Nonalcoholic Fatty Liver Disease
What is nonalcoholic fatty liver disease?
Nonalcoholic fatty liver disease (NAFLD) is a broad term for a range of liver conditions affecting people who drink little to no alcohol. As the name implies, the main characteristic of NAFLD is too much fat stored in liver cells.
Throughout the world, the prevalence of NAFLD has risen to a concerning level. In the United States, NAFLD is currently the most common form of liver disease, affectingnearly one quarter of the American population.
A small percentage of patients with NAFLD can develop an aggressive disease called nonalcoholic steatohepatitis (NASH), which is marked by liver inflammation and can lead to advanced scarring and liver failure. This damage is similar to the damage caused by heavy alcohol use.
What are the symptoms of NAFLD?
Most NAFLD patients experience few to no symptoms. Some of the reported symptoms include:
- Fatigue
- Pain or discomfort in the upper right abdomen
Risk factors for NAFLD include:
- Obesity
- Diabetes mellitus
- High cholesterol
- High levels of triglycerides in the blood
- Metabolic syndrome
- Obstructive sleep apnea
- Polycystic ovary syndrome
- Hypothyroidism
- Hypopituitarism
How is NAFLD diagnosed?
The diagnosis of NAFLD can be made on liver imaging, such as an abdominal ultrasound or CT scan. Your doctor may order these studies if you are at risk of NAFLD and/or you have abnormal liver enzymes on your routine blood work.
The diagnosis of NASH requires a liver biopsy. Your doctor may discuss this method of liver tissue sampling to look for signs of inflammation and scarring.
Patients with NAFLD without evidence of NASH rarely develop significant liver complications. However, 5-12 percent of patients with NASH are at risk of developing cirrhosis (a condition in which your liver is scarred and permanently damaged). Cirrhosis can lead to:
- Fluid build up in the abdomen (ascites)
- Swelling of the veins of the esophagus (esophageal varices), which can rupture and bleed
- Confusion, drowsiness and slurred speech (hepatic encephalopathy)
- Liver cancer
- Liver failure. NASH cirrhosis resulting in liver failure is a common indication for needing a liver transplant.
How is NAFLD treated?
The first line of treatment for NAFLD is usually weight loss. A loss of 10 percent of body weight is desirable, but improvement in NAFLD is apparent if you lose even 3 to 5 percent of your starting weight. Weight-loss surgery is also an option for those who need to lose a great deal of weight.
Implementation of a strict Mediterranean diet appears to improve NAFLD more than other types of diet. The principal aspects of this diet include high consumption of olive oil, dairy, fish, legumes and fresh fruits and vegetables.
Exercise is important. Aim for at least 30 minutes of exercise most days of the week. Weight-bearing exercise is preferred, if possible.
If you have diabetes, good blood glucose control is important. Follow your doctor’s instructions to keep your diabetes under control. Take your medications as directed and closely monitor your blood sugar. Similarly, maintaining healthy cholesterol levels are helpful. A healthy diet, exercise and the use of medications can help keep your cholesterol and your triglycerides at healthy levels.
It sounds obvious, but protecting your liver is also key. Avoid things that will put extra stress on your liver. For example, don’t drink alcohol. Follow the instructions on all medications and over-the-counter drugs. Check with your doctor before using any herbal remedies, as not all herbal products are safe.
In terms of medications, no alternative medicine treatments are proven to cure NAFLD, but some natural compounds are possibly beneficial. Some evidence suggests vitamin E supplements may be helpful for people with NASH. However, vitamin E must be used cautiously as it has been linked with increased risk of death in diabetics and an increased risk of prostate cancer in men. It’s not yet clear how coffee may influence liver damage, but studies suggest 1-2 cups of filtered black coffee may contain certain compounds that play a role in fighting inflammation. No drug treatment has been approved by the Food and Drug Administration for NAFLD, but several medications are being studied with promising results.
NAFLD experts in Colorado Springs
Our experienced team of physicians and advanced practice providers at Associates in Gastroenterology can help you with your concerns, questions and management of all aspects of gastrointestinal and liver disease. We would love to be your gastroenterology practice. Please schedule an appointment either by calling us (719-635-7321) or by clicking here.