Fatty Liver Disease

Nonalcoholic fatty liver disease is an umbrella term for a range of liver conditions affecting people who drink little to no alcohol. As the name implies, the main characteristic of nonalcoholic fatty liver disease is too much fat stored in liver cells.

Nonalcoholic steatohepatitis, a potentially serious form of the disease, is marked by liver inflammation, which may progress to scarring and irreversible damage. This damage is similar to the damage caused by heavy alcohol use. At its most severe, nonalcoholic steatohepatitis can progress to cirrhosis and liver failure

Nonalcoholic fatty liver disease is increasingly common around the world, especially in Western nations. In the United States, it is the most common form of chronic liver disease, affecting an estimated 80 to 100 million people.

Nonalcoholic fatty liver disease occurs in every age group but especially in people in their 40s and 50s who are at high risk of heart disease because of such risk factors as obesity and type 2 diabetes. The condition is also closely linked to metabolic syndrome, which is a cluster of abnormalities including increased abdominal fat, poor ability to use the hormone insulin, high blood pressure and high blood levels of triglycerides, a type of fat.

Symptoms
Nonalcoholic fatty liver disease usually causes no signs and symptoms. When it does, they may include:

• Enlarged liver

• Fatigue

• Pain in the upper right abdomen

Possible signs and symptoms of nonalcoholic steatohepatitis and cirrhosis (advanced scarring) include:

• Abdominal swelling (ascites)

• Enlarged blood vessels just beneath the skin's surface

• Enlarged breasts in men

• Enlarged spleen

• Red palms

• Yellowing of the skin and eyes (jaundice)

Causes
Experts don't know exactly why some people accumulate fat in the liver while others do not. Similarly, there is limited understanding of why some fatty livers develop inflammation that progresses to cirrhosis. Nonalcoholic fatty liver disease and nonalcoholic steatohepatitis are both linked to the following:

• Overweight or obesity

• Insulin resistance, in which your cells don't take up sugar in response to the hormone insulin

• High blood sugar (hyperglycemia), indicating prediabetes or actual type 2 diabetes

• High levels of fats, particularly triglycerides, in the blood

These combined health problems appear to promote the deposit of fat in the liver. For some people, this excess fat acts as a toxin to liver cells, causing liver inflammation and nonalcoholic steatohepatitis, which may lead to a buildup of scar tissue (fibrosis) in the liver.

Diagnosis
A diagnosis can be made using many tests including:

• Plain ultrasound, which is often the initial test when liver disease is suspected.

• Transient elastography, an enhanced form of ultrasound that measures the stiffness of your liver. Liver stiffness indicates fibrosis or scarring.

• Liver tissue examination. If other tests are inconclusive, your doctor may recommend a procedure to remove a sample of tissue from your liver (liver biopsy). The tissue sample is examined in a laboratory to look for signs of inflammation and scarring.

If you are concerned you have fatty liver disease or have been diagnosed with fatty liver disease, contact your doctor.  You can also call us at 978-459-6737 to request an appointment.