Friends today I am discussing about Fatty liver. Fatty liver, or hepatic steatosis, is a term that describes the buildup of fat in the liver. It’s normal to have small amounts of fat in your liver, but too much can become a health problem. The liver is the second largest organ in the body. It’s responsible for a wide variety of functions, including processing everything we eat and drink, and filtering harmful substances from the blood. Too much fat in the liver can lead to long-term liver damage. View a BodyMap of the liver and learn more about its function. Early stage fatty liver is diagnosed when the proportion of liver cells that contain fat is more than 5 percent. This is often diagnosed by looking at small sample taken from the liver under the microscope. Ultrasounds, CT scans, and MRI scans can also help evaluate the fat content of the liver. The liver commonly repairs itself by rebuilding new liver cells when the old ones are damaged. When there’s repeated damage to the liver, permanent scarring takes place. This condition is called cirrhosis. In mild forms, fatty liver can be a reversible condition that may improve with lifestyle modifications such as diet changes, weight loss, and increased physical activity. In many cases, fatty liver has no symptoms. Fatty liver becomes harmful to the liver when it progresses. Liver inflammation (steatohepatitis) can lead to liver scarring, liver cancer, and end-stage liver disease. Symptoms of fatty liver Fatty liver typically has no associated symptoms. However, research has shown that about 20 percent of people with fatty liver inflammation progress to worse conditions. If this occurs you may experience fatigue or abdominal discomfort. Your liver may become slightly enlarged, which your doctor may be able to detect during a physical exam. It’s believed that the excess fat in the liver, along with certain medical conditions, increases inflammation. If your liver becomes inflamed, you may have symptoms such as: a poor appetite weight loss abdominal pain physical weakness fatigue confusion If fatty liver progresses to cirrhosis and liver failure, symptoms can include: an enlarging, fluid-filled abdomen jaundice of the skin and eyes confusion abnormal bleeding What are the causes of fatty liver? The most common cause of fatty liver is alcohol use disorder and heavy drinking. In many cases, it’s much less clear what causes fatty liver in people who don’t drink much alcohol. However, higher body weight, a high processed sugar diet, high triglycerides, diabetes, low physical activity, and genetics all play a role. Fatty liver develops when the body creates too much fat or cannot metabolize fat efficiently enough. The excess fat is stored in liver cells where it accumulates and causes fatty liver disease. Besides alcohol use disorder, other common causes of fatty liver include: obesity hyperlipidemia, or high levels of fats in the blood, especially high triglycerides diabetes genetic inheritance rapid weight loss side effects of certain medications, including methotrexate (Trexall), tamoxifen (Nolvadex), amiodorone (Pacerone), and valproic acid (Depakote) Types of fatty liver? There are two basic types of fatty liver: nonalcoholic and alcoholic. Nonalcoholic fatty liver disease Nonalcoholic fatty liver disease (NAFLD) develops when the liver has difficulty breaking down fats, which causes a buildup in the liver tissue. The cause is not related to alcohol. NAFLD is diagnosed when more than 5 percent of the liver is fat. Nonalcoholic steatohepatitis (NASH) Nonalcoholic steatohepatitis (NASH) is a type of NAFLD. As fat builds up, it can cause inflammation. Once more than 5 percent of the liver is fat and inflammation is also present, the condition is known as NASH. Symptoms of this condition are related to inflammation and worsening liver function. These can include: appetite loss nausea vomiting abdominal pain jaundice If left untreated, steatohepatitis can progress to permanent scarring of the liver, liver cancer, and eventual liver failure. Acute fatty liver of pregnancy Acute fatty liver is a rare and potentially life-threatening complication of pregnancy. Signs and symptoms begin in the third trimester. These include: persistent nausea and vomiting pain in the upper-right abdomen headache jaundice general malaise fatigue decreased appetite Women who are pregnant with any of these signs or symptoms should be evaluated for this condition. Treatment includes managing any complications and prompt delivery. Most women improve within several weeks after delivery and have no lasting effects. Alcoholic fatty liver Alcoholic fatty liver is the earliest stage of alcohol-related liver disease. Heavy drinking