ASK THE DOCTOR: Yes, teetotallers can develop liver disease
By Dr Martin Scurr
After a recent blood test my doctor told me I had a fatty liver, but gave little explanation. I would like to know how this came about, as I don’t drink, smoke or eat fatty food. Can you help? I am 75.
Mrs E. Goatcher, Sunbury, Surrey.
First, let me reassure you that your condition is very common — affecting up to one-in-five adults, mostly between the ages of 40 and 60. The official term for your diagnosis is non-alcoholic fatty liver disease, which, as the name suggests, occurs in people who drink little or no alcohol.
This is the most common liver disorder in Western society and, in most cases, produces no symptoms. It is caused by a build up of trigylcerides, a type of fat, in the liver. Patients with the condition often also suffer from obesity and type-2 diabetes, but this is not always the case.
There is a genetic link and evidence suggests the underlying problem is insulin resistance — this means your body has problems metabolising glucose, the main type of sugar in the body. However, a fatty liver doesn’t pose problems unless it progresses to non-alcoholic steatohepatosis (NASH). This is where fat builds up in the liver, causing inflammation and scarring.
While it’s not clear what actually triggers this next stage, excess weight certainly increases the risk. Symptoms include fatigue and right-sided abdominal pain (the liver sits at the back of the abdomen, on the right).
If it’s left untreated, over time, NASH can lead to liver cirrhosis — a more chronic scarring of the liver that affects the function of the organ and can be life-threatening.
The only exception would be if someone with a fatty liver has diabetes or is obese, as these might be the factors that cause progression to NASH. You mention that you don’t eat fatty foods — in fact, this is not what makes a liver fatty; sugar is the main culprit.
The sugar in food and drinks is converted into fat and stored in the liver, which means anything with added sugar or added fructose (the fruit sugar piled into fruit juice) is a particular villain.
Note that I am not advising you to avoid eating fruit, just avoid cartons of fruit juice. But, aside from this, please continue as you were, and think no more of this condition.
http://www.dailymail.co.uk/health/article-2114017/Why-does-moving-arm-hurt-much.html
