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Nonalcoholic fatty liver disease (NAFLD) refers to a group of liver disorders that affect persons who use little to no alcohol. The fundamental feature of NAFLD, as the name suggests, is an excess of fat deposited in liver cells.
NAFLD is becoming more frequent over the world, particularly in Western countries. It is the most common type of chronic liver disease in the United States, affecting almost one-quarter of the population.
Nonalcoholic steatohepatitis (NASH), an aggressive form of fatty liver disease characterized by liver inflammation, can occur in some people with NAFLD and progress to severe scarring (cirrhosis) and liver failure. This is analogous to the damage produced by excessive alcohol consumption.
WHAT ARE THE SYMPTOMS OF NAFLD?
NAFLD generally produces no symptoms. When this occurs, they may include:
- Fatigue
- Upper right abdominal pain or discomfort
NASH with severe scarring (cirrhosis) can cause the following signs and symptoms:
- Swelling in the abdomen (ascites)
- Blood vessels that are enlarged just beneath the skin's surface
- Spleen enlargement
- Red palms
- Skin and eye yellowing (jaundice)
WHAT ARE THE CAUSES OF NAFLD?
Experts are baffled as to why some people build fat in their livers while others do not. Similarly, it is unclear why certain fatty livers develop inflammation that develops to cirrhosis.
Both NAFLD and NASH are associated with the following:
- Obesity or being overweight
- Insulin resistance, which is a condition in which your cells do not absorb sugar in response to the hormone insulin.
- Hyperglycemia (high blood sugar), which indicates prediabetes or type 2 diabetes.
- High quantities of fats in the blood, particularly triglycerides
These combined health issues appear to promote fat accumulation in the liver. For certain people, extra fat serves as a poison to liver cells, causing inflammation and NASH, which can lead to scar tissue formation in the liver.
WHAT ARE THE RISK FACTORS FOR NAFLD?
NAFLD risk can be increased by a variety of disorders and conditions, including:
- High cholesterol levels
- Triglyceride levels in the blood are high.
- Polycystic ovary syndrome (PCOS)
- Sleep apnea
- Type 2 diabetes 2
- Metabolic syndrome
- Obesity, especially if the fat is concentrated in the abdomen
- Underactive thyroid (hypothyroidism)
- Underactive pituitary gland (hypopituitarism)
NASH is more common in the following groups:
- Old people
- Diabetes patients
- People who have a high concentration of abdominal fat
- Without additional testing, it is difficult to distinguish NAFLD from NASH.
WHAT ARE THE COMPLICATIONS OF NAFLD?
Cirrhosis, or late-stage scarring in the liver, is the most common consequence of NAFLD and NASH. Cirrhosis develops as a result of liver injury, such as the inflammation seen in NASH. Scarring occurs as the liver attempts to reduce inflammation (fibrosis). Fibrosis spreads to take up more and more liver tissue as the inflammation continues.
Cirrhosis can result in the following if the process is not stopped:
- Abdominal fluid buildup (ascites)
- Swelling of veins in the esophagus (esophageal varices), which can burst and bleed
- Drowsiness, confusion, and slurred speech (hepatic encephalopathy)
- Cancer of the liver
- End-stage liver failure, which occurs when the liver no longer functions.
Cirrhosis will develop in between 5% and 12% of patients with NASH.
HOW IS NAFLD DIAGNOSED?
Because NAFLD rarely causes symptoms, it typically comes to light when tests for other reasons reveal a liver disease. This is possible if your liver seems abnormal on ultrasound or if you have an abnormal liver enzyme test.
The following tests are used to confirm the diagnosis and determine the severity of the disease:
Blood tests
- Complete blood count
- Liver enzyme and function tests
- Chronic viral hepatitis tests (hepatitis A, hepatitis C and others)
- Celiac disease screening test
- Fasting blood sugar
- Hemoglobin A1C, which indicates how stable your blood sugar is.
- Lipid profile, which assesses blood lipids like cholesterol and triglycerides.
Imaging procedures
The following imaging methods are used to diagnose NAFLD:
- Abdominal ultrasound: which is frequently used as the first test when liver disease is suspected.
- Abdominal computed tomography (CT) scanning or magnetic resonance imaging (MRI): These techniques, while unable to distinguish NASH from NAFLD, may still be useful.
