Fatty
liver, also known as fatty liver
disease (FLD), is a reversible
condition where large vacuoles of triglyceride fat accumulate in liver cells via the process of steatosis (i.e.
abnormal retention of lipids within a cell). Despite having multiple causes,
fatty liver can be considered a single disease that
occurs worldwide in those with excessive alcohol intake
and those who are obese (with or without effects of insulin resistance). The condition is also associated with other
diseases that influence fat metabolism.
Nonalcoholic
fatty liver disease(NAFLD) is a term used to
describe the accumulation of fat in the liver of people who drink little or no
alcohol. Nonalcoholic fatty liver disease is common and, for most people,
causes 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. This more serious form of nonalcoholic
fatty liver disease is sometimes called nonalcoholic steatohepatitis(NASH). At
its most severe, nonalcoholic fatty liver disease can progress to cirrhosis,
liver failure, or liver cancer. The disease often goes hand in hand with
diabetes. According to latest research about 70 percent of people with type 2
diabetes have a fatty liver. Morphologically, it is difficult to distinguish
alcoholic FLD from nonalcoholic FLD, and both show microvesicular and
macrovesicular fatty changes at different stages.
Aetiology
Exactly, is unknown. A fatty diet or overeating by itself
never results in a fatty liver. The fat may come from increased absorption from
the intestines or from elsewhere in the body. Some common causes of NAFLD are:
Metabolic
syndromes - Apart from alcohol, there are many conditions that cause an
imbalance in the body's metabolic capacity like Diabetes, High Hypertension, High
blood cholesterols, Pregnancy, Glycogen storage disease, Congenital disorders
like Wolman's disease, Congenital diseases like Wilson's disease, Weber-Christian
disease, Galactosemia, Infections like tuberculosis and malaria.
Nutritional
causes - Severe mal-nutrition, Obesity, Sudden rapid weight loss, Surgeries
performed to reduce obesity - gastric bypass surgery, jejuno-ileal bypass, etc.
Drugs
– Corticosteroids, Valproic acids (used in epileptic patients), Medications for
heart conditions like irregular heartbeats and high blood pressures e.g.
amiodarone; diltiazem, Sedatives, Tamoxifen - used in treating breast cancer, Methotrexate,
Anti-retroviral drugs (indinavir), Overdose of Vitamin A. In extreme cases,
amiodarone and methotexate can cause cirrhosis.
Other
- toxins from food stuffs like rancid peanuts - aflatoxins are extremely toxic,
mushroom poisonings, phosphorus from environment
Risk
factors:
- are obese
- are an alcoholic
- Suffer from high blood pressures which often fluctuate or are on long-term medications for the same.
- Blood cholesterol levels are high.
Types of nonalcoholic fatty liver disease
Nonalcoholic fatty liver disease can take several forms —
from harmless to life-threatening. Forms include:
Ø Nonalcoholic
fatty liver. It's not normal for fat to build up in your liver, but it
won't necessarily hurt you. In its simplest form, nonalcoholic fatty liver
disease can cause excess liver fat, but no complications. This condition is
thought to be very common.
Ø Nonalcoholic
steatohepatitis. In a small number of people with fatty liver, the fat
causes inflammation in the liver. This can impair the liver's ability to function
and lead to complications.
Ø Nonalcoholic
fatty liver disease-associated cirrhosis. Liver inflammation leads to
scarring of the liver tissue. With time, scarring can become so severe that the
liver no longer functions adequately (liver failure).
Clinical Presentation
Mild Fatty liver is usually asymptomatic. It is detected
incidentally during routine tests performed. However, some persons can have
symptoms which are often vague like Malaise , Fatigue - even with moderate
exertion, Fullness and heaviness in the abdomen, more in the right upper corner,
Occasionally the liver maybe painful on pressure.
However, with fatty liver unchecked can progress into
cirrhosis which is life-threatening.
Diagnosis :
Commonly, the diagnosis is incidental. Some tests which
identify the disorder are:-
- Ultrasound (Ultrasonography): A painless, non-invasive test, when performed by an experienced personnel, it can accurately identify fatty liver. The liver size can be measured and this test can be valuable in grading the improvement.
- Liver Function Tests: Abnormal levels of liver enzymes in the blood identify as well as provide a deeper understanding of the cause of fatty liver. This test also provides insight into the efficacy of treatment and the improvement to be expected.
- Computed Tomography Scan (CT scan): non-invasive. Measures internal organs accurately and in detail by the use of X-rays.
- MRI: Also non-invasive. Uses radio waves in a magnetic field to scan the structures of internal organs.
