as inflammation of the
liver associated with the accumulation of fat in the liver. It differs from
the simple accumulation of fat in the liver (fatty liver, or hepatic
steatosis) in that the inflammation causes damage to the liver cells while
simple fatty liver probably does not. NASH is not connected with other
causes of chronic liver disease, including hepatitis B and C viruses,
autoimmune disorders, alcohol, drug toxicity, and the accumulation of copper
(Wilson’s Disease) or iron (hemochromatosis).
What causes NASH?
There is no known specific cause of NASH. In the past, the typical NASH
patient was described as a middle-aged, obese woman with excess sugar in the
blood, which may have been caused by diabetes mellitus. The patient may have
had excess fat in the blood. However, it has recently been reported that
patients with NASH do not always fit this description. One study included
men, as well as women, who were not overweight, did not suffer from diabetes
mellitus, and did not have excess lipids (fat) in their blood. Another group
diagnosed with NASH was composed of children between nine and 16 years old.
Most of the children were overweight, but only a few had diabetes mellitus.
What is the risk of NASH?
In NASH, which resembles alcoholic steatohepatitis, the inflammation of the
liver is associated with an increase of fat deposits and typically occurs in
middle-aged, overweight, and often diabetic patients who do not drink
alcohol. It has also been connected with rapid weight loss, or in women
taking hormones (estrogen). The fatty tissue in the liver may break up liver
cells (steatonecrosis) and the patient may develop cirrhosis (scarring of
the liver). Recent studies indicate that NASH can result in the development
of fibrous tissue in the liver (fibrosis) in up to 40% of
patients or cirrhosis in 5-10% of patients. It is not certain why some NASH
patients will progress to this serious form of chronic liver disease while
others do not. Studies report that the progression to fibrosis or cirrhosis
for NASH patients is variable but can occasionally occur in less that 20
years.
Some studies have shown that 20% to 40% of people who are grossly overweight
will develop NASH. If a patient is grossly overweight, however, it does not
mean that he/she will develop NASH. Many patients with NASH will show an
increase of certain iron proteins (ferritin) in their blood, but whether
this relates to any injury to the liver is unknown.
How is NASH diagnosed?
Many NASH patients are unaware of their conditions because they do not
exhibit any symptoms. In most cases, NASH causes a slight increase during
liver enzyme tests, as do other forms of liver disease.
AS with fatty liver, the physician will first eliminate the other possible
causes of chronic liver disease. Images of the liver are obtained by an
ultrasound test, a CT scan, or an MRI scan. The diagnosis must be confirmed
by liver biopsy.
How is NASH treated?
Presently, there is no specific treatment for NASH that is universally
agreed upon. However, patients who are obese, diabetic, and have high lipids
(fats) in their blood are advised to lose weight and control their diabetes
and elevated lipids. Usually, a low fat, low calorie diet is recommended
along with insulin or medications to lower blood sugar for diabetes. For
many patients with NASH whow are not overweight and not diabetic, a low fat
diet is recommended. Patients with NASH should avoid alcohol or other
substances that could be harmful to the liver. More research is needed to
understand what causes NASH so that more effective therapies can be
developed.
The information contained in this brochure is provided for information only.
This information does not constitute medical advice and it should not be
relied upon as such. The American Liver Foundation (ALF) does not engage in
the practice of medicine. ALF, under no circumstances, recommends particular
treatments for specific individuals and, in all cases, recommends that you
consult your physician before pursuing any course of treatment.
Jeannette
stomach is large and hard and sometimes painful. There is no way to counter
this as explained by my dr. It is very frustrating because I am small in
other areas of my body except for a large stomach. Looks like I am 8 months
pregnant all the time and I hate it.
Nettie
"J" <Magic...@example.com> wrote in message
news:3E55386A...@execulink.com...
ironjustice
Jeannette <linksto...@charter.net> wrote in message
news:v5aefp3...@corp.supernews.com...
> I have a fatty infiltrated liver which was caused my Prednisone...... my
> stomach is large and hard and sometimes painful. There is no way to
counter
> this as explained by my dr. It is very frustrating because I am small in
> other areas of my body except for a large stomach. Looks like I am 8
months
> pregnant all the time and I hate it.
This article clearly shows the effects of iron on the liver.
It SPECIFICALLY says that WHAT THE DOCTORS SAY IS RIGHT .. is wrong.
It specifically shows by lowering the iron levels PAST what the doctors have
been saying .. is IMPROVING the outcomes of these patients ..