damages the liver, and the liver cannot break down fats as a result. Abstaining from alcohol will likely cause the fatty liver to subside. Within six weeks of not drinking alcohol, the fat can disappear. However, if excessive alcohol use continues, inflammation known as alcoholic steatohepatitis may develop, leading to cirrhosis. Read more about the effects of alcohol on the body. homeopathic medicines for fatty liver are Chelidonium: This is often used to treat a fatty liver accompanied by right upper abdominal pain. In such cases, the liver may be enlarged and the patient also usually suffers from constipation or experience nausea and vomiting. The patient will also probably suffer from excessive weakness and have a desire for hot food and drinks. Lycopodium: A fatty liver accompanied by acidity can be treated with this type of homeopathic medication. In such cases, the patient will also complain of bloating and belching with a burning sensation. These symptoms tend to worsen n the evening and the patient may have an intense craving for sweets and hot drinks. Phosphorus: This is used to treat cases of fatty acid which triggers regurgitation accompanied by sour belching. In some cases, the patient may also experience pain in the liver and excessive flatulence. Vomiting may also occur along with weakness while passing stool. Calcarea carb: Obese patients suffering from this condition can be treated with calcarea carb. These people often have a distended abdomen, are lactose intolerant and suffer from chronic constipation. They are also overly sensitive to cold air and sweat excessively from the head. Nux Vomica: homeopathic remedy for fatty liver with pain in abdomen after eating. Nux vomica is great for any abdominal problem including fatty liver caused by excessive consumption of alcohol. These patients often suffer from abdominal pain a few hours after eating with sour or bitter tasting belches. They may constantly feel the urge to pass stool but are unable to do so.

Friends today I am discussing about Fatty Liver (Hepatic Steatosis) disease. Fatty liver, or hepatic steatosis, is a term that describes the buildup of fat in the liver. It’s normal to have small amounts of fat in your liver, but too much can become a health problem. The liver is the second largest organ in the body. It’s responsible for a wide variety of functions, including processing everything we eat and drink, and filtering harmful substances from the blood. Too much fat in the liver can lead to long-term liver damage. View a body map of the liver and learn more about its function. Early stage fatty liver is diagnosed when the proportion of liver cells that contain fat is more than 5 percent. This is often diagnosed by looking at small samples taken from the liver under a microscope. Ultrasounds, CT scans, and MRI scans can also help evaluate the fat content of the liver. The liver commonly repairs itself by rebuilding new liver cells when the old ones are damaged. When there’s repeated damage to the liver, permanent scarring takes place. This condition is called cirrhosis. In mild forms, fatty liver can be a reversible condition that may improve with lifestyle modifications such as diet changes, weight loss, and increased physical activity. In many cases, fatty liver has no symptoms. Fatty liver is becoming a more common condition, currently affecting around 25 to 30 percent of people in Europe and the United States. Fatty liver becomes harmful when the condition progresses. Liver inflammation (steatohepatitis) can lead to liver scarring, liver cancer, and end-stage liver disease. What are the symptoms of fatty liver? Fatty liver typically has no associated symptoms. However, research has shown has shown that about 20 percent of people with fatty liver inflammation progress to worse conditions. If this occurs, you may experience fatigue or abdominal discomfort. Your liver may become slightly enlarged, which your doctor may be able to detect during a physical exam. It’s believed that the excess fat in the liver, along with certain medical conditions, increases inflammation. If your liver becomes inflamed, you may have symptoms such as: a poor appetite weight loss abdominal pain physical weakness fatigue confusion If fatty liver progresses to cirrhosis and liver failure, symptoms can include: an enlarging, fluid-filled abdomen jaundice of the skin and eyes confusion abnormal bleeding What are the causes of fatty liver? The most common cause of fatty liver identified in most cases is alcohol use disorder and heavy drinking. In many cases, it’s much less clear what causes fatty liver in people who don’t drink much alcohol. However, higher body weight, a diet high