The American Association for the Study of Liver Diseases has published in Journal of Hepatology magazine, new guidelines regarding the management of this disease.
There are several stages of evolution in liver diseases: F0 (healthy liver), F1 (liver with some inflammation and minimal fibrosis), F2 (with more intensity than F1), F3 (with a lot of fibrosis and in a pre-cirrhotic stage that otherwise treated evolves to cirrhosis) and F4 (liver cirrhosis). The tendency of fatty liver disease is to advance in stage until it ends in liver cirrhosis. The new guidelines recognize that for a fatty liver without inflammation the progression to a worse stage takes 14 years, while if there is inflammation and destruction of liver cells (steatohepatitis), only 7 years are necessary.
In fatty liver disease, it is important to determine if there is liver cirrhosis through a biopsy or other methods (Fibroscan,…) since its presence modifies the surveillance and medical reviews that the hepatologist must perform on the patient. Thus, in the event that there is cirrhosis, it is necessary to do biannual check-ups to detect the development of liver cancer, esophageal varices, etc. In patients with cirrhosis due to fatty liver, the probability of progressing to major complications (digestive bleeding, ascites, etc.) ranges between 3-20% per year.
In summary, fatty liver is a relevant disease, not only because of the large number of people affected throughout the world, but also because of the possibility of evolution to liver cirrhosis.
The group of hepatologists from our Foundation, headed by Dr. Carreño, has been making all these diagnostic and follow-up recommendations for several years.