Hepatic Steatosis

Hepatic steatosis, also known as fatty liver disease, is an affliction that strikes approximately twenty percent of the adult population. It is associated with obesity (75% of obese people have this disorder) and with alcoholism or excessive alcohol consumption.

It takes the form of fatty deposits forming in the liver. It can lead to  complications including liver cancer, fibrosis of the liver and cirrhosis of the liver. It is usually asymptomatic and can be treated with diet, exercise, and (where appropriate) reduced alcohol consumption or abstinence from alcohol.

The disease is diagnosed in two forms, called alcohol-related hepatic steatosis and non-alcoholic steatosis. The only difference between the two is the cause, however; the way the disease progresses and potential complications are identical. Because the cause is different, though, treatment emphasis differs between the two. Someone diagnosed with non-alcoholic fatty liver whose alcohol consumption is moderate or nonexistent would not treat the disease by reducing alcohol consumption but rather by losing weight or changing diet and exercise regimens.

ICD-9/10

The International Statistical Classification of Diseases and Related Health Problems, also known as the ICD classification system, includes chronic alcoholic and nonalcoholic hepatic steatosis as diseases of the digestive system (520-579). The ICD-9 gives nonalcoholic fatty liver the designation 571.8 and alcoholic fatty liver as 571.0. These designations are used for billing and claim purposes such as with Medicare. In the new version, ICD-10, fatty liver is classified as K76.0 or K76.8.

Hepatomegaly

Hepatomegaly, or enlarged liver, can sometimes be associated with hepatic steatosis, although it also has other causes including infections, toxins, cancers, and alcoholism (the latter also being a common cause of fatty liver disease, of course). Sometimes an enlarged liver with its symptoms can lead to a diagnosis of hepatic steatosis. However, very often hepatic steatosis is asymptomatic and is not associated with hepatomegaly. Diagnosis in that case is less obvious, and generally results from routine blood work revealing an elevation of liver enzymes.

Diagnosis

The first indication of hepatic steatosis is usually an elevation of liver enzyme
levels detected through a blood test. Afterwards, a screen is used to eliminate hepatitis, which can also cause elevated liver enzymes (and is usually a much more serious illness).

The next step is a visual diagnosis using ultrasound or other imaging technology, which can reveal the presence of fatty deposits in the liver. The final step is to assess the patient’s alcohol intake and so differentiate between alcoholic and non-alcoholic fatty liver.

Because liver conditions can be the result of very serious and potentially life-threatening illnesses, it’s important to eliminate these possibilities from the diagnosis before proceeding with treatment for hepatic steatosis. It’s also important to isolate the likely cause before treatment is undertaken.

Treatment

Treatment of hepatic steatosis or fatty liver generally does not involve drugs, surgery, or any other invasive medical procedures but relies on diet and other lifestyle measures.

If the disease is alcohol-related, obviously a reduction (or elimination) of alcohol indicate is indicated. If it’s not, usually controlled and gradual weight loss will reduce the syndrome. More aggressive treatment is only likely if complications develop such as liver cancer or cirrhosis. In some of those cases, a liver transplant may even be necessary.

Hepatic steatosis is on the increase in the population. The most likely explanation for this is that it arises from the increase in obesity. Obesity is also associated with other chronic problems that are on the rise, including diabetes and cardio-vascular disease. Good diet high in fiber and low in fat can help reduce all of these conditions, not just fatty liver disease.