in processed sugar, high triglycerides, diabetes, low physical activity, and genetics all play a role. Fatty liver develops when the body creates too much fat or can’t metabolize fat efficiently enough. The excess fat is stored in liver cells where it accumulates and causes fatty liver disease. Besides alcohol use disorder, other common causes of fatty liver include: obesity hyperlipidemia, or high levels of fats in the blood, especially high triglycerides diabetes genetic inheritance rapid weight loss side effects of certain medications, including methotrexate (Trexall), tamoxifen (Nolvadex), amiodorone (Pacerone), and valproic acid (Depakote) What are the types of fatty liver? There are two basic types of fatty liver: nonalcoholic and alcoholic. Nonalcoholic fatty liver disease Nonalcoholic fatty liver disease (NAFLD) develops when the liver has difficulty breaking down fats, which causes a buildup in the liver tissue. The cause isn’t related to alcohol. NAFLD is diagnosed when more than 5 percent of the liver is fat. Nonalcoholic steatohepatitis (NASH) Nonalcoholic steatohepatitis (NASH) is a type of NAFLD. As fat builds up, it can cause inflammation. Once more than 5 percent of the liver is fat and inflammation is also present, the condition is known as NASH. Symptoms of this condition are related to inflammation and worsening liver function. These can include: appetite loss nausea vomiting abdominal pain jaundice Most cases of NASH are detected in people between ages 40 and 60, according to the American Liver Foundation. If left untreated, steatohepatitis can progress to permanent scarring of the liver, liver cancer, and eventual liver failure. Acute fatty liver of pregnancy Acute fatty liver is a rare and potentially life-threatening complication of pregnancy. Signs and symptoms begin in the third trimester. These include: persistent nausea and vomiting pain in the upper-right abdomen headache jaundice general malaise fatigue decreased appetite Women who are pregnant with any of these signs or symptoms should be evaluated for this condition. Treatment includes managing any complications and prompt delivery. Most women improve within several weeks after delivery and have no lasting effects. Alcoholic fatty liver Alcoholic fatty liver is the earliest stage of alcohol-related liver disease. Heavy drinking damages the liver, and the liver can’t break down fats as a result. Abstaining from alcohol will likely cause the fatty liver to subside. Within six weeks of not drinking alcohol, the fat can disappear. However, if excessive alcohol use continues, inflammation known as alcoholic steatohepatitis may develop, leading to cirrhosis. Read more about the effects of alcohol on the body. Who’s at risk for fatty liver? Fatty liver is the buildup of extra fats in the liver. It’s more likely to develop if you’re overweight or obese. Having type 2 diabetes also may increase your risk for fatty liver. Fat accumulation in the liver has been linked to insulin resistance, which is the most common cause of type 2 diabetes. Other factors that may increase your risk for fatty liver include: excessive alcohol use taking more than the recommended doses of certain over-the-counter medications, such as acetaminophen (Tylenol) pregnancy high cholesterol high triglyceride levels malnutrition metabolic syndrome low physical activity How is fatty liver diagnosed? Physical exam If your liver is inflamed, your doctor may be able to detect it by examining your abdomen for an enlarged liver. However, your liver can be inflamed without being enlarged. Let your doctor know if you’ve been experiencing fatigue or loss of appetite. Also, tell your doctor about any history of alcohol, medication, and supplement use. Blood tests Your doctor may find that liver enzymes are higher than normal during a routine blood test. This doesn’t confirm a diagnosis of fatty liver, but it does relate to liver inflammation. Further analysis is necessary to find the cause of the inflammation. Imaging studies Your doctor may use an ultrasound to detect fat in your liver. Other imaging studies may also be done, such as CT or MRI scans. Another imaging test similar to ultrasound is a FibroScan. Like an ultrasound, a FibroScan utilizes sound waves to determine the density of the liver and the corresponding areas of fat and normal liver tissue. Imaging studies can detect fat in the liver, but they can’t help your doctor confirm the extent of damage. Liver biopsy A liver biopsy is still considered the best way to determine the severity of liver disease. During a liver biopsy, your doctor will insert a needle into the liver and remove a piece of tissue for examination. They will give you a