Fatty liver causes and therapy

Liver adiposity / steatosis hepatis

The fatty liver is a very common complaint in modern affluent societies. In the past, excessive consumption of alcohol was considered to be the main cause of fatty liver disease, so today unhealthy diet and too little exercise are other important factors. But even medicines can trigger a fatty liver. Increasing fatty liver is considered as a warning for incipient liver diseases such as:

• Fatty liver hepatitis,
• Liver cirrhosis and
• liver cancer.

Other diseases such as diabetes or a heart attack are favored by a fatty liver.

contents

• Liver adiposity / steatosis hepatis
• definition
• symptoms
• Causes of fatty liver
• Diagnosis of fatty liver
• treatment
• Naturopathy in fatty liver disease
• prevention

According to the German Society for Digestive and Metabolic Diseases (DGVS), every third to every fourth adult in the US and Europe could be affected by a non-alcoholic fatty liver disease. In addition, the fatty liver diseases as a result of increased alcohol consumption, according to the information provided by the gastro-league (German Society for the Control of Diseases of the Stomach, Intestines and Liver and Disorders of Metabolism and Nutrition), according to a share of about 50 percent of the Make up total cases. For many people, work-related and recreational behavior causes a lack of exercise.

Symptoms of fatty liver may include: Complaints such as feeling of fullness and pressure pain in the liver area (liver pain) be. (Image: Adiano / fotolia.com)

definition

The fatty liver is characterized by increased, basically reversible fat deposits in the liver cells (hepatocytes), as a result of which the organ as a whole becomes significantly larger and heavier. The definition can here be made about the proportion of liver cells that have increased fat deposits or the percentage by weight of stored fat in the total weight of the liver. If more than half of the liver cells are obese, this is defined as fatty liver. The same applies to an increase in the fat content of the total liver weight to ten percent.

Concomitant inflammatory processes in the liver, in the professional world of a fatty liver inflammation (steatohepatitis) is mentioned. In addition, a distinction is made between alcoholic and non-alcoholic fatty liver diseases. This also applies to fatty liver inflammation, which is divided into alcoholic steatohepatitis (ASH) and non-alcoholic steatohepatitis (NASH).

symptoms

Liver deficiency causes no complaints, especially in moderately pronounced forms, usually for a long time. In patients with pronounced fatty liver, according to the Gastro-Liga more unspecific complaints

• bloating,
• Pressure pain in the liver area (liver pain),
• bloating,
• listlessness,
• as well as a general physical and mental disability occur.

Also, complaints are often found when lying on the right side. According to the DGVS, the symptoms are often not associated with a disease of the liver, so that the progression of fatty liver disease is imminent. Later on, fatty liver may develop into fatty liver inflammation, with yellowing of the skin and eyeballs (jaundice), right upper abdominal pain and nausea and vomiting possibly presenting symptoms.

In the case of a fatty liver disease especially the sequelae are dangerous. If dead liver tissue is transformed into connective tissue and scarred, the development of incurable liver cirrhosis is threatened and the risk of liver cancer increases. Not least, the inflammatory processes can also damage the cardiovascular system, which significantly increases the risk of stroke and heart attack.

Causes of fatty liver

In particular, excessive consumption of alcohol is a major factor in the development of fatty liver, but other factors may also play a role, including:

• an unhealthy diet,
• lack of exercise,
• the intake of medication,
• poisoning,
• Metabolic Diseases
• and viral infections.

According to the Gastro-Liga, however, the fatty liver is usually "an expression of overeating and / or excessive consumption of alcohol over a long period of time."

