Understanding Non-Alcoholic Fatty Liver Disease (NAFLD): Causes, Symptoms, Diagnosis, and Treatment

Liver disease is often associated with the consumption of excessive amounts of alcohol. While this may result in the development of cirrhosis of the liver and other ailments, Non-Alcoholic Fatty Liver Disease (NAFLD) can affect those who consume little or no alcohol. NAFLD is an umbrella term for a range of liver conditions that arise when too much fat is stored in the liver. The condition is very prevalent in Western nations like the U.S.A. where an estimated 25% of the population suffers from it. In recent years with the adoption of more Western lifestyles and food habits in India, the ailment is being increasingly found here. In severe cases, NAFLD can develop into Non-alcoholic Steatohepatitis (NASH) where the liver becomes highly inflamed and scarred which may lead to the development of cirrhosis and liver failure. As the liver attempts to stop the inflammation, areas of scarring may develop, which is known as fibrosis. If the inflammation is not stopped, the fibrosis spread in the liver which, in the end, will cause liver failure.

The Causes

Scientists are still researching why some people develop the condition while others with similar lifestyles and diets do not. That said there is concrete evidence that the following factors are linked to the development of NAFLD and NASH:

Being overweight or obese
Lack of sufficient exercise
A diet that contains an excess of saturated fats, triglycerides and oils
High blood sugar is linked to type 2 diabetes
High LDL cholesterol levels
Metabolic syndrome
Polycystic ovary syndrome
Sleep apnea
Underactive thyroid (hypothyroidism)
Underactive pituitary gland (hypopituitarism)
Increasing age may also be a factor in the development of NAFLD

Any or all of these factors contribute to the development of fat deposits in the liver. When that happens, the following problems may appear:

Liver function is adversely affected
Toxins may buildup in the liver, causing the organ to become inflamed causing NASH
In the most severe cases, cirrhosis may develop

Also Read: Causes And Treatment Of Cirrhosis Of Liver

Symptoms

NAFLD often causes no noticeable signs or symptoms. People may live long lives without ever knowing that they suffer from the condition. However, once excess fat starts to be deposited in the liver, it can often progress into a more serious state. Among the most common signs of NAFLD are:

Pain and/or discomfort in the upper right region of the abdomen
Fatigue

If NAFLD has progressed into NASH, and scarring of the liver has developed or is starting to be present, then the possible symptoms include:

Enlarged blood vessels just below the surface of the skin
Yellowness of the eyes and skin (jaundice)
Redness of the palms
An enlarged spleen
Weight loss
Itching that is long-lasting and persistent

Diagnosis

Because NAFLD may not produce any symptoms, it is often only noticed when investigations are done to find another possible liver problem. The condition often comes to light when an ultrasound reveals a liver abnormality or a liver enzyme test produces abnormal results. Once the possibility of NAFLD exists, a variety of tests are done to confirm if it is present. These include:

A variety of blood tests
Various imaging procedures such as:
- Abdominal ultrasounds
- Abdominal CT scan
- MRI of the abdomen
A liver biopsy in which a small sample of the liver tissue is surgically removed for laboratory examination to determine the exact nature and extent of the condition.

Treatment

At present that is no medication or surgical procedure available for the treatment of NAFLD or NASH. However, various lifestyle changes can help to stop, or even reverse the progression of the disease. These include:

Weight loss
Regular and sufficient exercise
Lowering cholesterol and triglyceride levels
Avoiding alcohol consumption
Stopping smoking
Having a low-fat diet
Controlling diabetes
Controlling blood pressure (medication may be prescribed)
Controlling the use of over-the-counter medications. A doctor will advise on the ones to avoid or prescribe safer alternatives.

In addition to these actions, the most important is to consult a liver specialist who will be able to advise on the best treatment options based on the specific needs of each patient.

Prevention

There is no guaranteed way of avoiding the onset of NAFLD. However, there are some things a person can easily do to significantly reduce the risk of the development of the condition. These include:

Having a nutritious diet that is rich in fruits, vegetables, healthy fats and whole grains
Avoiding junk foods
Maintaining a healthy weight through diet control and getting enough exercise
Avoiding alcohol
Stopping smoking
Having regular health check-ups where the possible development of NAFLD will be noticed early

Also Read: 9 Symptoms of Liver Damage

It is easy to dismiss the signs of NAFLD as indigestion or a passing bout of fatigue, both of which are common occurrences. However, if the symptoms have become severe or chronic, then it is essential that a detailed examination is done to determine the cause and if NAFLD or NASH is the source of the problem. A person with suspected NALFD or a confirmed diagnosis that it is present should visit a multispecialty hospital that will have the medical specialists and cutting-edge medical technology and equipment required to diagnose the condition, evaluate how far it has progressed and prescribe a course of treatment. If NALFD has progressed to NASH and the liver has been damaged enough to cause end-stage liver failure, then the only option is for the patient to undergo a liver transplant.

With early diagnosis and medically supervised lifestyle changes a person with NAFLD may live a normal and active life, with no health concerns. The key is early diagnosis and appropriate treatment.

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Understanding Non-alcoholic Fatty Liver Disease

The Causes

Symptoms

Diagnosis

Treatment

Prevention

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