20/02/2020
Non-Alcoholic Fatty Liver Disease (NAFLD)
NAFLD is the term for a wide range of conditions caused by a build-up of fat within the liver cells which is NOT caused by alcohol.
A liver that is healthy should contain little or no fat. Most people with NAFLD have small amounts of fat in their liver, often causing no symptoms.
Four stages of NAFLD
Stage 1: simple fatty liver (steatosis)
This early stage of the disease is known as simple fatty liver. This is one of the most common causes of liver disease affecting 25-30% of people in the U.K. most of who are overweight or obese. Usually, there are no symptoms and it is often discovered during routine blood tests or routine health screening. In most cases, it is considered to be harmless. However, steatosis is always taken seriously as in some people the fat can build up, leading to the next stage of NAFLD. Also, if linked to obesity, there will be further health issues to be addressed such as the risk of heart attack or stroke.
Stage 2: non-alcoholic steatohepatitis (NASH)
A small number of people with simple fatty liver will go on to develop stage 2 of NAFLD called non-alcoholic steatohepatitis (NASH). This is a more aggressive form of the condition when the liver has become inflamed. Inflammation is part of the body's response to injury, which suggests that cells in the liver are being damaged and that some liver cells are dying. Patients who have NASH may have a dull or aching pain in the top right of their abdomen (over the lower right side of their ribs), or there may be no symptoms at all. It is estimated that around 2-5% of the UK population has NASH.
Stage 3: fibrosis
Some people with NASH go on to develop fibrosis, which is where persistent inflammation in the liver results in the formation of fibrous scar tissue around the liver cells and blood vessels.
This fibrous tissue replaces some of the healthy liver tissue, but there is still enough healthy tissue for the liver to function normally.
Stage 4: cirrhosis
Cirrhosis is the most serious stage of NAFLD. Scar tissue develops and the liver shrinks and becomes lumpy. Cirrhosis is more common after the age of 50yrs being associated with many years of stage 1 of the disease. However, in some people, it can occur much earlier. Cirrhosis will progress slowly over the years, gradually causing the liver to stop functioning (liver failure). It can also lead to primary liver cancer. Unfortunately, liver damage caused by cirrhosis is permanent and cannot be reversed.
Who is at risk?
You are more likely to develop NAFLD if you:
• are overweight or obese
• have type 2 diabetes
• have high blood pressure
• have high cholesterol
• smoke
• are over the age of 50
Living with NAFLD
The good news is that for the majority of people with stage 1 NAFLD, the condition does not progress for many years (if at all) and for some, it may be possible for the fatty liver to completely resolve with some lifestyle changes:
• loose weight and exercise
• stop smoking
• ensure any conditions such as diabetes, high blood pressure, high cholesterol are controlled by your G.P.
• either stop or limit alcohol intake – although NAFLD is not caused by alcohol, it may make the condition worse.
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