Fatty liver disease: what symptoms, is it serious?

Fatty liver disease is a disorder of the liver: it is a abnormal fat accumulation in liver cells. She is usually asymptomatic or causes non-specific symptoms such as tiredness or a abdominal discomfort. According to French National Society of Gastro-Enterology (SNFGE), one in 5 French adults has hepatic steatosis. What is it due to? What are the symptoms fatty liver disease? What is it’s serious ? Reversible? How to treat it?

Definition: what is hepatic steatosis?

Hepatic steatosis is an accumulation of fat in the liver. Specifically, steatosis is an infiltration of triglycerides in the cells. “Droplets of fat reach the hepatic cells and accumulate there; they are not toxic as such“, explains Professor Victor de Lédinghen, hepatologist at the Bordeaux University Hospital.

► Hepatic steatosis can be due to problematic alcohol consumption: this is the fatty liver alcoholic

► Hepatic steatosis may have another cause and not be associated with excessive alcohol consumption: this is called non-alcoholic fatty liver disease or NASH

What are the symptoms of fatty liver disease?

In the vast majority of cases, fatty liver disease is not responsible for any symptoms: we speak of an asymptomatic disease. “The disease is silent, hence the need to get tested if you combine risk factors“, warns Victor de Lédinghen. On a smaller scale, we can meet:

• An enlarged liver (hepatomegaly)
• Abdominal discomfort
• A significant tiredness

The disease can thus progress to the stage of early cirrhosis without any symptoms or clinical signs. “On the other hand, the “crisis of liver” or the “crisis of hepatic steatosis” is a myth: it refers to a dysfunction of the stomach, the liver is not in question. There are no acute symptoms associated with fatty liver disease.” would like to restore our expert.

What is simple fatty liver disease?

We are talking about simple steatosis when the liver cells are not damaged: this is a benign stage characterized by an accumulation of fat in the liver.

What is diffuse fatty liver disease?

We are talking about diffuse, or severe, steatosiswhen you reach an advanced stage of the pathology, where all the liver tissue is affected.

What is homogeneous hepatic steatosis?

It is on ultrasound that we will see if the steatosis is homogeneous or heterogeneous. It is homogeneous when fats are stored evenly in liver cells.

Is fatty liver disease caused by alcohol?

Fatty liver disease can be linked to excessive and regular use of alcohol (alcoholic fatty liver disease) or occur without any alcohol consumption. This form, non-alcoholic fatty liver disease (NASH), is increasingly common in France. “It would concern 15 to 20% of the population and is linked to the increase in the number of people with metabolic syndrome”, says Professor de Lédinghen

Is fatty liver disease caused by being overweight?

Metabolic syndrome (diabetes, overweight or obesity, high blood pressurehypercholesterolemia), as well as a poor diet, too rich in sweets, can cause non-alcoholic fatty liver disease. “The more these factors are combined, the greater the risk of having steatosis.“, adds Victor de Lédinghen. In France, 90% of obese people with type 2 diabetes have hepatic steatosis.

What drugs can cause fatty liver disease?

Taking certain medications (corticosteroids, amiodarone, methotrexate) may also be involved in non-alcoholic fatty liver disease. “But cases are rare and the molecules are very specific“, specifies Professor de Lédinghen. Finally, pregnancy is a risk factor steatosis gravidarum, a potentially fatal case for mother and child but also very rare.

“Being asymptomatic, the disease is often diagnosed by chance, during a routine ultrasound or blood test. The doctor then detects a liver abnormality“, explains Professor de Lédinghen. The diagnosis of hepatic steatosis is made througha palpationduring which one can discover hepatomegaly (enlargement of the volume of the liver) and imaging of the liver. Ultrasound can identify steatosis by a “shiny” appearance of the liver. “The normal level of fat in the cells is less than 5%. Ultrasound can detect steatosis when it is greater than 30%“, specifies the hepatologist. A blood test will be regularly carried out to control the transaminases and the gamma GT, and to check the absence of drift towards the stage of cirrhosis.

What are the complications of fatty liver disease?

When no measures are implemented and the overload in triglycerides is maintainedthe risk of complications increases. Inflammation may occur in the liver. This inflammation, if left unchecked, can lead to more severe manifestations such as liver fibrosis and cirrhosis of the liver, with a risk of liver cancer. In patients with cirrhosis, performing an ultrasound of the liver every six months is systematic in order to detect liver cancers when they are small and thus offer a curative treatment.

What treatment to cure hepatic steatosis?

The first step in treating fatty liver disease is to treat its cause.

► If alcohol is the cause of the diseaseit should be deleted.

► In case of metabolic syndrome“lifestyle and dietary measures must be taken – adapted diet, physical activity“. By these non-drug measures, the liver can return to a normal appearance within a few weeks.

► “No drug, to date, to treat hepatic steatosis has marketing authorization (AMM), but many therapeutic trials are underway“, comments Victor de Lédinghen.

Is fatty liver disease reversible?

Yes, she can. Already, by losing a little weight, the patient improves the liver damage observed in the disease. Weight loss allows reversibility of inflammation or even hepatic fibrosis: losing 10% of body weight eliminates hepatic steatosis in 90% of casesindicates the French National Society of Gastro-Enterology (SNFGE).

What is the life expectancy with fatty liver disease?

fatty liver disease does not shorten life expectancy. On the other hand, when complications occur (cirrhosis of the liver,

Thanks to Professor Victor de Lédinghen, hepatologist at the Bordeaux University Hospital.