Can Fatty Liver Grade 2 be Completely Cured?

Introduction

If you or someone you know has been diagnosed with fatty liver grade 2, you may be wondering about the possibility of a cure and the available treatment options. In this article, we will delve into the nature of fatty liver grade 2, its causes, and whether it can be reversed or managed effectively. Non-Alcoholic Fatty Liver Disease is estimated to impact around 25% of the global population.¹ Extra sugar is changed into a form called glycogen and stored in the body for later energy use. At any given time, the liver contains approximately one pint (around 13%) of the body’s total blood supply.²

Overview of Fatty Liver

Fatty liver is also called steatosis.³ Fatty liver is a condition where fat accumulates in the liver up to the level of 5% to 10% of the liver’s weight.^1,3 Based on the reason for fat buildup, this condition of fatty disease can be classified into 2 types: 

• Non-alcoholic fatty liver disease: This is not linked to heavy alcohol consumption.¹ 
• Alcoholic fatty liver disease: Alcoholic fatty liver disease, as the name indicates, is highly associated with a high amount of alcohol usage.¹ 

Fatty liver is again classified into 3 grades:

• Grade 1: When there is 5% to 33% fat in the liver.
• Grade 2: Marked by 34-66% fat accumulation in the liver.
• Grade 3: Severe grade with more than 66% fat accumulated in the liver.

Signs and Symptoms of Fatty Liver Grade 2

Until the disease progresses to the cirrhosis stage, fatty liver grade 2 mostly does not show any symptoms.^1,3 However when present, there are symptoms like: 

• Lack of appetite
• Weight-loss
• Vomiting 
• Legs and abdomen appear swollen
• The feeling of exhaustion and debility
• Skin colour changes to yellow
• The white portion of your eyes may appear yellow 
• Pain in the upper right side of the abdomen.³

I may suggest, if you have liver disease, one important step you may take is to quit smoking. It’s a proactive measure that might greatly reduce the risks associated with liver disease. By giving up smoking, you might also significantly decrease your chances of developing complications like heart attack and stroke.

Dr. Siddharth Gupta, B.A.M.S M.D (Ayu)

When to See a Doctor

It is recommended to see a doctor if you have been diagnosed with fatty liver grade 2 or suspect that you may have it. Symptoms may not be present in the early stages, so it is important to have regular check-ups and blood tests to monitor liver function. The crucial symptoms include:

• Fatigue 
• Abdominal pain
• Yellowing of the skin or eyes³

Let me give you a helpful tip for managing fatty liver disease. Make sure to include foods that are rich in fibre in your diet. Fibre is known to have several benefits for the liver and possibly promote healthy digestion.

Dr. Rajeev Singh, BAMS

Causes of Fatty Liver Grade 2

The causes of NAFLD are still being investigated. Studies indicate that certain health conditions or diseases, genetic factors, and diet patterns may increase the likelihood of developing NAFLD.⁵

• Medical conditions and illnesses 

Having certain health conditions or diseases can increase your chances of developing NAFLD. 

• Overweight or obesity
• Insulin resistance or type 2 diabetes
• Abnormal levels of fats in your blood, such as high triglycerides or abnormal cholesterol levels (high total cholesterol, high LDL cholesterol, or low HDL cholesterol).
• Genetics or hereditary factors
• Scientists have discovered that specific genetic factors can increase the likelihood of developing NAFLD. The scientific community is actively investigating the genes that may contribute to NAFLD.
• Nutrition and gastrointestinal system
• Research is being conducted to investigate if diets high in fructose, a sugar commonly added to sweeten drinks and foods may increase the risk of NAFLD.
• The relationship between NAFLD and the gut flora, which consists of the bacteria in the digestive tract that assist with digestion, has been studied by experts.
• Differences in the gut flora of individuals with NAFLD and those without the condition have been observed in studies. The impact of the gut flora on NAFLD is an ongoing area of research.⁵

I have a friendly suggestion for you. If you have chronic liver disease, incorporating regular, caffeinated coffee into your daily routine may have some positive benefits. In fact, studies have shown that drinking three or more cups of black coffee a day might be helpful for people with fatty liver disease.

