World Liver Day: Things You Should Know About Your Liver

Healthwire Bureau

World Liver Day

— Dr. Hemanth Kr Kasargod, Consultant- GI, MAS, and bariatrics surgery at Fortis Hospital Vasant Kunj

Liver is an important part of our digestive/metabolic system of the body. It is the largest solid organ and the largest gland in the body. It performs plenty of tasks including regulation of metabolism, production of clotting proteins, and blood detoxification. It is the only organ that can generate.

A healthy liver functions quite efficiently. However, like other organs in the body, it can be affected by various disease processes leading from mild to fatal outcomes. Fatty liver is one such disease of the liver.

What is Fatty Liver?

Fatty liver as a broad term refers to the deposition of fat in the liver. This condition is quite common, existing in the general population without any symptoms. This is usually detected during a routine ultrasound. This a progressive disease ranging from steatosis to cirrhosis/cancer and liver failure due to liver scarring and loss of normal liver tissue.

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When the fat content of the liver increases to greater than 5-10%, its function can become significantly impaired. The fatty liver is resistant to the action of insulin to suppress hepatic glucose production, which results in hyperglycemia and hyperinsulinemia.

What Causes Fatty Liver?

Fatty liver is generally classified into the following categories (which have different causes but result in similar liver damages.)

  1. Alcoholic Liver Disease (ALD): It is caused by high alcohol consumption (>20gms/20ml per day)
  2. Non-Alcoholic Fatty Liver Disease (NAFLD): It occurs for reasons other than alcohol consumption (It is often associated with symptoms of insulin resistance (a condition affecting fat metabolism) including obesity, Type 2 diabetes, hypertension and dyslipidemia.
  3. Others: Medications (such as corticosteroids, certain antidepressants and antipsychotics, Amiodarone and Methotrexate), hepatitis infections, auto-immune or inherited liver disease, fast weight loss, and malnutrition.

Obesity is considered as the single most independent predictor of fatty liver

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What are the Manifestations?

  1. Asymptomatic: Most patients do not have symptoms and are diagnosed on the basis of investigations done like ultrasound, MRI.
  2. Prodromal symptoms: Usually, non-specific and presents as fatigue, loss of appetite and weight, weakness, nausea, confusion, and difficulty concentrating.
  3. The liver may become enlarged and cause pain in the upper-middle or upper right quadrant of the abdomen. Symptoms of liver failure appear at a later stage.

Diagnosis

  1. Clinically– Based on suspicion of symptoms, Jaundice, liver enlargement (palpable liver)
  2. Laboratory investigations– S.ALT (more specific), S.AST, GGT levels are usually elevated. Kindly note, non-elevation does not rule out fatty liver.
  3. Radiology/Imaging modalities– Ultrasound, CT scan, MRI
  4. Liver Biopsy– This is the gold standard in diagnosing the disease as well as assessing its severity. However, it is an invasive procedure and this limits its use.

Treatment Of Fatty Liver

There is no specific medication or surgery to cure fatty liver. These methods have been largely found useful.

  1. weight loss especially in obese individuals
  2. Diet and exercise have been found to be of benefit
  3. Insulin therapy and other medications altering fat metabolism is still under trials.

How to Prevent the Progression Once Diagnosed?

This is the most often question by the patient once the condition is diagnosed.Since the cure is still at large, the prevention of further progression is the key. Some of the recommendations would be

  1. Exercise routine– At least 180 minutes per week in any form is acceptable.
  2. Diet– Healthy diet with plenty of fruits and vegetables, reduced refined sugar, protein rich diet
  3. Coffee may be beneficial
  4. Vitamin E– Vitamin E is a powerful antioxidant and may relieve symptoms of NAFLD.
  5. Medications– Insulin for diabetes, Medications for deranged lipid profile
  6. Regular follow up with your doctor to monitor health of your liver.

Final Thought 

On this World Liver Day, I urge people to go easy on this forgiving organ for a better life ahead. Epidemiological data have shown the fatty liver to predict, independent of other factors, metabolic syndrome, type 2 diabetes, and cardiovascular disease. The simple steatosis may remain stable for many years. Those detected with an advanced disease tend to progress more rapidly to end-stage and hence need an aggressive intervention.

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