Fatty Liver and Cirrhosis

Fatty Liver – This One’s Personal

 

Dear Reader,

This is a disease that upsets me deeply, as it is the one which took my Mom.  Until the time of her diagnosis, the only thing I “knew” about cirrhosis was that it was a disease which only affected alcoholics and drug abusers.  I was so wrong.

 

There are, in fact, several paths to liver disease, which I will cover in a separate post.  In my Mom’s case, her cirrhosis developed as a progression from NASH or Nonalcoholic steatohepatitis.  It is also called NAFL (non alcoholic fatty liver), or simply Fatty Liver.

 

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NASH is a common, often “silent” liver disease. It resembles alcoholic liver disease, but occurs in people who drink little or no alcohol. The major feature in NASH is fat in the liver, along with inflammation and damage. Most people with NASH feel well and are not aware that they have a liver problem.

 

Nevertheless, NASH can be severe and can lead to cirrhosis, in which the liver is permanently damaged and scarred and no longer able to work properly.

 

Although having fat in the liver is not normal, by itself it probably causes little harm or permanent damage. If fat is suspected based on blood test results or scans of the liver, this problem is called nonalcoholic fatty liver disease (NAFLD). If a liver biopsy is performed in this case, it will show that some people have NASH while others have simple fatty liver.

 

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NASH is usually a silent disease with few or no symptoms. Patients generally feel well in the early stages and only begin to have symptoms—such as fatigue, weight loss, and weakness—once the disease is more advanced or cirrhosis develops.

 

The progression of NASH can take years, even decades. The process can stop and, in some cases, reverse on its own without specific therapy. Or NASH can slowly worsen, causing scarring or “fibrosis” to appear and accumulate in the liver.

 

As fibrosis worsens, cirrhosis develops; the liver becomes seriously scarred, hardened, and unable to function normally.

 

Not every person with NASH develops cirrhosis, but once serious scarring or cirrhosis is present, few treatments can halt the progression. A person with cirrhosis experiences fluid retention, muscle wasting, bleeding from the intestines, and liver failure.

 

Liver transplantation is the only treatment for advanced cirrhosis with liver failure, and transplantation is increasingly performed in people with NASH.

 

Although NASH has become more common, its underlying cause is still not clear. It most often occurs in persons who are middle-aged and overweight or obese.

 

See Alarming New Liver Statistics

 

Many patients with NASH have elevated blood lipids, such as cholesterol and triglycerides, and many have diabetes or pre-diabetes, but not every obese person or every patient with diabetes has NASH.

 

Furthermore, some patients with NASH are not obese, do not have diabetes, and have normal blood cholesterol and lipids. NASH can occur without any apparent risk factor and can even occur in children. Thus, NASH is not simply obesity that affects the liver.

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My Mom was 73, and had most of the risk factors for NASH, including age, obesity, sedentary lifestyle, insulin resistance and high triglycerides.  Doctors see NASH often, and usually call it “Fatty Liver.” 

Perhaps because it is fairly commonplace, it seems that most physicians don’t adequately impress on the patient the need to make the necessary lifestyle changes to reverse the condition before it potentially progresses to non-reversible cirrhosis of the liver.

 

Fatty Liver can be potentially reversed by weight reduction (if overweight), activity and healthy diet, and avoiding alcohol and unnecessary medications.  Most importantly, a major attempt should be made to lower body weight into the healthy range. Weight loss can improve liver tests in patients with NASH and may reverse the disease.

 

These are standard recommendations, but they can absolutely make a difference. They are also helpful for other conditions, such as heart disease, diabetes, and high cholesterol.

 

People with NASH often have other medical conditions, such as diabetes, high blood pressure, or elevated cholesterol. These conditions should be treated with medication and adequately controlled; having NASH or elevated liver enzymes should not lead people to avoid treating these other conditions.

 

Experimental approaches under evaluation in patients with NASH include antioxidants, such as vitamin E, selenium, and betaine. These medications act by reducing the oxidative stress that appears to increase inside the liver in patients with NASH. Whether these substances actually help treat the disease is not known, but the results of clinical trials should become available in the next few years.

 

Over time, more research will help physicians to better understand the liver injury found in this disease. When the pathways that lead to the injury are fully known, safe and effective means can be developed and used along with lifestyle changes to reverse these pathways and help patients with NASH. Recent breakthroughs in mapping the human genome and uncovering the individual steps by which insulin and other hormones regulate blood glucose and fat could provide the necessary clues.

 

My Mom was told that she had fatty liver by her doctor many years ago, but that information was accompanied by only the advice to lose some weight.  It haunts me to think that the disease could have been reversed if she had been warned of the potentially fatal consequences of ignoring it.  I wish somebody had frightened her into changing her lifestyle when it could have made a difference in her future outcome.

It is a sad thought, indeed, that I lost my Mom to a lifestyle disease which could have been prevented or reversed.

 

 

Please share your thoughts or experience with liver issues in the comment section below.

 

 

You may also be interested in:

Alarming New Liver Statistics

Symptoms of Cirrhosis of the Liver

Causes of Cirrhosis of the Liver

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15 thoughts on “Fatty Liver and Cirrhosis”

  1. Sorry to hear of your loss. I’ve never heard of NASH before or fatty liver. I think your advice is spot on, prevention is key. If only we could see what was going on inside our bodies. I think it would motivate a lot of us to change our diets and lifestyles.
    It worrying how little we are educated on these matter until we are diagnosed. Thanks for a great article and extra motivation to live a healthy lifestyle.

