Fatty Liver Clinic

FATTY LIVER CLINIC

Non-alcoholic fatty liver disease affects nearly 30% of Americans. Fatty liver disease was historically thought to be of little importance, but recent advances have uncovered that fatty liver disease can lead to end stage liver disease, cirrhosis and liver cancer. It is estimated that by the year 2020 fatty liver disease will be the leading reason for liver transplants in the United States.

Fatty liver disease means you have extra fat in the liver.

Heavy drinking puts you at risk for it. Over time, too much alcoholleads to a buildup of fat inside your liver cells. This makes it harder for your liver to work.

But you can get fatty liver disease, even if you don't drink a lot of alcohol and this is called nonalcoholic fatty liver disease.

The Digestive and Liver Center of Florida Fatty Liver Clinic provides comprehensive care for patients with suspected or established fatty liver disease. We see all forms of fatty liver disease including steatosis, steatohepatitis and cirrhosis. The Digestive and Liver Center of Florida Fatty Liver Clinic offers evaluation, diagnosis and treatment plans for patients suffering from fatty liver disease.

YOUR EXPERIENCE WITH OUR FATTY LIVER CLINIC

To schedule your appointment in the Fatty Liver Clinic at please call 407-384-7388 or request an appointment online

At your first visit to the Fatty Liver Disease Clinic you will undergo:

  • Evaluation of your medical history
  • Physical examination
  • Assessment of your risk factors for fatty liver disease, including your family's history of medical conditions, your medical conditions andyour lifestyle

After a complete evaluation you will work with your physician to determine if further tests are needed. These tests can include:

  • Blood tests
  • Radiographic studies such as an ultrasound or MRI
  • Liver biopsy

A liver biopsy is often recommended because it may be needed to confirm your diagnosis of fatty liver disease and determine what type of fattyliver disease you have. A liver biopsy can also tell you if you have early or advanced disease, which impacts the treatment you need.

After you have completed these tests you will return to the Fatty Liver Clinic to review the tests results and work with your doctor to determine a treatment plan.

Treatment for fatty liver disease can include:

  • Exercise plans available
  • Weight loss and nutrition counseling
  • Medications

The Digestive and Liver Center of Florida provides you access to dieticians, nutrition and exercise programs, medications for weight loss and, in special cases, non-surgical or surgical weight loss procedures.

After this you will be followed closely in the Fatty Liver Clinic to monitor your progress and response to treatment. Our goal is to keep your liver healthy and we are dedicated with working with you to ensure this happens!

Nonalcoholic Fatty Liver Disease (NAFLD)

Like the name says, alcohol isn't involved in this condition. There are different types of NAFLD.

Simple fatty liver means you have fat in your liver, but you may not have any inflammation [1] in your liver or damage to your liver cells. It usually doesn't get worse or cause problems with your liver. Most people with NAFLD have simple fatty liver.

Non-alcoholic steatohepatitis (NASH) is another type. It's much worse than simple fatty liver. NASH means you have inflammation [2] in your liver. You may also have damage to your liver cells. The inflammation and liver cell damage that happen with NASH can cause serious problems such as:

  • Fibrosis: scarring of the liver
  • Cirrhosis: lots of scarring in the liver, which can lead to liver failure and death
  • Liver cancer [3]

About 20% of people with NAFLD have NASH.

ALCOHOL-RELATED FATTY LIVER DISEASE

You might hear this called "ALD."

Some people don't have any symptoms. But if your liver becomes enlarged, you may develop pain or discomfort on the upper right side of your belly.

ALD is preventable. It usually gets better when you stop drinking alcohol.

If you keep drinking, ALD can cause serious problems. These include:

Alcoholic hepatitis. This is swelling in the liver that can cause fever, nausea, vomiting, abdominal pain, and jaundice (yellowish skin andeyes).

