Severe fatty liver

　　The six major causes of fatty liver:

　　One, Alcohol

　　Alcohol is the main cause of fatty liver. Long-term excessive drinking and protein deficiency, or a lack of riboflavin, pantothenic acid, and niacin in the diet, can damage liver function. The damaged liver has difficulty in metabolizing fatty acids, which leads to an excessive accumulation of fat in the liver, causing fatty liver.

　　Two, Nutritional Overload

　　Long-term consumption of large amounts of meat, fried food, and sweets can cause the liver to synthesize too much fat. When the fat content in the food is too high, exceeding the liver's processing limit, it increases the liver's burden. It interferes with the metabolism of fat, disrupts the input-output balance of the liver, and fat will accumulate in the liver, forming fatty liver.

　　Three, Malnutrition

　　This is due to the lack of protein during malnutrition, which leads to a decrease in the synthesis of very low-density lipoprotein. It causes the liver to have difficulty in transporting triglycerides, resulting in fat accumulation in the liver, which, of course, can also cause fatty liver.

　　Four, Obesity

　　About half of the obese people have a tendency to develop fatty liver, as the blood of obese people contains a large amount of free fatty acids. They are continuously transported to the liver, far exceeding the liver's metabolic capacity, causing liver fat accumulation and leading to fatty liver due to obesity.

　　Five, Hyperlipidemia

　　When the amount of lipids in the blood exceeds the limit that the liver can handle, it will cause fat to accumulate in the liver, leading to fatty liver.

　　Six, Diabetes

　　About half of type 2 diabetic patients have fatty liver, because in diabetic patients, glucose and fatty acids cannot be utilized well, and the synthesis of lipoproteins also appears to be impaired. Most of the glucose and fatty acids are converted into fat in the liver, eventually causing fat to accumulate in the liver, triggering fatty liver.

　　Fatty liver can be an independent disease or a concurrent manifestation of certain systemic diseases.

　　1.It often has other manifestations of alcoholism, such as alcohol-dependent pancreatitis, peripheral neuritis, anemia, glossitis, alcoholic hepatitis, liver cirrhosis, and so on.

　　2.Nutritional deficiency fatty liver often coexists with chronic consumptive diseases, such as tuberculosis, ulcerative colitis, and so on.

　　3.Nutritional excess fatty liver often occurs concurrently with other basic diseases, such as obesity, diabetes, hyperlipidemia, hypertension, coronary atherosclerotic heart disease (commonly known as coronary heart disease), gout, cholelithiasis, and so on.

　　4.Severe fatty liver patients may have ascites and lower limb edema, and other symptoms may include spider veins, gynecomastia in males, testicular atrophy, impotence, amenorrhea and infertility in females, and so on.

　　5.Acute fatty liver of pregnancy often complicates renal failure, hypoglycemia, pancreatitis, sepsis, disseminated intravascular coagulation (DIC), and other conditions.

　　Clinical symptoms of severe fatty liver: There are similar symptoms to chronic hepatitis, such as loss of appetite, fatigue, nausea, vomiting, weight loss, pain in the liver area or upper right abdomen, etc. The liver is slightly enlarged and painful, with slightly tough texture, dull edges, and smooth surface. A few patients may have splenomegaly and liver palm.

　　1. Pay attention to eliminating the triggering factors of fatty liver:

　　Alcoholic fatty liver should abstain from alcohol; obesity-related fatty liver should lose weight; drug-induced fatty liver should avoid taking drugs that cause fatty liver; gestational fatty liver should take timely measures, and if necessary, terminate pregnancy; fatty liver associated with other diseases should actively control the condition; malnutrition-related fatty liver should pay attention to increasing nutrition and avoiding unscientific weight loss. Severe fatty liver patients can gradually decompose, improve, and even recover after eliminating these factors.

　　2. Pay attention to the following aspects of diet:

　　1. Avoid foods that may worsen the condition and damage the liver:

　　① Abstain from alcohol

　　② Eat less egg yolk, not more than 2 a day.

　　③ Do not eat animal fats, do not eat animal internal organs and skin foods, do not eat fish roe, crab roe, brain, and other foods.

　　④ Do not eat fried and fried foods

　　⑤ Eat less sweets, chocolate, and eat less or not eat snacks.

　　⑥ Do not eat too much at each meal, you can have four meals a day, eat to seven parts full, and do not eat before going to bed at night.

　　⑦ Potatoes, taros, yams, sweet potatoes, wide noodles, and cold noodles should be eaten moderately, and when necessary, they should be limited to be eaten with staple foods.

　　⑧ The intake of salt should not be too much, about 4 grams a day, not more than 6 grams.

　　When fatty liver is detected, some related items can be checked mainly:

　　Liver function tests: Liver function tests are also one of the methods for diagnosing fatty liver. For patients with fatty liver due to excessive nutrition, the GOT and GPT values may slightly increase, less than 100; when the GOT and GPT values are greater than 100, it is necessary to consider other types and causes of fatty liver. No matter what the cause of the fatty liver, once diagnosed, timely treatment of fatty liver should be carried out.

　　Ultrasound examination: Ultrasound examination is the simplest, most economical, accurate, and quick method in imaging examination, and it has no trauma to the body, making it an ideal examination method for fatty liver. Generally speaking, during ultrasound scanning, it is possible to see the liver parenchyma present with fine, dense, strong reflective spots, and the deep tissue enhancement is weakened, which can be used as a basis for the doctor to diagnose fatty liver.

　　A healthy diet can enhance the patient's resistance and help severe fatty liver patients get rid of the pain of the disease as soon as possible. In order to get rid of fatty liver disease as soon as possible, it is very important to pay attention to diet in daily life.

