Fatty liver disease often appears harmless and rarely shows symptoms in the early stages. It all starts with an accumulation of fat in the liver that is not broken down properly due to excessive consumption of calories or diseases such as diabetes, high cholesterol, among others. In the early stages, there is virtually no inflammation from liver damage and many people may not reach the advanced stages of fatty liver disease where the risks of liver cirrhosis and liver cancer increase. Fatty liver disease in many people goes undiagnosed in the early stages because it is the most asymptomatic. However, as the disease progresses, one may begin to notice yellowing of the skin, dull pain in the lower right side of the ribs, swelling in the abdomen, legs, weight loss among many other symptoms . (Also read: 8 fruits you must eat to reverse fatty liver disease)
“Fatty liver disease is on the rise due to lifestyle and diet changes. A sedentary lifestyle and excessive consumption of processed, high-calorie foods are some of the major causes of this condition. Although alcohol is at the top of the chart of fatty liver etiologies, non-alcoholic fatty liver disease is also on the rise due to this,” says Dr. Amol Dahale, Gastroenterology Consultant, Manipal Hospitals, Baner-Pune.
“Mostly detected in asymptomatic patients, few people may develop symptoms such as upper abdominal pain, nausea, fatigue, decreased appetite, even jaundice in a few cases. Initially, few people develop cirrhosis and even liver cancer, which can be fatal,” says Doctor Dahale.
Dr. Pratik Tibdewal, Consultant Gastroenterologist, Wockhardt Hospitals, Mira Road explains in detail the four stages of fatty liver and when to start to worry.
STEP ONE: NO RED FLAG
There are four stages of non-alcoholic fatty liver disease (NAFLD) that determine the progression of the disease. The first stage is a simple hepatic steatosis or steatosis. This happens when liver cells start to accumulate fat, but without inflammation or scarring at this stage. There are no red flags at this point and a lot of people don’t even know they have foie gras. Not everyone with fatty liver disease will get nonalcoholic steatohepatitis (NASH), which is the second stage.
SECOND STAGE: INFLAMMATION
The second stage of NAFLD is non-alcoholic steatohepatitis (NASH). Here there is a buildup of fat in the liver cells as well as inflammation as the liver repairs damaged tissue. If the damaged tissue is more extensive, there may be scarring of the liver leading to fibrosis
THIRD STAGE: FIBROSIS
The third stage of NAFLD is fibrosis. It is seen when the scar tissue is there in the liver and in the blood vessels around the liver. Thus, treating the inflammation may prevent further progression or even reverse some of the damage. However, if not treated at the right time, it can lead to cirrhosis.
FOURTH STAGE: CIRRHOSIS
The fourth stage of NAFLD is cirrhosis. At this point the liver will completely stop working and there may be signs and symptoms such as yellowing of the skin and dull pain in the lower right side of the ribs and one will suffer from liver damage which may lead to ascites ( abnormal swelling), swelling of the legs, bleeding due to vomiting, or altered consciousness requiring hospitalization and possibly requiring liver transplantation.
Dr. Shankar Zanwar Consultant Gastroenterologist, Wockhardt Hospital, Central Mumbai shares fatty liver disease danger signs that no one should ignore.
– If the patient begins to tire during activities that are not usually strenuous
– Loss of desire to eat
– Yellowish discoloration of eyes and urine
– Fullness of the abdomen usually due to fluid accumulation
– Vomiting blood
– Stools in black color
– Swelling of the legs
– Weightloss
– Abnormal mental activity in the form of disturbed sleep and wake cycle, irrelevant conversation, disorientation
– Easy contusion, which means bleeding under the skin with insignificant wounds
“As the saying goes that prevention is better than cure, early diagnosis and treatment can lead to complete reversal of the disease. Today, with the availability of several detection tools like ultrasound, fibroscan, blood tests, early diagnosis is possible.Regular exercise, dietary and lifestyle changes as well as medications can help us cure fatty liver,” says Dr. Dahale.
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