Dr. Raghu DK

Consultant Gastroenterologist and Hepatologist,

Apollo Hospitals, Jubilee Hills.

Non Alcoholic Fatty Liver Disease (NAFLD) is a condition characterised by the build up of fat (fatty infiltration) in the liver. NAFLD has become increasingly common in the recent times in India and the west as there is increased incidence of obesity, sedentary lifestyle and co morbid conditions like diabetes.  NAFLD is emerging to be the leading cause of liver disease world-wide and is moving ahead of alcohol and chronic viruses like Hep-B and Hep-C. The prevalence of fatty liver disease is increasing from 10 to 46 percent world-wide.

There are two types of Fatty liver disease

• Non-alcoholic fatty liver in which there is only fatty infiltration without inflammation which is a benign condition.
• NASH-Non-alcoholic steato-hepatitis in which there is inflammation of the liver.

What causes Non- alcoholic Fatty liver disease?

To diagnose Non-alcoholic fatty liver disease, there should be no history of significant alcohol intake and other causes that could lead to liver disease like Hep-B or Hep-C.  Most common risk factors for fatty liver disease are Diabetes, Hyperlipidaemia, PCOS, certain drugs.

NAFLD or any liver disease for that matter, is unusual in the sense that it doesn’t present with any symptoms until the liver has reached the stage of irreversible damage what we refer to as CIRRHOSIS OF LIVER. However, some patients might present with fatigue, vague abdominal discomfort and symptoms that pertain to the associated conditions rather than fatty liver disease per se. NAFLD is most often diagnosed on routine check-up after ruling out other causes of liver disease.

What to do if someone has fatty liver?

Fatty liver unfortunately has become a very routine finding on the Ultrasound of the abdomen and most often is dismissed as “NORMAL FINDING”. Fatty liver, if left untreated can lead to Cirrhosis of liver- the outcome of which is either demise or liver transplantation. Fatty liver, when found on the ultrasound, is like an alarm to work on one’s lifestyle and dietary habits.

Such patients should be referred to a gastroenterologist for adequate counselling and further management.

The cornerstone for the treatment of NAFLD is weight management, active lifestyle, good control of associated conditions like Diabetes, PCOS, Hypertension.  Patient education is highly important and regular follow-up of NAFLD with FIBROSCAN which can quantify the fat content in the liver along with assessing the response to treatment, plays a pivotal role to arrest the progression of NAFLD to cirrhosis.