Fatty liver screening is not known by many people but there is, in fact, a subset of people who should be screened for this condition, also called fatty liver disease or FLD. It is a completely reversible condition in which the liver is filled with triglycerides due to “steatosis” or the process where the liver builds up fatty vacuoles due to an increase in fatty accumulation in the liver.
There are multiple causes of this disease, many of which can be treated so that fatty liver does not occur. It is associated with other diseases that play into fat metabolism.
Most fatty liver disease is alcoholic in nature. Alcohol causes the formation of fat in the liver so that when the liver is seen under the microscope, multiple vacuoles of fat show up. There can be a nonalcoholic fatty liver disease as well, including that from certain types of hepatitis. When this occurs, it is known as steatohepatitis. Non-alcoholic fatty liver disease is called NAFLD and tends to be less severe than fatty liver disease, which can progress to cirrhosis of the liver.
When the liver is fatty, the liver enzymes can increase and the liver can appear slightly enlarged during the physical examination. An ultrasound of the abdomen shows a large liver and the fat will appear on this type of exam. Unfortunately, there are no particular symptoms with fatty liver so patients don’t know they have it.
There are several treatments based on the cause of the fatty liver. If it is due to obesity, weight loss can help manage it. If alcohol is the cause, the person needs to stop drinking. If it is due to diabetes and high triglycerides (or metabolic syndrome), it is a good idea to get the triglyceride and blood sugar numbers under control. Avoid taking potentially toxic medication like acetaminophen if you have fatty liver or in high doses if you don’t have fatty liver disease. Weight reduction of at least 10 percent is necessary with diet and exercise.
Those who qualify for fatty liver screening include those with: obesity or being overweight, high blood cholesterol, diabetes, high blood pressure, and alcoholism.
The preparations for the various tests for fatty liver disease are as follows:
· Blood testing for liver function disease: This involves being fasting for about 10-12 hours prior to the blood test. The blood test itself involves just a venipuncture and some lab work. Tell your doctor about any medications you are currently taking.
· Ultrasound: No food or water for 8 hours before the test. The test involves using a transducer to visualize the liver under ultrasound. You should tell the doctor if you have diabetes before the test.
· CT scan of the liver: You should not eat or drink for 4-6 hours before the test and expect that a contrast medium will be used to visualize the liver.
· MRI scan of the liver: You shouldn’t eat for 6 hours before the test. A contrast medium is injected into your arm.