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Fatty liver - nonalcoholic

Fatty liver; Steatosis; Nonalcoholic steatohepatitis; NASH

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Causes

There is no clear cause for NAFLD or NASH. However, certain things may put you at risk:

Other risk factors may include:

  • Rapid weight loss and poor diet
  • Gastric bypass surgery
  • Bowel disease
  • Certain medicines, such as calcium channel blockers and some cancer drugs

NAFLD also occurs in people who have no known risk factors.

Definition

Nonalcoholic fatty liver disease (NAFLD) is the buildup of fat in the liver that is NOT caused by drinking too much alcohol. People who have it do not have a history of heavy drinking. NAFLD is closely related to being overweight.

For many people, NAFLD causes no symptoms or problems. A more serious form of the disease is called non-alcoholic steatohepatitis (NASH). NASH can cause liver failure. It can also cause cancer.

Exams and Tests

NAFLD is often found during routine blood tests that are used to see how well the liver is working.

You may have the following tests to measure liver function:

Your health care provider may ask for certain imaging tests, including:

  • Ultrasound is often used to confirm a diagnosis of NAFLD
  • MRI and CT scan may also be needed

A liver biopsy is needed to confirm a diagnosis of NASH, the more severe form of NAFLD.

Outlook (Prognosis)

Many people with NAFLD have no health problems and do not go on to develop NASH. Losing weight and making healthy lifestyle choices can help prevent more serious problems.

It is unclear why some people develop NASH. NASH can lead to cirrhosis.

Prevention

To help prevent NAFLD:

  • Maintain a healthy weight.
  • Eat a healthy diet.
  • Exercise regularly.
  • Limit alcohol consumption.
  • Use medicines properly.

Symptoms

People with NAFLD often have no symptoms. When symptoms occur, the most common include:

  • Fatigue
  • Pain in the upper right abdomen

In people with NASH who have liver damage (cirrhosis), symptoms may include:

  • Weakness
  • Loss of appetite
  • Nausea
  • Yellow skin and eyes (jaundice)
  • Itching
  • Fluid buildup and swelling in the legs and abdomen
  • Mental confusion
  • GI bleeding

Treatment

There is no specific treatment for NAFLD. The goal is to manage your risk factors and any health conditions.

Your provider will help you understand your condition and the healthy choices that can help you take care of your liver. These may include:

  • Losing weight if you are overweight.
  • Eating a healthy diet that is low in salt.
  • Not drinking alcohol.
  • Staying physically active.
  • Managing health conditions such as diabetes and high blood pressure.
  • Getting vaccinated for diseases such as hepatitis A and hepatitis B.
  • Lowering your cholesterol and triglyceride levels.
  • Taking medicines as directed. Talk to your provider about all medicines you take, including herbs and supplements and over-the-counter medicines.

Losing weight and managing diabetes can slow or sometimes reverse the deposit of fat in the liver.

When to Contact a Medical Professional

Most people with NAFLD do not know they have it. See your provider if you begin to have unusual symptoms such as fatigue or abdominal pain.

Review Date: 4/21/2017
Reviewed By: Michael M. Phillips, MD, Clinical Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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