The liver is one of the most important organs in the body: it processes and removes waste products to prevent them from accumulating through its involvement in processes such as metabolism or immune function. When the activity of the liver is severely affected, a person’s life is at great risk.

In this article we will discuss the causes, symptoms and types of hepatic steatosis or fatty liver , one of the most common disorders of this organ, which predisposes to the appearance of cirrhosis (pathological scarring of the liver) if not treated adequately through lifestyle changes, particularly alcohol withdrawal.

What is hepatic steatosis?

Hepatic steatosis is a disease, often asymptomatic, that consists of the accumulation of fats in the cells of the liver ; the most common are triglycerides, which are related to atherosclerosis and hypercholesterolemia. The name most commonly used by most people to designate this disorder is “fatty liver”.

It is a reversible disease, since its evolution usually depends on changes in habits and lifestyle, such as adopting a healthy diet or stopping alcohol consumption. However, hepatic steatosis can progress to cirrhosis if it is not managed properly.

The prevalence of this disorder varies greatly depending on the country concerned; while in some countries it is about 10% , in many rich countries this figure exceeds 20% of the population . In any case, hepatic steatosis is a very common disease, especially in people with obesity.

Signs and symptoms of this disorder

Liver steatosis often manifests itself as an asymptomatic disorder, or only nonspecific symptoms such as tiredness or discomfort in the belly appear. This is why many people are not aware that they have this problem if no physical examination detects a characteristic sign: a slight increase in the size of the liver.

Most of the symptoms of the fatty liver are associated with inflammation of this organ . When this happens, it is common for symptoms to appear such as the feeling of fatigue, physical weakness, confusion, pain in the abdomen, decreased appetite and consequently decreased body weight.

The liver has a certain capacity for self-repair. This process occurs through the generation of new liver cells that replace those that are damaged. However, if the liver is forced to excess, chronic scarring of the tissues can occur; when steatosis evolves to this point we speak of liver cirrhosis.

Causes of fatty liver

When fats accumulate in excess in the liver, the functioning of this organ is altered; this makes it impossible for our body to correctly eliminate the waste substances that are introduced into our organism, especially through what we eat and drink.

Alcohol abuse and dependence are the most common causes of hepatic steatosis , since excessive consumption of this substance causes lesions in the liver. The terms “alcoholic fatty liver steatosis” and “alcoholic fatty liver” are used when this is the main causative factor in the development of the disease.

Some of the most relevant risk factors for the appearance of fatty liver are obesity, diets rich in sugars and fats (which can lead to type 2 diabetes and hyperlipidemia) and having an advanced age; most cases occur between 40 and 60 years old. Heredity and the use of aspirin or steroids are also associated with this disorder.

Types of hepatic steatosis

Fatty liver cases are usually classified according to whether their cause is excessive alcohol consumption or another cause. However, there is also a special variant worth mentioning: acute hepatic steatosis of pregnancy.

1. Non-alcoholic fatty liver

Nonalcoholic hepatic steatosis is usually associated with disorders in the breakdown of fats ; this causes them to accumulate in the liver. The basic criterion used to diagnose this variant of the fatty liver is that at least 10% of the fatty liver tissue is composed of lipids.

2. Alcoholic Fatty Liver

Alcoholism damages the cells of the liver and interferes with their functioning; this includes the breakdown of lipids. If alcohol consumption continues after alcoholic liver steatosis has been detected, the disorder will most likely progress to cirrhosis.

3. Acute and associated with pregnancy

This type of hepatic steatosis is a rare complication that appears in the third trimester of pregnancy. Symptoms tend to disappear after delivery, and include a feeling of general malaise, upper abdominal pain, nausea and vomiting, and jaundice, which is the yellowing of the skin and mucous membranes.