Non-Alcoholic Fatty Liver Disease, as the name implies, is a liver disease where there is increased amount of fat deposited in liver cells.
It consists of a spectrum of conditions and they are as stated below:
- Simple fatty liver – a build-up of fat tissues in liver cells, usually asymptomatic, detected incidentally upon ultrasound of abdomen
- Non-alcoholic steatohepatitis (NASH) – the liver becomes inflamed, usually causing deranged liver enzymes in blood test results
- Fibrosis – Scarring of the liver after persistent inflammation
- Cirrhosis – Hardening and shrinking of the liver after repetitive inflammation and scarring. This is the most severe stage of NAFLD. Besides leading to liver failure, it increases one’s risk for liver cancer
While it is hard to say why some people develop fatty liver while others are spared, and why some fatty liver progresses to inflammation and fibrosis while some do not, a few of the following factors have been linked to increased risk of developing NAFLD :
- Central obesity and overweight
- Type 2 Diabetes mellitus and prediabetes (high blood sugar level)
- High Cholesterol
- High triglyceride level
- High blood pressure
- Metabolic syndrome
- Polycystic Ovary Syndrome
Signs and Symptoms
There are hardly any signs and symptoms at early stages, but for some, they may experience:
- Poor appetite
- Pain in upper right abdomen area
As the disease progresses and worsens to cirrhosis, there will be yellowing of skin and white of eyes, abdominal swelling, leg swelling, dilated superficial small vessels around chest area, confusion, memory loss and etc.
About 20% of non-alcoholic steatohepatitis will progress to cirrhosis
What Tests To Perform?
- Blood test for liver function, and test to rule out other causes such as Hepatitis.
- Fatty liver maybe spotted during Ultrasound scan of your abdomen. We will proceed to FibroScan test for staging. FibroScan measures fatty change and any scarring of patient’s liver.
- Some patients may need further biopsy test.
Steps to Prevent Developing and Progression of NAFLD
- Maintain a healthy diet – have a balanced meal rich in vegetables and fruits, low in fat, sugar and salt.
- Maintain an ideal BMI – ideal BMI according to WHO is 18.5-24.9 kg/m2. However, for Asians, our ideal BMI falls between 18.5-22.9kg/m2 (calculate BMI with BMI calculator) ; losing more than 10% of body weight may help reduce fat tissues from the liver.
- Exercise regularly – aim for 150min/week of moderate intensity exercise such as brisk walking or slow jog; you may start with shorter duration and slowly build up your exercise tolerance.
- Stop smoking.
- Take medication to help keep blood sugar, blood pressure, cholesterol and triglyceride within normal range if you have these medical problems.
- Stop drinking alcohol – although alcohol is not a causative factor in NAFLD, but drinking may worsen it.