Understanding the fatty liver (NALFLD)

Fatty Liver means accumulation of excessive fat in the liver. It can be due to intake of excess alcohol or in many cases occurs without alcohol intake which is called as Non Alcoholic Fatty Liver Disease (NAFLD). NAFLD is very common in India. NAFLD can lead to inflammation in the liver which is known as Non alcoholic Steatohepatitis (NASH). This NASH leads to development of Liver Cirrhosis. In fact NASH is becoming a major cause of Liver Cirrhosis.

Symptoms

Fatty Liver itself does not cause much symptoms. Sometimes it may cause dull aching pain in the Rt upper abdomen. NASH when leads to Cirrhosis cane have symptoms like fluid accumulation in the abdomen, jaundice, blood in vomiting etc.

Causes

Risk factors for development of Fatty liver or NAFLD are

• Being overweight or obesity
• Deranged lipids content like high triglycerides
• Type II Diabetes Mellitus

NASH is seen more commonly in NAFLD patients who are diabetic and have more belly fat.

Diagnosis:

The diagnosis of Fatty Liver is usually coincidental and usually on Ultrasound for some other causes. Ultrasounds grade the fatty liver I-III with increasing severity.

NASH may be considered when fatty liver is accompanied by the deranged Liver functions. But the final diagnosis of the NASH depends upon liver biopsy only.

Fibroscan is used to quantify the fat content in the liver and may aid in devising the management.

CAP Score(dB/m)	Steatosis Grade	Fatty change in the liver (%)
238-260	S1	11-33
260-290	S2	33-66
>290	S3	>67

Prevention of Fatty Liver:

• Reduce weight
• Control Diabetes
• Exercise regularly
• Avoid fatty foods
• Medicines may be required for lipid derangement