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Non-alcoholic fatty liver disease is a condition in which
the accumulation of excess fat in the liver,
not due to excessive alcohol consumption.
It's a very common condition in clinical practice.
It's affect about 20% of the world population.
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We care about fatty liver disease because it is one
of the problem which can cause liver failure, liver cancer, and
the need for liver transplantation.
The presence of extra fat in the liver
can cause chronic irritation of the liver cells and
subsequently can cause further liver damage.
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There are three common causes of fatty liver disease,
being overweight, patient's with diabetes and
also patient's with high cholesterol.
Keeping in mind some people with normal body weight
can have fatty liver disease.
The increasing epidemic of fatty liver disease has been recently
attributed to overweight and the high prevalence of diabetes.
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Fatty liver disease used to be a very rare condition in children.
However, recently with the increasing problem of obesity
in children,
fatty liver disease became affecting about 10% of children.
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Early in the course of the disease,
many patients have no symptoms.
However, when the scaring and
the inflammation of the liver progress.
Many patients start to complain of problems
related to enlargement of the liver or fatigue.
If complications happened from fatty liver disease such as
cirrhosis or complete scaring,
patient can have problems with bleeding and symptoms of other
complications of liver disease such as liver cancer.
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When we do a blood test for a patient with fatty liver
disease, many patients will have elevated liver function test.
Imaging modalities can be very helpful for
diagnoses of fatty liver disease,
such as ultrasound, CT scan, MRI, or fiber scan.
Occasionally, patients might need liver biopsy to assess
the significance of the damage in the liver.
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Fatty liver disease in early stage could be completely
reversible.
However, if patient continues to have excess fat in the liver.
This can lead to complete scarring of the liver,
or what we call sclerosis.
And subsequently liver failure, and its complications such as
liver cancer, and the need for liver transplantation.
Fatty liver disease become a more common indication for
liver transplantation globally.
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There is no specific treatment for fatty liver disease.
The most important step is to control the risk factors
to liver disease such as high cholesterol and controlling
the blood sugar, and lose weight for obese individuals.
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There are recent studies which confirm clearly the benefit of
coffee for patients with liver disease.
There have been some suggestions that drinking two or
three cups of coffee a day will prevent liver cancer,
and liver scarring in patients with fatty liver disease.
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The most important food to avoid for patients with fatty liver
disease, are food rich in refined sugars, such as bread,
rice, potatoes and corn.
Also we recommend for patients to consume lean meat and
increase the amount of vegetables and
salads in their diet.
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At Johns Hopkins Hospital we are conducting several clinical
trials.
Looking for a novel therapy for fatty liver disease.
We're using tablets form for specific drugs that
alter the pathophysiology of fatty liver disease.
What we are hoping is to prevent the accumulation of
fat in the liver.
To reduce the amount of scarring in the liver from fatty
liver disease.
And eventually preventing liver cancer and liver failure.
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