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Fatty Liver Disease

Acute Fatty Liver of Pregnancy


Though very rare, fat can build up in the liver of a mother during pregnancy, putting both mother and fetus at serious risk. Either may develop liver failure, kidney failure, severe infection, or hemorrhage. No one fully understands its cause, but hormones may play a role.

Once a diagnosis is confirmed, the baby is delivered as quickly as possible. Although the mother may need intensive care for several days, liver function often returns to normal within a few weeks.

Symptoms of Fatty Liver Disease


Fatty liver disease is often silent, producing no symptoms, especially in the beginning. If the disease advances -- which is usually over a period of years, or even decades -- it can cause vague problems such as:

  • Fatigue
  • Weight loss or loss of appetite
  • Weakness
  • Nausea
  • Confusion, impaired judgment, or trouble concentrating

These symptoms may also be present:

  • Pain in the center or right upper part of the abdomen 
  • An enlarged liver
  • Patchy, dark skin discoloration, usually on the neck or underarm area

With alcoholic liver disease, symptoms may worsen after periods of heavy drinking. With NAFLD, the disease process can stop or reverse, or it may worsen. If cirrhosis develops, the liver loses its ability to function. This can cause signs and symptoms such as:

  • Fluid retention
  • Muscle wasting
  • Internal bleeding
  • Jaundice (yellowing of skin and eyes)
  • Liver failure


Diagnosis of Fatty Liver Disease


Often a fatty liver shows up during a routine checkup. Your doctor might notice that your liver is slightly enlarged or see signs of a fatty liver on a blood test. Or, your doctor may suspect a problem after taking a health history or doing a physical exam.

Blood tests. During routine blood tests, elevations in certain liver enzymes may show up. These might include alanine aminotransferase (ALT) or aspartate aminotransferase (AST).

Imaging studies. A fatty liver may also show up on imaging tests, such as an abdominal ultrasound. 

Liver biopsy. The only way to confirm a diagnosis of fatty liver disease is with a liver biopsy. This is usually done once other causes have been ruled out. After application of local anesthesia, the doctor inserts a needle through the skin to remove a tiny piece of liver. This is then examined under a microscope for signs of fat, inflammation, and damaged liver cells. If inflammation or damage is not present, the diagnosis is simply a fatty liver.

Treatment of Fatty Liver Disease


There is no specific treatment at this time for fatty liver disease. However, getting treatment for any underlying disease, such as diabetes, is essential. And you can take other steps to improve your condition.

If you have alcoholic liver disease and you are a heavy drinker, quitting drinking is the most important thing you can do. Find the support you need to be successful. With ALD, continued use of alcohol can lead to advanced disease, including alcoholic hepatitis or cirrhosis. Even for those with NAFLD, however, avoiding alcohol may help.

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