Medical questions & health advice by board certified doctors
"How does a liver become fatty?"
Is it from too much drinking. I am 29 and I drink all the time. Or is it sugar or fat?
Fatty infiltration of the liver follows two distinct patterns: alcoholic and nonalcoholic. There is one pattern of alcoholic liver disease called alcoholic steatohepatitis in which hepatocytes (liver cells) become infiltrated by microscopic fat droplets. This is caused by a metabolic abnormality induced by excessive alcohol consumption, which causes the hepatocytes to store excess enegy as fat. The other pattern of disease is nonalcohoic steatohepatitis or NASH. This is a disease characterized by similar microscopic abnormalities to those seen in alcoholic steatoheptitis, but without documented overuse of alcohol. This disease most often affects people who are overweight or obese. The prognoses of the two diseases are quite different. Because alcohol is directly toxic to the liver in addition to causing steatosis, people with alcoholic steatohepatitis are very likely to progress to end stage liver disease (also known as cirrhosis or liver failure) if they continue to drink. The prognosis is significantly better for NASH, where the relative risk of mortality is about 1.5 times higer than the general population. In the case of alcoholic steatohepatitis, the best thing that can be done to improve the prognosis is to stop drinking. In NASH the best way to improve the prognosis is to exercise and lose weight. These are both serious diseases with very serious implications and mortality rates. If you been diagnosed with fatty liver, you absolutely must make an appointment to be evaluated in person by a specialist such as a gastroenterologist. Only consultation with a doctor can provide accurate diagnosis of the cause of fatty liver, as well as appropriate recommendations for treatment.