The Non Alcoholic Fatty Liver Strategy™ By Julissa Clay the program discussed in the eBook, Non Alcoholic Fatty Liver Strategy, has been designed to improve the health of your liver just by eliminating the factors and reversing the effects caused by your fatty liver. It has been made an easy-to-follow program by breaking it up into lists of recipes and stepwise instructions. Everyone can use this clinically proven program without any risk. You can claim your money back within 60 days if its results are not appealing to you.
How does NASH progress to cirrhosis?
Non-Alcoholic Steatohepatitis (NASH) progresses to cirrhosis by a series of events involving inflammation, injury to liver cells, and fibrosis. This is how NASH typically causes cirrhosis:
1. Fatty Liver (Steatosis)
It begins with simple fatty liver (steatosis), when there is increased fat accumulation in liver cells. It is a symptomless process and does not involve inflammation of the liver.
Even though fat deposition per se is not harmful, it is an insult that establishes a setting for inflammation and liver damage if its root causes (obesity, insulin resistance, or metabolic syndrome) are not addressed.
2. Inflammation Development (NASH)
The second step is Non-Alcoholic Steatohepatitis (NASH), where liver inflammation is the consequence of fat deposition. It leads to liver cell injury and death. It is characterized by:
Fat deposition within liver cells.
Inflammation of liver tissue.
Damage to liver cells, which elicits an immune response.
The liver cell damage and inflammation cause oxidative stress, which in turn results in the release of harmful substances that increase liver damage. This causes the release of inflammatory cytokines and the activation of liver cells called stellate cells, which begin producing scar tissue.
3. Fibrosis (Scar Tissue Formation)
As the inflammation continues in the liver, the liver begins to heal itself by developing fibrous tissue. This is called fibrosis. The liver tries to repair the damage but does so in the form of scar tissue.
The fibrous tissue builds up over time and disrupts the normal structure and function of the liver. Initially, fibrosis may be slight and localized, but with repeated inflammation and injury, it is more widespread.
Fibrosis can be divided into stages (F1-F4), with F1 being mild fibrosis and F4 being severe fibrosis (cirrhosis). With progression of fibrosis, the functioning of the liver is increasingly impaired.
4. Cirrhosis
Cirrhosis is the final stage of liver fibrosis. At this point, extensive scar tissue has invaded much of the normal liver tissue, significantly impairing the liver’s ability to function. This stage is defined by:
Severe liver scarring.
Disruption of liver function, including inability to detoxify the blood, synthesize proteins such as albumin, and regulate metabolism.
Development of complications such as portal hypertension (increased pressure within the liver’s blood vessels), liver failure, and liver cancer (hepatocellular carcinoma).
Cirrhosis is typically irreversible, and liver transplantation can be required in advanced cases at this stage.
Factors That Cause More Rapid Progression of NASH to Cirrhosis
Obesity: Visceral fat and total body fat substantially contribute to insulin resistance, resulting in enhanced fat accumulation in the liver and inflammation.
Insulin Resistance and Type 2 Diabetes: Insulin resistance and hyperglycemia result in fat accumulation in the liver and make the liver susceptible to inflammation and fibrosis.
Genetics: Genetic play is present in the pace of progression of NASH to cirrhosis. Some other persons have genetic variability that makes them susceptible to liver injury and fibrosis.
Age: Older individuals are at increased risk for progression because the ability of the liver to regenerate is reduced with advancing age.
Male Sex: Males are predisposed to having more severe liver disease, i.e., cirrhosis, than females.
Metabolic Syndrome: The presence of high cholesterol, hypertension, and elevated triglycerides increases the likelihood of progression from NASH to cirrhosis.
Alcohol Consumption: NASH is not caused by alcohol, but excessive alcohol consumption may increase liver damage and hasten cirrhosis development.
Other Liver Diseases: Hepatitis C or autoimmune liver disease may worsen NASH and cause cirrhosis.
How Long Before NASH Becomes Cirrhosis?
Years or even decades are needed for the progression of NASH to cirrhosis, depending on factors such as one’s lifestyle, underlying condition, and heredity. Slow progression might be observed in some, but in others, liver function is severely worsened quickly.
Preventing Progression
Lifestyle Modification: The primary and initial step in preventing NASH from progressing to cirrhosis is regulation of the risk factors through weight loss, diet change, and exercise. Reduction of weight may reduce liver inflammation and fat.
Control of Diabetes and Cholesterol: Proper control of diabetes, cholesterol, and other metabolic syndrome-related factors helps in preventing additional liver damage.
Avoidance of Alcohol: NASH is not caused by alcohol, yet alcohol is capable of enhancing liver damage and accelerating cirrhosis development, so it is recommended to avoid alcohol or consume it in moderation.
Conclusion
NASH progresses to cirrhosis through an intermediate pathway involving fat deposition, inflammation, liver cell injury, fibrosis, and finally scarring. Early identification and dietary changes are crucial in preventing or slowing the disease and preventing severe liver damage. NASH patients need close observation and medical care to track the disease and prevent cirrhosis and other complications.
