Fatty Liver

[NYRR]

About 17 years ago I was diagnosis with a mild/moderate Fatty Liver (non-alcoholic).  I had an ultrasound recently which showed the fatty liver still exists at a mild/moderate level.  All my blood work has been normal ( liver enzymes included).  Occasionally I will get a dull pain underneath my right ribs.  I seldom drink alcohol.  I also suffer from GERD, I take Aciphex for this condition.  I also take Advil on occasions to treat pain, headaches, etc.  I'm not a diabetic.  I'm not overweight.  I’m 42 years old male.



I'm considering taking polyenphosphatidylcholine (PPC).  The research on this soy extract has shown some promise with fatty livers.



My concerns are;  What are  the likelihood that fatty livers can  turn into something more serious like Steatohepatitis or Cirrhosis?



Am I at a disadvantage having NAFLD if I start showing symptoms compared to those who have fatty livers that are alcohol related, re-treatment?



Will taking PPC help?  Can it interact with Aciphex ?



What can I do in combating a fatty liver so that I can prevent serious issues latter on in life?  Not taking certain medicines (Advil, diet, vitamins, etc)?



Thanks

[Kevin Pho, MD]

To answer your questions:

1) I cannot quote exact numbers reflecting the incidence of fatty livers progressing to steatohepatitis (which is diagnosed by biopsy).  However, there seems to be an increased risk.  If NASH (non-alcoholic steatohepatits) is present, the chance of progression to cirrhosis is quoted at 6 to 26 percent over a 7 year period.



2) Typically fatty liver that is due to non-alcoholic causes (i.e. NASH) would have less of a chance of progressing to cirrhosis compared to alcoholic causes (35 to 50 percent compared with 6 to 26 percent over 7 years).



3) I am not aware of data concerning PPC and NAFLD.  I am also not aware of an interection with Aciphex.  You should discuss this question with your personal physician.



4) Not taking medications that affect the liver would help (i.e. tylenol, alcohol etc.).  There is no clear guideline dictating treatment for NAFLD.  Weight loss is a key treatment decision that is recommended.  



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.



Thanks,

Kevin, M.D.