Gastroenterology clinic often meets some patients, with B-mode ultrasound results to consult: “Doctor, I have fatty liver, but I never drink, nor fat, eat relatively light, you see how to return a responsibility?” I will tell them that this is non-alcoholic fatty liver disease. It is a common liver disease. It is not a serious disease, but it should not be underestimated. Today, I will take you to know “non-alcoholic fatty liver disease”.
What is nonalcoholic fatty liver disease?
Nonalcoholic fatty liver disease (NAFLD) is a clinical syndrome characterized by excessive deposition of fat in the liver, which is caused by exclusion of alcohol or other definite liver damage factors. It consists of three stages, the earliest of which is called simple fatty liver, in which there is a large amount of fat deposition in the liver, but it has not yet led to liver cell damage. The second stage, known as nonalcoholic steatohepatitis, is when liver damage occurs but can often be reversed with treatment. The third stage is called intrahepatic fibrosis or even cirrhosis, which causes severe liver damage and is usually difficult to reverse by treatment, and even develops into liver cancer.
2. Common causes
of nonalcoholic fatty liver disease 1. Obesity, which is the most common cause of nonalcoholic fatty liver disease;
2. Type 2 diabetes mellitus, hyperlipidemia and metabolic syndrome, which are risk factors for non-alcoholic fatty liver disease alone or together;
3. Bad lifestyle, such as high-calorie diet, high-sugar drinks, sedentary, etc.
4. Immune dysfunction, psychological stress, heredity and so on also play a certain role in the occurrence and development of non-alcoholic fatty liver disease.
3. Common symptoms
of nonalcoholic fatty liver disease 1. The onset of the disease is insidious, often asymptomatic in the early stage, and its existence is not felt.
2. A few people showed atypical symptoms such as fatigue, mild discomfort in the right upper abdomen, and distending pain in the upper abdomen.
3. Severe cases can be manifested as anorexia, jaundice, nausea, vomiting, etc.
4. If it develops to decompensated cirrhosis, there will be corresponding symptoms of portal hypertension and liver dysfunction, such as hematemesis, melena, ascites, etc.
4. Common examination methods
for nonalcoholic fatty liver disease 1. Laboratory examination
Patients need blood routine, liver function, blood lipids, blood sugar and other hematological tests; if serum transaminase is elevated, viral hepatitis antibody, antinuclear antibody, ceruloplasmin and other indicators need to be checked to exclude abnormal liver function caused by other reasons.
2. Imaging examination
Ultrasonography is the first choice for the diagnosis of fatty liver. CT and MRI are expensive and not superior to B ultrasound in the diagnosis of fatty liver.
3. Pathological examination
It is the main method to diagnose non-alcoholic fatty liver disease, which can determine the degree of liver steatosis, inflammation and fibrosis.
Diagnostic methods
of nonalcoholic fatty liver disease 1. Predisposing factors such as hyperlipidemia, type 2 diabetes mellitus and obesity;
2. No history of alcohol consumption or daily alcohol consumption equivalent to ethanol < 140 G/week in men and < 70 G/week in women;
3. Exclude specific diseases that can cause fatty liver, such as viral hepatitis, drug-induced hepatitis, etc.
4. Symptoms such as fatigue and dull pain in the liver area may occur.
5. Elevated serum transaminase or r-GT;
6. Radiological characteristic is consistent with fatty liver
. 7. Pathological diagnosis was consistent with fatty liver disease
. Nonalcoholic fatty liver disease can be diagnosed by meeting any of items 1 to 5 and 6 or 7.
Treatment
of nonalcoholic fatty liver disease 1. Etiological treatment
Such as the treatment of diabetes, hyperlipidemia and so on, for lifestyle can strengthen exercise, healthy diet; if obese, appropriate weight loss.
2. Medication
Simple fatty liver disease generally requires no treatment, only lifestyle changes. Steatohepatitis requires hepatoprotective drugs such as glycyrrhizic acid preparations and polyene phosphatidylcholine.
3. Other treatments
Failure to change lifestyle or poor drug treatment can also be treated by weight loss surgery.
Prognosis
of nonalcoholic fatty liver disease Simple fatty liver disease can be completely restored, and most of the early treatment of early detection of steatohepatitis can be reversed. If it develops into cirrhosis or even liver cancer, the prognosis will be poor.
Sum up
In a word, the development of NAFLD from simple fatty liver to cirrhosis is a long process, but it should not be underestimated. Early detection, early diagnosis and early treatment should be taken to delay or even cure NAFLD by actively changing living habits, eating habits, moderate exercise and weight loss.
Nonalcoholic fatty liver disease
