Hepatic steatosis popularly called as ‘fatty liver’ is a pathological aspect of liver, whose specific cells (hepatocytes) are filled with lipids (fats). It is a reversible liver disease: ‘is not still very ill, but cries for help’.
Causes of hepatic steatosis:
1. Alcohol consumption produces alcoholic liver disease.
Two-thirds of chronic alcohol consumers have fatty liver, alcoholic hepatitis, but anyone of the chronic users of alcohol can make diseases such as chronic pancreatitis or dilated cardiomyopathy which generates heart failure with a grim prognosis.
It is considered a toxic dose of absolute alcohol per day of 60-80 ml for men and for women 40-50ml/zi. Women are more susceptible than men, and behavioral patterns related to alcohol consumption seems to be inherited. B or C virus coinfection, unbalanced diet, protein malnutrition worse disease severity.
Fatty liver is the easiest suffering of the liver due to alcohol consumption. If it stops consumption, liver recover. A more severe form is then the development of hepatitis, and the last and most severe stage is cirrhosis. It can lead to cirrhosis without passing through the stages of steatosis or hepatitis. For developing this disease is considered necessary consumption of 160 g alcohol / day for 15 years in men, and 60 grams of alcohol per day for women for 10 years.
Symptoms: Hepatomegaly (increase in volume of the liver) with painful embarrassment, palmar erythema, testicular atrophy, gynecomastia, weight loss, vomiting, jaundice, fatigue, anemia, gynecomastia (breast growth in men). In the final stage of cirrhosis appears ascites (fluid in the abdomen), edema, the clinical picture dramatically worsens. Cirrhosis occurs seven times more common in big drinkers, than people who not consume alcohol.
2. Non-alcoholic steatohepatitis can be due to several factors such as diabetes (mostly type 2), high triglycerides, obesity, occupational exposure to solvents, use of medications such as amiodarone, diltiazem, tamoxifen.
Treatment aims primarily to a healthy lifestyle, weight loss, diet avoiding fats, exercise. As recommended medications: metformin, vitamin E, Ursofalk.
Bibliography: 1. Braunwald's Heart Disease; 2. Harrison's Principles of Internal Medicine; 3. European Society of Cardiology - Clinical Practice Guidelines.