Fatty Liver - A Summary from Dr. Ruane

If you are visiting our site it may be because you have been told by your doctor that you have a fatty liver, or something called NAFLD or NASH.

LiverYou might have had some blood tests done that showed some inflammation in the liver, or maybe you had some discomfort below the diaphragm, to the right of the stomach that caused your doctor to order an ultrasound and the ultrasound showed a bright signal – which would be due to fat filled cells in the liver.

And by now you may know that there are two important kinds of fatty liver:

  1. The first and most common is simple fatty liver disease where there’s just fat in the liver and no inflammation. This is not so bad, and all you need to do is cut back on carbohydrates, cut back on sugars, get in shape, exercise and get this checked maybe once a year by your doctor.
  2. The second type is less common, but more serious:
    This is fatty liver with inflammation. In this case the liver is inflamed by the fat and over time there’s a buildup of fine threads of scar tissue, which accumulates and lead to real liver injury. Doctors call these fine threads of scar tissue fibers, and when these fibers grow and lengthen and link up, they make the liver stiffer. We call this liver FIBROSIS: stiffening of the liver from fibers of scar tissue.

Fibrosis scarring in the liver is just like scarring anywhere else in the body. For example if you are scratching an area of your skin you will gradually build up a scar. It is very much the same thing.

The most advance form of fibrosis is CIRRHOSIS. Cirrhosis usually takes a very long time to occur, but when it does, it can lead to liver failure and sometimes a cancer can form in the liver, caused by the cirrhosis.

So how do you know if you have a case of simple fatty liver or the more serious form of fatty liver disease with the inflammation?

Well there are 3 things we need to find out:

  1. How much fat is in your liver
  2. Are there any signs of inflammation
  3. Is there already any sign of fibrosis: scarring of liver tissue

Of these three we can now easily measure two with FibroScan – a new bedside device. This device can measure how much fat is in the liver and also answer the most important and urgent question: is there already any scarring in the liver – and if so, how much.

So what do you do, if after these tests it turns out that you have the more serious form of fatty liver?

Well, just like with the simple case, you want to get on a good weight-loss diet and exercise as much as your body will allow. But for this more serious case, diet and exercise might not be enough. Ruane Medical and other centers around the country are conducting trials with new medications that we hope will help people with this condition.

If you want to learn more about the new medications in our clinical trials and enroll now, or in the future, please contact us so we can keep you updated about available trials.

Should you be concerned if you have Fatty Liver Disease?


We know that fatty liver disease is very common, but the people who are more likely to have fatty liver disease with inflammation and fibrosis, are people who have diabetes or pre-diabetes, people who have high blood pressure or high cholesterol, or have a big tummy with fat inside that tummy. People who have many of these symptoms are often diagnosed with something called the ‘metabolic syndrome’.  There are people who are thin and have fatty liver disease – so being thin does not exclude the possibility of fatty liver disease.


How do we measure your liver's health


There are many different ways to measuring the health of the liver. Proper diagnosis starts with a detailed medical history and a careful physical examination, in addition to blood tests to exclude other causes of liver disease. In our office we prefer to use FibroScan. FibroScan is an FDA approved device that is now capable of measuring the amount of fat in the liver and also the amount of fibrosis in the liver. All this can be done without using any needles or biopsies or stay in the hospital. All you need to do is fast for 3 hours before the examination.


What are the available treatment options in 2016


Currently there are no specific effective treatment options for fatty liver disease.
Doctors try to help their patients with the risk factors and other conditions that the patient may have: diabetes, cholesterol, high blood pressure and obesity. Some medications that are toxic to the liver should be avoided as well as alcohol.


Is coffee really benefitial for Fatty Liver Disease?


One of the things I like to tell my patients is that coffee, 2-3 cups a day turns out to be good for many forms of liver disease. The exact mechanism for this is unclear, but it shows up in multiple trials, so it’s one of the good pieces of advice we like to give out to our patients.

Measuring Liver Health