HCA Midwest Health - June 14, 2017

A diagnosis of liver disease can be frightening, but early detection is the best defense. One of three Americans is now living with fatty liver disease, the presence of too much fat in the liver. While many people associate liver disease with heavy alcohol consumption, there are actually two main types of fatty liver disease:

  • Alcoholic fatty liver disease is caused by high alcohol consumption. It is the first stage of alcohol related liver disease (ALD) and can progress into alcoholic hepatitis and cirrhosis (irreversible scaring).
  • Nonalcoholic fatty liver disease (NAFLD) tends to develop in people who are overweight, have diabetes, high cholesterol or high triglycerides. NAFLD can progress into Nonalcoholic Steatohepatitis (NASH) and from there cirrhosis.

Early detection, life-style changes and continual monitoring are essential to reversing damage and preventing progression. Both types of fatty liver disease often have no symptoms which can make early detection difficult.


When symptoms occur, they may include:

  • Fatigue or weakness
  • Loss of appetite, nausea or weight loss
  • Abdominal pain
  • Spider-like blood vessels
  • Yellowing of the skin and eyes (jaundice)
  • Itching
  • Fluid build up and swelling of the legs (edema) and abdomen (ascites)
  • Mental confusion

Fatty liver disease is usually first suspected if an enlarged liver is detected through physical examination and if routine blood work shows high liver enzymes. From there, additional tests such as a liver biopsy are used to confirm the diagnosis and measure the extent of damage and disease progression.

A leading-edge procedure called MR Elastography (MRE) is now available in the Kansas City area. It's an advanced technology that offers a safer, more comfortable, non-invasive alternative to liver biopsy. It's only available in about 100 locations worldwide. Research Medical Center is the first in the Kansas City area. Within a decade, fatty liver disease will be the leading cause of liver transplants.

MRE is expected to be an important tool in the early detection and treatment of this condition.

The traditional assessment of liver disease involves an often-painful needle biopsy, and it comes with the possible risks of infection, bleeding and inaccurate results. MRE is more reliable than a biopsy because it evaluates a much larger cross-section of the liver than a biopsy can. And is more accurate due to its high sensitivity. This allows doctors to assess the elasticity of the liver, identifying parts of the organ that might be hardening, signaling disease. Hardening of the liver begins slowly and progresses to become more dangerous. With MRE, doctors are better able to diagnose liver disease at an earlier stage, when intervention is critical and treatments can be the most effective.

MRE is also faster and less costly than a traditional liver biopsy. Additionally, it's extremely useful in the diagnosis of viral hepatitis B and C, well before the development of end-stage liver disease.

There are currently no FDA approved medical treatments for NAFLD, but due to the growth of the disease, there are many drugs currently in development. Right now, the primary treatment is life-style changes. And in the beginning stages, they may even reverse the disease. Some changes to consider are:

  • Losing weight. The rise of NAFLD is closely linked to the obesity epidemic
  • Eating a healthy diet and exercising
  • Avoiding alcohol which can put further strain on and damage the liver
  • Only taking medications you need and at the correct dose. Pain relievers such as acetaminophen and even some vitamins and herbal medications can put strain on the liver

It is important to see your doctors regularly in order to monitor any changes in the disease. And if your doctors should suspect that you have fatty liver disease, or if they want to monitor an already-diagnosed case, the latest technology, like MR Elastography makes testing easier, less painful and safer than it's been in the past.

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