Cryptogenic cirrhosis is a type of liver cirrhosis whose etiology remains undetermined even upon extensive investigation. “Cryptogenic” means “of unknown etiology,” thus despite investigation of potential etiologies (e.g., chronic alcohol use, viral hepatitis, autoimmune disease), no etiology can be identified specifically. It is in most cases believed to be linked with non-alcoholic fatty liver disease (NAFLD), like non-alcoholic steatohepatitis (NASH), because the condition usually progresses to cirrhosis with no definite etiology.
Key Features of Cryptogenic Cirrhosis:
Unidentified Cause: The predominant feature of cryptogenic cirrhosis is that after thorough evaluation, doctors cannot identify a specific reason for the cirrhosis. The diagnosis is made once the usual suspects such as alcohol, hepatitis B or C infection, autoimmune illness, or familial disorders like hemochromatosis have been eliminated.
Advanced Liver Damage: Cryptogenic cirrhosis is advanced liver damage, where the liver is seriously scarred (fibrosed) from chronic injury or inflammation, and is dysfunctional. It may lead to complications such as portal hypertension, liver failure, and hepatocellular carcinoma (liver cancer).
Symptoms of Cirrhosis: Patients with cryptogenic cirrhosis might have the following common symptoms of cirrhosis:
Fatigue
Jaundice (yellowing of skin and eyes)
Abdominal swelling (ascites)
Easy bruising or bleeding
Confusion (secondary to hepatic encephalopathy)
Itchy skin
Varices (stretched veins of the esophagus or stomach)
Association with Fatty Liver Disease:
Cryptogenic cirrhosis is considered to be a progression of non-alcoholic fatty liver disease (NAFLD), particularly its severe form, non-alcoholic steatohepatitis (NASH). They are as follows:
Non-Alcoholic Fatty Liver Disease (NAFLD):
NAFLD is a fat accumulation in the liver with minimal or no inflammation or liver damage. It’s most often associated with obesity, type 2 diabetes, insulin resistance, and other metabolic risk factors.
Steatosis may progress to NASH, which involves inflammation, liver cell damage, and potential fibrosis (scarring).
Non-Alcoholic Steatohepatitis (NASH):
NASH is the more advanced form of NAFLD, and it can lead to cirrhosis in the long term. It is related to fat accumulation, inflammation, and liver cell injury. NASH-induced injury and inflammation can lead to fibrosis, and, if left untreated, it can progress to cirrhosis.
Evolution to Cryptogenic Cirrhosis
In some patients, NASH or NAFLD progresses to cirrhosis. When the etiology of cirrhosis cannot be determined (e.g., no significant alcohol use, viral hepatitis, or autoimmune illness), it is termed cryptogenic cirrhosis.
Fatty liver disease, particularly NASH, more and more is being considered a robust risk factor for cirrhosis to ensue in the lack of other attributable causes.
Metabolic Syndrome: The risk factors for NASH and NAFLD—diabetes, obesity, and insulin resistance—are likewise common risk factors for cryptogenic cirrhosis. In fact, the majority of cases of cryptogenic cirrhosis are thought to be the result of metabolic diseases causing fat accumulation in the liver and consequent liver damage.
Diagnosis of Cryptogenic Cirrhosis:
Diagnosis of cryptogenic cirrhosis is often made after exclusion of other common causes of cirrhosis, e.g., alcoholic liver disease, chronic viral hepatitis (B or C), autoimmune hepatitis, and inherited diseases such as hemochromatosis or Wilson’s disease. This may entail:
Blood investigations (to rule out viral or autoimmune liver disease)
Imaging (ultrasound, CT, or MRI to detect liver abnormality)
Liver biopsy (in a selected group) to measure liver damage and fibrosis
FibroScan or elastography (non-invasive tests of liver stiffness or scarring)
Treatment of Cryptogenic Cirrhosis:
Since the cause is unknown, treatment consists of treating liver complications and preventing further damage. In individuals whose cirrhosis is secondary to fatty liver disease (e.g., NASH), lifestyle modifications are crucial:
Weight loss: Gradual weight loss (5-10% of body weight) can reduce liver fat and improve liver function.
Healthy diet: A diet low in fat, sugar, and processed foods, and high in fruits, vegetables, whole grains, and lean proteins, is recommended.
Exercise: Regular physical activity can improve insulin sensitivity and help manage metabolic risk factors.
Control of underlying conditions: Managing diabetes, cholesterol, and blood pressure can prevent further liver damage.
Liver transplant: In cases of end-stage cirrhosis with liver failure, a liver transplant may be necessary.
Conclusion:
Cryptogenic cirrhosis is cirrhosis of the liver with no apparent cause, and it is usually associated with non-alcoholic fatty liver disease (NAFLD) and its more severe form, non-alcoholic steatohepatitis (NASH). Both diseases are related through the cascade of liver fat accumulation and inflammation that can lead to liver fibrosis and cirrhosis. Lifestyle change, including weight reduction, dietary modification, and exercise, is a mainstay in managing the etiology and arresting progression to severe liver damage.
The Non Alcoholic Fatty Liver Strategy™ By Julissa Clay the program discussed in the eBook, Non Alcoholic Fatty Liver Strategy, has been designed to improve the health of your liver just by eliminating the factors and reversing the effects caused by your fatty liver. It has been made an easy-to-follow program by breaking it up into lists of recipes and stepwise instructions. Everyone can use this clinically proven program without any risk. You can claim your money back within 60 days if its results are not appealing to you