local anesthetic to lessen the pain. A liver biopsy is the only way to know for certain the severity of fatty liver or other liver diseases. The biopsy can also help your doctor determine the exact cause. How is fatty liver treated? Research is ongoing into medications that may help treat fatty liver. The first-line of treatment continues to be following recommendations to reduce your risk factors. These recommendations typically include: limiting or avoiding alcoholic beverages managing your cholesterol and reducing your intake of sugars and saturated fats losing weight controlling your blood sugar If you have fatty liver because of obesity or unhealthy eating habits, your doctor may also suggest that you increase physical activity and eliminate or add certain types of foods to your diet. Reducing the number of calories you eat each day can help you lose weight and heal your liver. In the early stages, you can improve and reverse fatty liver disease by reducing or eliminating fatty foods and foods high in sugar from your diet. Choose a balanced diet with healthier foods such as fresh fruits, fresh vegetables, whole grains, and healthy fats like those in nuts and avocados. Replace red meats with lean proteins such as soy, chicken, turkey, and fish. Sweetened drinks, juices, and sodas should be avoided. What is the long-term outlook for fatty liver? Most cases of fatty liver don’t progress into other forms of liver disease. The liver can repair itself, so if you take the necessary steps to treat high cholesterol, diabetes, an unhealthy diet, and obesity, you can reverse fatty liver. If you’re a heavy drinker, stop drinking alcohol or limit your intake to 1 drink or less per day for women and 2 drinks or less per day for men. A liver biopsy can help your doctor identify permanent liver damage and determine the severity of damage. If fatty liver persists and isn’t reversed, it can progress into liver disease, cirrhosis, or cancer. The progression to cirrhosis is dependent on the cause. In alcoholic fatty liver, continuing to drink alcohol in excess can lead to liver failure. The progression of nonalcoholic fatty liver disease varies, but in most people it does not lead to liver scarring and cirrhosis. However, if you’re diagnosed with steatohepatitis, you have a higher chance of developing scarring and liver disease. Twenty percent of people with steatohepatitis will go on to develop worsening liver disease. If fatty liver progresses to cirrhosis, the risk of liver failure and death rises significantly. There is also a higher risk for liver cancer and death from heart disease. How do I prevent fatty liver disease? Protecting your liver is one of the best ways to prevent fatty liver and its complications. You can start by taking several steps: Limit or eliminate alcohol from your diet. Eat a healthy, balanced diet. Control diabetes if you have developed the condition. Aim for at least 30 minutes of exercise most days of the week. By taking these steps, you’ll not only keep your liver healthy, but also improve your overall health. Some of the most common homeopathic medicines for fatty liver are Chelidonium: This is often used to treat a fatty liver accompanied by right upper abdominal pain. In such cases, the liver may be enlarged and the patient also usually suffers from constipation or experience nausea and vomiting. The patient will also probably suffer from excessive weakness and have a desire for hot food and drinks. Lycopodium: A fatty liver accompanied by acidity can be treated with this type of homeopathic medication. In such cases, the patient will also complain of bloating and belching with a burning sensation. These symptoms tend to worsen n the evening and the patient may have an intense craving for sweets and hot drinks. Phosphorus: This is used to treat cases of fatty acid which triggers regurgitation accompanied by sour belching. In some cases, the patient may also experience pain in the liver and excessive flatulence. Vomiting may also occur along with weakness while passing stool. Calcarea carb: Obese patients suffering from this condition can be treated with calcarea carb. These people often have a distended abdomen, are lactose intolerant and suffer from chronic constipation. They are also overly sensitive to cold air and sweat excessively from the head. Nux Vomica: homeopathic remedy for fatty liver with pain in abdomen after eating. Nux vomica is great for any abdominal problem including fatty liver caused by excessive consumption of alcohol. These patients often suffer from abdominal pain a few hours after eating with sour or bitter tasting belches. They may constantly feel the urge to pass stool but are unable to do so.

