Fatty Liver and Enlarged Spleen

Hi Dr,

I have been diagnosed with non-alcoholic fatty liver. I had an ultrasound to confirm. Along the way, they saw I had a slightly enlarged spleen. Are these related? Will a simple fatty liver cause that? Also, with the enlarged spleen, does this mean I can no longer weight lift?

FYI-I am a 29 year old male, in decent shape, maybe 10-20 lbs overweight, and have been known to binge drink at parties, but definitely not a heavy drinker.  I also have asthma, and have taken Prednisone, although not recently.  I have taken the steroid pump as recently as last year.

I have a decent diet, although I have been known to eat too much fast food. I am now in the process of cutting out all alcohol, and going to a low fat diet. My liver enzymes were "mild", according to my physician.

Should I see a specialist regarding the relation to the spleen and fatty liver?  I am not currently experiencing any symptoms, and I have the Hepatitis panel testing scheduled for next week.

Any info would be appreciated.

Thanks,

Joe

[Kevin Pho, MD]

It is possible for liver disease to enlarge the spleen, however there are many other things as well that can do this - namely a variety of blood disorders.  A simple blood count would be a good place to ensure this isn't the case.  

To determine if there is any damage from the fatty liver, I would suggest serial liver function tests to ensure there isn't futher damage.  

If you aren't a significant drinking, there is a disease known as NASH (non-alcholic steatohepatitis) that can cause fatty liver.  Weight loss would be the best way to combat this.  

You may want to discuss these options with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
Medical Weblog:
kevinmd_b

[surgeon]

They may or may not be related: spleens can enlarge from liver disease, if the disease is such that it restricts flow of blood into it through the portal vein, which is the vein draining blood from the intestines to the liver. When pressure builds up in the portal vein ("portal hypertension" if you want to search it) it causes back pressure which can, among other things, cause the spleen to enlarge. Other things can cause "splenomegaly" also; and some people just have a bigger than normal spleen. There's no reason to stop weight lifting just because of a mildly enlarged spleen. There is, however, a HUGE reason to stop drinking completely. Namely, it could be killing you slowing, given your liver disorder.

[surgeon]

oops: meant "slowly" not "slowing"

[lmroswell]

I am sorry to tag this along, but was wondering if you would reply...My husband has a fatty liver, which was diagnosed 2 years ago.  He's 42, in fairly good health, overwieght.  He drinks socially, but not regularly.  What should he be doing to ensure the health of his liver?  Stop drinking completely?  Have an ultrasound yearly?  BTW, his father had a liver transplant 2 years ago.  Thanks.

[yoshi]

you may have to start a new thread/

[roxnsox]

I don't understand how the doctor could tell you that you have nonalcoholic fatty liver when you admit to drinking alcohol.  Just doesn't make sense to me.  The only way to confirm Nonalcoholic steatohepatitis (NASH) is with a liver biopsy.  

  Low fat diet is a step in the right direction.

[lmroswell]

I am not an expert, but, I believe that a fatty liver can be caused by a number of different things, including obesity and disease.  Just because one drinks alcohol, does not mean that their fatty liver was caused by just that.  I've learned that if you do have a fatty liver, you should avoid alcohol consumption.  What I'd like to find out is if it has to be avoided completely or can one embibe occasionally.  My husband has a fatty liver, but never drank alcohol in excessive amounts.  His father has had a liver transplant two years ago.  I am wondering if a predisposition of a fatty liver can be passed on from generations, making one more suseptable to problems in the future.

[SMSIRL]

I've a fatty liver but have only had 5 drinks in as many years. The cause of mine is associated with crohn's. It is not an uncommon finding with this condition. But before one could possibly rule out alcohol related fatty liver one must not be a regular/binge drinker. It also appears to be related to relativily moderate consumption in certain subgroups.

[lmroswell]

Do you do anything to monitor your fatty liver?  My husband had two ultrasounds in two years, which both indicated a fatty liver.  He had a CAT scan recently, and no remark was made about the fatty liver.  I was wondering if the CAT scan did not pick it up.  The docs are not giving these findings much attention, but I am wondering if the liver should be monitored yearly or so.  His father had a liver transplant two years ago, and was a moderate drinker, but clearly had no dependency on it.  I am wondering if my husband should stay completely away from drinking.

[SMSIRL]

Fatty liver of itself is not a major concern however in some it can preceed more significant liver problems. To that end it is wise to get LFT's done on a regular basis. For my part I get these done for monitoring the effect my medication has on my liver.
With regards to anyone with any liver disorder it is probably wise to get LFT's done regularly, and then if there are any symptoms [such as pain] to also get Ultrasound. It is also important to monitor any insults such as medications. Many medications are metabolised by the liver. If the liver has to do more than its usual share of work it is important to check out the impact that work is having.

If the fatty liver is not due to alcohol, weight reduction is helpful. If it is related to alcohol consumption then it would be wise to reduce or eliminate this insult - as one is on a path that could lead to significant liver problems.

The single most useful survailence are the LFT's or liver function test - which are a blood based analysis. If the results are within normal ranges then monitoring the trend will indicate any major changes. If the LFT's are already significantly out of normal range it would be wise to act immediately under medical supervision and removing any insults to the liver.

With respect to questions about drinking in general I'm reminded of a talk given by a clergyman who was also a recovering alcoholic - if a person's drinking is a cause for comment there is a drinking problem. So, with respect to anyone reading this comment, it wise to assertain, when dealing with questions of drink and health, is the cause of the question a health issue being questioned where the drink is not the centre of the question, or is it the drinking itself. The later would imply a drink problem and will require treatment regardless of the health issue. The former may or may not imply a drink problem but the health issue may require abstainance anyway.

Hope this helps
SMSIRL

[llewes]

My 22 year old son went to get life insurance and the blood test they give showed that his liver emzyems was 287 that was dangerly high they said ..
took him to the doctor and the doctor retested it and it was still really high... went for a ultra sound all it showed was that his sleen was enlarge just very little, Doctor didnt seem to concernd about it just wanted another blood test in 3 weeks ...
should we be concernd or not ... what could be causing his enzymes to be extremly high... Please help me understand someone...

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Hi Everyone, I was diagnosed with BiPolar Disorder in January and am now taking Lithium and Respiridone. At this same time I put on 20kg due to the medication. My liver function tests came back with discernably raised AST and ALT, an ultrasound showed I have a very fatty liver and an enlarged spleen, I also suffer from constant gastro. I weigh 105kg at 6 foot tall (Male). Can anyone help or offer any ideas. I am due for a colonoscopy Dec 1st, hopefully that will show something.

[mac999]

A related discussion, Splenomegaly, fatty liver and gallbladder was started.