Non-Alcoholic Fatty Liver Disease
Medically Reviewed by Dr Aifric Boylan
Last updated on 10.07.2024
Non-alcoholic fatty liver disease (NAFLD) is a condition where there are high amounts of fat in the liver. It is also known as non-alcoholic steatohepatitis (NASH), which describes the subsequent process of liver inflammation. However, no matter what you call it, excess fat in your liver can lead to serious long-term health problems.
NAFLD is a common condition, affecting approximately 30% of Australians, and the rates continue to increase in line with obesity. It is more common in men and those over 50.
Associated conditions
NAFLD is associated with diabetes, high blood pressure, high cholesterol, and overweight/obesity. It is worsened by alcohol and some medications because the liver processes them, and certain infections that target the liver, like hepatitis. Importantly, however, NAFLD does occur in those who don’t drink alcohol at all.
Frequently, people with NAFLD will have diabetes, high blood pressure, high cholesterol, or have suffered a stroke or heart attack. All these other conditions need to be well managed in conjunction with their NAFLD.
Symptoms and diagnosis of Fatty Liver Disease
Usually, there are no symptoms of NAFLD, which can mean diagnosis is delayed. Less commonly, some people complain of fatigue, pain in the right upper part of the abdomen, and general feelings of malaise.
Because there are usually no symptoms, NAFLD is frequently picked up on routine blood tests through a GP, and liver function tests (LFTs) are requested. One or several liver markers can be elevated, which usually prompts an abdominal ultrasound to examine the liver in more detail. At times, more detailed investigation is necessary, including CT, MRI, and fibroscan, which is a non-invasive machine that checks the “stiffness” of the liver.
Progression and complications of Fatty Liver Disease
If NAFLD progresses to NASH or more severe liver disease, some people can have swelling in their ankles, a yellow tinge to their skin or eyes, and a swollen abdomen. Without treatment, NAFLD can lead to chronic inflammation in the liver, which can lead to cirrhosis (scarred liver) and liver cancer.
Treatment options of Fatty Liver Disease
- Weight loss: Weight loss is vitally the number one factor in resolving NAFLD and preventing complications. Bariatric surgery should be considered in those with a persistently high body mass index (BMI) who are unable to lose weight and have complications from their obesity.
- Exercise: Exercise is particularly beneficial if it increases muscle mass and helps lose excess weight.
- Diet: Avoiding fatty and processed foods, increasing vegetables, fish, and fruit in the diet, and choosing water instead of fizzy and flavoured drinks are crucial dietary changes.
- Avoiding medications and alcohol: Since medications and alcohol are processed by the liver, avoiding them helps to prevent the worsening of NAFLD.
Speak to your GP
There is no one specific drug or medication that can improve NAFLD. If you have it, you should engage with your GP regularly to check your LFTs and discuss your treatment plan, which could include referral to a dietitian, exercise physiologist, psychologist, or bariatric surgeon.
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