Dr. Smita Barode, B.A.M.S M.S.

Risk Factors for Fatty Liver Grade 2

Risk factors for fatty liver grade 2 are as follows: 

• Unhealthy weight gain (obese)
• Pre-existing conditions like type 2 diabetes
• Hypertension and hypercholesterolemia
• Consuming steroids
• Sleep disorders like sleep apnoea
• Infected with hepatitis C
• High cholesterol levels in the levels.¹

I may have some exciting news for you. Incorporating olive oil into your diet might be incredibly beneficial for your liver. You see, olive oil may have the amazing ability to raise your good cholesterol, which in turn might help protect your liver from fatty liver disease. And the best part? It’s not just your liver that benefits—olive oil may also be good for your heart.

Dr. Anuja Bodhare, B.A.M.S M.D (Ayu)

Diagnosis of Fatty Liver Grade 2

1. Patient Medical History

Your doctor will ask about your medical history and any conditions or diseases that increase the risk of NAFLD.

• Weight 
• History of type 2 diabetes 
• Cholesterol levels in your body
• Metabolism related illnesses

The doctor might ask about your- 

• Diet
• Physical activity
• Sugar consumption
• Alcohol consumption⁶

2. Physical Examination

• Your doctor will check for an enlarged liver.
• They will also look for signs of insulin resistance, like darkened skin patches on certain areas.
• Additionally, they will examine for signs of cirrhosis, such as:
  • Enlarged spleen
  • Fluid build-up in the abdomen
  • Muscle loss⁶

3. Testing Parameters

• Liver function test: Fatty liver is usually diagnosed after a liver function test shows unusual results and other liver problems like hepatitis are ruled out, however, blood tests do not always show fatty liver.⁷ 
• High levels of liver enzymes in your blood, specifically alanine aminotransferase (ALT) and aspartate aminotransferase (AST) may indicate NAFLD according to your doctor.⁶
• Ultrasound scan
• Fibroscan: It is a special ultrasound method that replaces liver biopsy to measure liver fat and scar tissue.³
• Biopsy test: In some cases, a biopsy may be done to take a small sample of liver tissue for examination.
• Sometimes, additional tests such as CT scans or MRI scans are required.

Children and young people at higher risk of NAFLD, like those with type 2 diabetes, may have an ultrasound scan of their liver every 3 years.⁷

Treatment of Fatty Liver Grade 2

No specific medication is available for treating fatty liver disease. Instead, doctors concentrate on assisting individuals in managing the factors that contribute to the condition.

• Medication: Currently, there are no approved medications specifically for the treatment of NAFLD. 
• However, ongoing research is being conducted to explore potential medications that could potentially improve these conditions.⁸
• Weight management: Doctors recommend weight loss as a treatment for non-alcoholic fatty liver disease (NAFLD), including non-alcoholic fatty liver (NAFL) and non-alcoholic steatohepatitis (NASH).
• Losing weight helps reduce fat, inflammation, and scarring in the liver.
• To achieve weight loss, make healthy food choices, control portion sizes, and increase your physical activity. 
• Rapid weight loss or inadequate nutrition can make liver disease worse. It is important to lose weight gradually to avoid worsening liver disease.⁸
• Dietary changes: Your doctor may suggest reducing the amount of fatty foods you eat because they are high in calories and can contribute to weight gain.
• It is a good idea to choose healthier fats like those found in fish and nuts instead of unhealthy fats like those in fried or processed foods. 
• Eating more fruits, vegetables, and whole grains is recommended. These foods stabilize your blood sugar level unlike foods like white bread, white rice, and potatoes.
• Avoiding sugary foods and drinks, especially those with fructose, is important. This includes sweetened sodas, sports drinks, sweet tea, and fruit juices.
  • Regular table sugar (sucrose) also contains fructose, which can be harmful to your liver.

