Fatty liver/Non Alcoholic Fatty Liver Disease (NAFLD)
It is a medical condition characterised by build-up of fat in the liver. It is a condition with a spectrum starting with simple fat deposition leading to varying degrees of inflammation (Non Alcoholic Steatohepatitis – NASH) over a period of time.This is diagnosed by the blood tests which show raised liver enzymes signifying ongoing inflammation. As the name suggests, this condition is particularly seen in patients who take little or no alcohol and is related to lifestyle and our body mass index (being overweight or obese). As inflammation in liver (which has immense power to regenerates itself), heals with scarring this can lead to permanent liver damage. Once permanent damage or Cirrhosis sets in, chances of liver cancer increases manifolds.
Conditions related to NASH
- Obesity – more than 70% of people with NASH are obese.
- Diabetes – Up to 75% of people with this condition have type 2 diabetes.
- Raised Cholesterol (Hyperlipidaemia) – 20-80% of people with NASH have high cholesterol.
- Insulin resistance – This is again a silent condition when a person actually does not have diabetes but the body fails to respond appropriately to insulin, a hormone which is secreted by pancreas and regulates our sugar levels. This is usually seen in overweight and obese people.
- Drugs and toxins – Many drugs used for other medical conditions as well as pesticides can be responsible for NASH.
Symptoms of NASH
It is largely a silent disease and hence awareness is the key to prevent this disease.Given a sedentary lifestyle of an individual, it can go from bad to worse without one’s knowledge.
Diagnosis of NASH
It is usually diagnosed as an incidental finding when imaging or blood tests are done for vague tummy symptoms or an unrelated reason. However basic tests cannot differentiate it from other types of liver diseases, hence additional tests are required to rule out other causes of liver damage. A fibroscan used serially can be helpful in the assessment of fatty liver and is an important tool for diagnosis and follow up.
Treatment of NASH
The aim is to treat the conditions associated with NASH, eg.
- gradual weight loss,
- treatment of insulin resistance which is presently related to lifestyle changes,
- Vitamin E may or may not be helpful and should be used in selectively only when recommended by a doctor.
- Avoid alcohol
- Since there is no specific treatment and it is a silent disease a follow up with the doctor is very important.
NASH can lead to serious liver disease called Cirrhosis. This is preventable.
