Fatty Liver Disease

What is fatty liver disease?

Fatty liver disease is a condition when too much fat builds up in the liver. It is also called non-alcoholic fatty liver disease (NAFLD).

Fatty liver can be more likely to happen if you have certain risk factors, such as being overweight, having high cholesterol or having high blood pressure.

NAFLD is divided into four main stages:

1.    Fatty liver – a build-up of fat in your liver cells
2.    Non-alcoholic steatohepatitis (NASH) – the liver becomes inflamed due to the fat build-up
3.    Fibrosis – continuous inflammation leads to scar tissue around the liver
4.    Cirrhosis – persistent inflammation and scarring damages the liver and reduces its function

Our expert team at the London Liver Group provides specialist care across a range of liver conditions, including fatty liver and cirrhosis. 

Causes

The cause of fatty liver disease is unclear. Certain risk factors make it more likely to develop the condition.

The risk factors for NAFLD include:

•    Being overweight or obese
•    Type 2 diabetes
•    High cholesterol or triglycerides
•    High blood pressure

In some cases, fatty liver disease can be caused by rare genetic diseases such as Wilson disease. Some medications can also cause excess fat to build up. These include corticosteroids, HIV treatment and oestrogen.

Symptoms

Fatty liver disease often has no symptoms, especially in the early stages. 

If the condition has progressed to fibrosis where there is some scarring on your liver, you may have the following symptoms:

•    Feeling very tired
•    Unintentional weight loss
•    Weakness
•    An aching pain on the top right side of your tummy

Fatty liver disease can be diagnosed during routine tests or scans for another reason. 

Diagnosis

Your doctor will ask you questions about your medical history and do some tests to investigate whether you have fatty liver disease.

Blood tests that are used for diagnosis include checking your liver enzyme levels. These include alanine aminotransferase (ALT) and aspartate aminotransferase (AST).

Abnormal liver blood tests do not necessarily always indicate fatty liver disease. Your doctor may repeat these blood tests if they come back high.

Your doctor may also do some scans to check your liver. These include ultrasounds, CT scans or an MRI scan.

In a small number of cases, your doctor may perform a liver biopsy. During a biopsy, a small piece of tissue is taken from your liver to be looked at for any diseases.

Your consultant at the London Liver Group will discuss your options for diagnosis and take the time to answer all your questions.

Treatments

There are no medications used to treat fatty liver disease. The main treatment for fatty liver disease is to change lifestyle factors that contribute to the disease. 

Weight loss is an important part of treating fatty liver disease. By losing around 5% of your body weight, you can reduce the excess fat build up in your liver.

You should try to lose weight in a sustainable and healthy way. This involves eating a healthy and balanced diet and doing regular exercise.

Stopping smoking can reduce your risk of complications from fatty liver disease. Smoking can damage the blood vessels in your liver and potentially cause liver cancer.

Cutting down on alcohol can also help your liver to recover. While NAFLD is not caused by alcohol, drinking alcohol can increase the damage to your liver. 

Your consultant will help you by giving you guidance and advice about changes you can make that will a difference. Together, you will develop a plan and goals to help improve your symptoms and long-term outcomes of your condition.

If your liver disease has progressed to severe cirrhosis, your consultant may consider a liver transplant.