“Fatty liver” refers to an increased fat accumulation in the liver cells, which can cause liver inflammation (hepatitis) and chronic liver damage.
Depending on the cause of fatty liver disease divided into the non-alcoholic and alcoholic fatty liver disease without elevated liver enzymes as inflammatory indications and non-alcoholic and alcoholic fatty liver hepatitis with elevated liver values.
Non-alcoholic fatty liver and fatty liver hepatitis (NASH = Non alcoholic steatohepatitis)
Epidemiological studies in Europe and USA can be found in 30% of the general population a fatty liver. Risk factors of non-alcoholic fatty liver is a combination of metabolic problems (metabolic syndrome): Overweight (obesity), diabetes – type II (diabetes), hyperlipidemia (dyslipidaemia), insulin resistance, drugs, and some operations on the gastrointestinal tract. 20% of non-alcoholic fatty liver go into a fatty liver hepatitis (NASH) of, which lead up to 10% within 5 years in the liver cirrhosis. NASH is an underrated disorder that is often only as liver cirrhosis “of unknown origin” in the final stage of diagnosis.
Clinical symptoms are not characteristic of NASH with fatigue, tiredness and pressure in the right upper abdomen. Diagnostic path breaking elevated serum transaminases, the exclusion of other liver diseases such as chronic viral hepatitis, alcohol use among credible 20-25 g daily and, if necessary, a liver biopsy with microscopic analysis of liver tissue (histology). Histologically, it is possible to determine the extent of fatty degeneration of liver cells and divided into degrees of severity. In addition, inflammatory cells, fibrosis and finally examined the possible presence of liver cirrhosis. Histology should be sought in all patients with long-term elevated serum transaminases, age over 40 years and after exclusion of other liver diseases.
The treatment of NASH is the one in the treatment of concomitant risk factors such as obesity (slow weight loss, no drastic dieting!), Diabetes and hyperlipemia. The use of drugs for the treatment of fatty liver hepatitis is the subject of scientific study.
Alcoholic fatty liver hepatitis and fatty liver
Starting with a daily alcohol consumption over 40 – 60 g (about 1 liter of beer or ½ liter of white wine) in men and 20-30 g in women is the risk of fatty liver hepatitis. Cause of liver damage by alcohol is mainly a harmful effect of metabolites of the alcohol produced during alcohol metabolism in the liver cell. The most important therapeutic measures in alcoholic fatty liver disease is a strict abstinence from alcohol. In severe cases, a psychological support through self-help groups and psychologists are available.
Combined version
These described dietary liver diseases are a common problem in the population and pose like all inflammatory liver diseases, the risk of progression of the disease from inflammation to fibrosis, cirrhosis and liver cell cancer.