Non-Alcoholic Fatty Liver Disease (NAFLD)

Non-alcoholic fatty liver disease (NAFLD) is the accumulation of fat in the liver not caused by alcohol. NAFLD occurs in adults and children.

According to the Liver Foundation, NAFLD is the most common liver disorder in children and has more than doubled over the last 20 years. NAFLD affects an estimated 100 million Americans.

NAFLD includes a wide spectrum of liver damage, including uncomplicated steatosis (fatty liver), nonalcoholic steatohepatitis (NASH), and advanced fibrosis (scar tissue). Once damage to the liver progresses too far, it can lead to cirrhosis, which in turn can cause liver failure and loss of liver function.

Experts are still studying exactly what causes NAFLD, but some scenarios make you more likely to develop NAFLD. Conditions include:

• Being overweight or obese
• Insulin resistance
• Elevated blood lipids such as cholesterol and triglycerides
• Having a metabolic syndrome 
• High blood pressure

In children, insulin resistance is an almost universal finding in NAFLD. As a result, several conditions associated with insulin resistance such as obesity, diabetes mellitus, dyslipidemia, hypertension, obstructive apnea, and gallstones are common in children who suffer from NAFLD.

NAFLD typically does not cause any symptoms and is a silent disease. If you do experience symptoms, the most common are lethargy and discomfort in the abdomen.

Treatment for NAFLD should focus on weight loss, making modifications to lifestyle and diet. In most cases, liver injury is reversible if it is in the early stages, and no scarring is present.

If you are diabetic, maintaining control of blood sugar, as well as decreasing blood triglyceride and cholesterol levels when elevated, will help in the treatment of this condition.

NASH stands for nonalcoholic steatohepatitis. NASH is the most severe form of nonalcoholic fatty liver disease (NAFLD). 

NASH is heavily influenced by lifestyle factors such as chronic excessive calorie intake, sedentary activity, etc.

NASH is closely related to obesity, pre-diabetes, and diabetes. NASH symptoms are often silent or non-specific, making it difficult to diagnose. As a result, NASH patients may remain unaware of their condition until late stages of the disease. 

NASH can progress to more serious disease stages, such as advanced fibrosis, cirrhosis, liver failure, or liver cancer, driven by hepatocellular ballooning and inflammation.