For many years, non-alcoholic fatty liver disease (NAFLD) refers to a group of liver diseases that occur when too much fat is stored in liver cells. It is the most common chronic liver disease, affecting 25-30% of the world’s adult population and is on the rise globally.
The name of fatty liver disease is changing to fatty liver disease (SLD). Why is the name change important? The term “non-alcoholic” does not accurately describe the cause of the disease, while “fat” has a negative association.
Categories of SLD include:
- Metabolic dysfunction-associated fatty liver disease (MASLD), formerly known as nonalcoholic fatty liver disease (NAFLD).
- MASLD and increased alcohol intake (MetALD).
- Alcohol-related liver disease (ALD).
- Specific causes of SLD include drug-induced liver injury and liver disease caused by celiac disease or malnutrition.
- Cryptogenic SLD, a liver disease of uncertain origin.
Some people may develop an aggressive form of MADLD called metabolic-associated steatohepatitis (MASH). The main concern with MASH is that inflammation of the liver can progress to advanced scarring, called fibrosis. If inflammation persists, fibrosis can spread and take over more liver tissue.
causes of liver disease
Medical professionals have yet to figure out why fat accumulates in some people’s livers. Some factors associated with this condition include:
- obese or overweight
- High blood sugar, called hyperglycemia, may indicate prediabetes or type 2 diabetes
- High levels of fat in the blood, especially triglycerides
These factors may lead to the accumulation of fat in the liver, which can lead to chronic liver disease over time.
liver disease symptoms
People with early-stage MASLD often have no symptoms of the disease. General symptoms may include fatigue, feeling unwell, or pain in the upper right abdomen.
When liver disease progresses to advanced fibrosis or severe scarring of the liver (called cirrhosis), possible symptoms include:
- Abdominal swelling caused by ascites, which is fluid in the abdomen
- enlarged spleen
- gastrointestinal bleeding
- itchy skin
- Shortness of breath
- swelling of the legs
- Yellowing of the eyes and skin (jaundice)
Please contact your health care professional to discuss your risk factors for liver disease and to evaluate any symptoms.
Get screened for liver disease
Because liver disease has no obvious signs or symptoms in its early stages, it can develop for years without being diagnosed. Screening and early diagnosis are critical to identifying and managing the condition.
Several non-invasive screening methods are available, including blood tests and imaging tests such as abdominal ultrasound and transient elastography. Your primary care provider, endocrinologist, cardiologist, or gastroenterologist can order these tests.
If a member of your care team determines that you are at increased risk for fatty liver disease or have advanced fibrosis or cirrhosis, they may refer you to a gastroenterologist or hepatologist for evaluation and treatment.
have liver disease
You can prevent, slow, or improve fatty liver disease by taking actions that can help control the disease. If you are overweight or obese, your first step should be to lose weight combined with a healthy diet and exercise. Actions you can take include:
- Take control of your diabetes.
If you have prediabetes or diabetes, talk to your healthcare team about whether you need to be screened for fatty liver disease. According to the American Diabetes Association, up to 70 percent of people with type 2 diabetes have liver disease. If you have diabetes, monitor your blood sugar and take medications as directed by your healthcare team to control your condition.
- healthy diet.
Your meal plan should include fruits, vegetables, lean proteins, and whole grains. Avoid sugary drinks and watch portion sizes. Interestingly, drinking at least three cups of coffee per day was associated with mild liver disease.
- Exercise and find ways to be active.
Whether you want to lose weight or not, staying active can be good for you. Try to exercise for at least 30 minutes most days of the week. If you don’t exercise regularly, talk to your health care team first and start exercising slowly.
- Go to the doctor.
Liver health is vital. If you have liver disease, a team of health care professionals in primary care, gastroenterology, endocrinology, and cardiology may work together to evaluate, manage, and treat your condition.
- lose weight.
Healthy diet and exercise are effective ways to lose weight. Consider working with a registered dietitian to help assess your caloric needs to achieve weight loss. If you are overweight or obese, talk with your health care team about a weight loss plan or bariatric surgery.
- reduce cholesterol.
If you have high cholesterol or triglyceride levels, medications, a plant-based diet, and exercise can help keep your blood fat levels at an average level.
- Protect your liver.
Drinking alcohol puts extra stress on the liver. People with liver disease are often advised to limit or avoid alcohol consumption. These same steps can also prevent liver disease in people who don’t already have it. Follow directions for prescription and over-the-counter medicines. Consult your healthcare professional before taking herbal supplements. There are no approved or safe ways to detoxify your liver, so avoid treatment options that claim to do this.
Victoria Louwagie is a physician assistant at Gastroenterology in Mankato, Minnesota.