Non-alcoholic fatty liver disease (NAFLD) or fatty liver if continues for long time can cause fibrosis (scarring or shrinkage) in the liver which ultimately may damage the liver and can cause cirrhosis liver and even liver cancer. Hence it is very important to determine the presence and extent of fibrosis in patients with fatty liver as early as possible so as to treat it and to predict the outcome in those who already have advanced fibrosis and cirrhosis.
Introduction
Liver is a large organ present on the right, upper side of the abdomen. It has a large number of functions such as production of body proteins, filtration of toxins and ingested drugs, control of blood sugar, cholesterol and proteins.
What is fatty liver?
Fatty liver refers to the deposition of excessive fat in the liver.
What causes fatty liver?
Earlier, it was though that fatty liver used to occur only due to excessive alcohol intake. However it was recognized over last one decade, that patients who do not drink also develop fatty liver. These patients are labeled as having non-alcoholic fatty liver disease (NAFLD).
NAFLD is a life style disease. The risk factors for NAFLD are obesity, diabetes mellitus, abnormal lipid profile. Other causes of NAFLD include certain drugs, malnutrition, i.v nutrition and certain genetic diseases.
What are the symptoms of NAFLD?
Most patients with NAFLD do not have any symptoms at the time of diagnosis and they will come to light only by chance. Once the patients develop symptoms of liver disease, it suggests that the disease may be already quite advanced
How is NAFLD diagnosed?
As mentioned earlier most patients are detected by chance when they undergo ultrasonography or during investigation for abnormal blood tests (LFT).
What other tests should a patient with NAFLD undergo?
Once diagnosed, patients with NAFLD should undergo a fibroscan. The Fibroscan test gives two informations:
1. It tells us about the amount of fat in the liver. So there is an objective measure of the quantity of liver fat which can then be followed up over time in order to find if the fat is increasing or decreasing.
2. It also tells about the presence of scarring in the liver, also called fibrosis. Patients with long term fatty liver and with other risk factors have persistent liver inflammation which can lead to scarring and hardening of the liver. This can even lead to cirrhosis. This can be picked up easily by fibroscan
Some patients may have to under go a liver biopsy in order to determine the stage of the disease.
Is it a serious disease?
Although most patients tend to have a milder from of NAFLD. But, it is clear that NAFLD can cause all the complications associated with any chronic liver disease. So patients with uncontrolled NAFLD are at an increased risk of developing cirrhosis, liver cancer and liver failure. So if left untreated, NAFLD can have serious outcomes.
Not only liver complications, it has been seen that patients with NAFLD are also at an increased risk of later development of diabetes, hypertension, and heart disease.
Which patient with NAFLD develop serious complications?
Persons are risk of serious outcomes in presence of NAFLD are those with uncontrolled diabetes, those with sever obesity and those with a family history of advanced NAFLD
What is the treatment for NAFLD?
Since NAFLD is a lifestyle disease, the most effective treatment is ‘lifetyle interventions’. So the back bone of therapy in NAFLD patients is to increase physical activity along with dietary advice in order to achieve weight reduction in overweight individuals. If patients are able to reduce about 10% of their body weight, they are able to benefit immensely and have significant improvement in their liver complications.
This therapy not only reduces liver fat and inflammation due to fat, but also prevents other lifestyle conditions such as diabetes, hypertension and high cholesterol. Treatment with pills is required only in patients with advanced liver disease due to NAFLD.
In addition , other associated conditions such as diabetes, hypertension and high cholesterol should also be treated along side.
What not to do, if you have fatty liver?
- You should avoid herbal medications since they can also cause unpredictable harms to the liver.
- You should not self medicate.
- You should not eat foods which can make you gain weight, like sweets and saturated fats.
- You should avoid alcohol intake
Whom should you contact if you have NAFLD
For more and specific advice on Fatty liver disease, you should contact a Hepatologist or a liver specialist near you. In addition, if you have other risk factors, like diabetes or hypertension or high cholesterol, then you should meet the concerned specialists also.