Fatty liver occurs when there is an accumulation inside its cells of small droplets containing different types of fats(mainly fatty acids and triglyceride). It is a widespread pathology in the western world and in Spain, where it affects 25% of the population.

It can occurafter taking certain drugs, in people who consume significant amounts of alcohol (in which cases we call it fatty liver or alcoholic steatosis), but also in people who do not consume drugs or significant amounts of alcohol. It is in these latter cases when we use the term FATTY LIVER OR NON-ALCOHOLIC STEATOSIS.

 The causes are multiple

Although genetic predispositionis one of the causes of this pathology, it is not the only one, since other factors also play a role, among which we can highlight overweight and obesity, which fundamentally affects the increase in the abdominal perimeter. Fatty liver is a pathology that also develops especially in diabetic patients(more than half of the patientsdiagnosed with diabetes develop a fatty liver), and in patients with increased levels of fats such as cholesterol and triglyceride in the blood. When all these factors coincide, we say that the patient has metabolicsyndrome. Metabolic syndrome implies that a series of alterations occur in some of the proteins that regulate the formation and elimination of fats inside the liver cell, causing fat to accumulate inside small vacuoles or fat droplets. These gradually increase in size until they cause the rupture of the hepatic cell, and in affected patients it is reflected in frequently altered “liver transaminase” (enzymes found inside the hepatic cell and which pass into the blood, elevating their levels with the ruptures of the hepatocyte). Thisis often the only sign of the disease, asthepatient usually has no or very mild symptoms.

 The Risks

Most patients with non-alcoholic fatty liver have mild liver inflammation, and the likelihood of long-term severe liver lesions or complications in liver function is low. However,in 20% of cases, the damage caused to the liver is significant, and the patients may develop cirrhosis, thereby increasing the risk of liver failure or complications such as liver tumours.But this isn’t the only complication of fatty liver. It is knownthat the presence of significant hepatic steatosis is also an indirect cardiovascular risk,with these patients having a higher incidence of cardiac and vascular complications.The incidence of other tumours outside the liver is also higher among patients with the non-alcoholic fatty liver.

Diagnosis

Diagnosing non-alcoholic fatty liver in patients with the suspectedliver disease is a challenge. The study of these patients, at the first instance, has to rule out the existence of other coinciding liver pathologies,such as hepatitis or alcohol abuse, as well as those that could worsen the prognosis of the patients. It is also important to try to identify those cases when a patient has a fatty liver with more pronounced inflammation and is, therefore, more likely to have complications in the future. Detection of such cases allows special surveillance for this high-risk subgroup, as well as the implementation of a therapeutic plan based on the combination of a diet and physical exercise to reduce the overweight and insulin resistance usually present in diagnosed patients. Besides, the use of some drugsin certain circumstances can also help control and improve the disease and its associated comorbidities.

Some pains arevery familiar to all of us. One of them is back pain. This ailment is, for various reasons, one of the most frequent reasons for medical consultations both in adults and children, but why? As we approach back-to-schooland back-to-work time of the year, what recommendations can we use to prevent and alleviate these annoying pains?

Dr Antonio Narvaez, Head of the Traumatology Department at the Vithas Xanit International Hospital in Benalmádena tells us why our back hurts, and also offers us some advice on how to address this problem.

Back pain is very common among the general population and is largely due to bad postural habits in a spine with poorly exercised back musculature.

Back pain problems can vary according to patient’s age – in children they may be due to problems of scoliosis or small fractures in some parts of the vertebrae.In middle age patients, the back problems are mainly due to pathological intervertebral discsthat can trigger herniated discs and in elderly patients,the back pain is usually due toproblems in disc dehydration, resulting in nerve compressions and instabilities in the spine. Whetherwe are dealing with cervical or lumbar pain, usually in almost all cases the origin of the pain is in disc pathologies which are a commondenominator.

Recommendations for back-to-school… and work

Oftenwhen children complain of back pain at school, the main recommendation is to maintain good postures while studying, avoid carrying heavy loads on the back and do physical exercise.

For adults with back problems at work, the recommendations are similar, fundamentally postural changes and building muscle strength and flexibility.

We might avoid back pain or prevent its recurrence by improving our physical condition and learning and practisingproper body mechanics.

If we analyse the way we should hold our body, the correctposture is sitting with the back upright, avoiding flexure.We should choose a seat with good lower back support, armrests and a swivel base.

We must avoid, whenever possible, carrying the heavy load on our back, movements that twist or strainour back and avoid heavy lifting. Our spinal column is not designed to carry heavy loads. We should be using alternative weight-bearing systems so that our vertebrae and discs do not have to sufferthe weight, thus helping us maintain the health of our back.

Well-practisedsportsactivity can also help us to prevent back pain, because the strengthenmusculature stabilisesthe spine. However, it is important that we carry out the physical activity in a controlled way and whenever possible to be monitored by a good instructor, and to avoid exercises with heavy weights without being supervised.

We cantake measures to prevent or relieve most back pain episodes simply by following the recommendations given by the specialists in this field. However, in the case of severe pain, or development of further complications and symptoms, we should seek medicalhelp.