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Fatty Liver (NAFLD/NASH)


What is Fatty Liver?

Nonalcoholic fatty liver disease (NAFLD) refers to a liver condition affecting people who drink little to no alcohol. The main characteristic of NAFLD is fat being abnormally stored in liver cells.
NAFLD is increasingly common around the world and it is thought to affect about one-quarter of the population of the United States.
Some individuals with NAFLD can develop nonalcoholic steatohepatitis (NASH), where the liver becomes inflamed from the fat. This inflammation may result in scarring (fibrosis) of the liver. As fibrosis worsens, some individuals will develop advanced scarring (cirrhosis) and potentially other complications.

What are the symptoms fatty liver?

NAFLD usually causes no signs or symptoms. However, patients may experience fatigue or discomfort in the right upper abdomen.
NASH typically has no associated symptoms. This condition will often be discovered by an elevation in liver enzymes found in blood work.
Cirrhosis may result in abdominal swelling from retained fluid (ascites), enlarged blood vessels just beneath the skin’s surface or in the esophagus, an enlarged spleen, red palms and or a yellowing of the skin and eyes (jaundice). This condition can be life threatening.
Risk factors
A wide range of diseases and conditions can increase your risk of NAFLD / NASH which may include:
High cholesterol / High triglycerides
Metabolic syndrome
Obesity, particularly when fat is concentrated around the abdomen
Polycystic ovary syndrome
Type 2 diabetes
Underactive thyroid (hypothyroidism)
The main complication of NAFLD and NASH is cirrhosis. Cirrhosis occurs in response to liver injury, such as the inflammation from NASH. As the liver tries to halt inflammation, it produces areas of fibrosis. With continued inflammation, fibrosis spreads to take up more and more liver tissue.
Cirrhosis can lead to many complications such as fluid buildup in the abdomen (ascites), swelling of veins in the esophagus (esophageal varices), confusion / drowsiness (hepatic encephalopathy) and even liver cancer (hepatocellular carcinoma). Patient with cirrhosis may also develop end-stage liver failure, which means the liver has stopped functioning.
Between 5% and 12% of people with NASH will progress to cirrhosis.
Steps in evaluation
If needed, your doctor will discuss with you steps to take in evaluating the condition of your liver. This may include blood tests, an ultrasound and or a FibroScan (for more information on FibroScan, please see this section under “Our Procedures.”)
Treatment options / Prevention:
To reduce your risk of NAFLD:
Choose a healthy diet rich in fruits, vegetables, whole grains and healthy fats.
Maintain a healthy weight. If you are overweight or obese, reduce the number of calories you eat each day and get more exercise. If you are a healthy weight, work to maintain it by choosing a healthy diet and exercising. Working with your practitioner or a dietician may help you keep on track.