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Nonalcoholic Fatty Liver Disease(NAFLD, Nonalcoholic Steatohepatitis [NASH])
Definition

Nonalcoholic fatty liver disease involves the build-up of fat in the liver of people who drink little or no alcohol. It is a common condition. NAFLD may not cause any problems if it is mild. In some cases, it can cause inflammation and scarring in the liver. If this is severe, it can cause liver failure.

The Liver

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Causes

When the liver is unable to break down fats, they build up in liver tissue. Many conditions and diseases make it difficult for the liver to break down fats.

Risk Factors

NAFLD is more common in men and with increasing age. Other factors that increase your chance of developing NAFLD include:

Symptoms

This disease often causes no symptoms. If fatty build-up is causing the liver not to function well, you may have symptoms. Symptoms may include:

  • Fatigue
  • Pain in the upper right side of the abdomen
  • Muscle weakness
  • Jaundice
  • Itchy skin
  • Lack of appetite
  • Weight loss
  • Nausea

NAFLD should be treated as soon as possible. Untreated NAFLD can progress to cirrhosis and increase your risk of other conditions, such as chronic kidney disease.

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done.

Tests may include:

  • Blood tests—to look for raised liver enzymes
  • Ultrasound—a test that uses sound waves to examine the liver
  • CT scan —a type of x-ray that uses a computer to make pictures of structures inside the abdomen
  • Liver biopsy —a small piece of your liver is removed and examined
Treatment

Treatment focuses on the factors that are causing fatty liver disease. Talk with your doctor about the best treatment plan for you. Treatment may focus on avoiding certain medications, chemicals, or lifestyle factors that can damage your liver.

Weight Loss

Weight loss of 10% of a person's body weight has been shown to cure the disease. If you are overweight, your doctor may recommend weight loss through:

  • Healthy eating
  • Exercise
  • Behavioral therapy
  • Medication
  • Bariatric surgery in serious cases
Medications

Your doctor may recommend medications to control the condition causing NAFLD.

Prevention

To reduce your chance of getting fatty liver disease, take the following steps:

  • Maintain a healthy weight by eating a diet that is rich in fruits and vegetables , whole grains, and unsaturated fats.
  • Get at least 30 minutes of daily exercise.
  • Manage other medical conditions as directed by your doctor.

RESOURCES:

American Gastroenterological Association
http://www.gastro.org

American Liver Foundation
http://www.liverfoundation.org

CANADIAN RESOURCES:

The Canadian Association of Gastroenterology
http://www.cag-acg.org

Canadian Liver Foundation
http://www.liver.ca

References:

Bayard M, Holt J, Boroughs E. Nonalcoholic fatty liver disease. Am Fam Physician. 2006;73(11):1961-1968.

Nonalcoholic fatty liver disease. American Liver Foundation website. Available at: http://www.liverfoundation.org/abouttheliver/info/nafld. Updated October 4, 2011. Accessed May 14, 2013.

Nonalcoholic fatty liver disease. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated November 9, 2012. Accessed May 14, 2013.

Nonalcoholic steatohepatitis. National Digestive Diseases Information Clearinghouse website. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/nash. Updated April 30, 2012. Accessed May 14, 2013.

1/31/2008 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Zaman A. Promote weight loss in patients with NAFLD. NEJM Journal Watch. Published September 24, 2013. Accessed October 1, 2013.

10/8/2014 1/31/2008 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Musso G, Gambino R, et al. Association of non-alcoholic fatty liver disease with chronic kidney disease: a systematic review and meta-analysis. PLoS Med. 2014;11(7):e1001680.



Last reviewed March 2014 by Daus Mahnke, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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