What is Nonalcoholic Fatty Liver Disease?

Nonalcoholic fatty liver disease (NAFLD) refers to a common disorder in which excess fat builds up in the liver, but not due to heavy alcohol consumption. It’s estimated that 30 to 40 percent of U.S. adults have NAFLD. The most common form of the disease, fatty liver, is considered non-serious, as it is believed not to cause permanent damage. However, a small percentage of people with fatty liver will develop a more serious condition, nonalcoholic steatohepatitis (NASH), which may lead to severe liver scarring and cirrhosis, eventually resulting in the inability of the liver to work properly. Its prevalence has made NAFLD one of the leading causes of liver transplants in the U.S.

Risk Factors

Researchers have discovered that certain genes could make some people more susceptible to developing NAFLD. However, the most common risk factors are obesity, Type 2 diabetes, insulin resistance syndrome and high blood lipids (like triglycerides or cholesterol). As the number of patients with these metabolic conditions have risen, the prevalence of NAFLD is also on the rise. Less common causes for fatty liver include rapid weight loss; certain infections, such as hepatitis C; exposure to toxins, including illicit drugs and workplace chemicals or solvents; and medications used to treat HIV, seizures, heart arrhythmias and other health conditions.

Symptoms

People of any race, ethnicity, or age may develop NAFLD, including children, although the disease becomes more common with age. Both NAFLD and NASH are considered “silent diseases,” as they rarely cause any symptoms. As NASH progresses into cirrhosis, patients may experience tiredness and pain in the upper-right side of their abdomen. Advanced cirrhosis may cause swelling in the belly or legs, vomiting of blood, and mental confusion.

Diagnosis

If a doctor suspects NAFLD, he or she will collect a medical and family history and conduct a physical exam, looking for the following signs:

1. Enlarged liver
2. Signs of insulin resistance
3. Symptoms of cirrhosis, such as jaundice (yellowing of the skin and whites of the eyes)
4. Signs of advanced cirrhosis

Typically, a doctor will order blood tests to check for high levels of the liver enzymes alanine aminotransferase (ALT) and aspartate aminotransferase (AST) and imaging tests, such as ultrasound, computerized tomography (CT) scans, magnetic resonance imaging (MRI), and transient elastography, also known as Fibroscan. Depending on the results of these tests, the doctor may order a biopsy to check for liver inflammation and damage.

Treatment

Currently, no drug treatments have been approved to treat NAFLD, but efforts are underway to develop medications to help improve the condition. While some studies have shown that supplements may help improve the condition, patients should always consult with their health care provider before taking any supplemental vitamins or supplements, as some remedies may actually damage the liver.

Making wise dietary choices, combined with losing weight, can help reverse NAFLD. A weight reduction of just 3-5% can reduce the amount of fat in the liver, while a 10% loss can lessen swelling. Doctors recommend losing weight slowly, however, as rapid weight loss can make NAFLD worse. Patients are often referred to a nutritionist or dietician for guidance.

If you are diabetic or overweight, talk to your doctor about screening for fatty liver. Or call us at 815-397-7340 if you have questions about these conditions or any digestive issues you may be facing.