Poisons such as alcohol and medications can be the cause of fatty liver. (Image: Paolese / fotolia.com)

poisons

Should the liver be fed more pollutants (for example, alcohol, poisons, or medicines) than it can break down, the organ requires a very large proportion of the oxygen supplied and is ultimately no longer able to burn fat through oxidation or for energy use, explains the gastro-league. The undegraded fat remains in the liver. This is the case, for example, with alcoholic fatty liver, but also with drug-induced fatty liver disease. According to the DGVS, the latter are a "generally underestimated health problem". For example, more than one percent of inpatients are affected by drug-toxic liver damage.

nutrition

The Leberzellverfettung can also be triggered by an extremely high-calorie diet. The body is simply fed more energy via the food than it consumes and the organism therefore starts to store fat as an energy store. Those affected develop obesity or obesity (obesity) and as a result of the disorder of fat metabolism accumulate more fats in the liver cells, usually in the form of so-called triglycerides. The changes in the liver are comparable to those in alcoholic fatty liver.

Lipid metabolism may become so unbalanced in diabetic patients that increased fat deposits are formed in the liver and liver cell fatty acid is compromised. All in all, people are at particular risk with a so-called metabolic syndrome, which is characterized by the combination of obesity, diabetes, cholesterol metabolism disorders and high blood pressure.

The same applies to a malnutrition in which the body too little protein is led to. This shows the fat burning inhibited and there are more fats in the liver. Overall, disorders of lipid metabolism or cholesterol metabolism are relatively often triggers the non-alcoholic fatty liver disease. In this context, scientists from the Ludwig-Maximilians-Universität München were able to prove at the end of 2014 that the defect of a specific ion channel in the liver significantly increases the susceptibility to non-alcoholic fatty liver disease.

The cause of a fatty liver is not infrequently an increased alcohol consumption. (Image: designua / fotolia.com)

lack of exercise

Too little exercise, in conjunction with the above causes, is now considered a major cause of fatty liver. Already in adolescents are signs of fatty liver disease to observe, which have their cause in a combination of physical inactivity and improper diet.

pregnancy

A fatty liver can also develop during pregnancy. According to the "Deutsches Ärzteblatt", this so-called pregnancy obesity affects one in every 7,000 to one in 16,000 pregnant women and is mainly due to a "defect in the mitochondrial beta-oxidation of fatty acids and the hormone-induced increase in free fatty acids during pregnancy". Pregnancy fatty liver can lead to serious pregnancy complications and pose a serious threat to the mother and the unborn child.

Diagnosis of fatty liver

Relatively reliable indications of an existing fatty liver often already arise from the patient's medical history. A detailed medical history, which also addresses possibly existing alcohol problems, nutrition and possible pre-existing conditions, is therefore a good introduction to diagnostics. The enlargement of the liver can usually be detected even during palpation of the abdomen. If the subsequent blood test shows altered or elevated liver values, this may indicate inflammatory processes, such as fatty liver inflammation. The blood test also serves to exclude other liver diseases.

Modern imaging techniques such as sonography (ultrasound examination), magnetic resonance imaging (MRI) or computed tomography (CT) are used to determine the liver size and to detect possible changes in the shape of the organ. In case of doubt, the removal of a tissue sample or liver biopsy (puncture of the liver) is still necessary to ensure the diagnosis. "A small tissue sample is taken from the liver under local anesthesia using a long thin hollow needle and examined microscopically in the laboratory," reports the Gastro-Liga. Based on the biopsy can also determine whether there is a fatty liver inflammation, liver cirrhosis or even cancer.

treatment

The treatment of fatty liver is basically based on their causes, usually major changes in the lifestyle of patients are required. Since alcohol is associated with additional stress on the liver, it is important not only to avoid it with alcoholic fatty liver disease. Furthermore, a reduction of existing overweight - especially in the non-alcoholic steatosis hepatis - advised. "Loss of weight and adaptation of the lifestyles reduce the fatty liver and damage", so the statement in the guidelines of the German Society for Nutritional Medicine (DGEM) on the clinical nutrition in gastroenterology - liver.

A change in diet and regular exercise are very important to reduce fatty liver. (Source: healing practice)

The experts also recommend dieting obese or obese adipose patients according to current obesity guidelines. According to the DGEM, a very low calorie diet lowers body weight and effectively and safely improves non-alcoholic fatty liver disease within 12 weeks. Also, exercise is attributed a special role in the reduction of body weight and the normalization of lipid metabolism.

