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Diffuse Fatty Infiltration Of Liver,body Mass Index Is 30.7

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Posted on Wed, 16 May 2012
Question: Hi. A helical CT of my abdomen revealed diffuse fatty infiltration of the liver. I'm asymptomatic of fatty liver disease and do not drink at all. I'm 35 with a BMI of 30.7, and I have no other diseases or illnesses. What is the probability that, with a proper diet and exercise regime, the diffuse fatty infiltration can be completely reversed? Many thanks in advance!
doctor
Answered by Dr. Rhea Chanda (4 hours later)
Hi XXXXXXX

You have a condition called Non alcoholic fatty liver disease.I=This is a reversible condition. Mostly with proper nutrition and diet plan,and exercise the condition can be controlled. However,gradual weight loss is important as rapid weight loss has an adverse effect on the body. Therefore,a balanced diet and gradual weight loss are the two things that can help control this condition.

On the other hand, you have family history of heart disease so you also should be monitoring your lipid profile and blood sugar.

I would suggest that you consult a nutritionist/dietician who can help create a personalised diet chart for you to follow. You need to monitor weight and BMI every 6 months and a yearly health/cardiac check up.

Hope your query was answered. Follow up queries welcome.
Regards,

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Rhea Chanda (12 hours later)
You did not answer my question. I asked you to provide the stastistical likelihood of COMPLETE reversal of the condition given the history I provided. Such an answer requires XXXXXXX familiarity with the hepatology literature, whereas the answer you gave me can be had with a single Google search result. I'm disappointed.

Your answer carried no more information than the Wikipedia article on the topic.
doctor
Answered by Dr. Rhea Chanda (1 hour later)
Hi,

I just took a curbside consult from a Hepatologist.

There is no robust Randomised control trial done to look for sonographic / CT reversal of fatty liver. The time it takes to reverse is patient dependent, as well as how much damage was done to the liver ( liver enzymes needed). Experienced hepatologists opine that it takes atleast 6 to 12 months for reversal after the lifestyle modifications are started. A weight loss of 1 to 2 pound per week should be driven amongst the these population to achieve this reversal.

Trails are available on XXXXXXX ( Non Alcoholic Steatohepatitis) which is although a diagnosis on Liver biopsy. In RCT done so far, several empirical treatments have been proposed but none of them withstood the time sensitivity, such as Diet plus exercise, Diet Exercise plus Rosaglitazones, Diet plus lipid lowering agents. Vitamin E and ursodeoxycholic acid have shown improvement in specific populations.

Hope this answers.

Wish you Good Health.




Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Rhea Chanda (1 hour later)
Well, you're almost answering the question. I do appreciate that CT absorption does not allow us to know the severity of the infiltration, and you have suggested a timescale for reversal. But, what I'm really after is an estimation of how likely COMPLETE reversal is. Starting with the assumption of negligible liver damage--remember, I'm completely asymptomatic--is it impossible to bring te infiltration down below 5%? Is it possible but unlikely? In patients who are considered to have resolved fatty liver, what's the best they've typically done?

Btw, my BMI is actually 2.5 as of today.
doctor
Answered by Dr. Rhea Chanda (1 hour later)
Hi XXXXXXX

Almost all the persons with fatty liver are asymptomatic and that does not mean the liver enzymes are not elevated.

Yet there are no reports on Complete reversal. I hope there is no major fibrotic changes in the liver, if in such a case these can partly answer your question. Researchers at St. XXXXXXX University have found that a weight loss of at least 9 percent can reverse XXXXXXX but unclear if it is complete reversal. In another small non-controlled trials, 75-100 percent of patients saw complete reversal of XXXXXXX with Thiazolidineiones (TZDs) and diet.

Hope this is better.
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Rhea Chanda

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Diffuse Fatty Infiltration Of Liver,body Mass Index Is 30.7

Hi XXXXXXX

You have a condition called Non alcoholic fatty liver disease.I=This is a reversible condition. Mostly with proper nutrition and diet plan,and exercise the condition can be controlled. However,gradual weight loss is important as rapid weight loss has an adverse effect on the body. Therefore,a balanced diet and gradual weight loss are the two things that can help control this condition.

On the other hand, you have family history of heart disease so you also should be monitoring your lipid profile and blood sugar.

I would suggest that you consult a nutritionist/dietician who can help create a personalised diet chart for you to follow. You need to monitor weight and BMI every 6 months and a yearly health/cardiac check up.

Hope your query was answered. Follow up queries welcome.
Regards,