Fatty liver has large amounts of fats (triglycerides) accumulating within the liver cells. Excess aggregation of fats within the small hepatocytes swells them up and occasionally the whole liver is enlarged enough for feeling it.

Fatty liver can be a harbinger of more troublesome conditions. Steatosis simply means a collection of fat vacuoles within the liver cells (hepatocytes).

Alcohol and obesity are two leading causes of fatty liver worldwide. Alcoholic Liver Disease (ALD) and Alcoholic Fatty Liver (AFL) are entities by themselves. Obesity plus other non-alcoholic conditions comprise Non-Alcoholic Liver Disease (NALD).

When these fat cells cause inflammation of the liver tissues, it's called steatotic hepatitis and it is of notable concern. Both alcohol, as well as other conditions causing major biochemical changes in our bodies, can cause steatotic hepatitis. When this condition is due to reasons other than alcohol, it's denoted by the term Non-Alcoholic Steatotic Hepatitis or more commonly as NASH.

Fatty liver when inflamed, can over a period of time cause scarring and fibrosis of the liver. This condition called cirrhosis is serious and has serious side-effects if left unchecked.

be controlled with proper medication

 Causes of Fatty Liver

Why fatty liver occurs, 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. But, putting it generally, the liver loses its capacity to eliminate fats deposited within it.
Yet, 70% of persons suffering from NASH are found to be obese.

 Some common causes 

• Metabolic syndromes
  Apart from alcohol, there are many conditions that cause an imbalance in the body's metabolic capacity
• Diabetes
• High blood pressures (hypertension)
• High blood cholesterols
• Pregnancy
• Glycogen storage disease
• Congenital disorders like Wolman's disease
• Congenital diseases like Wilson's disease which affects copper levels
• Weber-Christian disease affecting nutrient absorption.
• Galactosemia - a disorder which affects the way milk is metabolized in the body.
• Infections like tuberculosis and malaria.
• Nutritional causes
  • Severe malnutrition
  • Obesity
  • Sudden rapid weight loss
  • Surgeries performed to reduce obesity - gastric bypass surgery, jejunoileal 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)
  • An overdose of Vitamin A.
• In extreme cases, amiodarone and methotrexate can cause cirrhosis.      
• Other
  • toxins from foodstuffs like
  • rancid peanuts - aflatoxins are extremely toxic
  • mushroom poisonings
  • phosphorus from the 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.    

Symptoms of Fatty Liver

The mild Fatty liver is usually asymptomatic. It is detected incidentally during routine tests performed. However, some persons can have symptoms which are often vague.

• Malaise - or a feeling of severe discomfort, making the person want to rest,
• 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 to cirrhosis which is life-threatening. Thereafter, features of liver failure present themselves.

• Yellowish discoloration of skin (jaundice), dark colored urine.
• Weight loss
• Nausea and vomiting
• Loss of appetite
• Mild to moderate reddish discolorations just below the superficial skin layers which blanch on pressure (spider naevi)
• Abdominal dissension (due to increased fluid in the abdomen - ascites)
• Easy bleeds from small trauma.
• Blood doesn't clot soon enough
• Fine to moderate tremors of the fingers
• Flapping tremors of the hands (asterixis)
• Itching in hands and legs which gradually spread all over the body
• Veins in legs, abdomen, seem engorged and distended.
• Giddiness.
• Poor memory, poor concentration, dullness of thoughts, mental confusion » this is an emergency (encephalopathy)!!
• Depression   

 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.   

 Prevention 

• Say No To Alcohol
  Or if you have started having alcohol, try not to have more than two pegs in a week.
• Quit Smoking
  Smoking can cause many biochemical and hemodynamic changes which make you more vulnerable to liver damage.
• Control Weight Gain
  70% of persons suffering from NASH are found to be obese.
• Omega-3 Fatty Acids
  Found to be promising in preventing fatty liver. Found in natural sources like walnuts, fish oils (cod, salmons), and flaxseed oils.

 Homoeopathic Treatment of Fatty Liver 

Conventional treatment
There is no standardized treatment for fatty liver. Treating the underlying cause can easily reverse the abnormal changes in the liver, provided, it is early in the disease.

Some common measures that improve fatty liver are:

• Exercise and weight loss programs: Obese patients have a Body Mass Index (BMI) of 30 or more. A realistic weight loss program should try reducing the BMI by two units of the existing one. Aerobic exercises are best suited to burn off fat. However, one should bear in mind that for long-term success, it is not the intensity of the workout, but the sustenance that matters.
• Control cholesterol levels.: Besides regular workouts, a healthy approach to avoid consumption of saturated fats in the 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 lifestyle changes, medications and insulin can stop further advancement of fatty liver into something serious like cirrhosis or liver failure.
• Avoid harmful substances.: Certain drugs, alcohol, junk foods etc. are better avoided when once diagnosed with fatty liver. Talk to your doctor regarding medications that can cause fatty liver. Chances are he can suggest better alternatives.

  HOMOEOPATHIC MEDICINE OF FATTY LIVER

1. Lycopodium: A fatty liver accompanied by acidity, bloating and belching with a burning sensation. These symptoms tend to worsen n the evening and the patient may have an intense craving for sweets and hot drinks.

2. Phosphorus: This is used to treat cases of fatty acid which triggers regurgitation accompanied by sour belching.There is pain in the liver and excessive flatulence. Vomiting may also occur along with weakness while passing stool.

3. Calcarea carb: Obese patients suffering from this condition can be treated with calcarea carb. These people often have a distended abdomen, are lactose intolerant and suffer from chronic constipation. They are also overly sensitive to cold air and sweat excessively from the head.

 RL31

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