What is Non-Alcoholic Fatty Liver Disease (NAFLD)?

Non-Alcoholic Fatty Liver Disease (NAFLD) is a surplus of fat accumulation in the liver. NAFLD is also referred to as fatty liver disease. Too much fat in the liver can cause inflammation that can damage and scar your liver. This condition is not the result of alcohol consumption (which can also impact your liver). In the most serious cases, NAFLD can lead to liver failure.

Types of Non-Alcoholic Fatty Liver Disease (NAFLD)

There are two different types of Non-Alcoholic Fatty Liver Disease:

• Simple fatty liver: This is when there is fat in your liver, but there is little inflammation or damage to your liver. Most people with NAFLD have simple fatty liver. This is the less serious of the two types of NAFLD.
• Nonalcoholic steatohepatitis (NASH): This is the more serious type of NAFLD. NASH means there is inflammation in the liver. Inflammation in your liver can cause liver scarring and liver cancer.

Signs & Symptoms

In many cases, NAFLD causes no noticeable fatty liver disease symptoms. However, some individuals with NAFLD develop complications, including liver scarring, also known as liver fibrosis. If the liver fibrosis is severe, it can lead to cirrhosis.

Other Non-alcoholic fatty liver disease signs and symptoms include:

• Swollen belly
• Tenderness
• Loss of appetite
• Weight loss
• Confusion
• Enlarged breasts (in men)
• Swollen legs
• Abdominal pain
• Fatigue
• Itchy skin
• Jaundice (Yellowish skin and eyes)
• Weakness

There may also be clusters of blood vessels under your skin and discomfort in the upper right side of your belly where your liver is located. If you or a loved one experience any of the signs of fatty liver disease, the providers at Baptist Health are here to help.

Causes

NAFLD develops when the body produces too much fat or does not metabolize it efficiently, leaving excess fat stored in the liver. The buildup of fat in the liver can be caused by several different issues. There is no clear consensus on Non-alcoholic fatty liver disease causes.

Doctors do know that the following factors can contribute to fatty liver disease:

• Obesity
• High levels of fat in the blood
• Elevated blood sugar
• Some infections (Such as Hepatitis C)
• Fast weight loss
• Resistance to insulin
• Medication side effects
• Certain toxins
• Certain genes
• Age (risk increases with age)
• Undernourishment
• Gallbladder removal
• Diabetes
• High blood pressure
• Sleep apnea

Postmenopausal women and individuals of Hispanic or Asian descent appear most prone to develop fatty liver disease.

Diagnosis

Since fatty liver disease has few recognizable symptoms, NAFLD diagnosis usually starts when a doctor spots elevated liver enzymes on a blood test for another condition. Raised levels of liver enzymes indicate a damaged liver. Enzymes are proteins in cells that create chemical reactions in the body.

Your doctor might use a few specific tests to make a diagnosis of Non-alcoholic fatty liver disease.

Common diagnostic tests include:

• Ultrasound or computed tomography (CT scan): These tests are used to capture images of your liver.
• Liver biopsy: A liver biopsy is when your doctor examines a small sample of liver tissue to determine the progression of advanced liver disease.
• FibroScan®: This is a specialized ultrasound that measures scarring in the liver.

The prognosis for the condition depends on a person’s general health, age, medical history, and the severity of damage and scarring in the liver.

Treatment

There is currently no medication prescribed to treat fatty liver disease. However, since there is a strong association between obesity and Non-alcoholic fatty liver disease, losing weight and a nutritional diet are often major factors in improving the condition. Losing weight helps reduce liver enzymes, inflammation, and scarring.

Individuals who struggle with losing weight may have the option to undergo weight loss surgery. Anyone with complications due to NASH may require a liver transplant.

Certain lifestyle changes can serve as a form of NFLD treatment:

• Limiting sugar
• Limiting salt
• Eating more vegetables
• Consuming whole grains
• Getting regular exercise

Complications

The main complication of fatty liver disease is severe scarring of the liver called cirrhosis.

Cirrhosis of the liver can cause the following possible effects:

• Accumulation of stomach fluid
• Drowsiness
• Confusion
• Cancer of the liver
• Liver failure

These complications are serious and can be scary for anyone with NAFLD. It may be helpful to remember that cirrhosis is rare and that your doctor can help you navigate your treatment options for the best possible outcome.