    1. Thanks for your comment, Amanda. The sad part is, so many people are told they have have fatty liver in a kind of casual way by their doctors. That early diagnosis is wasted in so many instances.

  2. Hi Laurie

    I am so sorry to hear about the loss of your mum. On a slightly different note to your story, my mum, who is still with me was told that she had a fatty liver, she however does drink and I know that this is the reason behind it.

    I found your article really interesting and informative. I will be forwarding this to my mum to try and open her eyes to the damage she is doing to herself.

    I hope that you can take comfort in knowing that you are helping others to potentially change their lives.

    1. Thanks for your comment, Dawn. The best thing about Fatty Liver disease, it that it can be reversed before it progresses into cirrhosis. I will go into detail about cirrhosis and my mom’s terrible ordeal in upcoming posts, and I assure you, it will help motivate your mom to make a change while she still can. I hope your mom will get some help to stop drinking immediately. Liver cirrhosis is an absolute nightmare.

  3. Nice article. I found it thorough in information and because it happened to a close family member in was also personal. Why is your heading not more pronounced? I know that dying and grief may not be elating but it is a fact of life. I would enhance the heading somehow to be more visible. It is a good article with great content. Good job!

    1. Thank you for your feedback. I will look at the heading with new eyes now, and may experiment with the appearance.

  4. I sympathize with your loss — it must be really hard. When you educate other people about this disease, you are preserving her memory by helping others not fall into the same fate. It is an important thing to do. By simply taking care of ourselves and being aware of the facts, we can save lives.

    1. Thank you, Ben. I have to stop myself sometimes from being too preachy, because my hurt and frustration is still pretty raw. On the positive side, I imagine someone hearing “fatty liver” at their next physical, and perhaps understanding it as a serious red flag because of stopping by my blog. That is my hope.

  5. Hi, Laurie!
    I’m deeply sorry for your lost! I think you felt powerless when you had to cope with the lack of information and professional help for your mother’s condition!
    I’ve found your website during research for a friend of mine, and I’ve discovered your very informative and well-written article. I’m sure that your experience will help others in the same situation!
    Kind regards,
    Cristina

  6. Interesting insight on fatty liver. I have heard about it but never really knew what it is. Your article has helped me to gain understanding on this. NASH sounds like a really serious condition and since there are no initial symptoms, are there any way we would know about it? Would going for yearly check ups help? Thank you this well-written piece.

    1. Thanks for your comment, Lily. If you are a heavy drinker or have a family history of liver disease, your doctor can order some simple blood tests to check your liver function.

  7. Omg! Thank you thank you thank you! My mom is going through the same thing right now. She was diagnosed a couple of years ago. All she really told us was that she needed to loose weight and her dad passed away of the same thing. So yes we were concerned but didn’t ask any questions.
    Now I’m paralyzed with fear! My mom is very religious and had always said she would not even consider a transplant. But here we are…we have meetings upon meetings. I don’t know what it means for me and my sister, or our kids. She has been the constant. She helped me raise my kids through divorce and other things. They are 13 and 10 now. How do I explain to them that grandma may go to heaven sooner than any of us ever thought? I hate seeing her in the hospital with fear in her eyes and voice! I hate laying on her bed listening to her struggle to talk because she can’t breath! I hate seeing her body swell with fluid and the bruises and marks all over her. And it’s all just beginning for us. How long can she last? Will they accept her as a transplant patient and does someone else have to die for her to live. If so I know it’s so selfish of me to want that! But my kids need her and my dad needs her!
    Like you said I wish someone would have scared her before it got to this point.
    I’m looking for others who have gone through this or are going through this. Mainly for support for me. Do you know of any?
    I’m reading up on it all the time now and looking for diets for myself. If there isn’t any I want to help others like me and my family.
    Thank you for this.
    Amy

  8. I’m sorry for your loss.. I just lost my mother a bit over a month ago from the same thing.. she was only 52 and had been told a few years ago to loose weight because she had scaring on her liver.. she starting gaining heaps of weight at the start of last year (which we later found out was fluid retention) and therefore had a gastric sleeve operation. Her surgeon almost stopped the surgery because her liver was enlarged and so scared but he said she needed to loose weight in order to control her liver disease and we all completely agree with him..
    I have to agree with you about how frustrating it is that when mum found out she had a bit of NASH years ago, that her doctor didn’t really tell her about how bad things can get and didn’t scare her into loosing weight! I wish they had scared her into it, my mum would defiantly be around still if they did.
    It’s such a terrible disease and it’s the worse thing to watch somebody struggle with. My mum was admitted to hospital and her liver specialist said she had chronic liver failure although when she was moved to a bigger city hospital that have more treatment and also specialise in liver and kidney diseases, the liver transplant team that assessed her told me it was acute liver failure. I’m so frustrated how I got two different answeres by ‘liver specialists’. My mum lasted just under 3 weeks before the toxins caused her breathing to become so weak that she was put on life support for her breathing. She then was put into palliative care a just over a week later, two days after my birthday. Such a scary thing and I wouldn’t wish it upon anyone to have to wittiness a friend or family member go through that.

    1. Thank you for your comment; your experience with your mother sounds very familiar. It is hard to come to terms with preventable terminal illness, and even harder not to bitter toward doctors who don’t warn their patients about the risks of fatty liver.

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