　　Patients with fatty liver should pay attention to the following foods that can be eaten more:

　　1, Fungal vegetables

　　Mushrooms, shiitake, black fungus, silver ear, and other edible fungi. They are rich in nutrients, belonging to high-protein, high-vitamin, low-fat, low-sugar, low-salt, and low-calorie vegetables for fatty liver. The high-quality protein they contain helps the body clear fat in the liver, protecting the liver and lowering blood lipids. The多元 vitamins and trace elements they contain are helpful for the repair and regeneration of damaged liver cells.

　　2, Celery

　　Celery contains dietary fiber, protein, fat, carbohydrates, vitamins, and minerals, which are not only nutritious but also have medicinal value. They can achieve good effects of weight loss, lowering blood lipids, lowering cholesterol, anti-inflammatory, and hemostasis.

　　3, Tomato

　　Tomatoes are rich in carotene, B, C, and P vitamins, which have the effects of invigorating the spleen and digestion, clearing heat and detoxifying, cooling blood and calming the liver. They can reduce the cholesterol content in the blood and are very beneficial to patients with fatty liver and hyperlipidemia when eaten regularly.

　　4, Onion

　　Onions are rich in calcium, iron, and various vitamins, as well as carotene, vitamin B1, niacin, and other vitamins, which have the effect of lowering cholesterol and blood lipids.

　　5, Radish

　　Radishes contain fewer calories and more fiber, making them easy to feel full after eating, which is beneficial for weight loss. They can also lower blood lipids, soften blood vessels, stabilize blood pressure, and prevent diseases such as fatty liver, coronary heart disease, and atherosclerosis.

　　6, Kelp

　　Kelp is rich in taurine, which can lower blood pressure and cholesterol, prevent gallstones, prevent atherosclerosis, and protect the liver and arteries very well. Kelp does not contain fat and has certain therapeutic effects and preventive effects on hyperlipidemia, obesity, fatty liver, and other conditions.

　　For patients who have been diagnosed with fatty liver, how to treat it is their most concerned issue. Many fatty liver patients will blindly take various health products, which results in not only failing to control the condition but also threatening their health. Moreover, fatty liver is closely related to obesity, diabetes, hyperlipidemia, and other diseases. After improper use of health products, someone's liver lesions may worsen. For children with fatty liver, parents should not easily give them health products with unknown efficacy. If a child's liver accumulates a large amount of fat, it is more likely to lead to necrosis of liver cells and develop into liver fibrosis and liver cirrhosis. Therefore, health products should be taken under the guidance of a doctor.

　　Fatty liver lacks targeted effective drugs

　　Most scholars believe that the key to treating fatty liver lies in changing lifestyle, such as diet control, exercise, abstinence from alcohol and smoking, removing the cause of the disease, and treating the primary disease. According to the different stages of fatty liver development, clinical manifestations, and laboratory test results, drugs should be selected appropriately. The main principles include: removing the cause and诱因, stopping the use of hepatotoxic drugs and avoiding contact with hepatotoxic substances, as well as correcting intestinal flora disorders. Intestinal endotoxemia is closely related to the progression of fatty liver disease. The use of probiotics and, if necessary, antibiotics that can inhibit intestinal flora can reduce the ectopic location of intestinal flora, inhibit the production of endotoxins, alleviate endotoxemia, reduce the release of inflammatory factors, but the potential toxic and side effects of drugs should be carefully considered.

　　Control of the primary underlying disease or associated diseases

　　Insulin resistance and increased free fatty acids lead to dyslipidemia, which is one of the causes of fatty liver. Actively improving insulin resistance and dyslipidemia can prevent liver cells from progressing from fatty degeneration to fatty liver hepatitis. And by inhibiting the activity of the rate-limiting enzyme for cholesterol synthesis, reducing the synthesis of cholesterol and fatty acids, it is also an important measure to prevent the progression of fatty liver.

　　Oxidative stress/lipid peroxidation is another main factor in the progression of fatty liver disease, which is the key to the development of fatty liver into fatty liver hepatitis. Therefore, protecting the liver cell membrane, improving the antioxidant capacity of liver cells, can reduce the content of fat in the liver, promote the regression of fatty liver, prevent hepatitis, necrosis, and fibrosis, and prevent the progression of chronic liver disease, which has a positive significance for the relief or delay of the disease.

　　In fact, there is still no magic drug for the treatment of fatty liver disease in China and abroad. For the prevention and treatment of obesity-related fatty liver, a modern urban disease, weight loss through diet and exercise is more important than hepatoprotective drug treatment. Especially for the treatment of simple obesity-related fatty liver, the main approach is to change lifestyle, which is the only effective choice among simple fatty liver treatments. However, for those who have not shown improvement after treatment for 3-6 months or more, attention should be paid to: whether the primary disease etiology or诱因 is still in effect; unclear pathogenic factors and the disease has developed into fatty liver hepatitis.

　　Hepatoprotective drugs are used as adjuvant therapy

　　Hepatoprotective drugs are mainly used for patients with clinical manifestations of persistent abnormal serum transaminase levels or liver biopsy showing inflammation, necrosis, and fibrosis; cryptogenic fatty liver with no known etiology after comprehensive examination; simple fatty liver with no efficacy after 6 months of basic treatment or basic treatment that may induce and lead to the deterioration of liver disease. The method of medication mainly adopts: selecting 1-2 hepatoprotective drugs for more than half a year, or until the serum transaminase returns to normal levels and imaging examination suggests the regression of fatty liver. A few patients may still progress to irreversible cirrhosis of the liver even after the etiology is removed.

　　In summary, early diagnosis and treatment of fatty liver disease should be strengthened, and appropriate medication should be used.