Nonalcoholic Fatty Liver Disease: NAFLD Explained
It is no secret that drinking to excess can damage your liver. Over many years, the stress caused by high levels of alcohol consumption can damage liver tissue and result in chronic liver disease. What is less well known is that you might find yourself facing liver problems even if you don’t drink heavily.
Known as nonalcoholic fatty liver disease or hepatic steatosis, a buildup of fat in the liver tissue can impair liver function, and eventually lead to serious healthcare concerns such as cirrhosis of the liver.
What is Nonalcoholic Fatty Liver Disease (NAFLD)?
There are many things that can go wrong with your liver over a lifetime. Some of these conditions are easier to avoid than others. Prolonged alcohol use or misuse, infectious conditions such as hepatitis, obesity, type 2 diabetes or prediabetes insulin resistance issues, and even prolonged high blood pressure can all contribute to liver problems. Alcohol abuse and liver inflammation can also cause liver damage as you age.
It is also important to know that liver disease does not affect everyone the same way. There is a higher prevalence of liver disease among individuals of Hispanic descent than in the wider population. Other genetic, health, and lifestyle factors may influence how susceptible you are to developing fatty liver disease.
NAFLD vs. NASH
There are two main types of nonalcoholic liver disease. The first, sometimes known as simple fatty liver, is marked by fat storage in the liver, but there is no accompanying inflammation. NASH, or nonalcoholic steatohepatitis, on the other hand, adds chronic inflammation to the mixture in addition to the fat being stored in the liver. This can lead to increased scarring and raise your chances of cirrhosis.
Fat deposition and the accompanying inflammation have an insidious effect on the liver. As adipose tissue builds up in the liver, portions of your liver are no longer able to do their job. The remaining portion of your liver needs to work harder, potentially leading to damage to liver tissue. This can cause scar tissue and eventually fibrosis, further reducing the number of healthy liver cells available to keep doing the liver’s important work.
Obesity is a major risk factor for nonalcoholic steatohepatitis. Chronic inflammation throughout the body has links to obesity, type 2 diabetes, and other conditions. This inflammation is increasingly being identified as the root cause of many kinds of cellular and tissue damage seen in a variety of diseases.
Can NAFLD be Cured?
Depending on the severity of liver damage you are facing, NAFLD can be treated. Losing weight will reduce the amount of inflammation and fat tissue inside the liver. There are also combinations of medicines and supplements that can contribute to liver disease. If you are taking these medications, switching treatments may be necessary to stop the progression of liver damage. If you are consuming alcohol regularly, you will want to stop drinking, even if alcohol use is not the primary cause of your liver issues.
So far there is no simple drug treatment that targets NAFLD specifically. Research is ongoing to see if vitamin E or certain diabetes medications could possibly play a role in helping people recover from certain kinds of liver disease, but results are inconclusive so far.
How Long do You Live with NAFLD?
How long you can live with NAFLD depends on many factors. How advanced your liver disease has become at the time of diagnosis, how effective you are at making lifestyle changes, and whether there are other conditions contributing to liver damage will all play a role.
Millions of people around the world live with NAFLD, many for long periods of their lives without ever having the condition diagnosed. This is due to the relatively minimal and poorly recognized symptoms of the early stages of liver disease. If you are diagnosed with NAFLD early on before much tissue damage has occurred, you may be able to live normally without danger of liver failure. If, on the other hand, your doctor finds that too much damage has been done, full recovery may not be possible, and extreme measures like liver transplantation may need to be considered.
Like so many medical conditions, especially those involving your digestive tract, the immediate signs and symptoms of liver failure can go unnoticed at first. If you go in for a medical exam and your doctor finds telltale signs of liver disease such as an enlarged liver or jaundice, they may order blood tests to check lipid levels and liver enzymes such as aminotransferase to get an idea of how well your liver is functioning.
Several risk factors can indicate something might be wrong with your liver. A few of the most common include:
- rapid, unexplained weight loss
- metabolic syndrome
- hepatitis C infection
- high levels of triglycerides and cholesterol in your blood
- high blood pressure
- prediabetes or type 2 diabetes
The second step in diagnosing liver problems is typically imaging tests to see if anything can be seen that is obviously wrong with your liver. If imaging tests such as elastography appear to confirm that you may be suffering from liver damage, a liver biopsy may be performed. In this minimally invasive procedure, a tiny sample of liver tissue is removed from your liver to look for diseases like hepatocellular carcinoma (liver cancer).
What to do About a Fatty Liver Diagnosis
If you have been diagnosed with severe liver damage, you will want to talk to a healthcare specialist who understands the field of hepatology. As a subset of gastroenterology, this field specializes in treating liver problems, and can help you understand the risks you face and what it will take to avoid liver failure as long as possible.
For some individuals, the amount of liver damage is too extensive. In these cases, a liver transplant may be the only option. This can be expensive, donors can be hard to find, and positive outcomes after surgery are not guaranteed. That is why it is important to make positive lifestyle changes early in life to eliminate risk factors that could put you at risk of liver cancer, cirrhosis, steatosis, or outright liver failure.
Losing weight if you have been diagnosed with metabolic syndrome is one of the best things you can do for your liver. Avoiding smoking and curtailing or eliminating alcohol use may also help slow down the progress of liver disease, though once your liver tissue has become damaged, it will be an uphill battle to keep your liver healthy.
A diagnosis of NAFLD is not necessarily a death sentence, but it is something you need to take seriously. Eating a healthy diet, watching your weight, keeping an eye on your cholesterol, and keeping an eye on your liver enzymes, especially as you age, are all part of helping to avoid or reduce the severity of liver injury.
Liver disease and the mechanisms of liver failure are still being researched, with organizations like the National Institute of Diabetes and Digestive and Kidney Diseases, American Association for the Study of Liver Diseases, and the National Institutes of Health (NIH) conducting ongoing research and clinical trials on new medications and treatments to help the millions of people living with liver disease have better prospects for positive health outcomes.
The good news is, making lifestyle changes to lower your chances of chronic liver disease also helps to lower the likelihood of incidence of many other chronic killers. Metabolic syndrome not only contributes to liver failure, but it has links to type 2 diabetes, high cholesterol, and cardiovascular disease as well. Staying healthy, eating well, keeping an eye on alcohol use and exercising regularly can provide protection against many of these diseases and conditions that can become life-threatening as we age.
Even if you have not already been diagnosed with NAFLD, NASH, or another form of liver disease, it pays to make sure you are getting the medical care you need. Having specialists on hand to help keep an eye out for the many health concerns that can crop up as we age can make the difference between an early diagnosis and problematic treatment of a late-stage disease. If you are interested in learning more about your liver health, request an appointment at Cary Gastroenterology today.