Evidenced based medicine ..
Low iron equals low fatty liver disease.
Which would explain somewhat the REVERSAL OF CIRRHOSIS which has been
demonstrated by the iron reduction therapy.
<<snip>>
These results reflect the insulin-sparing effect of iron depletion and
indicate a key role of iron and hyperinsulinemia in the pathogenesis of
NAFLD
<<snip>>
1: Gastroenterology 2002 Apr;122(4):931-9 Related Articles, Links
Effect of iron depletion in carbohydrate-intolerant patients with clinical
evidence of nonalcoholic fatty liver disease.
Facchini FS, Hua NW, Stoohs RA.
Department of Medicine, University of California San Francisco and San
Francisco General Hospital, San Francisco, California, USA.
ffac...@ecnea.org
BACKGROUND & AIMS: Increased body iron, genetic hemochromatosis (GH)
mutations, and nonalcoholic fatty liver disease (NAFLD) tend to cluster in
carbohydrate-intolerant patients. In an attempt to further clarify the
interrelationships among these conditions, we studied 42
carbohydrate-intolerant patients who were free of the common GH mutations
C282Y and H63D, and had a serum iron saturation lower than 50%. METHODS: We
measured body iron stores, and induced iron depletion to a level of
near-iron deficiency (NID) by quantitative phlebotomy. RESULTS: In the 17
patients with clinical evidence of NAFLD, we could not demonstrate
supranormal levels of body iron (1.6 +/- 0.2 vs. 1.4 +/- 0.2 g; P = 0.06).
However, at NID, there was a 40%-55% improvement (P = 0.05-0.0001) of both
fasting and glucose-stimulated plasma insulin concentrations, and
near-normalization of serum alanine aminotransferase activity (from 61 +/- 5
to 32 +/- 2 IU/L; P < 0.001). CONCLUSIONS: These results reflect the
insulin-sparing effect of iron depletion and indicate a key role of iron and
hyperinsulinemia in the pathogenesis of NAFLD.
PMID: 11910345 [PubMed - indexed for MEDLINE]
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Who loves ya.
Tom
--
Jesus Was A Vegetarian! http://jesuswasavegetarian.7h.com
Man Is A Herbivore! http://pages.ivillage.com/ironjustice/manisaherbivore
Randy
An old (well, 35 or so now) girlfriend from school was diagnosed with this
last year. Not a pleasant prognosis.
She faced a total hysterectomy at the same time for excessive pain and
bleeding during periods. When it rained it poured. A side benefit was the
hystero was supposed to remove perpetuating factors from her fibro, but we
haven't kept touch enough for me to know if that's been he case. Hopefully
it's because she's been too busy catching up with her life, now healthy
again. :~)
"J" <Magic...@example.com> wrote in message
news:3E55386A...@execulink.com...
J
> An old (well, 35 or so now) girlfriend from school was diagnosed with this
> last year. Not a pleasant prognosis.
> She faced a total hysterectomy at the same time for excessive pain and
> bleeding during periods. When it rained it poured. A side benefit was the
> hystero was supposed to remove perpetuating factors from her fibro, but we
> haven't kept touch enough for me to know if that's been he case. Hopefully
> it's because she's been too busy catching up with her life, now healthy
> again. :~)
Fibro can be secondary to "XXX"
Maybe she is Randy (healthy again), Hope so. But my understanding that the
fatty deposits stay forever.
If I'm wrong, someone'll tell me (and post a good url), I guess.
:-)
J
BBE...@webtv.net
to schedule a complete abdominal hysterectomy. She's had just TOO much
pain for too long.
Her doctor told her she was anemic to the level that the anemia has been
the source of her misery.
I'm not sure what she meant, but she said something about having at
least one fibroid, maybe more, and that it was someway related to her
anemia. Is this possible?
BTW....She's had a lot of guesses about whether she had some type of
liver disorder.
If I find out anything from you guys, I'll relate to her...except from
idjit.
ra...@noname.net (Randy) wrote:
Thanks, J.
An old (well, 35 or so now) girlfriend from school was diagnosed with
this last year. Not a pleasant prognosis.
She faced a total hysterectomy at the same time for excessive pain and
bleeding during periods. When it rained it poured. A side benefit was
the hystero was supposed to remove perpetuating factors from her fibro,
but we haven't kept touch enough for me to know if that's been he case.
Hopefully it's because she's been too busy catching up with her life,
now healthy again. :~)
~*~Barb~*~TOO!