What is fatty liver disease?

Fatty liver disease is deposition of fat in the liver; the obesity epidemic has created a rapid increase in this condition. Watch as integrative gastroenterologist Robynne Chutkan, MD, discusses basic information and symptoms of fatty liver disease.

Transcript

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ROBYNNE CHUTKAN (VOICEOVER): Fatty liver disease refers to deposition of fat in the liver. And we are seeing a virtual epidemic of it because

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of the obesity epidemic. So with two out of three Americans being overweight, and one out of every three Americans being obese,

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we're seeing a corresponding rapid increase in fatty liver disease. [MUSIC PLAYING]

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So with fatty liver disease in the early stages, we see a lot of extra fat being deposited in the liver. And this can cause the liver to become enlarged.

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It can cause pain in the right upper quadrant where the liver is located because the fibrous capsule around the liver stretches as the liver gets bigger.

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And it most commonly causes an abnormality in the liver function testing, a blood test we do to liver enzymes called

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the AST and the ALT. So the combination of being overweight, particularly if you have what we call central obesity, where you

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tend to put on most of your weight around your middle, or if you also have elevated blood pressure, high cholesterol, if you're diabetic or pre-diabetic,

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and you have these elevated liver enzymes, there's a strong likelihood that you might have fatty liver disease. Now, the first thing that we do is exclude other causes

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of liver disease, like viral hepatitis, hepatitis C, or hepatitis B, like alcoholic liver disease.

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So we take a careful history to try and figure out how much alcohol you're drinking and see whether that could be contributing. We look at other medications you might be taking

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that can also damage the liver. Once those other factors are excluded, then the overwhelming likelihood is that it's fatty liver disease.

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The next thing we might do would be an imaging test of the liver so that we can actually see the fat. And what's usually done is an ultrasound exam.

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It's a noninvasive test where sound waves are used to look at the liver. And the fat has a very characteristic appearance,

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both on ultrasound and on other types of imaging, like CAT scan or MRI. So we can generally make a diagnosis, again,

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based on your history, the abnormal liver enzymes, and the imaging study. The next step is really to see whether you

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have early fatty liver disease, where you just have fat deposited in the liver and an enlarged liver, or whether you might have progression of that to a stage

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where there's actually inflammation of the liver, or even end stage liver disease, something we call cirrhosis. And that's usually done by doing a liver biopsy.

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We don't do liver biopsies in everyone with fatty liver disease. But if we suspect that you have progression, that's generally the next step.

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And what we're looking for, again, is evidence of inflammation as sort of the second step or scarring, which is the third step.

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Now, the good news is that the early stages of fatty liver disease are reversible by changing your diet and losing weight.

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But unfortunately, the end stage, cirrhosis, which can progress and can be fatal, is not reversible. So it's very important if you think

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you're at risk to seek help from a medical professional, get some testing done, and find out, A, if you have it,

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and, B, if you do have it, where in the progression you might be. --