Non alcoholic fatty liver disease

Non-alcoholic fatty liver disease (NAFLD) is a very common liver disease that results in fat accumulation in the liver. It is often called as “silent” liver disease; it resembles alcoholic liver disease but occurs in people who do not drink or drink very little alcohol.

The most common form of NAFLD is fatty liver, which is a non-serious condition. Accumulation of small amount of fat in the liver does not cause any complications as the liver itself has fat, in its normal condition.

NAFLD in most people do not cause any sign and symptoms, many do not even know that they have liver disease. NAFLD in its severe form, is called as nonalcoholic steatohepatitis (NASH), which results in inflammation and scarring of the liver due to excess fat deposition and later results in liver cirrhosis (a condition in which the liver responds to the death or injury of some liver cells), and finally results in permanent liver damage and the liver, is no longer able to perform its function.

The likelihood of being affected with NAFLD is directly proportional to the body weight of a person. The risk of NAFLD also increases in diabetic and high cholesterol patients. NAFLD is very common and is found affecting about 20% of the adults and almost 5% of children.


NAFLD results when the liver is unable to break down fats and result in accumulation of the fat. What causes this is still unknown. Though NAFLD and NASH are very common among Americans, the underlying cause is still unclear. It is observed that NASH and NAFLD are more common in people who are obese.

Many patients with NASH and NAFLD are found to have an elevated level of cholesterol and triglycerides; and high blood glucose. This doesn’t mean that every obese person with or without diabetes will have NASH or NAFLD or neither it means that every person having NAFLD should be obese or diabetic.

The most probable causes of NAFLD are mentioned below:

  • Insulin resistance (body does not respond to insulin hormone and therefore results in increased glucose level)
  • Release of cytokines (toxic inflammatory proteins) by fat cells
  • Oxidative stress (imbalance between the pro-oxidant and anti-oxidant that results in deterioration of the liver cell) inside the liver
  • In some its hereditary
  • Death of liver cells
  • A number of drugs prescribed for other medical condition results in fatty liver
  • Very rarely pregnancy results in acute fatty liver disease (AFLD)

Many patients with NAFLD do not show up any symptoms until the fat deposition is sufficient enough to damage the liver. Here are a few nonalcoholic fatty liver disease symptoms:

  • Tiredness or fatigue
  • Pain on the right side due to liver enlargement
  • Yellowing of eye and skin (jaundice)
  • Lower abdomen may be swollen due to accumulation of fluids
  • Weight loss may be noted in some patients
  • Bloody vomit
  • Blood in stool causing it to become dark black or tarry
  • Tend to bruise easily

In case of liver cirrhosis, a person may experience fluid retention, muscle wasting (decrease in size of skeletal muscle), intestinal bleeding, and finally liver failure.

Some tests and procedures may be performed to diagnose NAFLD.

Blood sample is taken to perform liver function test, to check the liver enzymes present in blood.

Along with this, blood glucose level and blood cholesterol and triglyceride levels are also checked.

Imaging tests like ultrasound, magnetic resonance imaging, and computer tomography are used to check the structure and function of the liver. These imaging tests can diagnose NAFLD, but does not give any clue about the severity of the disease.

A Liver biopsy may be required for confirmation of diagnosis.

A small sample of liver tissue is removed and checked for signs of scarring and inflammation. This test is done only if severe liver damage is suspected.

Presently, there is no specific treatment for patients with NAFLD. But doctors may advise the patients to reduce weight, if obese; eat healthy balanced diet; and to avoid alcohol and unnecessary medications.

Gradual weight loss usually improves liver test and reverses the disease to some extent and sudden weight loss usually worsen the condition.

People with NASH often have associated complications like diabetes and high blood cholesterol level; therefore medications to treat these underlying conditions are prescribed mostly.

If medicines are the cause for NAFLD then the physician might change the medicine and prescribe different medications. In case of severe liver cirrhosis or liver failure the patient might require liver transplantation. These were a few nonalcoholic fatty liver disease treatments.

Although NAFLD cannot be prevented completely, it is possible to reduce the risk by:

  • Exercising regularly
  • Eating healthy diet
  • Keeping weight under control
  • Maintaining blood glucose level and blood cholesterol level

Another very important thing is avoid taking unnecessary drugs, which might also result in fat deposition in the liver. If diagnosed with non-serious NAFLD, then avoiding alcohol will prevent further serious complications.