Alcoholic Liver Disease (ALD)
More than 15 million people in the U.S. abuse or overuse alcohol. Almost all of them — 90%-100% — develop fatty livers.
Fatty liver can occur after drinking moderate or large amounts of alcohol. It can even occur after a short period of heavy drinking (acute alcoholic liver disease).
Genetics or heredity (what is passed down from parent to child) plays a role in alcoholic liver disease in two ways: It may influence how much alcohol you consume and your likelihood of developing alcoholism. And, it may also affect levels of liver enzymes involved in the breakdown (metabolism) of alcohol.
Other factors that may influence your chances of developing alcoholic fatty liver disease include:
- Hepatitis C (which can lead to liver inflammation)
- An overload of iron
Nonalcoholic fatty liver disease (NAFLD)
Nonalcoholic fatty liver disease is now the most common cause of chronic liver disease in the U.S. Some people with excess fat in the liver simply have what’s called a fatty liver. Although this is not normal, it is not serious if it doesn’t lead to inflammation or damage.
Others have what’s called nonalcoholic steatohepatisis (NASH). Although it is similar to alcoholic liver disease, people with this type of fatty liver disease drink little or no alcohol. NASH can lead to permanent liver damage. The liver may enlarge and, over time, liver cells may be replaced by scar tissue. This is called cirrhosis. The liver can’t work right and you may develop liver failure, liver cancer, and liver-related death. NASH is one of the leading causes of cirrhosis.
Both types of NAFLD are becoming more common. Up to 20% of adults may have either fatty liver or NASH. And more than 6 million children have one of these conditions, which are most common in Asian and Hispanic children. Recent evidence indicates that NAFLD increases the risk of heart disease in children who are overweight or obese.
Symptoms of Fatty Liver Disease
Fatty liver disease is often silent, producing no symptoms, especially in the beginning. If the disease advances — which is usually over a period of years, or even decades — it can cause vague problems such as:
- Weight loss or loss of appetite
- Confusion, impaired judgment, or trouble concentrating
These symptoms may also be present:
- Pain in the center or right upper part of the abdomen
- An enlarged liver
- Patchy, dark skin discoloration, usually on the neck or underarm area
With alcoholic liver disease, symptoms may worsen after periods of heavy drinking. With NAFLD, the disease process can stop or reverse, or it may worsen. If cirrhosis develops, the liver loses its ability to function. This can cause signs and symptoms such as:
- Fluid retention
- Muscle wasting
- Internal bleeding
- Jaundice (yellowing of skin and eyes)
- Liver failure
Treatment of Fatty Liver Disease
There is no specific treatment at this time for fatty liver disease. However, getting treatment for any underlying disease, such as diabetes, is essential. And you can take other steps to improve your condition.
If you have alcoholic liver disease and you are a heavy drinker, quitting drinking is the most important thing you can do. Find the support you need to be successful. With ALD, continued use of alcohol can lead to advanced disease, including alcoholic hepatitis or cirrhosis. Even for those with NAFLD, however, avoiding alcohol may help.
If you are overweight or obese, do what you can to gradually lose weight — no more than 1 or 2 pounds a week. A recent study showed that weight loss of at least 9% over a period of months can help reverse NASH. Even less weight loss than this can help lessen buildup of fat in the liver.
Eat a balanced and healthy diet and increase your physical activity. In addition to limiting calories, avoid diets rich in refined, rapidly digested carbohydrates. This includes limiting foods such as bread, grits, rice, potatoes, corn, and concentrated sugar that is found in sports drinks and juice.