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Fatty Liver Disease

What is Fatty Liver disease?
“Fatty liver disease” (also known as “hepatic steatosis”) refers to the accumulation of fat in the liver. It affects approximately 10% of adults in the Western world, and it’s the most common cause of abnormal results on liver function testing.

What causes Fatty Liver disease?
Fatty liver disease can be caused by a range of conditions, but can generally be divided into “non alcoholic fatty liver disease” (NAFLD) and “alcoholic fatty liver disease” (AFLD). Of these two categories, NAFLD is much more common. NAFLD is often occurs in people with: obesity (~75%), diabetes (~75%), high cholesterol (~50%) and polycystic ovarian syndrome. Other less common causes include can include an underactive thyroid, certain medications (e.g. amiodarone, steroids, tamoxifen) and very rapid weight loss.

What are the symptoms of Fatty Liver disease?
People affected with fatty liver disease usually do not have any symptoms. Most people with fatty liver disease are unaware of their condition, and is it often only picked up when routine blood testing of the liver function is abnormal.

Are there any complications of Fatty Liver disease?
In general, AFLD has a worse prognosis than NAFLD. In a small proportion of people with NAFLD some may develop liver inflammation (called Non Alcoholic SteatoHepatitis or NASH) and scarring or “fibrosis”. Severe scarring of the liver can occur leading to cirrhosis (hyperlink), and this in turn can result in liver failure.

How is Fatty Liver diagnosed?
Fatty liver disease is often suspected when routine blood tests of liver function are abnormal. The only definitive test to differentiate simple fatty liver from inflammation/steatohepatitis is a liver biopsy. Although a liver biopsy is not routinely performed, it may be recommended if the diagnosis is unclear, or the blood tests for the liver are very abnormal.

What is the treatment of Fatty Liver disease?
Although medication is available for the treatment of conditions such as diabetes or obesity, there is currently no proven specific medication for fatty liver disease. The general recommendations for fatty liver include:

> Healthy lifestyle

— Weight loss: weight loss should be steady (up to 0.5kg per week) but maintained
— Regular exercise
— Dietary modification

> Limit alcohol intake
> Diabetes management
> Monitoring and treatment of other conditions such as high blood pressure, high cholesterol

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