Fatty Liver Disease: Prevention, Diagnosis & Treatment
Prevention of Non-Alcoholic Fatty Liver Disease
Prevention of non-alcoholic steatohepatitis is based on maintaining a healthy lifestyle. Primarily, you should focus on proper nutrition and eat fewer high-fat foods. It is essential to limit not only the consumption of fats but also carbohydrates. They are a source of glucose, which is actively converted into triglycerides. Be sure to treat all diseases in time.
Especially, don’t delay treatment for endocrine disorders. Diabetes mellitus is the most dangerous endocrine disease. Suspicions of non-alcoholic steatohepatitis require immediate medical attention.
Diagnosis of Non-Alcoholic Fatty Liver Disease
- Collection of anamnesis (information about the patient's life, medical history and etc.).
- Medical check-up.
- Clinical laboratory tests (complete blood count and blood biochemistry tests).
- Instrumental methods of examination (ultrasound examination, computed tomography (CT), magnetic resonance imaging (MRI), liver biopsy, elastography).
When Should you go to The Doctor?
If you experience a constant feeling of fatigue, drowsiness, exhaustion, or pressure in the right upper quadrant, then you should consult a doctor. Besides, people with diabetes, obesity, high cholesterol, or bilirubin should pay special attention to liver health.
Treatment of Non-Alcoholic Fatty Liver Disease
Generally, treatment is aimed at eliminating or reducing the negative impact of the causes that provoke fat accumulation in the liver. Also, among the priorities is to strengthen the whole body, protect and restore liver cells (hepatocytes), maintain the disease in a compensated condition (a state when the body adapts to the disease, resulting in a minimal negative effect pathological process).
The dosage of drugs and the duration of treatment are selected by the doctor individually for each patient. He takes into account the weight, concomitant diseases, stage, and degree of the disease. There is no approved evidence-based drug therapy for NAFLD/NASH at present. Lifestyle changes are essential in an attempt to bring about a positive impact on the course of NAFLD/NASH. The goals of treatment are to reduce the signs of the disease on a cellular level, improve insulin resistance and liver enzyme levels. The overall goal of lifestyle change is weight loss. A possible reduction of 5-10% shows an improvement in liver health.
- Diet: It is recommended to reduce weight and number of calories by 25% of the normal diet (approximately 2500 calories per day), depending on the age and gender of the patient. A moderate-calorie restriction diet with modified nutrient selection brings better results than a very low-calorie diet.
- Exercise: A patient should follow an individual program of moderate exercise based on his comorbidities.
- Weight loss surgery (bariatrics) may be beneficial for severely obese patients.
- Medications are aimed at controlling insulin resistance.
A liver transplant is the only treatment option for people with liver failure. About 30–40% of patients with cirrhosis need transplantation due to non-alcoholic steatohepatitis. Many transplant programs decline liver transplantation to obese patients.