It takes upwards of ten years for alcohol-related liver disease to progress from fatty liver through fibrosis to cirrhosis to acute on chronic liver failure. This process is silent and symptom free and can easily be missed in primary care, usually presenting with advanced cirrhosis.
It may take 30 years for fatty liver to turn into cirrhosis (unless the patient has a genetic predisposition), so the typical age people are diagnosed with cirrhosis is 60.
People with fatty liver disease often have no symptoms until the disease progresses to cirrhosis of the liver. If you do have symptoms, they may include: Abdominal pain or a feeling of fullness in the upper right side of the abdomen (belly). Nausea, loss of appetite or weight loss.
You may live the rest of your natural life without having any complications from it. It becomes more complicated for a small percentage of people when it turns to steatohepatitis (NASH), and especially when NASH progresses to cirrhosis. Research suggests that NAFLD overall may lower life expectancy by four years.
Early-stage NAFLD doesn't usually cause any harm, but it can lead to serious liver damage, including cirrhosis, if it gets worse. Having high levels of fat in your liver is also associated with an increased risk of problems such as diabetes, heart attacks and strokes.
Virtually all heavy alcohol drinkers will develop fatty liver disease, with 10 to 20 percent eventually developing cirrhosis. In order to minimize your risk of alcohol-related liver disease, limit yourself to moderate drinking, defined as up to one drink a day for women and two drinks a day for men.
Fibrosis progresses at a speed of 0.07 stages/year in NAFL and 0.14 stages/year in NASH, so NAFL progresses by 1 stage every 14 years and NASH by 1 stage every 7 years (4).
Patients can live for many years with NAFLD, but many – about 30% – eventually end up with an inflamed liver or NASH (non-alcoholic steatohepatitis), and scarring. Of these, about 20% will develop end-stage cirrhosis, which can lead to liver failure and cancer.
According to the American Liver Foundation, there are no medical treatments – yet – for non-alcoholic fatty liver disease. So that means that eating a healthy diet and exercising regularly are the best ways to both prevent liver damage from starting or reverse liver disease once it's in the early stages.
NAFLD treatment includes diet and exercise with a target 7–10% weight reduction. Treatment goals include improvements in liver fat content, liver inflammation, and fibrosis.
The first stage is referred to as simple fatty liver or steatosis; This occurs when the liver cells start to build-up fat, although there is no inflammation or scarring at this stage.
Symptoms of fatty liver disease
NASH can damage your liver for years or even decades without causing any symptoms. If the disease gets worse, you may experience fatigue, weight loss, abdominal discomfort, weakness and confusion.
Liver failure can develop slowly or rapidly, depending on the cause and the condition of the liver. Chronic liver failure: The most common type of liver failure is chronic, which can take months or years to develop.
Prognosis in early-stage liver disease is good since steatosis and steatohepatitis lesions may be reversible after alcohol cessation. However, up to 20% of patients with steatosis may still progress to cirrhosis.
Depending on the cause, cirrhosis can develop over months or years. There is no cure. Treatment aims to halt liver damage, manage the symptoms and reduce the risk of complications, such as diabetes, osteoporosis (brittle bones), liver cancer and liver failure.
Patients with compensated cirrhosis have a median survival that may extend beyond 12 years. Patients with decompensated cirrhosis have a worse prognosis than do those with compensated cirrhosis; the average survival without transplantation is approximately two years [13,14].
Avoiding Alcohol
Moderate or heavy alcohol use can cause additional damage and fat accumulation in the liver in people with NAFLD. Therefore, patients with NAFLD should avoid alcohol entirely if possible.
These substances can damage liver cells, promote inflammation, and weaken your body's natural defenses. The more alcohol that you drink, the more you damage your liver. Alcoholic fatty liver disease is the earliest stage of alcohol-related liver disease.
Fatty liver disease rarely causes any symptoms, but it's an important warning sign that you're drinking at a harmful level. Fatty liver disease is reversible. If you stop drinking alcohol for 2 weeks, your liver should return to normal.
Losing weight addresses the conditions that contribute to NAFLD . Ideally, a loss of 10% of body weight is desirable, but improvement in risk factors can become apparent if you lose even 3% to 5% of your starting weight. Weight-loss surgery is also an option for those who need to lose a great deal of weight.
The onset of liver fibrosis is usually insidious, and most of the related morbidity and mortality occur after the development of cirrhosis (16). In the majority of patients, progression to cirrhosis occurs after an interval of 15–20 years.
Increase physical activity by doing cardio and strength training exercises like weightlifting - these can increase basal metabolism to reduce the fat deposits.