What is Fatty Liver?

Fatty liver is the accumulation of excess fat in liver cells. Another term used to identify this condition is fatty infiltration of the liver. 

What causes Fatty Liver?

Fat accumulates in the liver, usually in connection with heavy use of alcohol, significant weight gain or type 2 diabetes mellitis (the type which usually develops later in life).
Fatty liver can also be associated with poor diet and certain illnesses, such as tuberculosis, intestinal bypass surgery for obesity and certain drugs such as corticosteroids.

How is Fatty Liver identified?

Fatty liver is usually suspected in a person with the diseases or conditions mentioned above.Microscope 
Fatty LiverThe patient may have an enlarged liver and/or minor elevation of liver enzyme tests. Several studies show that fatty liver is one of the most common causes of isolated minor elevation of liver enzymes found in routine blood screening.
To find out for certain whether a person has fatty liver requires that a sample of liver tissue be obtained (a liver biopsy) to be examined under a microscope. An ultrasound examination, MRI scan, or a CT scan can also suggest the presence of a fatty liver. 

How does fat get into the liver?

It is not certain how this happens. A person is said to have fatty liver when the fat present in the liver increases the weight by 5% or more. 
Possible explanations for fatty liver include the transfer of fat from other parts of the body, or an increase in the extraction of fat presented to the liver via the intestine. 
Another explanation is that for some reason the liver cannot break down or remove fat at a fast enough rate and the fat builds up.
People who drink too much alcohol for many years may develop alcoholic liver damage that includes fatty liver. Fatty liver may also occur in middle-aged, overweight, and often diabetic patients who do not drink alcohol.   
Although the majority of patients with fatty liver do not have any significant liver disease, some will develop severe liver inflammation and scarring. This scarring can develop into cirrhosis.
Non alcoholic steatohepatitis (NASH) is the term given to patients who do develop liver inflammation in the presence of fatty liver but where alcohol consumption is negligible or absent. This is an important condition as some of these patients can develop liver scarring and cirrhosis.  In the United States NASH related cirrhosis is the third commonest reason for liver transplantation and is predicted to become the most common reason by the middle of the next decade.

Can fatty liver be treated?

The treatment of fatty liver is related to the cause. 
Simple fatty liver does not require treatment since it does not result in damage to liver cells or liver disease.
GutsBy losing a substantial amount of weight, obese patients with fatty liver will have a reduction of excess fat in liver cells as well as in other cells of the body.
Patients, who are overweight and have fatty liver, can have a high cholesterol level in the blood and may have glucose intolerance if not established diabetes. 
Patients, who are overweight and have fatty liver, can have a high cholesterol level in the blood and may have glucose intolerance if not established diabetes. 
This is usually associated with a resistance to the action of the hormone, insulin. Such patients are at high risk of stroke or heart attack. 
Weight reduction in these patients will not only help the fatty liver but will substantially decrease the chance of stroke or heart attack.
Patients who drink alcohol to excess will also have a loss of fat in the liver when alcohol is ceased. 
Good control of diabetes mellitus with diet, medication or insulin will usually decrease the fat content of the liver.
Acknowledgement: Web sites for Hepatitis Central and the Mayo clinic – research on liver diseases.