What is nonalcoholic fatty liver?
Nonalcoholic fatty liver (nonalcoholic steatohepatitis) disease is a term for people who are affected by liver conditions drink but little to no alcohol. As the name implies, the main characteristic of nonalcoholic fatty liver disease is too much fat stored in liver cells.
Nonalcoholic steatohepatitis which is a potentially serious form of the disease is marked by severe liver inflammation (which may progress to scarring and irreversible damage). This damage is similar to the damage caused by heavy alcohol use. At its most severe, nonalcoholic steatohepatitis can progress to cirrhosis and liver failure. If the process isn’t interrupted, cirrhosis can lead to:
- Fluid buildup in the abdomen (ascites)
- Swelling of veins in your esophagus (esophageal varices), which can rupture and bleed
- Confusion, drowsiness and slurred speech (hepatic encephalopathy)
- Liver cancer
- End-stage liver failure, which means the liver has stopped functioning
How common is nonalcoholic fatty liver?
This health condition is extremely common. It can affect patients at any age, especially in people in their 40s and 50s who are at high risk of heart disease because of such risk factors as obesity and type II diabetes. It can be managed by reducing your risk factors. Please discuss with your doctor for further information.
What are the symptoms of nonalcoholic fatty liver?
The common symptoms of nonalcoholic fatty liver are
- Enlarged liver
- Pain in the upper right abdomen
Possible signs and symptoms of nonalcoholic steatohepatitis and cirrhosis (advanced scarring) include:
- Abdominal swelling (ascites)
- Enlarged blood vessels just beneath the skin’s surface
- Enlarged breasts in men
- Enlarged spleen
- Red palms
- Yellowing of the skin and eyes (jaundice)
There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.
When should I see my doctor?
If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.
What causes nonalcoholic fatty liver?
Nonalcoholic fatty liver is a condition caused by high-fat level in the liver. Diabetes, or pre-diabetes (insulin resistance), being overweight or obese, elevated blood lipids such as cholesterol and triglycerides, as well as high blood pressure can be a cause of this condition.
Researchers are focusing on several factors that may be related to the development of nonalcoholic fatty liver. These include:
- Oxidative stress (imbalance between pro-oxidant and antioxidant chemicals that lead to liver cell damage)
- Production and release of toxic inflammatory proteins (cytokines) by the patient’s own inflammatory cells, liver cells, or fat cells
- Liver cell necrosis or cell death (apoptosis)
- Adipose tissue (fat tissue) inflammation and infiltration by white blood cells
- Gut microbiota (intestinal bacteria) which may be considered as a cause of liver inflammation
What increases my risk for nonalcoholic fatty liver?
There are many risk factors for nonalcoholic fatty liver, such as:
- High cholesterol
- High levels of triglycerides in the blood
- Metabolic syndrome
- Obesity, particularly when fat is concentrated in the abdomen
- Polycystic ovary syndrome
- Sleep apnea
- Type 2 diabetes
- Underactive thyroid (hypothyroidism)
- Underactive pituitary gland (hypopituitarism)
- Older people
Diagnosis & Treatment
The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.
How is nonalcoholic fatty liver diagnosed?
No single test can diagnose nonalcoholic fatty liver. Your doctor will ask you about other health problems you’ve had.
- Complete blood count
- Liver enzyme and liver function tests
- Tests for chronic viral hepatitis (hepatitis A, hepatitis C and others)
- Celiac disease screening test
- Fasting blood sugar
- Hemoglobin A1C, which shows how stable your blood sugar is
- Lipid profile, which measures blood fats, such as cholesterol and triglycerides
- Ultrasound, which is often the initial test when liver disease is suspected.
- Computerized tomography (CT) scanning or magnetic resonance imaging (MRI)of the abdomen. These techniques lack the ability to distinguish nonalcoholic steatohepatitis from nonalcoholic fatty liver disease, but still may be used.
- Transient elastography, an enhanced form of ultrasound that measures the stiffness of your liver. Liver stiffness indicates fibrosis or scarring.
- Magnetic resonance elastography, which combines magnetic resonance imaging with patterns formed by sound waves bouncing off the liver to create a visual map showing gradients of stiffness throughout the liver reflecting fibrosis or scarring.
Liver tissue examination
If other tests are inconclusive, a liver tissue examination may be recommended. In this procedure, your doctor or a technician will remove a sample of tissue from your liver (liver biopsy) via a needle insertion through the abdominal wall and into the liver. The tissue sample is examined in a laboratory to look for signs of inflammation and scarring. A liver biopsy may be painful for some patients, and it does have small risks that your doctor will review with you in detail.
How is nonalcoholic fatty liver treated?
Treatment for nonalcoholic fatty liver includes managing your risk factors and control the symptoms. You can:
- Reduce your total cholesterol level.
- Reach a healthy weight. Losing 3% to 10% of your total body weight can make a difference.
- Control diabetes.
- Stop or cut back on drinking alcohol.
- Exercise regularly.
Lifestyle changes & Home remedies
What are some lifestyle changes or home remedies that can help me manage nonalcoholic fatty liver?
The following lifestyles and home remedies might help you cope with nonalcoholic fatty liver:
- Maintain a healthy weight
- Eat a healthy diet
- Exercise regularly
- Limit alcohol intake
- Only take medicines that you need and follow dosing recommendations.
If you have any questions, please consult with your doctor to better understand the best solution for you.
Hello Health Group does not provide medical advice, diagnosis or treatment.
Review Date: March 12, 2017 | Last Modified: September 12, 2019
Topic Overview-nonalcoholic stetohepatitis (NASH). http://www.webmd.com/digestive-disorders/tc/nonalcoholic-steatohepatitis-nash-overview#1. Accessed Mar 12, 2017.
Nonalcoholic fatty liver disease. http://www.mayoclinic.org/diseases-conditions/nonalcoholic-fatty-liver-disease/home/ovc-20211638. Accessed Mar 12, 2017.
Fatty Liver Disease NAFLD. http://patients.gi.org/topics/fatty-liver-disease-nafld/. Accessed Mar 12, 2017.