Stomach-Related Symptoms Triggered By A Fatty Liver

The human body is complex, where one organ can impact the health of another. For instance, a troubled liver may take a toll on one’s digestive system, leading to stomach-related issues. Together, the two organs perform several functions and share many roles. In an interaction with the OnlyMyHealth team, Dr Vijay Kumar HJ, MD, DM Gastroenterology Consultant, Gastroenterologist and Hepatologist, Apollo Clinic, HSR Layout, discusses the link between the liver and the gut.

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The Link Between The Digestive System And The Liver

“The digestive system and the liver are closely linked and work together to process and metabolise nutrients, as well as eliminate waste from the body,” said Dr Kumar, adding, “The liver is one of the largest organs in the human body and plays a crucial role in digestion.”

“When you eat, food passes through the digestive system, starting from the mouth and travelling through the oesophagus to the stomach and then the small intestine. In the small intestine, nutrients from the food are absorbed into the bloodstream. This is where the link between the digestive system and the liver comes into play,” he explained.

According to the doctor, after absorbing nutrients, the small intestine sends them to the liver through a network of blood vessels called the hepatic portal system. The hepatic portal vein carries blood from the intestines, pancreas, and spleen to the liver. The liver acts as a filter, processing and regulating the levels of nutrients, toxins, and other substances in the blood.

How Does A Fatty Liver Affect The Gut

Fatty liver disease, also known as hepatic steatosis, occurs when excess fat accumulates in the liver. Fatty liver disease is often associated with low-grade inflammation in the liver, known as Non-Alcoholic Steatohepatitis (NASH). According to Dr Kumar, this inflammation can extend beyond the liver and affect the gut. It has also been linked to alterations in the gut microbiota composition and diversity. 

There are two main types of fatty liver disease:

Non-alcoholic fatty liver disease (NAFLD): This is the most common form of fatty liver disease and occurs in people who do not consume excessive amounts of alcohol. NAFLD is typically associated with obesity, insulin resistance, metabolic syndrome, and other risk factors such as diabetes and high cholesterol.

Alcoholic fatty liver disease (AFLD): This type of fatty liver disease is caused by excessive alcohol consumption. The liver metabolises alcohol, and heavy or prolonged alcohol intake can lead to the accumulation of fat in the liver cells. AFLD can progress from simple fatty liver to more severe conditions such as alcoholic hepatitis and alcoholic cirrhosis if alcohol consumption continues.

In India, the prevalence of adult NAFLD in India has been reported between 6.7% and 55.1%, as per a study published in the Journal of Clinical and Experimental Hepatology.

Dr Kumar explains how the excessive fat accumulation in the liver can impair the normal functioning of the intestinal barrier, allowing substances that are normally restricted to the gut lumen to pass through the intestinal wall and enter the bloodstream. “When the liver is affected by excess fat, it may lead to changes in bile acid composition and impaired bile flow. These alterations can impact the digestion and absorption of dietary fats, leading to further complications in the gut,” he said. 

Also Read: What Your Bowel Movement Reveals About Your Gut Health

Digestive Symptoms Associated With Fatty Liver

Fatty liver disease can be associated with various digestive issues. Some people with fatty liver disease may experience gastrointestinal symptoms, such as:

• Abdominal pain
• Bloating and discomfort

“These symptoms can be caused by inflammation in the liver or associated gut inflammation.” the doctor said, adding that it can lead to malabsorption of essential vitamins, minerals, and other nutrients, in turn resulting in deficiencies and further digestive issues.

In addition, Dr Kumar shared, “Fatty liver disease has been associated with increased intestinal permeability, or leaky gut syndrome. This condition compromises the integrity of the intestinal barrier, allowing toxins, bacteria, and undigested food particles to enter the bloodstream.” “This can trigger inflammation and contribute to digestive symptoms like abdominal pain and bowel irregularities," he concluded.