Tips for preventing and treating nonalcoholic fatty
liver disease
·
Lose weight, and
exercise. Doctors often recommend weight loss as a first step for those newly diagnosed with fatty
liver disease. The American Gastroenterological Association suggests weight
loss of 10 percent or more for those with NASH. Aim for at least 30 minutes of
exercise most days of the week. For instance, take the stairs instead of the
elevator. Walk instead of taking short trips in your car. If you're trying to
lose weight, you might find that more exercise is helpful. But if you don't
already exercise regularly, get your doctor's OK first and start slowly.
·
Improve your diet, even if you're having trouble
losing weight. A healthful
diet is considered key to
a long and healthy life. It may be especially important for those with
nonalcoholic fatty liver disease. Eat a healthy diet that's rich in fruits and
vegetables. Reduce the amount of saturated fat in your diet and instead select
healthy unsaturated fats, such as those found in fish, olive oil and nuts.
Include whole grains in your diet, such as whole-wheat breads and brown rice.
·
Consider a
glass of wine. The prevailing advice
for people with nonalcoholic fatty liver disease continues to be to avoid
alcohol altogether. But a study published last year suggests an unconventional
approach to preventing the condition. Researchers at the University of
California-San Diego School of Medicine found that drinking a
glass of wine a day may
decrease the risk of nonalcoholic fatty liver disease. Study participants who
reported drinking up to one glass of wine per day had their risk of liver
disease cut in half, in comparison with those who drank no alcohol.
·
Control cholesterol levels.
Besides regular workouts, a healthy approach to avoid consumption of saturated
fats in diet can reverse fatty liver. Cholesterol lowering medications used in
adjunct to exercise can reverse fatty liver.
·
Control Diabetes.
Effective management of sugar levels with life-style changes, medications and
insulin can stop further advancement of fatty liver into something serious like
cirrhosis or liver failure.
Management
Natural Treatment
Certain natural remedies may be helpful in healing
fatty liver when part of a personalized and well-rounded treatment plan. Before
taking natural remedies, consult with medical doctor as well as a nutritionally
and botanically trained health care professional.
Vitamin E is an antioxidant, meaning it protects against free
radical damage. This can be especially helpful for the liver because free
radicals form during the natural detoxification process. Vitamin E also
supports the immune system and can help prevent fibrosis and cirrhosis, which
are common complications of long-term fatty liver.
Turmeric is popular both as a culinary spice and for its
medical properties. Turmeric, also known as Curcuma longa, is used in Chinese
and Ayurvedic medicine to treat liver ailments, digestive problems and skin
diseases. Turmeric has a strong antioxidant and anti-inflammatory properties.
It protects liver cells against damage and reduces inflammation that results
from fatty liver. Turmeric may be sprinkled on food as a spice or taken as a
tincture or capsule.
Milk thistle is a
well-known all-natural solution for the treatment of liver disorders. The
active component perfectly located at the seed will be the phytochemical
silymarin. Silymarin is often a flavonoid which helps bring about regeneration
regarding harmed hard working liver tissue and also improves liver organ
purpose.
Omega-3 essential fatty acids are located naturally within flax plant seeds, seed
natural skin oils like flaxseed along with canola oils, bass oils as
well as chilly water seafood like fish. Omega-3 essential fatty acids can have
outstanding hard working liver health improvements, enhance the action
involving insulin, as well as aid many individuals who are suffering through
junk lean meats condition. In addition, Omega-3 fat lower swelling and pain
some of those those who are experiencing any junk liver condition.
HOMOEOPATHIC MANAGEMENT
Homeopathy is one of the most popular holistic systems
of medicine. The selection of remedy is based upon the theory of
individualization and symptoms similarity by using holistic approach. This is
the only way through which a state of complete health can be regained by
removing all the sign and symptoms from which the patient is suffering. The aim
of homeopathy is not only to treat fatty liver symptoms but to address its
underlying cause and individual susceptibility. As far as therapeutic
medication is concerned, several remedies are available to treat fatty liver
symptoms that can be selected on the basis of cause, sensations and modalities
of the complaints. For individualized remedy selection and treatment, the
patient should consult a qualified homeopathic doctor in person. There are following
remedies which are helpful in the treatment of fatty liver symptoms:
Arsenic Album, Nux Vomica, Chelidonium, Cardus m,
Apocynum, Lycopodium, Sepia, Phosphorous, Digitalis, Bryonia, Helleborus Niger,
Ferrum Met, kali Carb, Iris V, Natrum Carb and many other medicines.
Bryonia. [Bry] When there are stitching pains in the right
hypochondriac region, Bryonia is the first remedy to be thought of, though for
these pains we have other remedies, such as Chelidonium and Kali carbonicum.
Under Bryonia the liver is swollen, congested and inflamed; the pains in the
hypochondriac region are worse from any motion, and better from lying on the
right side, which lessens the motion of the parts when breathing . It is one of
the chief remedies for jaundice brought on by a fit of anger. Chelidonium
is distinguished by the character of the stools. Bryonia is pre-eminently a
gastro-hepatic remedy, and has pain in right shoulder,giddiness, skin and eyes
slightly yellow. Hughes says it hardly reaches true hepatitis.