A middle aged obese female ( BMI - 30) a k/c/o Hypothyroidism presented to ED with complains of Pain Right Hypochondrium, weight gain and Anorexia since 1 month....On examination, she was found to have Hepatomegaly (4 inches below the right costal margin)....USG and CECT W/A was done....Comment on the treatment approach to this patient...

FATTY LIVER Nonalcoholic fatty liver disease is an umbrella term for a range of liver conditions affecting people who drink little to no alcohol. As the name implies, the main characteristic of nonalcoholic fatty liver disease is too much fat stored in liver cells. Nonalcoholic steatohepatitis, a potentially serious form of the disease, is marked by liver inflammation, which may progress to scarring and irreversible damage. This damage is similar to the damage caused by heavy alcohol use. At its most severe, nonalcoholic steatohepatitis can progress to cirrhosis and liver failure Nonalcoholic fatty liver disease is increasingly common around the world, especially in Western nations. In the United States, it is the most common form of chronic liver disease, affecting an estimated 80 to 100 million people. Nonalcoholic fatty liver disease occurs in every age group but especially in people in their 40s and 50s who are at high risk of heart disease because of such risk factors as obesity and type 2 diabetes. The condition is also closely linked to metabolic syndrome, which is a cluster of abnormalities including increased abdominal fat, poor ability to use the hormone insulin, high blood pressure and high blood levels of triglycerides, a type of fat. Causes Experts don't know exactly why some people accumulate fat in the liver while others do not. Similarly, there is limited understanding of why some fatty livers develop inflammation that progresses to cirrhosis. Nonalcoholic fatty liver disease and nonalcoholic steatohepatitis are both linked to the following: · Overweight or obesity · Insulin resistance, in which your cells don't take up sugar in response to the hormone insulin · High blood sugar (hyperglycemia), indicating prediabetes or actual type 2 diabetes · High levels of fats, particularly triglycerides, in the blood These combined health problems appear to promote the deposit of fat in the liver. For some people, this excess fat acts as a toxin to liver cells, causing liver inflammation and nonalcoholic steatohepatitis, which may lead to a buildup of scar tissue (fibrosis) in the liver. Symptoms Nonalcoholic fatty liver disease usually causes no signs and symptoms. When it does, they may include: · Enlarged liver · Fatigue · Pain in the upper right abdomen Possible signs and symptoms of nonalcoholic steatohepatitis and cirrhosis (advanced scarring) include: · Abdominal swelling (ascites) · Enlarged blood vessels just beneath the skin's surface · Enlarged breasts in men · Enlarged spleen · Red palms · Yellowing of the skin and eyes (jaundice) Risk factors A wide range of diseases and conditions can increase your risk of nonalcoholic fatty liver disease, including: · High cholesterol · High levels of triglycerides in the blood · Metabolic syndrome · Obesity, particularly when fat is concentrated in the abdomen · Polycystic ovary syndrome · Sleep apnea · Type 2 diabetes · Underactive thyroid (hypothyroidism) · Underactive pituitary gland (hypopituitarism) Nonalcoholic steatohepatitis is more likely in these groups: · Older people · People with diabetes · People with body fat concentrated in the abdomen It is difficult to distinguish nonalcoholic fatty liver disease from nonalcoholic steatohepatitis without further testing. Complications The main complication of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis is cirrhosis, which is late-stage scarring (fibrosis) in the liver. Cirrhosis occurs in response to liver injury, such as the inflammation in nonalcoholic steatohepatitis. As the liver tries to halt inflammation, it produces areas of scarring (fibrosis). With continued inflammation, fibrosis spreads to take up more and more liver tissue. If the process isn't interrupted, cirrhosis