If you have NAFLD, it is important to reduce your alcohol intake to as low as possible because alcohol can further damage your liver.⁹

• Liver transplant: If severe cirrhosis occurs and the liver stops working properly, a liver transplant may be needed. This can involve receiving a liver from a deceased donor or using a portion of a liver donated by a living person.⁷

Prevention of Fatty Liver Grade 2

Since fatty liver grade 2 can worsen and result in liver failure and other complications, one should take preventive measures to avoid getting fatty liver: 

Diet Modification

• Instead of saturated and trans-fats, choose unsaturated fats.
• Include more fruits, vegetables, and whole grains in your diet.⁹
• Instead of soft drinks, drink more plain water.⁷

Lifestyle Modification

• To reduce liver inflammation and fibrosis, it may be necessary to shed around 7% to 10% of your body weight. 
• Engaging in physical activity, even without weight loss, can also have positive effects.⁹
• Cease alcohol intake as it can further hamper your liver health.³

Complications of Fatty Liver Grade 2

NAFLD may lead to liver complications and other health problems.

• Individuals with NAFL (non-alcoholic fatty liver) generally have a lower risk of liver complications, but are at higher risk for other health problems.
• NASH (non-alcoholic steatohepatitis) can result in liver complications like cirrhosis and liver cancer. It also increases the risk of death from liver-related causes.
• NAFLD is associated with a higher risk of cardiovascular disease, which is the leading cause of death among NAFLD patients.¹⁰

Other health problems related to NAFLD include –

• Type 2 diabetes
• Metabolic syndrome
• High blood pressure (hypertension)
• Abnormal levels of cholesterol
• Abnormal levels of triglycerides¹⁰

Research Facts About Fatty Liver Grade 2

• Studies also indicate that non-alcoholic fatty liver disease (NAFLD) is found in approximately 75% of individuals who are overweight and in over 90% of individuals with severe obesity.¹⁰

Also Read: Grade 1 Fatty Liver: Causes, Symptoms, Diagnosis, and Reversal Strategies

Frequently Asked Questions (FAQs):

Reference

1. Fatty Liver Disease | MedlinePlus [Internet]. Available from: https://medlineplus.gov/fattyliverdisease.html

2. Liver: Anatomy and Functions | Johns Hopkins Medicine [Internet]. Available from: https://www.hopkinsmedicine.org/health/conditions-and-diseases/liver-anatomy-and-functions

3. Fatty Liver Disease: Risk Factors, Symptoms, Types & Prevention [Internet]. Available from: https://my.clevelandclinic.org/health/diseases/15831-fatty-liver-disease

4. Pathogenesis and Prevention of Hepatic Steatosis – PMC [Internet]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4836586/

5. Symptoms & Causes of NAFLD & NASH – NIDDK [Internet]. Available from: https://www.niddk.nih.gov/health-information/liver-disease/nafld-nash/symptoms-causes

6. Diagnosis of NAFLD & NASH – NIDDK [Internet]. Available from: https://www.niddk.nih.gov/health-information/liver-disease/nafld-nash/diagnosis

7. Non-alcoholic fatty liver disease (NAFLD) – NHS [Internet]. Available from: https://www.nhs.uk/conditions/non-alcoholic-fatty-liver-disease/

8. Treatment for NAFLD & NASH – NIDDK [Internet]. Available from: https://www.niddk.nih.gov/health-information/liver-disease/nafld-nash/treatment

9. Eating, Diet, & Nutrition for NAFLD & NASH – NIDDK [Internet]. Available from: https://www.niddk.nih.gov/health-information/liver-disease/nafld-nash/eating-diet-nutrition

10. Definition & Facts of NAFLD & NASH – NIDDK [Internet]. Available from: https://www.niddk.nih.gov/health-information/liver-disease/nafld-nash/definition-facts

11. Effect of dietary supplementation of grape skin and seeds on liver fibrosis induced by dimethylnitrosamine in rats – PMC [Internet]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2981719/

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