- Transient elastography: This is an improved form of ultrasonography that determines the stiffness of your liver. Fibrosis or scarring of the liver is indicated by stiffness.
- Magnetic resonance elastography: This creates a visual map (elastogram) of the stiffness of bodily tissues by combining MRI imaging with sound waves.
Examination of liver tissue
If additional tests are unclear, your doctor may suggest removing a sample of tissue from your liver (liver biopsy). A laboratory examines the tissue sample for evidence of inflammation and scarring.
A liver biopsy can be painful, and there are certain minor dangers that your doctor will go through with you in detail. A needle is inserted through the abdominal wall and into the liver to perform this surgery.
HOW IS NAFLD TREATED?
Weight loss through a mix of a healthy diet and exercise is usually the first line of treatment. Losing weight tackles the underlying causes of NAFLD. A loss of 10% of body weight is ideal, however improvements in risk variables can be shown even if you lose 3% to 5% of your starting weight. For those who need to reduce a significant amount of weight, weight-loss surgery is a possibility.
Cirrhosis caused by NASH may be treated with liver transplantation.
Future treatment options
The Food and Pharmacological Administration has not approved any drug treatment for nonalcoholic fatty liver disease, however a few medicines are being researched with encouraging results.
HOME REMEDIES FOR NAFLD
You can regulate your nonalcoholic fatty liver disease with the advice of your doctor. You may:
- Weight loss: To lose weight if you are overweight or obese, limit the quantity of calories you consume each day and increase your physical activity. Calorie restriction is essential for weight loss and disease management. If you've tried and failed to reduce weight in the past, seek advice from your doctor.
- Choose a nutritious diet: Consume a balanced diet rich in fruits, vegetables, and whole grains, and keep track of all calories consumed.
- Increase your physical activity and exercise: Aim for at least 30 minutes of physical activity on most days of the week. More exercise may be beneficial if you are trying to reduce weight. However, if you don't currently exercise consistently, consult your doctor first and begin slowly.
- Diabetes management: To keep your diabetes under control, follow your doctor's advice. Take your medications as instructed and keep a close eye on your blood sugar levels.
- Reduce your cholesterol: A healthy plant-based diet, exercise, and medications can all help you maintain good cholesterol and triglyceride levels.
- Take care of your liver: Avoid anything that will put further strain on your liver. Don't consume alcohol, for example. Follow all pharmaceutical and over-the-counter medicine directions. Before using any herbal medicines, consult with your doctor because not all herbal products are safe.
ALTERNATIVE MEDICINE FOR NAFLD
There is no evidence that alternative medicine treatments can heal nonalcoholic fatty liver disease. However, researchers are investigating if certain natural chemicals, such as:
- Vitamin E: Vitamin E and other vitamins known as antioxidants, in theory, should help preserve the liver by minimizing or neutralizing the damage produced by inflammation. However, more research is required.
Some research suggests that vitamin E supplementation may be beneficial for persons suffering from nonalcoholic fatty liver disease. However, vitamin E has been associated to an increased risk of death as well as an increased chance of prostate cancer in men.
- Coffee: People with nonalcoholic fatty liver disease who reported consuming two or more cups of coffee per day had less liver damage than those who drank little or no coffee, according to research. It's not known how coffee affects liver damage, but new research suggests it may include molecules that help combat inflammation.
If you currently consume coffee, these findings might make you feel better about your morning cup. If you don't drink coffee already, this is probably not a good reason to start. Consult your doctor about the potential benefits of coffee.
HOW CAN NAFLD BE PREVENTED?
To lower your risk of NAFLD, do the following:
- Choose a nutritious diet: Choose a plant-based diet high in fruits and vegetables, whole grains, and healthy fats.
- Keep a healthy weight: Reduce your daily calorie intake and increase your physical activity if you are overweight or obese. If you have a healthy weight, work to keep it that way by eating well and exercising often.
- Exercise: Most days of the week, exercise. If you haven't been exercising consistently, get permission from your doctor first.
CONCLUSION
Non-alcoholic fatty liver disease is becoming more widespread worldwide, particularly in Western industrialized countries where obesity, diabetes, and other metabolic illnesses are also on the rise. While numerous factors may be at work, a poor diet and sedentary lifestyle are frequently shared by these disorders. Fortunately, we have the ability to change these things. You can lower the risk and potentially reverse the progression of non-alcoholic fatty liver disease by doing so.