Nonalcoholic fatty liver disease (NAFLD) is a term used to describe the accumulation of fat in the liver of people who drink little or no alcohol. By definition, alcohol consumption of over 20 g/day (about 25 ml/day) excludes the condition.
Nonalcoholic fatty liver disease is common and, for most people, causes no signs or symptoms. But in some people, the fat that accumulates can cause inflammation and scarring in the liver. Non-alcoholic steatohepatitis (NASH) is the most extreme form of NAFLD, which is regarded as a major cause of cirrhosis of the liver of unknown cause. At its most severe, nonalcoholic fatty liver disease can progress to liver failure.
Indian men have a high prevalence of non-alcoholic fatty liver disease. Two genetic mutations for this susceptibility have been identified.
The signs and symptoms of nonalcoholic fatty liver disease vary widely, depending on the stage of the condition. During the early or middle stages of the disease, patients typically have no symptoms directly related to liver disease. However, as the disease advances, patients may experience symptoms of cirrhosis, including:
- Fatigue
- Memory loss or confusion
- Fluid retention in the abdomen or legs
- Passage of tarry black stools, which suggests internal bleeding
No standard treatment for nonalcoholic fatty liver disease exists. Instead, doctors typically work to treat the risk factors that contribute to your liver disease. Because NAFLD is related to insulin resistance and the metabolic syndrome, and may respond to treatments originally developed for other insulin-resistant states (e.g. diabetes mellitus type 2), such as weight loss, metformin and thiazolidinediones.
Treatments for the risk factors of NAFLD include:
- Diet changes
- Gradual weight loss may improve the process in obese patients
- Weight-loss surgery leads to improvement and or resolution of NASH
- Insulin sensitisers
- Vitamin E