This month GP, Alice Fitzgibbon covers Non-Alcoholic Fatty Liver Disease (NAFLD).
This is a condition many people have never heard of, and some may be completely unaware they have it. Non-Alcoholic Fatty Liver Disease (NAFLD) is often, but not exclusively, related to being overweight or obese. In the UK, it is estimated that 1 in 3 of us will have early NAFLD.
NAFLD is a liver disease related to a build-up of fat within the liver. A normal, healthy liver should contain little or no fat. Along with so many other conditions we have covered, the health of your liver is closely linked with your overall health. Having high levels of fat in the liver is linked with diabetes, high blood pressure and kidney disease. If you have diabetes and NAFLD, your chances of developing heart disease also increase. This is why, once again, early recognition of this condition is important as we can stop it getting worse and manage it at an early stage.
The stages of NAFLD can be split into 4:
Stage 1: Simple fatty liver – a build-up of mainly harmless fat in the liver. It may be picked up on an ultrasound scan you are having for another reason or show up on blood tests as slightly abnormal liver function.
Stage 2: Non-Alcoholic Steatohepatitis (NASH) – this occurs when the fatty liver becomes inflamed.
Stage 3: Fibrosis – the inflamed liver begins to become scarred within its tissue and around blood vessels but can still function normally.
Stage 4: Cirrhosis – the scarred liver shrinks and stops working properly, normally after years of inflammation. This can lead to liver failure and liver cancer.
So how do you know you might have NAFLD? The answer to this is you probably don’t. There are often no symptoms early in this condition. Several risk factors increase your risk, however, and these include being overweight or obese, having high blood pressure, type 2 diabetes or high cholesterol, being aged over 50 and being a smoker. Some people do develop NAFLD without any of these risk factors though and it has even been seen in children.
A small proportion of people with early NAFLD will go on to develop the more serious stages of NASH, fibrosis and cirrhosis. This may happen over a number of years. By this stage some symptoms may appear. These include:
- Extreme tiredness
- Right sided upper stomach ache
- Weakness
- Weight loss that is unexplained
- Jaundice, itchy skin and swelling of the hands and feet (called oedema) may occur if the liver starts to fail.
NAFLD can be diagnosed on blood tests and ultrasound scans. If it is recognised, further tests may be needed to see what stage it is at, depending on the person’s risk of developing progressive disease. These further tests may include specialised scans called fibro-scans or a liver biopsy, where a sample of liver tissue is taken using a needle and looked at under a microscope. If you are diagnosed with NAFLD you will be followed up to keep an eye on the health of your liver and to monitor for any changes.
So how can we best look after our liver health? No surprise this is the same as many other conditions we have covered! We need to use lifestyle measures to ensure we stay healthy so losing weight, eating a balanced diet, exercising, reducing alcohol intake, stopping smoking and ensuring other conditions like high blood pressure, diabetes and high cholesterol are well controlled will help keep damage from fatty liver to a minimum.
Overall, NAFLD is a condition many people will have some evidence of if tested. It is important to try and manage this to prevent this condition progressing to serious liver disease. Being healthy generally and looking after our health as best we can will lower the risk.
For further information on Non-Alcoholic Fatty Liver Disease (NAFLD) from the NHS visit https://www.nhs.uk/conditions/non-alcoholic-fatty-liver-disease/