can lead to: · Fluid buildup in the abdomen (ascites) · Swelling of veins in your esophagus (esophageal varices), which can rupture and bleed · Confusion, drowsiness and slurred speech (hepatic encephalopathy) · Liver cancer · End-stage liver failure, which means the liver has stopped functioning About 20 percent of people with nonalcoholic steatohepatitis will progress to cirrhosis. HOMOEOPATHIC REMEDIES Homoeopathic remedies are safe remedies for the treatment of fatty liver. Some of the important remedies are given below-- CHELIDONIUM Q- Chelidonium is the top Homeopathic medicine for Fatty Liver treatment. The marked symptom for using this medicine is pain in right upper abdomen and pain under right shoulder. There may also be an enlargement of liver.The person is usually constipated. The stool passes in the form of hard balls. A distended abdomen with nausea and vomiting is also experienced. The patient suffers from excessive weakness. In case of jaundice in a patient with Fatty Liver too, Chelidonium is the best Homeopathic remedy. Desire for very hot drinks and hot food CARDUS MARIANUS Q—.Pain in the liver region . Left lobe is very sensitive. Fullness and soreness with moist skin. Constipation. Stool hard, difficul and knotty. Alternates with diarrhea. Golden colored urine Nausea, vomiting of green acid fluid BOLDO Q- Congestion of liver . Burning weight in liver and stomach. Bitter taste , no appetite LYCOPODIUM CLAVATUM 200- Lycopodium is another remedy of great help for treating Fatty Liver with gastric symptoms and acidity. The patient complains of distension or bloating of abdomen soon after eating anything. The abdomen feels full of gas. Burning belching is also experienced. Even eating a little causes fullness in abdomen. The patient feels heaviness and pain in the right upper part of abdomen. Usually the symptoms get worse towards the evening. Farinaceous food makes the person worse. An unusual craving for sweets and hot drinks in excess may be present. PHOSPHOROUS 200-Phosphorus is the best Homeopathic medicine for patients of Fatty Liver who feel as if the food is coming upwards after eating. This is accompanied by sour belching. Vomiting may also occur in a few cases, along with pain in liver. The stool and flatus are very offensive. The patient feels weak after passing stool. The craving for peculiar things in diet is an important indication for using this medicine in Fatty Liver patients. These peculiar things include ice creams, cold drinks and refreshing items like juices. CALCAREA CARB 30- Calcarea Carb is a very beneficial Homeopathic medicine for mainly obese Fatty Liver patients. The person is fatty, flabby with excess fat in liver and whole abdomen. This Homeopathic remedy successfully helps in burning excess fat in liver.The digestion is very slow in such persons with a long-standing constipation. The abdomen always remains distended. Milk is not suitable for these persons. Desire for boiled eggs or strange things like chalk and pencils. Sensitivity to cold air and excessive sweating on the head. NUX VOMICA 30- Nux Vomica is the best fatty liver remedy in homeopathy when the cause is over consumption of Alcohol . It is prescribed when pain in abdomen begins a few hours after eating, with a feeling of stone in abdomen. Sour or bitter belching accompanies the pain. A very significant symptom for selecting Homeopathic remedy Nux Vomica for Fatty Liver is constipation with an ineffectual urge to pass stool or poop. The stool, however, is insufficient and unsatisfactory. The passing out of stool gives some relief from the pain in abdomen but the urge to pass stool is renewed soon after. The patient craves for fattyfood, spicy food, coffee and alcoholic drinks in diet.

A 9 yr old boy weighing 46 kg comes with a c/o dark thickened coarse skin over the nape of neck and bilateral axillae. Parents too are obese . Other than high serum triglycerides and raised SGPT, no other abnormality in other investigations. Other than lifestyle modifications, what else can be given. Do statins have a role in children?