Risks of Untreated Fatty Liver: Symptoms and Treatment Options Explained

Having fatty liver disease without actively participating in treatment can pose risks. If left unmanaged, it may progress to more severe liver conditions, such as non-alcoholic steatohepatitis (NASH), fibrosis, or cirrhosis. Additionally, it can increase the risk of cardiovascular diseases and diabetes. Therefore, it is important to seek appropriate medical guidance and lifestyle modifications to mitigate these risks?

Last month, I went to the hospital for a check-up and found that my GOT was 67 and GPT was 170.
Further tests indicated severe fatty liver, and the weight management clinic also noted that my body fat percentage is 37%.
However, I currently do not experience any significant discomfort due to these conditions.
Could you please advise me on the potential problems or symptoms that may arise if fatty liver is not actively treated? Additionally, if I were to pursue treatment, would it be sufficient to follow the medications prescribed by my doctor for lowering lipids and bile acids (urso), along with exercise and dietary changes? Thank you.

Baoli Long, 20~29 year old female. Ask Date: 2006/06/06

Dr. Chen Shidian reply Gastroenterology and Hepatology

Dear Mr.
Baolilong,
Fatty liver is primarily caused by insufficient glucose utilization in the liver (insulin resistance).
The main approach to management remains exercise and dietary modification to prevent the future onset of diabetes and related complications.
The efficacy of treatment medications is still under investigation; however, lipid-lowering agents and URSO have shown some effectiveness.
You may consider trying these for 1 to 2 months and then follow up on liver function.
Best regards,
Chen Shidian
Changhua Hospital

Reply Date: 2006/06/06

More Info

Untreated fatty liver disease, particularly non-alcoholic fatty liver disease (NAFLD), can lead to several serious health risks over time. While you may not currently experience noticeable symptoms, the condition can progress and result in more severe complications if left unaddressed.

Risks of Untreated Fatty Liver
1. Progression to Non-Alcoholic Steatohepatitis (NASH): Fatty liver can progress to NASH, which is characterized by inflammation and liver cell damage. This condition can lead to fibrosis (scarring of the liver) and is a significant risk factor for more severe liver diseases.

2. Liver Fibrosis and Cirrhosis: Continued inflammation can result in fibrosis, where scar tissue forms in the liver. Over time, this can progress to cirrhosis, a severe condition where the liver is extensively scarred and can no longer function properly. Cirrhosis can lead to liver failure, requiring a liver transplant.

3. Increased Risk of Liver Cancer: Individuals with cirrhosis have a higher risk of developing hepatocellular carcinoma (liver cancer). The chronic inflammation and damage to liver cells can lead to mutations that result in cancer.

4. Metabolic Syndrome: Fatty liver is often associated with metabolic syndrome, which includes conditions such as obesity, type 2 diabetes, and cardiovascular disease. This syndrome increases the risk of heart disease and stroke.

5. Potential for Symptoms: While many individuals with fatty liver do not experience symptoms initially, as the disease progresses, symptoms may include fatigue, weakness, weight loss, and abdominal discomfort. In advanced stages, symptoms can become more severe, including jaundice, swelling in the abdomen (ascites), and confusion due to liver failure.

Treatment Options
The primary approach to treating fatty liver disease focuses on lifestyle modifications, as there are currently no FDA-approved medications specifically for fatty liver disease. Here are some recommended strategies:
1. Weight Loss: Losing weight is one of the most effective ways to reduce liver fat. A weight loss of 5-10% can significantly improve liver health. This can be achieved through a combination of diet and exercise.

2. Dietary Changes: Adopting a balanced diet that is low in saturated fats, refined carbohydrates, and sugars can help manage fatty liver. Emphasizing whole foods, such as fruits, vegetables, whole grains, and lean proteins, is beneficial.

3. Regular Exercise: Engaging in regular physical activity can help reduce liver fat and improve overall health. Aim for at least 150 minutes of moderate-intensity exercise each week.

4. Medications: While there are no specific medications for fatty liver, certain medications may be prescribed to manage associated conditions, such as high cholesterol or diabetes. For example, statins may be used to lower cholesterol levels, and medications like ursodeoxycholic acid (urso) can help improve liver function in some cases. However, the efficacy of these treatments specifically for fatty liver is still under investigation.

5. Monitoring: Regular follow-up with healthcare providers is essential to monitor liver function and assess the progression of the disease. Blood tests to check liver enzymes (like GOT and GPT) and imaging studies (like ultrasound) can help track changes in liver health.

6. Avoid Alcohol and Toxins: It is crucial to avoid alcohol consumption, as it can exacerbate liver damage. Additionally, minimizing exposure to environmental toxins can also be beneficial.

Conclusion
In summary, untreated fatty liver disease poses significant health risks, including the potential for liver damage, metabolic syndrome, and increased risk of liver cancer. The best approach to treatment involves lifestyle changes, including weight loss, dietary modifications, and regular exercise. While medications may assist in managing associated conditions, they should be used in conjunction with these lifestyle changes. Regular monitoring and follow-up with healthcare providers are essential to ensure optimal liver health and prevent complications. If you have concerns about your liver health, it is crucial to discuss them with your healthcare provider for personalized advice and treatment options.

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