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what is fatty infiltration of the liver versus hepatocellular disease and its prognosis?
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Liver cells store fat, more specifically triglycerides, in their cytoplasm. Triglycerides occupy 5% of the liver weight under normal conditions. The problem arises when their concentration go beyond limit. This condition is known as fatty infiltration of the liver. It is also called fatty metamorphosis or steatosis of the liver. The accumulation of triglycerides in the liver is reversible. The patients often do not show any particular symptoms. It is caused by various reasons.

Causes of Fatty Infiltration of the Liver: The main reasons for fatty infiltration of liver are increase in the amount of fat transferred to liver from other parts of the body. It might be due to the increase in the removal of fat presented to the liver from the intestine or reduction in the rate at which the liver breaks down and removes the fat. Any alteration in any of the steps followed by the liver for lipid metabolism also leads to this liver disorder.

Other factors that may lead to fatty infiltration of liver are alcoholism, long term parenteral nutrition, obesity, starvation, steroids administration or excessive endogenous production of steroids, and diabetes mellitus. Some chemicals such as carbon tetrachloride and yellow phosphorus can also result in steatosis of liver. Fatty liver diseases including Cushing's syndrome and hyperlipidemia are highly damaging for the liver. Fatty infiltration of the liver can also occur during pregnancy.

What is hepatocellular disease?

The liver can be affected by infections, drugs or toxic chemicals. The majority of liver problems are transient or acute in nature because the liver has great healing power. However, chronic hepatocellular disease can last for a long time and present with a variety of symptoms. The classic symptoms of diffuse hepatocellular liver disease include:
• Yellowish discoloration of the skin and eyes
• Abdominal pain
• Distension of the abdomen
• Severe itching of skin
• Dark or tea colored urine
• Pale stools
• Intermittent blood in the stools
• Extreme fatigue
• Nausea
• Loss of appetite

There are many disorders that can cause chronic liver disease and these include:
- Alcohol induced liver damage
- Hemachromatosis (excess iron deposition in the liver tissues)
- Hepatitis A
- Hepatitis B
- Hepatitis C
- Hepatitis D
- Hepatitis E
- Parasitic infections
- Liver masses
o Adenomas, which are generally benign
o Hepatocellular cancer
o Cysts
Wilson’s disease (deposition of copper into the liver)

Risk factors for liver disease include:
- Exposure to infected body fluids or blood
- Blood transfusions
- Tattoos or body piercing
- Certain herbs (Black cohosh, ma-huang, Chaparral, Comfrey, Germander, Greater celandine, Kava, Mistletoe, Pennyroyal, Skullcap, Valerian)
- Prescription medications like acetaminophen
- Diabetes mellitus
- Excessive alcohol use
- Intravenous drug use and sharing needles
- Exposure to toxic chemicals
- Having unprotected sex
Diagnosis of hepatocellular disorders includes:
- Blood tests which can measure liver function and presence of infections like hepatitis. The  blood tests can be used to follow the recovery after an infection or improvement in liver function.
- If any mass is suspected growing in the liver, then radiological tests like Ultrasound and CT scan are done
- Sometimes a liver biopsy may be required to determine the cause of liver problems. This small procedure can be done at the bedside using a small needle under local anesthesia.
The treatment of diffuse hepatocellular disease depends on the cause. While most cases can be treated with medications, some liver disorders may require surgery. If the liver is failing, the other option may be a liver transplant.
The best way to avoid liver disease is by preventing the problem in the first place. This means:
- Refraining from drinking excessive alcohol
- Avoiding promiscuous sexual behavior
- Avoiding use of intravenous drugs and sharing needles
- Avoiding tattoos and body piercing at unlicensed parlors
- Getting vaccinated with hepatitis B vaccine
- Using prescription medications wisely. Medications should not be mixed and not taken for prolonged time
- Avoiding contact with other people’s body fluids or blood. This also means avoiding sharing of personal care products.

Finally, one should eat healthy and exercise regularly. There are many causes of hepatocellular diseases, but by adopting a healthy life style, most of the disorders can be prevented.

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