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Nonalcoholic fatty liver disease

Fatty liver; Steatosis; Nonalcoholic steatohepatitis; NASH

Nonalcoholic 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 closely related to being overweight.

For many people, NAFLD causes no symptoms or problems. A more serious form of the disease is called non-alcoholic steatohepatitis (NASH). NASH can cause liver failure. It can also cause liver cancer.

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Liver

Causes

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:

Other risk factors may include:

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:

In people with NASH who have liver damage (cirrhosis), symptoms may include:

Exams and Tests

NAFLD is often found during routine blood tests that are used to see how well the liver is working.

You may have the following tests to measure liver function:

Your health care provider may order certain imaging tests, including:

A liver biopsy is needed to confirm a diagnosis of NASH, the more severe form of NAFLD.

Treatment

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 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.

When 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:

References

Chalasani N, Younossi Z, Lavine JE, et al. The diagnosis and management of nonalcoholic fatty liver disease: practice guidance from the American Association for the study of liver disease. Hepatology. 2018;67(1):328-357. PMID: 28714183 www.ncbi.nlm.nih.gov/pubmed/28714183.

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 November 2016. Accessed April 22, 2019.

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. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 87.

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Review Date: 3/27/2019  

Reviewed By: Michael M. Phillips, MD, Clinical Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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