As the name suggests, nonalcoholic fatty liver disease (NAFLD) is a term that describes a range of liver conditions among people who drink little to no alcohol. While the causes may differ, those who have NAFLD share one thing: too much fat stored in their liver cells.
Having small amounts of fat in the liver is normal. Having too much fat can cause the liver to become inflamed, which, over time, may cause scarring and may even lead to liver cancer or liver failure.
According to the American Liver Foundation, NAFLD affects up to 25% of people in the United States. It is the most common chronic liver disorder in the U.S. and has been on the rise. Five times as many people have NAFLD now as compared to 1997.
Types of Nonalcoholic Fatty Liver Disease
- Nonalcoholic fatty liver (NAFLD) refers to having excess fat in the liver, but no inflammation or liver cell damage. In patients with NAFLD, the liver functions normally and there are no symptoms. It is now the most common cause of liver disorder in the U.S.
- Nonalcoholic steatohepatitis (NASH) is a form of NAFLD characterized by inflammation of the liver (hepatitis) resulting in liver cell damage, in addition to excess fat in the liver. NASH can lead to fibrosis (scarring) of the liver and possibly cirrhosis, liver failure or liver cancer. Some people with NASH may need a liver transplant to survive.
It is currently unknown why some people with nonalcoholic fatty liver disease have NASH while others do not.
The liver is the largest organ in the body and serves many vital functions, including aiding in the removal of toxins and waste products from the body. Although the cause of NASH is unknown, it is most frequently seen in people with one or more of following conditions:
- Obesity (70% of people with NASH are obese)
- Type 2 diabetes (up to 75% of people with NASH have diabetes)
- high blood pressure
- insulin resistance
- high levels of fats in the blood (i.e. cholesterol, triglycerides)
- drug and toxin exposure (some medications and toxins have been associated with NAFLD, including steroids, synthetic estrogens, and certain chemotherapy medications)
NAFLD can affect people of any age, including children.
Symptoms and Diagnosis
Usually a "silent disease," NAFLD causes few or no symptoms.
Possible signs include:
- weight loss or loss of appetite
- abdominal pain
NAFLD is often discovered following routine blood tests. Imaging tests such as ultrasound, CT scan and MRI, and sometimes a liver biopsy, confirms the diagnosis.
Nonalcoholic fatty liver disease requires care by a specialist who is specially trained in a wide range of liver diseases and disorders. Hepatology, a subspecialty of gastroenterology, is a branch of medicine that focuses on the diagnosis, treatment and management of any disturbance of proper liver function.
Treatment options that a gastroenterologist or hepatologist may recommend include:
- adopting a healthy diet, limiting caloric intake and adding fruits, vegetables, and whole grains
- gradual weight loss monitored by a registered dietitian/medical weight loss professional
- risk factor control: tight glucose control (diabetes), lowering cholesterol and triglycerides
- regular exercise
- reviewing all medications with the doctor, stopping certain medications or switching to other medicines as needed
- getting vaccinations for hepatitis A and B, the flu and pneumococcal disease
- avoiding alcohol intake
- liver transplant
Welcome Hepatologist Raja Koteswar Dhanekula, MD
Doylestown Health is proud to welcome Raja Koteswar Dhanekula, MD, to its team of gastroenterology specialists. Dr. Dhanekula is an experienced, fellowship-trained expert in hepatology. He delivers individualized care to patients for complex liver disease, including hepatitis C, fatty liver disease, and cirrhosis, as well as provides evaluations for liver transplant and post-transplant care.
Find a Hepatologist
Our caring, compassionate gastroenterologists are experts in the diagnosis and treatment of disorders and diseases of the digestive system. Using advanced screening tools, state-of-the-art treatments and innovative technology, our gastroenterology team delivers comprehensive care for conditions of the esophagus, stomach, small intestine, colon and rectum, pancreas, gallbladder, bile ducts and liver. The Open Access Colonoscopy Program allows healthy patients the convenience of scheduling a screening colonoscopy without an initial office visit.