Quite often I receive laboratory tests results on a patient and I realize they have some liver damage. After we check a few things, we sometimes end up getting an ultrasound of the liver where the radiologist rubs a probe over your belly and takes pictures of your liver through the skin. Almost always, without another major problem like a hepatitis infection, we find the same diagnosis: fatty liver disease.
Non-alcoholic fatty liver disease, and a relative called non-alcoholic steatohepatitis (NASH) can be related to diabetes, especially poorly controlled Type 2 diabetes. These two diseases are specifically in people who DO NOT drink a lot of alcohol. If you do drink a lot of rum etc, you likely have a different form of liver disease. We have paid more attention to these diagnoses of fatty liver and NASH during the past 15 years or so. Without getting too much into detail, these diseases basically involve actual fatty deposits in the liver. In the case of fatty liver disease, the fat may not be damaging per se, but only time will tell. A great number of people have NASH, in which case the fatty liver IS undergoing some damage slowly. There is no telling how fast it may progress. But there is a good chance it will do so â in fact, NASH is one of the leading causes of liver cirrhosis and failure in the United States. It is more common in people who are overweight or have diabetes, and having high cholesterol also puts you at risk for NASH.
Now the interesting thing about this is that often fatty liver disease and NASH cause no symptoms. Thatâs right, you feel fine. The abnormal liver is usually found by accident on lab tests. Great, you say, so why should I care? You, in fact, should care a great deal because of the risk of liver damage in future, of which you will have symptoms. Liver damage can progress to liver failure. When this little organ does not work well, your entire body and health are affected more than you can imagine. Want a picture of liver failure? Picture this: big belly full of fluid, bony legs and arms, skin that bruises all the time, muscles that disappear, yellow eyes. Not pretty, is it?
What can you do to prevent fatty liver disease and NASH?
Control those blood sugars.
Get your cholesterol under control also.
Avoid excessive amounts of alcohol. Yes, two drinks ARE enough for tonight…
Stay active and exercise.
Anita Ramsetty, MD email@example.com
Medical Director Endocrine Care Group