What is NAFLD and NASH?

NAFLD (non-alcoholic fatty liver disease) is a disease of inflammation of the liver that can lead to permanent liver damage. NASH (non-alcoholic steatohepatitis) is the most severe form of this disease and can progress to chronic liver disease known as cirrhosis, and ultimately may lead to the need for a liver transplant. Cirrhosis can also lead to liver cancer (HCC; hepatocellular carcinoma). That is why it is important to diagnose and treat NAFLD and NASH. There are rarely symptoms of NAFLD and NASH, but some people will feel right upper abdominal fullness or pain and may be especially tired. The liver may be enlarged.

NAFLD occurs in both men and women of all ethnicities and age groups. It is associated with obesity, diabetes, high blood pressure, and high cholesterol. When a patient develops insulin resistance (where the cells cannot take in glucose from the blood, thus leading to high blood sugar) this causes the liver to take in and store more fat in the liver cells (hepatocytes). When this fat is broken down, damage to the cells occurs. Fatty liver can be seen on an ultrasound of the right upper abdomen. In some cases, a biopsy of the liver (a surgical procedure) is needed to see how severe the disease is.

Treatment for NAFLD is limited. The most effective therapy is weight loss, exercise, and a diet low in saturated fat and high in fiber. In people with diabetes, tight control of the blood sugar should be maintained. In those with high cholesterol, lowering of the triglycerides is especially important. There are no specific medications that can be used to treat NAFLD or NASH.

Symptoms of NAFLD and NASH: