Can diffuse hepatic steatosis be treated?

  • 1
75 year old female.  Diarrhea, bleeding, tired.

1 Answer

These messages are for mutual support and information sharing only. Always consult your doctor before trying anything you read here.

Hepatic steatosis is also called fatty liver. It does not cause diarrhea and bleeding. By the way, where did you bleed?

Fatty liver can be treated. If you have been diagnosed with fatty liver disease, it is important to keep your liver as healthy as possible and avoid anything that can damage your liver. Here are some important things you should do.

  • Don’t drink too much alcohol. How much is too much remains controversial, but it’s probably best to avoid alcohol completely.
  • Make sure that none of your medications, herbs, and supplements are toxic to the liver; you can crosscheck your list with this LiverTox Even acetaminophen (the generic ingredient in Tylenol and some cold medicines) may be harmful if you take too much for too long, especially if you have liver disease or drink alcohol heavily.
  • Get vaccinated to protect against liver viruses hepatitis A and B.
  • Control other health conditions that might also affect your liver, and check with your doctor if you might have other underlying, treatable diseases contributing to your fatty liver.
  • Get regular screening tests for liver cancer if you already have cirrhosis.

Unfortunately, there are no FDA-approved medications for fatty liver disease. So far, the two best drug options affirmed by the American Association for the Study of Liver Diseases for biopsy-proven NASH are vitamin E (an antioxidant) and pioglitazone (used to treat diabetes). However, not everyone will benefit from these treatments, and there has been some concern about safety and side effects. If you have NASH, it’s best to speak to your doctor about whether these treatments are appropriate for you, as they are not for everyone. There are more drugs in the pipeline, some with promising initial study results.

The good news is that the most effective treatment so far for fatty liver disease does not involve medications, but rather lifestyle changes. The bad news is that these are typically hard to achieve and maintain for many people. Here’s what we know helps:

  • Lose weight. Weight loss of roughly 5% of your body weight might be enough to improve abnormal liver tests and decrease the fat in the liver. Losing between 7% and 10% of body weight seems to decrease the amount of inflammation and injury to liver cells, and it may even reverse some of the damage of fibrosis. Target a gradual weight loss of 1 to 2 pounds per week, as very rapid weight loss may worsen inflammation and fibrosis. You may want to explore the option of weight loss surgery with your doctor, if you aren’t making any headway with weight loss and your health is suffering.
  • It appears that aerobic exercise also leads to decreased fat in the liver, and with vigorous intensity, possibly also decreased inflammation independent of weight loss.
  • Eat well. Some studies suggest that the Mediterranean diet may also decrease the fat in the liver. This nutrition plan emphasizes fruits, vegetables, whole grains, legumes, nuts, replacing butter with olive or canola oil, limiting red meat, and eating more fish and lean poultry.
  • Drink coffee, maybe? Some studies showed that patients with NAFLD who drank coffee (about two cups every day) had a decreased risk of fibrosis. However, take into consideration the downsides of regular caffeine intake.
...