Nonalcoholic Fatty Liver Disease – Symptoms and Causes
Overview
Fatty liver disease affects people who drink very little or no alcohol. This condition happens when excess fat builds up in the liver. It’s most common in those with excess weight or obesity.
The disease is becoming more widespread, particularly in Western and Middle Eastern countries where obesity rates are rising. It ranks as the world’s most common liver disease. This condition has different stages of severity:
- Hepatic steatosis: Fat in the liver without major inflammation.
- Nonalcoholic steatohepatitis (NASH) : More serious form with liver inflammation and damage.
NASH can worsen over time, potentially causing serious liver scarring (cirrhosis) and even liver cancer. The damage resembles what happens with heavy alcohol use, though the cause is different.
Medical experts are moving toward new terminology for these conditions:
- Metabolic dysfunction-associated steatotic liver disease (MASLD) instead of nonalcoholic fatty liver disease
- Metabolic dysfunction-associated steatohepatitis (MASH) replacing nonalcoholic steatohepatitis
These name changes better reflect the connection between these liver conditions and metabolic health problems.
Signs and Symptoms
People with NAFLD often don’t feel sick. However, some may experience these symptoms:
- Feeling tired
- General discomfort
- Pain in the upper right side of the belly
When NAFLD progresses to NASH or severe scarring (cirrhosis), more serious symptoms may appear:
- Itchy skin
- Swollen abdomen (ascites)
- Trouble breathing
- Swollen legs
- Visible spider-like blood vessels under the skin
- Enlarged spleen
- Reddening of the palms
- Yellow skin and eyes (jaundice)
When to Visit Your Healthcare Provider
If you notice any ongoing symptoms that concern you, schedule an appointment with your healthcare provider. Early detection can help manage the condition more effectively.
Causes
The exact reason why fat builds up in the liver remains unclear to medical experts. Similarly, they don’t completely understand why some fatty livers develop into NASH.
Both nonalcoholic fatty liver disease (NAFLD) and NASH share several common risk factors:
- Genetic factors that may predispose some individuals.
- Excess weight, particularly obesity.
- Insulin resistance where cells fail to respond properly to insulin.
- Type 2 diabetes with elevated blood sugar levels.
- High blood fat levels, especially triglycerides.
These health conditions often work together to create conditions favorable for fat accumulation in the liver. However, some people develop fatty liver disease without having any of these known risk factors.
Risk Factors
Several health conditions raise your chances of developing NAFLD:
- Family history of fatty liver disease or obesity
- Metabolic conditions including high cholesterol, high triglycerides, insulin resistance, and metabolic syndrome.
- Obesity, particularly when fat accumulates around the waist
- Hormonal issues like growth hormone deficiency, polycystic ovary syndrome, hypothyroidism, and hypopituitarism
- Sleep disorders such as obstructive sleep apnea
- Type 2 Diabetes
For NASH, risk increases in:
- People over age 50
- Those with certain genetic factors
- Individuals with obesity
- People with diabetes or high blood sugar
- Those showing signs of metabolic syndrome (high blood pressure, high triglycerides, large waist circumference)
Distinguishing between NAFLD and NASH requires proper medical evaluation and testing. These conditions often develop without obvious symptoms, making regular health screenings important for those with multiple risk factors.
Complications
Serious liver scarring, known as cirrhosis, is the primary complication of fatty liver disease. This scarring occurs due to the liver’s response to inflammation.
As the liver attempts to heal itself, it creates fibrosis (scar tissue) that can gradually spread throughout the organ.
If cirrhosis continues to progress unchecked, several serious health problems may develop:
- Ascites – fluid buildup in the abdomen.
- Esophageal Varices – swollen veins in the throat that may rupture and cause bleeding.
- Hepatic Encephalopathy – brain function issues causing confusion, drowsiness and slurred speech.
- Hypersplenism – enlarged spleen that can reduce blood platelet count.
- Liver Cancer – malignant tumors in the liver tissue.
- Liver Failure – complete loss of liver function.
Research indicates that around 24% of American adults have nonalcoholic fatty liver disease, and 1.5% to 6.5% have the more severe inflammatory type. This condition represents a significant health concern that requires medical attention to prevent potentially life-threatening complications.
Prevention
Reducing your risk of NAFLD involves several lifestyle changes.
Maintain a Balanced Diet
- Focus on fruits, vegetables, whole grains, and healthy fats.
- Avoid sugary beverages like soda, sports drinks, and sweetened tea.
- Limit alcohol consumption as it can harm your liver.
Weight management
If you’re carrying extra weight, work with healthcare providers to create a sustainable weight loss plan. For those at a healthy weight, continue healthy eating and regular physical activity to maintain it.
Regular Exercise
Try to be physically active most days of the week. Before starting any new exercise routine, check with your healthcare provider for guidance, especially if you haven’t been active recently.
These lifestyle modifications can significantly reduce your risk of developing fatty liver disease.
