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Fatty Liver Disease
Liver cells

Non-Alcoholic Fatty Liver Disease (NAFLD)

NAFLD refers to a spectrum of conditions characterised by a build-up of fat in the liver caused by reasons other than excessive alcohol. In developed countries about 20 per cent of the population is likely to have NAFLD. The precise cause of NAFLD is unknown but it is thought to be linked to insulin resistance leading to an uptake of fat into the liver.

At one end the range of NAFLD is steatosis which is generally benign or harmless. The other extreme is characterised by non-alcoholic steatohepatitis (NASH), a more aggressive condition that can progress to cirrhosis – untreatable scarring/damage to the liver.

Symptoms

The symptoms are non-specific and can occur in men and women as well as children typically over the age of ten. Most patients have no symptoms. However, some may experience a dull, aching pain under the right hand side of the rib-cage (ie, in the liver). Obesity and signs of insulin resistance such as high blood sugar levels may also be indicative of NAFLD – although not everyone who is obese or diabetic will develop NAFLD as there is likely to be a genetic link.

Diagnosis

Diagnosis is usually achieved by blood testing and the use of imaging scans such as ultrasound , CT or MRI.

Treatment

There is no single treatment for NAFLD that all doctors everywhere agree on. Further research into new treatments is taking place, particularly into drugs (including statins normally used to treat heart disease) that reduce appetite, lower blood fats and increase insulin sensitivity.

If your condition is linked to being overweight then you will be advised to lose weight slowly and take more exercise. If you are diabetic, have high blood pressure or high cholesterol, you will also need to look carefully at your diet and weight-loss programme; medication may also be required. Because some people will go on to develop cirrhosis of the liver, which adds to the risk of liver cancer and liver failure in the future, you may also be advised to attend regular check-ups.

Prognosis/outlook

Progression of NAFLD into more serious liver conditions (cirrhosis) does occur, but only in very few patients. If you have steatosis you should recover and have no long term ill effects.

Patients who develop NASH have around a 20 per cent chance of developing cirrhosis and a less than ten per cent chance of dying from a liver-related condition.

To arrange a consultation with a liver consultant please contact The Princess Grace Hospital, Liver, Bile Duct and Pancreas Unit