The liver is likened to a factory that synthesizes essential substances for the body: storing sugar, synthesizing lipids, proteins, and clotting factors. Liver damage from any cause can lead to inflammation and then cirrhosis. When cirrhosis occurs, the body becomes weakened due to nutrient deficiency, blood clotting disorders, ascites, esophageal varices rupture, etc. At this stage, treatment methods are often ineffective. One of the most common causes of liver damage today is fatty liver disease.

Fatty liver disease is divided into two groups: alcoholic and non-alcoholic fatty liver disease. In both groups, liver cells are found to be filled with fat droplets. Alcoholic fatty liver disease is a stage in the progression of alcoholic liver disease. If left untreated, it can lead to inflammation and alcoholic cirrhosis.

Non-alcoholic fatty liver disease is often caused by metabolic disorders:

- Obesity, overweight

- Insulin resistance

- Increased blood sugar

- Dyslipidemia

Most cases of fatty liver disease are asymptomatic and are only discovered incidentally during a medical examination. Some signs of fatty liver disease appear when the condition progresses to steatohepatitis:

- Tired

- Loss of appetite

- Enlarged liver

When cirrhosis develops, the following symptoms may occur:

- Jaundice (yellowing of the skin and eyes)

- The vascular stars appear

- Red palms

- Ascites (fluid accumulation in the abdominal cavity)

- Enlarged spleen

- People with high cholesterol and triglycerides in their blood

- People who are obese or have belly fat.

- People with diabetes

- Polycystic ovary syndrome

- Sleep apnea syndrome

- Hypothyroidism

- Pituitary insufficiency

- A healthy diet, eating plenty of green vegetables and fruits, and reducing animal fats by replacing them with vegetable oils.

- Exercise regularly: at least 30 minutes a day, 5 days a week

- Lose weight if you are overweight.

- Do not drink alcohol.

- Hepatitis B vaccination

There is no medication or treatment that can instantly cure fatty liver disease, but it can gradually improve with timely lifestyle changes combined with treatment of co-existing conditions.

Losing weight: Weight loss will reduce liver damage and improve insulin resistance, making it essential. The goal is to lose 0,5-1 kg of weight per week. For those who cannot reach their weight goal within 6 months and have fatty liver disease, partial gastrectomy and gastroenteritis (gastrojejunostomy) may be necessary.

Vitamin E: Vitamin E may improve inflammation in patients with fatty liver disease without diabetes, according to some studies. However, because these studies did not include patients with diabetes and decompensated cirrhosis, the benefits of vitamin E have not been demonstrated for these patients. Additionally, vitamin E should not be used in male patients with a history or family history of prostate cancer, as it increases the risk of this cancer in men. High doses of vitamin E exceeding 800 IU/day should also be avoided as they may increase all-cause mortality. Fatty liver disease with diabetes may be managed with certain medications as prescribed by a doctor to improve inflammation and fibrosis.

Omega 3: Some studies suggest that omega-3 fatty acids may improve fatty liver disease, however, more research is needed.

Control of lipid disorders: statins that are not metabolized extensively in the liver, such as rosuvastatin or pravastatin, should be used.

- Blood tests: Cholesterol, triglycerides, and elevated liver enzymes AST, ALT, and alkaline phosphatase. In suspected cases of cirrhosis, further tests are needed: basic coagulation tests, bilirubin, albumin, and blood protein.

- Further tests for hepatitis B and C viruses are needed to rule out viral hepatitis.

- Abdominal ultrasound: a simple method for diagnosing fatty liver disease. The ultrasound will show an increased echogenicity of the liver.

- Liver elasticity can be measured if cirrhosis is suspected.