Non Alcoholic Fatty Liver Disease (NAFLD)- By definition NAFLD is a spectrum of many manifestations of this emerging disease of the liver in the US and around the world. With increasing incidence of obesity, more patients will have NAFLD, it is estimated that approximately 25% of individuals in the US have NAFLD.
NAFLD is the result of increased accumulation of fatty deposits (steatosis) in the liver cells. Healthy liver tissue generally has 0-5% fatty tissue.
NAFLD is common in those individuals who are obese, have history of Diabetes, known history of elevated cholesterol including triglycerides. Some individuals may not have all these risk factors and still develop fat deposition in the liver.
Fat deposition (steatosis) can cause liver inflammation (steatohepatitis) which with time can cause buildup of scar in the liver (fibrosis).
NASH (Nonalcoholic Steatohepatitis) is the consequence of the cycle of fat (steatosis) causing inflammation in the liver. It affects middle aged individuals who are obese with Diabetes and elevated triglycerides. As this cycle of liver inflammation (hepatitis) and steatosis (fat) deposition continues it results in significant scarring of the liver and it can evolve to cirrhosis (completely scarred liver). Cirrhosis increases risk of liver cancer and other complications which can only be reversed in appropriate patients with a liver transplant.
How do you know you have it?
Individuals may have very non-specific symptoms of fatigue, lack of endurance to having symptoms of advanced liver failure like jaundice (yellowish discoloration of skin), leg swelling (edema), belly swelling or onset of umbilical hernia (ascites from fluid accumulation in the belly).
Please talk to your doctor if you have Diabetes, elevated triglycerides and are overweight and have abnormal liver function tests to be screened for NAFLD. Ultrasound of the abdomen is a good screening test to determine fatty liver (NAFLD). NASH which is a severe of NAFLD can be confirmed by liver biopsy. Approximately a quarter of individuals with NASH have cirrhosis of the liver.
What can you do about it?
If you have NAFLD and early scarring of the liver from NASH, you can prevent further liver disease progression by decreasing your weight if you are obese from where you are currently by 7-10 %, refrain from alcoholic beverages, optimize your blood sugar management and treat your triglycerides. Nutrition counseling would be ideal to adjust your caloric intake. There is tremendous research to help reduce the long term burden of this growing illness with new molecules that are being studies in clinical trials.
A healthy diet, regular exercise and maintaining an ideal body weight will all be beneficial both for your general health and also a healthy liver.