Important in a diet designed to reduce fatty liver is that it is slow, as too much fat cell depletion releases the toxins it contains, which in turn increases the burden on the liver.

In addition to the normalization of body weight, a review of blood sugar levels is recommended, especially in diabetics. Too high blood sugar should be avoided and if necessary an adjustment of the medication should be made.

drugs

If lipid metabolism disorders are not reversed as part of the dietary changes, they can be treated with medication, if necessary, in order to avoid further fatty degeneration of the liver. However, medications can also be the trigger of fatty liver. The discontinuation of the drugs is highly recommended, but sometimes not possible, otherwise threaten more serious health consequences of the disease against which the drugs were originally used.

Fatty liver of pregnancy

The pregnancy fatty liver is usually in the last trimester of pregnancy and in view of the acute course, intensive care treatment is often required. According to the "German Medical Journal", for example, the administration of glucocorticoids to improve the liver situation is planned here. If there is no improvement, the immediate initiation of childbirth remains the last option. After birth, the pregnancy fatty liver usually goes back completely.

Naturopathy in fatty liver disease

In naturopathy, nutritional therapy plays a significant role in the treatment of non-alcoholic fatty liver. These include, for example:

• fasting,
• Detoxify liver,
• dietary changes,
• acupressure,
• leech therapy.

With the so-called fasting cure there is a special option here to combat the fatty degeneration of the liver, but it is necessary to be careful. Additional burdens on the liver, such as those that can be triggered by abrupt changes in eating habits, are urgently to be avoided.

Naturally detoxify the liver

In the naturopathic fatty liver therapy furthermore often find procedures to the liver detoxify application. They are intended to relieve the liver and promote the breakdown of fat deposits. In the context of the normalization of the lipid metabolism is also various medicinal plants such as

• garlic,
• artichokes,
• Evening primrose, as well
• horseradish,
• Grapefruit,
• and beets

a liver detoxifying effect awarded.

Various medicinal herbs also support the detoxification of the liver

• dandelion,
• Milk thistle,
• Boldo and
• a tea made from ginger.

Adding a little lemon to food and drinks also helps the liver to heal as it helps the organ burn off the accumulated fat. Lemon water before breakfast provides an extra boost of vitamin C. Pour the freshly squeezed juice of half a lemon into a glass of warm water and drink the mixture in the morning on an empty stomach.

With the help of evening primrose oil it is possible to detoxify the liver.
(Image: Madeleine Steinbach / fotolia.com)

In addition, naturopathic therapy offers a variety of ways to help patients reduce existing obesity, in addition to diet changes. Here, for example, from the field of Traditional Chinese Medicine (TCM) acupressure to mention, but also homeopathy knows various remedies that help with weight loss. For example, Fucus vesiculosus causes a loss of appetite and increased fat burning. Helianthus tuberosus, however, is especially recommended as an aid to weight loss for obese diabetics.

Other options for the treatment of fatty liver or to support treatment

• hydrotherapy (water applications),
• orthomolecular medicine, as well
• diverting procedures such as leech therapy.

Overall, numerous naturopathic treatment approaches for the treatment of fatty liver are available, the selection of suitable methods should be based on the causes of fatty liver disease and the severity.

prevention

A healthy lifestyle with sufficient exercise, the lowest possible alcohol consumption and the avoidance of liver-damaging substances as well as a protein-rich and low-fat diet with low carbohydrates can usually be used to prevent the development of fatty liver quite efficiently. Obesity is a clear risk factor to evaluate and therefore to pay attention to a normal body weight. In addition, diabetics should keep an eye on the optimal setting of their blood sugar in order to avoid fatty degeneration of the liver cells. (fp, ok, updated on 15/03/2018)
Specialist supervision: Barbara Schindewolf-Lensch (doctor)