Non Alcoholic Fatty Liver Disease – A Silent Killer

MEDICAL WORLD 

Usually, nonalcoholic fatty liver disease (NAFLD) is a silent disease with few or no symptoms. Certain health conditions and diseases including obesity, metabolic syndrome, and type 2 diabetes make you more likely to develop NAFLD. Doctors use your medical history, a physical exam, and tests to diagnose nonalcoholic fatty liver disease (NAFLD). Doctors may use blood tests, imaging tests and liver biopsy to diagnose NAFLD and tell the difference between nonalcoholic fatty liver (NAFL) or nonalcoholic steatohepatitis (NASH). 

Nonalcoholic fatty liver disease (NAFLD) is a condition in which excess fat builds up in your liver. This buildup of fat is not caused by heavy alcohol use. When heavy alcohol use causes fat to build up in the liver, the condition is called alcohol-associated liver disease.

Two types of NAFLD are nonalcoholic fatty liver (NAFL) and nonalcoholic steatohepatitis (NASH). People typically develop one type of NAFLD or the other, although sometimes people with one form are later diagnosed with the other form of NAFLD.

When compared to the western world, India is emerging as the hub/hotbed of NAFLD. We are all aware that India is the new diabetic capital in the world. Along with increased prevalence of diabetes and a westernized life style we are getting more and more cases of NAFLD. Needlees to say, this will have a huge impact on our health care system in the future.

NAFL is a form of NAFLD in which you have fat in your liver but little or no inflammation or liver damage. NAFL typically does not progress to cause liver damage or complications. However, NAFL can cause vague abdominal discomfort due to the enlarged liver.

NASH is the form of NAFLD in which you have inflammation of the liver and liver damage, in addition to fat in your liver. The inflammation and liver damage of NASH can cause fibrosis, or scarring of the liver. NASH may lead to cirrhosis, in which the liver is scarred and permanently damaged. Cirrhosis can also lead to liver cancer. Experts are not sure why some people with NAFLD have NASH while others have NAFL.

So how common is NAFLD?

NAFLD is one of the most common causes of liver disease in the United States. The majority of people with NAFLD have NAFL. Only a small number of people with NAFLD have NASH. Experts estimate about 24% of U.S. adults have NAFLD and about 1.5% to 6.5% of U.S. adults have NASH.

And who is more likely to develop NAFLD?

NAFLD is more common in people who have certain diseases and conditions, including obesity and conditions that may be related to obesity, such as type 2 diabetes. Studies suggest that one-third to two-thirds of people with type 2 diabetes have NAFLD. Research also suggests that NAFLD is present in up to 75% of people who are overweight and in more than 90% of people who have severe obesity.

NAFLD can affect people of any age, including children. Research suggests that close to 10% of U.S. children (ages 2 to 19) have NAFLD. However, people are more likely to develop NAFLD as they age.

While NAFLD occurs in people of all races and ethnicities, it is most common among Hispanic individuals, followed by non-Hispanic whites and Asian Americans, including those of East Asian and South Asian descent. NAFLD is less common among non-Hispanic Blacks. On an average, Asian Americans with NAFLD have a lower BMI than non-Hispanic whites with NAFLD. Experts think that genes may help explain some of the racial and ethnic differences in NAFLD.

People with NAFLD may develop liver complications or other health problems.

Liver complications: People with NAFL typically don't develop liver complications, although they have a higher risk for other health problems. People with NASH can develop liver complications, such as cirrhosis and liver cancer. If cirrhosis leads to liver failure, you may need a liver transplant. People with NASH have an increased chance of dying from liver-related causes.

Other health problems: People with NAFLD have a higher risk for certain health problems, including cardiovascular disease, which is the most common cause of death in people who have NAFLD; type 2 diabetes; metabolic syndrome and conditions that may be part of metabolic syndrome, such as high blood pressure and abnormal levels of fats, cholesterol and triglycerides in the blood.

Usually, nonalcoholic fatty liver disease (NAFLD) is a silent disease with few or no symptoms. Certain health conditions and diseases including obesity, metabolic syndrome, and type 2 diabetes make you more likely to develop NAFLD. Doctors use your medical history, a physical exam, and tests to diagnose nonalcoholic fatty liver disease (NAFLD). Doctors may use blood tests, imaging tests and liver biopsy to diagnose NAFLD and tell the difference between nonalcoholic fatty liver (NAFL) or nonalcoholic steatohepatitis (NASH).

Doctors recommend weight loss to treat nonalcoholic fatty liver disease (NAFLD), which is either nonalcoholic fatty liver (NAFL) or nonalcoholic steatohepatitis (NASH). Weight loss can reduce fat, inflammation and fibrosis in the liver. No medicines have been approved to treat NAFLD or NASH. You may be able to prevent nonalcoholic fatty liver disease (NAFLD)—nonalcoholic fatty liver (NAFL) or nonalcoholic steatohepatitis (NASH)—by eating a healthy diet and maintaining a healthy weight. If you have NAFLD, don't ignore it and consult with your doctor immediately.

By Dr Bhaskar Jyoti Baruah MD DM (AIIMS)

Gastroenterologist and Hepatologist,

The GastroLife

Email ID – info@thegastrolife.com

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