Fatty Liver: Key Questions About Diagnosis and Management

Fatty liver disease

Hello Doctor: In October of last year (93rd year), my health check report showed liver function indices SGOT: 42, SGPT: 98, HBsAg: negative, HBsAb: positive.
A nearby clinic's scanning physician indicated that I have mild fatty liver.
Since then, I have been exercising and maintaining normal sleep.
To date, I have had six follow-up tests, and my SGOT levels have been within the normal range, but my SGPT has consistently been between 40 and 70.
In my most recent test today, July 13, my SGOT is 18 and SGPT is 63.
I would like to ask the doctor: 1.
Do I need to go to a major hospital to test for Hepatitis C? Is there medication available for Hepatitis C? 2.
Is this chronic inflammation? 3.
Besides reducing sweets, greasy foods, and fried foods, does consuming too much pasta affect my condition? How much exercise is necessary? Lastly, I appreciate the time you took to address my questions amidst your busy schedule.
Thank you!

Xiao Fei, 20~29 year old female. Ask Date: 2005/07/13

Dr. Yuan Hongdao reply Gastroenterology and Hepatology

Hello, abnormal liver function tests can be caused by several factors, including hepatitis B and C, as well as fatty liver disease.
Other potential causes include medications, alcohol consumption, biliary issues, autoimmune hepatitis, and hereditary metabolic disorders.
I would like to know if you consume alcohol, take long-term medications (including herbal remedies and dietary supplements), or have a family history of liver disease.
First, it is essential to test for hepatitis C antibodies to determine if you have hepatitis C.
Currently, there are medications available for hepatitis C treatment, with a success rate of 50% to 80%.
Elevated liver enzymes are most likely due to chronic inflammation, and to assess the degree of inflammation, a liver biopsy may be necessary.
For fatty liver disease, it is important to manage blood sugar levels (if you have diabetes), avoid alcohol, and lose weight.
Excessive consumption of carbohydrates can lead to increased caloric intake, which can also result in fat accumulation in the liver.
There is no specific amount of exercise required; the key is to reduce body weight.
Sincerely, Dr.
Yuan Hong-Dao, Internal Medicine.

Reply Date: 2005/07/13

More Info

Understanding fatty liver disease is crucial for maintaining liver health and preventing potential complications. Based on your inquiry, let's address your questions and provide a comprehensive overview of fatty liver diagnosis and management.

1. Need for C Hepatitis Testing: Given your history of elevated liver enzymes (SGOT and SGPT), it is prudent to consider testing for Hepatitis C, especially if you have risk factors such as a history of intravenous drug use, blood transfusions before 1992, or other potential exposures. Hepatitis C can lead to chronic liver disease and may exacerbate fatty liver conditions. If diagnosed, antiviral medications are available that can effectively treat Hepatitis C and potentially improve liver health.

2. Chronic Inflammation: Your liver enzyme levels indicate that while your SGOT is within normal limits, your SGPT remains elevated. This could suggest ongoing liver inflammation, which may not necessarily be classified as chronic hepatitis but could be related to fatty liver disease. Fatty liver can cause inflammation (steatohepatitis), which can progress to more severe liver damage if not managed properly. Regular monitoring of liver function tests is essential to assess any changes over time.

3. Diet and Lifestyle Modifications: Your dietary concerns are valid. Reducing intake of sugary foods, fried items, and high-fat foods is essential for managing fatty liver. Carbohydrates, particularly refined ones like white bread and pasta, can contribute to fat accumulation in the liver. Instead, focus on a balanced diet rich in whole grains, fruits, vegetables, lean proteins, and healthy fats (like those from fish, nuts, and olive oil).
Regarding exercise, the American College of Gastroenterology recommends at least 150 minutes of moderate-intensity aerobic exercise per week, combined with strength training on two or more days. Activities like brisk walking, cycling, or swimming can be beneficial. Incorporating physical activity into your daily routine can help reduce liver fat and improve overall health.

4. Monitoring and Follow-Up: Since your liver enzymes have shown fluctuations, it is essential to maintain regular follow-ups with your healthcare provider. They may recommend periodic liver function tests and possibly imaging studies, such as an ultrasound, to assess the degree of fatty liver. If your enzyme levels continue to rise or if you develop symptoms such as jaundice, abdominal pain, or fatigue, further evaluation may be necessary.

5. Potential for Reversal: The good news is that fatty liver disease is often reversible with lifestyle changes. Weight loss, even as little as 5-10% of your body weight, can significantly improve liver health. Regular exercise and a healthy diet can lead to improvements in liver enzyme levels and overall liver function.

In conclusion, managing fatty liver disease involves a multifaceted approach that includes regular monitoring, dietary modifications, increased physical activity, and possibly further testing for conditions like Hepatitis C. By taking proactive steps, you can improve your liver health and reduce the risk of complications associated with fatty liver disease. Always consult with your healthcare provider for personalized advice and treatment options tailored to your specific situation.

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