Alcoholic cirrhosis. This is a buildup of scar tissue in your liver. It can cause the same symptoms as alcoholic hepatitis plus:

  • High blood pressure in the liver
  • Bleeding in your body
  • Confusion and changes in behavior
  • Enlarged spleen
  • Liver failure, which can be fatal

Fatty liver disease usually comes first. It can then get worse and becomes alcoholic hepatitis. Over time, it may turn into alcoholic cirrhosis.

If you drink heavily, talk with your doctor. It's confidential, and it can help you get your drinking under control to save your health.

CAUSES

For ALD, the cause is too much alcohol. You may be even more likely to get it if you drink a lot and

  • Are obese
  • Are malnourished
  • Have chronic viral hepatitis, especially hepatitis C

NAFLD is more likely if:

  • You're overweight or obese
  • Your body doesn't respond to insulin as it should (called insulinresistance)
  • You have high levels of triglycerides or "bad" (LDL) cholesterol, orlow levels of "good" (HDL) cholesterol
  • You have type 2 diabetes
  • You have metabolic syndrome. This is a mix of conditions that make you more likely to get type 2 diabetes and heart disease.

With metabolic syndrome, you may have any three of these conditions:

  • Large waist size
  • High triglycerides
  • Low levels of HDL (good) cholesterol
  • High blood pressure
  • High blood sugar levels

NAFLD may also be due to certain genes that make the condition more likely.

The reason why some people with NAFLD have simple fatty liver and others develop NASH isn't known. It's possible that genes may be a reason. You may be more likely to have NASH if you:

  • Are obese
  • Have high blood pressure
  • Have high triglycerides or abnormal cholesterol levels
  • Have type 2 diabetes
  • Have metabolic syndrome

There are also some less common reasons why you may develop NAFLD or NASH. They include:

  • Medical conditions that affect how your body uses or stores fat
  • Hepatitis C or other infections
  • Fast weight loss
  • Taking certain medicines such as glucocorticoids,methotrexate(Rheumatrex, Trexall), synthetic estrogen, tamoxifen (Nolvadex, Soltamox), and others
  • Gallbladder removal. Some people who have surgery to remove their gallbladder are more likely to have NAFLD.

SYMPTOMS

With ALD and NAFLD, there are usually no symptoms. Some people may develop signs such as tiredness or pain in the upper right side of the abdomen where your liver is located.

If you have NASH or develop cirrhosis, you may have symptoms such as:

  • Swollen belly
  • Enlarged blood vessels underneath your skin's surface
  • Larger than normal breasts in men
  • Red palms
  • Skin and eyes that appear yellowish, due to a condition called jaundice

DIAGNOSIS

Your doctor may use different tests to find out if you have fatty liver disease. There's no test that can show whether the fat in your liver is due to alcohol or not, so your doctor will ask about your alcohol use. This information can help your doctor tell if you have ALD or NAFLD.

Some of the tests your doctor may use to diagnose fatty liver disease are:

Physical exam. Your doctor weighs you and checks your body for signs of liver problems such as an enlarged liver or jaundice.

Blood tests. These can show if you have high levels of liver enzymes such as alanine aminotransferase (ALT) and aspartate aminotransferase (AST). If so, there could be a problem with your liver.

Imaging tests. You may get ultrasound, computerized tomography (CT) scans, or magnetic resonance imaging (MRI). These tests can help show if there's any fat in your liver. But they can't tell whether you have simple fatty liver or NASH.

Liver biopsy. A doctor removes a sample of tissue from your liver and sends it to a lab to see if you have liver inflammation or damage. You'll get this done at a hospital or outpatient surgery center. Before the procedure, you'll get medicine to help you relax or control pain.

For the biopsy, your doctor numbs the area and uses a special needle to take a small piece of tissue from your liver. A liver biopsy is the only way for doctors to diagnose NASH.

Not everyone with NAFLD needs to have a liver biopsy. Your doctor may recommend a liver biopsy if you're at risk for NASH or if other tests show that you may have NASH complications such as cirrhosis.

Here is one of the tests we may do to check on your liver's health: