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Alcohol-induced liver disease
Alpha 1-antitrypsin deficiency
Benign liver tumors
Cholestatic liver disease
Non-alcoholic fatty liver disease
Primary biliary cirrhosis
Primary sclerosing cholangitis
Pancreatic neuroendocrine neoplasms
Familial adenomatous polyposis
Juvenile polyposis syndrome
Small bowel ischemia and infarction
Protein losing enteropathy
Short bowel syndrome (NORD)
Small bowel bacterial overgrowth syndrome
Diverticulosis and diverticulitis
Irritable bowel syndrome
Cleft lip and palate
Congenital diaphragmatic hernia
Diffuse esophageal spasm
Eosinophilic esophagitis (NORD)
Gastroesophageal reflux disease (GERD)
Cyclic vomiting syndrome
Gastric dumping syndrome
Dental caries disease
Gingivitis and periodontitis
Temporomandibular joint dysfunction
Appendicitis: Pathology review
Cirrhosis: Pathology review
Colorectal polyps and cancer: Pathology review
Congenital gastrointestinal disorders: Pathology review
Diverticular disease: Pathology review
Esophageal disorders: Pathology review
Gallbladder disorders: Pathology review
Gastrointestinal bleeding: Pathology review
GERD, peptic ulcers, gastritis, and stomach cancer: Pathology review
Inflammatory bowel disease: Pathology review
Jaundice: Pathology review
Malabsorption syndromes: Pathology review
Neuroendocrine tumors of the gastrointestinal system: Pathology review
Pancreatitis: Pathology review
Viral hepatitis: Pathology review
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Alcoholic and Non-alcoholic Fatty Liver Disease
Nonalcoholic fatty liver disease is actually a spectrum of disease, going from least to most severe—steatosis, steatohepatitis, fibrosis, and finally cirrhosis.
Nonalcoholic fatty liver disease results from fat deposition in the liver, which is unrelated to alcohol or viral causes.
Typically, it affects individuals with metabolic syndrome, which includes a combination of three of the following five diagnoses: obesity, hypertension, diabetes, hypertriglyceridemia, and hyperlipidemia.
Given how common metabolic syndrome has become, it’s not surprising that the rate of nonalcoholic fatty liver disease has also increased dramatically.
It’s a massive problem growing in lock-step with expanding waistlines, affecting about three quarters of all obese individuals, including many children.
Although the exact mechanism of nonalcoholic fatty liver disease isn’t clear, insulin resistance seems to play an important role.
Over time, insulin receptors on various tissues including the liver become less responsive to insulin, and as a result the liver goes into a mode where it increases fat storage and decreases fatty acid oxidation.
That means decreased secretion of lipids into the bloodstream, in the form of lipoproteins, and increased synthesis and uptake of free fatty acids from the blood, a process called steatosis.
Steatosis causes fat droplets to form within hepatocytes, some of which become large enough to cause the hepatocytes to swell up with fat and push the nuclei to the edge of the cell.
You can see this on a histopathology slide of the liver.
All of these white circles are large deposits of fat.
Zooming out and looking at the liver, you see widespread steatosis which makes the liver appear large, soft, yellow, and greasy.
Over time, that fat in the hepatocytes is vulnerable to degradation.
Unsaturated fatty acids, or fatty acids that have at least one double bond in their carbon chain, have hydrogen atoms that are especially vulnerable to initiators such as the reactive oxygen species like the hydroxyl radical that have an unpaired electron.
Non-alcoholic fatty liver disease (NAFLD) is a condition in which excess fat is deposited in the liver, leading to inflammation and scarring. NAFLD is a common liver disorder that affects people who do not drink alcohol excessively. NAFLD commonly affects people with metabolic syndrome, which includes a combination of three of the following five diagnoses: obesity, hypertension, diabetes, hypertriglyceridemia, and hyperlipidemia.
Symptoms of NAFLD may be subtle or absent in the early stages of the disease. In advanced stages, symptoms may include fatigue, abdominal pain, and jaundice. NAFLD can progress to a more serious condition called non-alcoholic steatohepatitis (NASH), which can lead to liver scarring and cirrhosis. Treatment for NAFLD may involve lifestyle changes such as weight loss, regular exercise, and a healthy diet to help reduce fat in the liver and improve insulin resistance.
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