Mild Fatty Liver And Elevated Liver Enzymes: When Does It Become Hepatitis?

Fatty liver disease is a common condition that can progress through several stages. If a person with mild fatty liver experiences elevated liver enzymes beyond the normal range, it may indicate the presence of fatty liver inflammation or hepatitis. Clinically, fatty liver can be categorized into four main types: simple fatty liver, fatty liver hepatitis, fatty liver fibrosis, and fatty liver cirrhosis.

1. Simple Fatty Liver: In this early stage, individuals typically show no symptoms and maintain normal liver function. The condition is often only detected through imaging tests that reveal fat accumulation in the liver.

2. Fatty Liver Hepatitis: This stage is characterized by abnormal liver function tests, particularly elevated levels of ALT (alanine aminotransferase), AST (aspartate aminotransferase), GGT (gamma-glutamyl transferase), or ALP (alkaline phosphatase). Imaging may show signs of fatty liver, but symptoms may still be absent or mild.

3. Fatty Liver Fibrosis: This condition develops from fatty liver hepatitis and involves the growth of fibrous tissue within the liver, indicating progressive damage.

4. Fatty Liver Cirrhosis: The most advanced stage, cirrhosis involves the formation of regenerative nodules (false lobules) in the liver tissue, indicating severe scarring and long-term damage.

Regardless of the type, it is essential to treat fatty liver disease seriously. Treatment strategies depend on the underlying cause. For individuals with obesity or overweight, weight loss and lifestyle changes are crucial. Those with elevated liver enzymes may benefit from medications that protect the liver, reduce enzyme levels, and combat inflammation, such as polyunsaturated phosphatidylcholine. If alcohol consumption is the cause, complete abstinence is necessary, along with appropriate liver-protecting treatments. In cases where medication is responsible for fatty liver hepatitis, discontinuation of the drug and supportive liver care are required.

Early diagnosis and management are key to preventing further liver damage and improving long-term health outcomes.