Non-Alcoholic Fatty Liver Disease: Causes, Treatment, and Screening

The liver is the body’s second largest organ and it performs a number of essential processes, from cleansing the blood to regulating hormones, proteins, and fats. The biggest risk factor for fatty liver disease is alcoholism, but poor diet and a lack of exercise can also lead to poor liver health. Here we’ll discuss how non-alcoholic fatty liver disease (NAFLD) manifests, ways it can be prevented or treated, and conditions for which people with fatty liver disease should be screened.

What Causes NAFLD

In people with alcoholic fatty liver disease, the condition stems from an increase in oxidative stress on the organ caused by alcohol intake. This causes fat buildup, inflammation, and fibrosis of the liver. In contrast, NAFLD is caused by high calorie intake and low physical activity that lead to a buildup of triglycerides in the organ, which can result in inflammation, scarring, or even cancer.

Some of the damage done by fatty liver disease can be reversed with treatment and healthy lifestyle changes, but not all forms of the condition are equal. Most patients with NAFLD have large fat deposits in the liver, while others have tiny droplets. When small deposits are too numerous to count, the condition is called microsteatosis and could be a precursor to nonalcoholic steatohepatitis (NASH).

NASH is an inflammatory response in the liver that’s less common with NAFLD and can lead to progressive liver disease and cirrhosis, or end-stage scarring of the liver. Risk factors for NASH include excess body fat and insulin resistance, but some people with the condition experience no metabolic risk factors, so the underlying causes aren’t clear and may be genetic. Additionally, microsteatosis can lead to hepatocyte ballooning, a type of cell injury that frequently leads to cirrhosis.

Along with the rising incidence of obesity in children, rates of pediatric NAFLD are also increasing. According to the American Liver Foundation, about 38% of obese children in the U.S. have NAFLD, which puts them at a high risk of needing a liver transplant in adulthood.

How Lifestyle Modifications Can Help

Currently, no medical treatments for NAFLD have been shown effective, but leading a healthy lifestyle may prevent further damage and even reverse symptoms in its early stages. The two most effective steps to reducing liver inflammation are weight loss and alcohol cessation. In some cases, these factors may even reverse progression to cirrhosis. A healthy diet and regular physical activity can lead to weight loss as well as improve insulin response and lower cholesterol and triglyceride levels, all of which are good for the liver.

Once scarring occurs, however, it cannot be reversed. Interventions involving vitamin E supplementation and a drug called pioglitazone have shown limited capabilities in trials, but researchers continue to look for ways in which NAFLD and cirrhosis can be treated.

Health Care With NAFLD

People who have NAFLD or are at risk of developing it should have regular discussions with their health care providers regarding disease progression, as well as comorbidities that often accompany the form of liver disease, such as liver cancer hepatocellular carcinoma. Early detection is key to successful treatment and preventing further liver damage.

Patients in the Newton-Wellesley area can contact us today to set up an appointment with a gastroenterologist to talk about liver health and how to maintain or improve it with a combination of lifestyle modifications and medical intervention.