Mercurius. [Merc] This remedy
has much sensitiveness and dull pain in the region of the liver; the patient
cannot lie on the right side. The liver is enlarged. The skin and conjunctiva
are jaundiced. The stools are either clay-colored from absence of bile, or
yellowish-green bilious stools passed with a great deal of tenesmus. There is a
yellowish white coated tongue which takes the imprint of the teeth and there is
a foetid breath, loss of appetite and depression of spirits.
Podophyllum. [Podo] The principal use of Podophyllum
is in liver affections. Primarily, it induces a large flow of bile, and,
secondarily, great torpidity, followed by jaundice. It is indicated in torpid
or chronically congested liver, when diarrhea is present. The liver is swollen
and sensitive, the face and eyes are yellow and there is a bad taste in the
mouth. The tongue is coated white or yellow and the bile may form gall stones.
Chelidonium. [Chel] The liver symptoms of Chelidonium are very
prominent. There is soreness and stitching pains in the region of the liver,
but the keynote for this drug in hepatic diseases is a pain under the angle of
the right shoulder blade, which may extend to the chest, stomach, or
hypochondrium; there is swelling of the liver, chilliness, fever, jaundice, yellow
coated tongue, bitter taste and a craving for acids and sour things, such as
pickles and vinegar.
Digitalis. [Dig] When jaundice arises from
cardiac diseases, Digitalis may be the remedy. There is no retention of bile,
nor obstruction of the ducts, but the jaundice is due to the fact that the
liver does not take from the blood the elements which go to form bile. There is
present drowsiness, bitter taste, soreness , enlargement and bruised feeling in
the region of the liver.
Myrica cerifera. [Myric] Myrica is an important liver
remedy. There is first despondency and also jaundice due to imperfect formation
of bile in the liver, and not to any obstruction, comparing here with
Digitalis. There is dull headache, worse in the morning, the eyes have a dingy,
dirty, yellowish hue, the tongue is coated yellow.
Nux vomica. [Nux-V] In liver affections occurring
in those who have indulged to excess in alcoholic liquors, highly seasoned
food, quinine, or in those who have abused themselves with purgatives, Nux is
the first remedy to be thought of. The liver is swollen hard and sensitive to
the touch and pressure of clothing is uncomfortable. The first remedy in
cirrhosis of the liver. Colic may be present.
Lycopodium. [Lyc] Lycopodium acts powerfully on
the liver. The region of the liver is sensitive to the touch, and there is a
feeling of tension in it, a feeling as if a cord were tied about the waist.
Cirrhosis. The pains are dull and aching instead of sharp and lancinating, as
under Chelidonium. Fulness in the stomach after eating a small quantity.
Carduus marianus. [Card-m] This remedy is indicated in
jaundice with dull headache, bitter taste, white tongue with red edges, nausea
and vomiting of a greenish fluid. There is an uncomfortable fullness in the
region of the liver, the stools are bilious and the urine golden yellow; there
is sensitiveness in the epigastrium and right hypochondrium. Burnett regards a
dark brownish patch over the lower part of the sternum as a useful hint for
Carduus, and in such cases he observes that both the liver and heart are at
fault. The presence of "liver spots seems to be a special indication for
the remedy.
Sulphur. [Sulph] Sulphur is suitable to chronic
affections of the liver; it increases the flow of bile and there is much pain
and soreness in the liver. Sulphur often completes the cure commenced by Nux.
Liver complaints from abuse of mercury will oftentimes call for Sulphur. If the
stools are colorless and if much jaundice or ascites be present Sulphur is
contra-indicated. Lachesis, however, has jaundice, as do all snake poisons, and
is useful in the enlarged livers of drunkards, with tenderness on pressure and
throbbing in the right side.
Phosphorus. [Phos] Phosphorus is homoeopathic to fatty
degeneration of the liver, with well marked soreness and jaundice. The stools
are grayish white. Cirrhosis and atrophy may also call for Phosphorus. The
jaundice is indicative of organic diseases, and the remedy is a useful one in
malignant diseases of the liver. Digitalis has also been recommended in acute
yellow atrophy. Jaundice accompanying pneumonia may also call for Phosphorus.
Taraxacum [Tarax] This is a decided liver
remedy, and the indications are a mapped tongue and a bitter taste in the
mouth, chilliness after eating, pain and soreness in the region of the liver
and bilious diarrhea. Kali bichromicum also has a mapped tongue. Yucca
filamentosa has a pain going from the upper region of the liver to the back and
a bad taste in the mouth. The stools are loose and bilious, accompanied with
much flatus.
