Fatty Liver Treatment

How fatty liver Treatment is done?

The aim of the fatty liver treatment is to reduce and avoid fat accumulation in the liver and to prevent further worsening into inflammation, fibrosis and cirrhosis.

Various fatty liver treatment options are given below which can help to treat NAFLD and to certain extent prevent its complications:

1. Weight loss in Fatty Liver Treatment:

It is the only treatment that is found effective in fatty liver. It is useful even in presence or absence of diabetes.

Methods recommended for weight loss and Fatty liver treatment:

• Diet: reduction in the diet alone can help in managing fatty liver. It is advised to target a diet which is 500 to 1000 kcal lower than what is standard per day, to achieve weight loss of 0.5 to 1 kg/week. The Mediterranean diet has been found to be better at reducing liver fat than a low-fat or a low-carbohydrate diets.

• Exercise: it has been found that exercise in form of resistance training or aerobic exercise can bring about reduction in liver fat. This effect is irrespective of loss in body weight. A physical activity of more than 150 minutes/week can significantly improve liver function.

• Diet and exercise done together is also recommended to reduce amount of fat in the liver.

Weight loss goals recommended: How much weight loss is required for Fatty liver treatment(NAFLD):

People are advised to loose 5% body weight and sustain it, to reduce accumulation of fat and help in improving associated metabolic issues.

It is advisable to loose 7 to 10% of body weight to improve fat accumulation with inflammation (steatohepatitis).

The weight loss criteria to manage steatohepatitis in children is not known.

2. Medicines:

Medicines may help to reduce fat accumulation and/or improve metabolic parameters.

However, they are generally recommended only for biopsy-proven nonalcoholic steatohepatitis.

• Antioxidants: Vitamin E intake of 400 international units twice daily, every day, in biopsy proven NASH not associated with diabetes helps in improving the condition. NICE guidelines (British guidelines) suggest use of same therapy even for NASH and cirrhosis with diabetes.

– Precaution: the above therapy may increase the risk of death due to multiple causes or may cause prostate cancer in some patients. It is advisable to discuss the risks and benefits with your doctor before planning to opt for fatty liver treatment.

• Insulin sensitizers: Pioglitazone Hydrochloride one 30 mg tablet daily every day can be given to biopsy-proven NASH with or without type 2 diabetes. It should not be taken by people with congestive heart failure or increased risk of fracture. NICE and European guidelines advise consideration of pioglitazone or vitamin E in adults with advanced liver fibrosis, irrespective of presence or absence of diabetes.

• Omega-3 fatty acids

• Not recommended for NAFLD or NASH as such. It is given for hypertriglyceridemia seen in people with NAFLD. A dose of 830 mg/day or more has been found to be beneficial.

• Lipid-lowering agents

• Statins may help in correcting lipid abnormalities in people with NAFLD/NASH, and thus may improve the liver function.

3. Bariatric surgery:

It is a surgery that reduces the size of the stomach and help in reducing weight. This surgery can be considered an option in people who are severely or morbidly obese. A study has found disappearance of NASH in about 85% of people after bariatric surgery. It suggested use of this operation in morbidly obese patients with NASH who doesn’t respond to lifestyle changes.

4. Immunization:

Both children and adults with chronic liver disease are recommended by CDC to take hepatitis A, hepatitis B and pneumococcal vaccines.

5. Alcohol consumption:

If a person has a fatty liver due to heavy drinking then complete cessation of drinking can help to resolve the fatty liver. It is said that 6 weeks of quitting can help these people. Consuming alcohol again increases the risk of developing fatty liver again. If a person has non-alcoholic fatty liver disease then also he should avoid consuming heavy amounts of alcohol.

6. Coffee:

Several studies have shown the protective effect of coffee against the development of fibrosis, liver cancer, and cirrhosis. The preventive effect is seen to depend upon the quantity of coffee with 2 to4 cups found to significantly reduce the chances of development of cirrhosis and death from it.

7. Liver transplantation:

May be needed in people who develop cirrhosis related to NASH.