Gastroenterology - Non Alcohol Fatty Liver Disease (NAFLD)

What is Non Alcohol Fatty Liver Disease?

This is the name given to a condition in which there is too much fat in the liver. Carrying a small amount of fat in the liver causes no major problems. However, the effects of having fat in the liver over a long period may lead to inflammation causing scarring (fibrosis).

In a small number of people, this can progress to a potentially life threatening condition known as cirrhosis. Cirrhosis is the result of progressive, long term damage to the liver and is the 3rd stage of liver disease. This is often irreversible and can lead to liver failure. This may cause multiple organ failure and lead to death.

The following people who are most at risk are:

• Overweight or obese
• Have a poor diet and do little or no exercise
• Smokers
• Have type 2 diabetes
• Have insulin resistant diabetes
• Have hypertension (high blood pressure)
• Have hyperlipidaemia (too much cholesterol and triglyceride in the body)
• Have polycystic ovaries
• Have hepatitis B and C
• Hake certain drugs prescribed for your conditions
• Genetic

Not everyone with these conditions will develop NAFLD.

How can my weight affect the liver?

The majority of people with NAFLD are overweight.

A person's weight alone is not particularly useful in assessing the risk of developing NAFLD. The ratio of weight to height, known as the body mass index (BMI) is a more realistic useful measurement.

A healthy BMI is regarded as being between 18.5 and 25kg/m2.

• 25 and 30kg/m2 defined as overweight
• Over 30kg/m2 defined as obese

Alcohol related Fatty Liver Disease

This is a fatty liver caused by the consumption of alcohol. Drinking more than the recommended limits of alcohol can lead to a serious health problem. Many people are unaware about the unseen damage that alcohol can cause on the body. Many people who have alcohol related health problems are NOT alcohol dependent. Consuming too much alcohol can cause an accumulation of fat in the liver.

• Men should drink no more than 3 - 4 units per day on a regular basis
• Women should drink no more than 2 - 3 units per day on a regular basis
• It is important to have at least 2 alcohol free days per week

Remember, the more alcohol you drink, the more you could damage your health.

Diagnosis

A routine blood sample (usually liver function tests) may show if there is a problem. You may be asked a lot of questions about your lifestyle such as any drugs you are taking (including any over-the-counter medications and nutritional supplements), your diet, the amount of exercise you do and the amount of alcohol you consume.

Further tests may be needed to confirm the diagnosis such as an ultrasound or a fibroscan. In some cases a liver biopsy may be needed.

Prevention

• Maintaining a healthy weight by eating a well-balanced diet and taking regular exercise
• Keep alcohol consumption within the government guidelines making sure you have at least 2 alcohol free days per week
• Better control of existing conditions e.g. glucose levels in diabetes; high blood pressure

Treatment of NAFLD

There is no specific treatment for NAFLD.

Lose weight gradually and take sensible exercise – there is good evidence that gradual weight loss coupled with increased exercise can reduce the fat in your liver.

Treat associated conditions such as obesity, diabetes, high blood pressure and high cholesterol as these conditions are often associated with NAFLD.

For tips on a more healthier lifestyle visit www.nhs.uk/ change4life.

Contact details

If you have any questions please do not hesitate to contact:

The Royal Oldham Hospital
Gastroenterology Nurse Specialists on 0161 656 1538

This document was produced with thanks to the British Liver Trust (Registered Charity 298858)
www.britishlivertrust.org.uk or phone the Helpline 08006527330.