Non-Alcoholic Fatty Liver Disease
Non-alcoholic fatty liver disease (NAFLD) is the term for a range
of conditions caused by a build-up of fat in the liver. It’s usually
seen in people who are overweight or obese.
A healthy liver should contain little or no fat. It’s estimated that up to
1 in every 3 people in the UK has early stages of NAFLD where there
are small amounts of fat in their liver.
Nonalcoholic fatty liver disease usually causes no signs and symptoms. When
it does, they may include:
- Enlarged liver
- Pain in the upper right abdomen.
Nonalcoholic fatty liver disease and nonalcoholic steatohepatitis are both
linked to the following:
- Overweight or Obesity.
- Insulin resistance, in which your cells don’t take up sugar in response
to the hormone insulin.
- High blood sugar (hyperglycemia), indicating prediabetes or actual
type 2 diabetes.
- High levels of fats, particularly triglycerides, in the blood.
These combined health problems appear to promote the deposit of fat in the liver.
For some people, this excess fat acts as a toxin to liver cells, causing liver
inflammation and nonalcoholic steatohepatitis, which may lead to a
buildup of scar tissue (fibrosis) in the liver.
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Stages of NAFLD
NAFLD develops in 4 main stages.
Most people will only ever develop the first stage, usually without realising it.
In a small number of cases, it can progress and eventually lead to liver damage
if not detected and managed.
The main stages of NAFLD are:
- simple fatty liver (steatosis) – a largely harmless build-up of fat in the liver
cells that may only be diagnosed during tests carried out for another
- non-alcoholic steatohepatitis (NASH) – a more serious form of NAFLD,
where the liver has become inflamed; this is estimated to affect up to 5%
of the UK population
- fibrosis – where persistent inflammation causes scar tissue around the
liver and nearby blood vessels, but the liver is still able to function
- cirrhosis – the most severe stage, occurring after years of inflammation,
where the liver shrinks and becomes scarred and lumpy; this damage is
permanent and can lead to liver failure (where your liver stops working
properly) and liver cancer.
It can take years for fibrosis or cirrhosis to develop. It’s important to make
lifestyle changes to prevent the disease getting worse.
How it’s diagnosed ?
NAFLD usually has no symptoms. So diagnosing the problem often starts after
a blood test finds higher-than-normal levels of liver enzymes. A standard
blood test could reveal these results.
High levels of liver enzymes could also suggest other liver diseases. Your doctor
will need to rule out other conditions before diagnosing NAFLD.
An ultrasound of the liver can help reveal excessive fat content in the liver.
Another type of ultrasound, called transient elastography, measures your
liver’s stiffness. Greater stiffness suggests greater scarring.
If these tests are inconclusive, your doctor may recommend a liver biopsy.
In this test, the doctor removes a small sample of liver tissue with a
needle inserted through your abdomen. The sample is studied in a
lab for signs of inflammation and scarring.
If you have symptoms such as right-side abdominal pain, jaundice, or
swelling, don’t hesitate to see a doctor.
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