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Treatment of non-alcoholic fatty liver disease consists of identifying and treating all underlying conditions (type 2 diabetes), improving insulin resistance with lifestyle changes, and using antioxidants to protect the liver against cirrhosis. The treatment will however depend on the stage of the disease
Weight Loss
If you suffer from non-alcoholic fatty liver disease, the first step will be to gradually lose about 7 to 10% of your body weight. Weight loss remains the most effective way to eliminate liver fats.
In addition to limiting your kilojoule intake and exercising most of the time (aerobic and bodybuilding exercises), it is important to limit your intake of saturated fat. (found in meat and other products of animal origin), refined sugar (especially sugary drinks and juices), processed foods and alcohol. Your doctor and / or dietitian can recommend you to follow a Mediterranean diet rich in fiber and monounsaturated fats made from fish, nuts, seeds, olive oil and avocado.
Doctors sometimes use bariatric surgery to induce weight loss, improve insulin resistance, and improve glucose metabolism in people with non-alcoholic steatohepatitis (NASH), a more serious form of NASH . But these procedures, in which changes are made to the digestive system, should only be reserved for people who require drastic weight loss.
Drug
No drug was approved to specifically treat NAFLD . However, if you have insulin resistance or overt diabetes, your doctor may prescribe insulin-sensitizing medications, such as thiazolidinediones or metformin. Medications to treat high levels of cholesterol and other types of fat in the blood (dyslipidemia) and hypertension (hypertension) may also be prescribed.
Your doctor may also recommend that you get vaccinated against viral hepatitis to protect your liver. more damage. It will also check if you are taking any medicine that may make your condition worse and stop or change this medicine.
If you have been diagnosed with NASH and you do not have diabetes or cirrhosis, your doctor may also recommend taking antioxidants in the form of vitamin E.
Pioglitazone, a medicine against diabetes, may also be prescribed
Essential probiotics and phospholipids
Probiotics and essential phospholipids (EPL) are attracting growing interest in NAFLD management.
Research shows that a strain of bacteria called Lactobacillus rhamnosus GG may protect against the development of fructose-induced NAFLDs. However, no firm recommendation can yet be made and further research is needed to confirm the benefits of probiotics in the treatment of non-alcoholic fatty liver disease.
Some studies also show promising results with essential phospholipids. Taken as supplements, phospholipids appear to have anti-inflammatory, antioxidant, and lipid-regulating effects in the liver, while helping to regenerate liver cell membranes.
However, treating the major problems of overweight and lack of exercise remains the key.
Reviewed by Dr. Mark Sonderup, B Pharm, MB ChB, FCP (SA). Senior Specialist, Division of Hepatology, Department of Medicine, University of Cape Town and Groote Schuur Hospital. July 2018.
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