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One liver, one life


How fatty liver disease forces you to re-asses your priorities.

By Ruth Collantes Reyes, M.A. Ed.

 
SEPTEMBER 2013 


Four months ago, I had a searing pain on my right side. This was unlike any pain I ever had and it lasted for the whole night. At first I thought it was just muscle cramps, or that it was because of my sleeping position but it kept appearing occasionally, especially after I ate. Hospital visits kept being put off due to my busy schedule, but when the pain didn’t abate two weeks later, I made an appointment with a doctor.

What the doctor told me turned my life around: I had fatty liver disease and if I didn’t learn to control it and change my lifestyle, it could progress to liver fibrosis and then fatal liver cirrhosis.


The reality of liver disease

The liver is a powerhouse organ. It processes chemicals, helps with your metabolism and digestion, and it even produces fats and cholesterol for important bodily functions. It’s of vital importance that we treat our liver well because it’s the only one we have. Although we associate liver disease with the amount of alcohol we consume, there are actually two major forms of fatty liver disease: alcoholic and nonalcoholic. This means that people who drink little to no alcohol are also at risk of contracting fatty liver disease.

According to Hildegarde Vistal, M.D., an internist and gastroenterologist at the Asian Hospital and Medical Center, fatty liver disease is “the accumulation of fat—mostly triglycerides, cholesterol and phospholipids—in excess up to 5 to 10 percent of the total weight of the liver.” Fatty liver disease doesn’t always have visible symptoms and since it’s a progressive disease, if it goes unnoticed and you don’t go for checkup or treatment, the fat will continue to accumulate, later causing scarring of the liver tissue, liver cirrhosis and then ultimately, liver failure.

It was my lifestyle that led to fatty liver disease. This was because I don’t exercise, and junk food was my vice. I considered potato chips, popcorn and a popular fast-food joint’s two-piece chicken meal as my comfort food. The small apartment near my workplace didn’t allow cooking, so it gave me limited food options. I thought I had no choice but to dine at fast-food places, sometimes opting to hold my tutorial sessions there with students. Before I knew it, I was 20 pounds overweight. The good news was that what I had was still reversible.


A common disease without symptoms

The Mayo Clinic defines nonalcoholic fatty liver disease (NAFLD) as “a term used to describe the accumulation of fat in the liver of people who drink little or no alcohol. It is a common disease and, for most people, it will cause no signs and symptoms and no complications. But in some people with nonalcoholic fatty liver disease, the fat that accumulates can cause inflammation and scarring in the liver. At its most severe, nonalcoholic fatty liver disease can progress to liver failure.”

Dr. Vistal further explains that NAFLD is “usually associated with obesity, insulin resistance and dyslipidemia.” She stresses that “there are actually two types of NAFLD. The first, a simple steatosis, is typically stable, while the second, nonalcoholic steatohepatitis (NASH), is characterized as significant cell injury and the possibility of progression to cirrhosis”.

The liver works to break down alcohol so that it can be removed from your body but if you consume too much, it can be injured or damaged. Alcoholic fatty liver disease is common among patients who consume alcohol on a regular basis. Dr. Vistal estimates that “with alcohol intake—300 to 600 ml or 10 to 20 oz of 86% proof daily—for eight to 10 days, [people at risk will] develop fatty changes in the liver.”

The American Liver Foundation states that alcoholic fatty liver disease is the “earliest stage of alcohol-related liver disease. There are usually no symptoms. If symptoms do occur, they may include fatigue, weakness and weight loss. Almost all heavy drinkers have fatty liver disease. However, if they stop drinking, fatty liver disease will usually go away.” Untreated, the condition can be followed by alcoholic hepatitis and cirrhosis. The former can be mild or severe, while the latter is the most serious form of liver disease.

If alcoholic hepatitis is mild, it’s reversible, but a severe form can suddenly occur and lead to liver failure and even death. Known symptoms are loss of appetite, nausea, vomiting, abdominal pain, fever and jaundice. Alcoholic cirrhosis has the same symptoms as alcoholic hepatitis, but causes irreversible scarring in the liver and organ failure.


Those diagnosed with alcoholic fatty liver are told to stop drinking alcohol, in the hopes that the patient’s liver will recover from fatty liver disease and hepatitis. How about for those with NAFLD? Get tips on better lifestyle choices—and learn more about the writer’s experiences—in the September issue of HealthToday.






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