Fatty liver - nonalcoholic
Fatty liver; Steatosis; Nonalcoholic steatohepatitis; NASH
Nonalcoholic fatty liver disease (NAFLD) is the buildup of fat in the liver that is NOT caused by drinking too much alcohol. People who have it do not have a history of heavy drinking. NAFLD is closely related to being overweight.
For many people, NAFLD causes no symptoms or problems. A more serious form of the disease is called non-alcoholic steatohepatitis (NASH). NASH can cause liver failure. It can also cause cancer.
There is no clear cause for NAFLD or NASH. However, certain things may put you at risk:
- Overweight or obesity. The more overweight you are, the higher the risk.
- Prediabetes (insulin resistance).
- Type 2 diabetes.
- High cholesterol.
- High triglycerides.
- High blood pressure.
Other risk factors may include:
- Rapid weight loss and poor diet
- Gastric bypass surgery
- Bowel disease
- Certain medicines, such as calcium channel blockers and some cancer drugs
NAFLD also occurs in people who have no known risk factors.
People with NAFLD often have no symptoms. When symptoms occur, the most common include:
- Pain in the upper right abdomen
In people with NASH who have liver damage (cirrhosis), symptoms may include:
- Loss of appetite
- Yellow skin and eyes (jaundice)
- Fluid buildup and swelling in the legs and abdomen
- Mental confusion
- GI bleeding
Exams and Tests
NAFLD is often found during routine blood tests that are used to see how well the liver is working.
You may have the following tests to measure liver function:
Your health care provider may ask for certain imaging tests, including:
A liver biopsy is needed to confirm a diagnosis of NASH, the more severe form of NAFLD.
There is no specific treatment for NAFLD. The goal is to manage your risk factors and any health conditions.
Your provider will help you understand your condition and the healthy choices that can help you take care of your liver. These may include:
- Losing weight if you are overweight.
- Eating a healthy diet that is low in salt.
- Not drinking alcohol.
- Staying physically active.
- Managing health conditions such as diabetes and high blood pressure.
- Getting vaccinated for diseases such as hepatitis A and hepatitis B.
- Lowering your cholesterol and triglyceride levels.
- Taking medicines as directed. Talk to your provider about all medicines you take, including herbs and supplements and over-the-counter medicines.
Losing weight and managing diabetes can slow or sometimes reverse the deposit of fat in the liver.
Many people with NAFLD have no health problems and do not go on to develop NASH. Losing weight and making healthy lifestyle choices can help prevent more serious problems.
It is unclear why some people develop NASH. NASH can lead to cirrhosis.
When to Contact a Medical Professional
Most people with NAFLD do not know they have it. See your provider if you begin to have unusual symptoms such as fatigue or abdominal pain.
To help prevent NAFLD:
- Maintain a healthy weight.
- Eat a healthy diet.
- Exercise regularly.
- Limit alcohol consumption.
- Use medicines properly.
Chalasani N, Younossi Z, Lavine JE, et al; American Association for the Study of Liver Diseases; American College of Gastroenterology; American Gastroenterological Association. The diagnosis and management of non-alcoholic fatty liver disease: practice guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association. Am J Gastroenterol. 2012;107(6):811-826. PMID: 22641309
Torres DM, Harrison SA. Nonalcoholic fatty liver disease. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 87.
Last reviewed on: 4/21/2017
Reviewed by: Michael M. Phillips, MD, Clinical Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.