Fatty Liver and Steatohepatitis

We have known for some time that patients with metabolic syndrome and diabetes type 2 have a high incidence of fat in the liver, called fatty liver. In some cases, this seems to induce an inflammation in the liver. This is called steatohepatitis. This inflammation can then lead to severe scarring and cirrhosis. In fact, fat in the liver is now the most common cause for a liver transplant in the US.

It was thought for a long time that the high-fat diet was the cause of fatty liver. Now we know that that idea was wrong. What we now know is that people with the metabolic syndrome, obesity and diabetes type 2 have an abnormal mix of bacteria within their gut, specifically the large bowel or colon. This seems to be caused by the type of diet they eat. The bowel wall becomes inflamed and leaky. Parts of bacteria and even toxic metabolic products that bacteria make then slide through the colon wall and reach the liver. It is here that they cause a fatty liver, inflammation and even cirrhosis.

This medical article outlines the current medical thinking about this condition.

Gut microbiota and liver disease

The following article also outlines the association between liver disease and an abnormal make up of bacteria within the gut.

Interactions Between the Intestinal Microbiome and Liver Diseases

This third article is another closely reasoned association between the gut and a fatty liver. It speaks to the need to change the makeup of the gut bacteria. We still don’t know exactly how to do this but the evidence is very strong that a plant-based diet is necessary. This should include large portions of vegetables that are rich in prebiotics. A reduction in the animal meat portion of the diet is also recommended.

Microbiota and nonalcoholic steatohepatitis