Nonalcoholic fatty liver disease
Fatty liver; Steatosis; Nonalcoholic steatohepatitis; NASHNonalcoholic 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 usually but not always related to being overweight.
For many people, NAFLD causes no symptoms or problems. A more severe form of the disease is called non-alcoholic steatohepatitis (NASH). NASH can cause cirrhosis and liver failure. It can also cause liver cancer.
Cirrhosis
Cirrhosis is scarring of the liver and poor liver function. It is the last stage of chronic liver disease.
Read Article Now Book Mark ArticleLiver cancer
Hepatocellular carcinoma is cancer that starts in the liver.
Read Article Now Book Mark ArticleCauses
NAFLD is the result of more than normal deposits of fat in the liver. Things that may put you at risk include any of the following:
- Being overweight or obese. The more overweight you are, the higher the risk.
Obese
Obesity means weighing more than what is healthy for a given height. Obesity is a serious, chronic disease. It can lead to other health problems, i...
Read Article Now Book Mark Article - Prediabetes (insulin resistance).
Prediabetes
Prediabetes occurs when the level of sugar (glucose) in your blood is too high, but not high enough to be called diabetes. If you have prediabetes, ...
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Type 2 diabetes
Type 2 diabetes is a lifelong (chronic) disease in which there is a high level of sugar (glucose) in the blood. Type 2 diabetes is the most common f...
Read Article Now Book Mark Article - High cholesterol.
High cholesterol
Cholesterol is a fat (also called a lipid) that your body needs to work properly. Too much bad cholesterol in your blood can increase your chance of...
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- High blood pressure.
Other risk factors may include:
- Rapid weight loss and poor diet
- Gastric bypass surgery
Gastric bypass surgery
Gastric bypass is surgery that helps you lose weight by changing how your stomach and small intestine handle the food you eat. After the surgery, you...
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- Certain medicines, such as calcium channel blockers and some cancer medicines
NAFLD also occurs in people who have no known risk factors.
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:
Liver damage
Cirrhosis is scarring of the liver and poor liver function. It is the last stage of chronic liver disease.
Read Article Now Book Mark Article- Weakness
- Loss of appetite
- Nausea
- Yellow skin and eyes (jaundice)
- Itching
- Fluid buildup and swelling in the legs and abdomen
- Mental confusion
- GI bleeding
Exams and Tests
NAFLD is often found during routine blood tests that are used to see how well the liver is working.
Routine blood tests
Liver function tests are common tests that are used to see how well the liver is working. Tests include:AlbuminAlpha-1 antitrypsinAlkaline phosphata...
Read Article Now Book Mark ArticleYou may have the following tests to measure liver function:
- Complete blood count
Complete blood count
A complete blood count (CBC) test measures the following:The number of white blood cells (WBC count)The number of red blood cells (RBC count)The numb...
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Prothrombin time
Prothrombin time (PT) is a blood test that measures the time it takes for the liquid portion (plasma) of your blood to clot. It measures the functio...
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Blood albumin level
Albumin is a protein made by the liver. A serum albumin test measures the amount of this protein in the clear liquid portion of the blood. Albumin c...
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Your health care provider may order certain imaging tests, including:
- Ultrasound to confirm a diagnosis of NAFLD
- MRI and CT scan
MRI
An abdominal magnetic resonance imaging scan is an imaging test that uses powerful magnets and radio waves. The waves create pictures of the inside ...
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An abdominal CT scan is an imaging method. This test uses x-rays to create cross-sectional pictures of the belly area. CT stands for computed tomog...
Read Article Now Book Mark Article - Fibroscan (elastography)
A liver biopsy is needed to confirm a diagnosis of NASH, the more severe form of NAFLD.
Liver biopsy
A liver biopsy is a test that takes a sample of tissue from the liver for examination.
Read Article Now Book Mark ArticleTreatment
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.
Diabetes
Diabetes is a long-term (chronic) disease in which the body cannot regulate the amount of sugar in the blood.
Read Article Now Book Mark Article - Getting vaccinated for diseases such as hepatitis A and hepatitis B.
Hepatitis A
Hepatitis A is inflammation (irritation and swelling) of the liver from the hepatitis A virus.
Read Article Now Book Mark ArticleHepatitis B
Hepatitis B is irritation and swelling (inflammation) of the liver due to infection with the hepatitis B virus (HBV). Other types of viral hepatitis ...
Read Article Now Book Mark Article - 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.
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.
Cirrhosis
Cirrhosis is scarring of the liver and poor liver function. It is the last stage of chronic liver disease.
Read Article Now Book Mark ArticleWhen 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.
Prevention
To help prevent NAFLD:
- Maintain a healthy weight.
- Eat a healthy diet.
- Exercise regularly.
- Limit alcohol consumption.
- Use medicines properly.
References
National Institute of Diabetes and Digestive and Kidney Diseases website. Eating, diet, and nutrition for NAFLD and NASH. www.niddk.nih.gov/health-information/liver-disease/nafld-nash/eating-diet-nutrition. Updated April 2021. Accessed June 8, 2023.
Rinella ME, Neuschwander-Tetri BA, Siddiqui MS, et al. AASLD Practice Guidance on the clinical assessment and management of nonalcoholic fatty liver disease. Hepatology. 2023;77(5):1797-1835. PMID: 36727674 pubmed.ncbi.nlm.nih.gov/36727674/.
Torres DM, Harrison SA. Nonalcoholic fatty liver disease. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 87.
Liver - illustration
The liver serves a wide variety of body functions, including detoxifying blood and producing bile that aids in digestion.
Liver
illustration
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Review Date: 5/3/2023
Reviewed By: Michael M. Phillips, MD, Emeritus Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.