Nonalcoholic fatty liver disease, sometimes called NAFLD, is a condition in which fat builds up in the liver. The liver is a big organ in the upper right side of the belly. There are two types of NAFLD:
This article is mostly about NASH, because that is the condition that can lead to the most problems.
People who drink too much alcohol can get a condition similar to NASH. But NASH is not related to drinking too much alcohol.
Doctors do not know what causes NASH. They do know that NASH happens more often in some people, such as those who:
Yes. If your doctor or nurse suspects that you have NASH, you will likely have:
Some people need a liver biopsy. During this test, a doctor removes a small sample of tissue from the liver.
Then another doctor looks at the sample under a microscope to see if NASH is present. A liver biopsy is the only test that can tell for sure if you have NASH. Your doctor might do this test if they are not sure if you have NASH or to see how much inflammation there is in the liver.
If your blood tests and imaging tests are normal you will not need a liver biopsy.
NASH is not typically treated directly. But the condition can get better when other medical conditions that often happen with NASH get treated. For example, losing weight, and controlling high blood sugar and cholesterol can help improve NASH. With that in mind, your doctor can:
Making these changes has benefits besides helping with NASH. These changes can also reduce your chances of having a heart attack or stroke. That's important because people with NASH are often also at risk for heart disease and stroke. If you take a medicine that could be causing NASH, your doctor will stop or change that medicine.
If you have a severe form of NASH but do not also have diabetes or heart disease, your doctor or nurse might suggest that you take vitamin E. A few studies suggest that vitamin E can reduce some of the liver damage that occurs as part of NASH. On the other hand, there are also studies that suggest that high doses of vitamin E increase the risk of death. So do not take vitamin E unless your doctor or nurse recommends it.
NASH might get worse over time. Sometimes it leads to serious scarring of the liver, called "cirrhosis." Cirrhosis can cause different symptoms, such as swelling in the legs, trouble breathing, or feeling tired. If you get cirrhosis, your doctor will talk with you about different possible treatments.
Yes. People who have NASH need to see their doctor for regular check-ups. Your doctor will do follow-up tests on a regular basis. These usually include blood tests.