Non-alcoholic fatty liver disease (NASH/NAFLD)

Non-Alcoholic Fatty Liver Disease


Non-alcoholic fatty liver disease (NAFLD) is an umbrella term for a plethora of diseases in people with negligible alcohol consumption that causes excess fat to be stored in the liver. NAFLD has three stages – inflammation, cirrhosis, and liver failure. NAFLD’s symptoms are very similar to those caused by long-term alcohol abuse.

Signs and symptoms

Non-alcoholic fatty liver disease usually causes no symptoms in the initial stages. Mild symptoms like stomach ache in the upper right abdomen and fatigue may be present. When the disease progresses to cirrhosis, patients usually experience abdominal swelling (ascites), enlarged spleen, jaundice, red palms and enlarged blood vessels beneath the skin.

Causes and risk factors

Non-alcoholic fatty liver disease is associated with obesity, high cholesterol and type 2 diabetes. This is mainly associated with a sedentary lifestyle, prolonged duration of high-calorie food intake and limited exercise. However, a small proportion of patients- especially of South Asian origin develop this problem despite the absence of any of these risk factors (Lean NASH). People with polycystic ovary syndrome, hypothyroidism and hypopituitarism are also at a higher risk of developing Non-alcoholic fatty liver disease.


The main complication of this disease is cirrhosis. Cirrhosis is a response to inflammation. Progression of cirrhosis will lead to its usual complications such as oesophageal varices, hepatic encephalopathy or disorientation, liver cancer and end-stage liver failure.


Since most patients do not have any symptoms, it is challenging to diagnose Non-alcoholic fatty liver disease at an early stage. The doctor may diagnose the disease based on patient medical history, a physical exam, blood tests, liver function tests, and an ultrasound, CT scan or MRI to check for fat deposits.

Treatment and Surgical Interventions

There are currently no approved drug therapies for Non-alcoholic fatty liver disease. However, weight reduction with a combination of healthy, low-calorie diet and exercise is usually the first course of action. Extreme fasting or attempting to follow rigid diet regimens may be counter-productive and should be followed only after careful discussion with your hepatologist. Occasionally, weight-loss surgery or gastric by-pass surgery may be recommended to help the patient lose weight. For patients with cirrhosis and its complications, a liver transplant may be needed.


To reduce your risk of developing non-alcoholic fatty liver disease, maintain a healthy weight and body mass index. Eat a healthy, balanced diet and exercise regularly.

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