Non Alcoholic Fatty Liver Disease (NAFLD) and Non Alcoholic Steatohepatitis (NASH)
What is Non Alcoholic Fatty Liver Disease and Non Alcoholic Steatohepatitis?
Non alcoholic fatty liver disease or NAFLD is a condition in which a person who drinks little or no alcohol accumulates fat in the liver. This occurs when the liver has trouble breaking down fats resulting in its build up in the liver tissue.
NDDIC states that about 2-5% of Americans have NASH, the more advanced case of NAFLD. And there are many others who have NAFLD but undiagnosed, perhaps this is why NAFLD/NASH is often referred to as the "silent" liver disease.
NAFLD rarely causes any signs, symptoms or complications, but when it does, it is accompanied by fatigue, pain in the upper right abdomen and weight loss. When these symptoms appear, it only means that the disease has progressed. This can happen years or maybe decades from the onset of the early stages. It's also possible that the disease will stop or reverse on its own.
Nonalcoholic fatty liver disease occurs in three forms - from harmless to life-threatening.
- At its simplest form, NAFLD can cause excess liver fat, but no complications. This condition is thought to be very common.
- In a small number of people with fatty liver, the fat causes liver inflammation and impairs its ability to function normally and leads to complications. This more serious form of NAFLD is called Non Alcholic Steatohepatitis or NASH.
- The most severe case of NAFLD is when scarring in the liver tissue occurs (liver fibrosis). With time, it can progress to cirrhosis, liver failure or liver cancer.
Fatty Liver Can Be Reversed!
Who are at risk of having NAFLD/NASH?
Doctors aren't really sure what causes NAFLD. But if you fall under certain conditions, you may be at risk of having NAFLD.
- Do you take certain medications like prednisone, amiodarone (Cordarone), tamoxifen (Nolvadex), methotrexate (Rheumatrex, Trexall), and nonsteroidal anti-inflammatory drugs (NSAIDS) or are frequently exposed to toxins or chemicals such as pesticides? You may be at risk.
- Do you have the following conditions like high cholesterol, high levels of triglycerides in the blood, malnutrition, metabolic syndrome, obesity, rapid weight loss, type 2 diabetes and Wilson's disease? You may also be at risk.
According to MedicineNet, NAFLD may also occur in children with the current epidemic of obesity in children. It is estimated that 10% of children aged 2-19 have NAFLD. It's not recommended, however, to have children undergo drug treatment. Only exercise and weight loss are supported as treatment of NAFLD in children.
How to Diagnose NAFLD/NASH?
To be sure whether you have NAFLD or not, you can undergo certain tests and procedures including blood tests, imaging procedures and liver tissue testing.
- Liver blood tests. These include tests of liver enzymes (transaminases) which may help your doctor make a diagnosis.
- Imaging procedures. A good quality liver ultrasound can be highly sensitive (detects all fatty livers) and specific (detects only fatty livers) in diagnosing fatty liver. Computerized tomography (CT) scan performs well in detecting fatty liver and can even measure the degree of fat infiltration. Magnetic resonance imaging (MRI) is the overall best imaging exam for fatty liver, but is the most expensive.
- Liver tissue testing. Only a liver biopsy, however, can establish a definite diagnosis and determine the severity of the condition. If it's suspected that you have a more serious form of nonalcoholic fatty liver disease, your doctor may recommend you undergo this procedure.
What should I do if I have NAFLD/NASH?
According to the National Digestive Diseases Information Clearinghouse, no specific medical therapies exist to treat nonalcoholic fatty liver diseases, so doctor's advice varies from patient patient. From a US News Health article about NAFLD I read, 5 tips for treatment and prevention of NAFLD are given by experts.
- Lose weight, and exercise.The first recommendation often made by doctors for those newly diagnosed with fatty liver disease is to lose weight. The American Gastroenterological Association suggests losing 10 percent or more weight for those with NASH.
- Improve your diet, even if you're having trouble losing weight.Choose a healthy diet that's rich in fruits and vegetables and whole grains such as whole-wheat bread and brown rice. Reduce the amount of saturated fat in your diet and instead select healthy unsaturated fats, such as those found in fish, olive oil and nuts.
- Consider a glass of wine. Contrary to the prevailing advice for people with nonalcoholic fatty liver disease to avoid alcohol, a recent study suggests that drinking a glass of wine a day may actually decrease the risk of nonalcoholic fatty liver disease. Study participants who reported drinking up to one glass of wine (not beer or other liquor) per day had their risk of liver disease cut in half, in comparison with those who drank no alcohol.
- Don't count on experimental treatments.While some studies suggest that experimental treatments such as taking vitamins C and E or use of new diabetes medicines in patients who are also diabetic could combat fatty liver disease, others show contradictory findings. So, don't count on them.
- Get other medical conditions treated. It's not uncommon for people with NAFLD to have other medical problems, such as diabetes, hypertension, or high cholesterol. If you have any of these conditions, follow your doctors' recommendations for medications and control of these conditions.