Fatty liver disease occurs when fat makes up more than 5-10% of the liver's weight. There are two main types: alcoholic fatty liver disease and non-alcoholic fatty liver disease (NAFLD). NAFLD is increasingly common in India due to rising rates of obesity, diabetes, and sedentary lifestyles.
NAFLD vs NASH
NAFLD covers a spectrum:
- Simple fatty liver (steatosis): fat in the liver, no significant inflammation. Often reversible with lifestyle changes.
- NASH (Non-Alcoholic SteatoHepatitis): fat plus inflammation and liver cell damage. Can progress to fibrosis, cirrhosis, and liver cancer.
NASH is the more serious form and requires active medical management.
Who Is at Risk?
Risk factors for NAFLD include:
- Obesity or being overweight
- Type 2 diabetes
- High cholesterol or triglycerides
- Metabolic syndrome
- Rapid weight loss
- Certain medications
Symptoms
Most people with fatty liver disease have no symptoms at all. When symptoms occur, they may include:
- Fatigue
- Vague discomfort in the upper right abdomen
- Enlarged liver on examination
Because it is usually silent, fatty liver is often discovered incidentally during an ultrasound done for another reason.
Diagnosis
Diagnosis typically involves:
- Liver function tests
- Ultrasound or CT scan
- FibroScan to assess liver stiffness
- Blood tests to rule out other causes
- Liver biopsy if NASH or advanced fibrosis is suspected
Treatment
Currently there is no specific approved drug for NAFLD, but treatment is highly effective:
- Weight loss of 7-10% significantly reduces liver fat and inflammation
- Control of blood sugar, cholesterol, and blood pressure
- Avoid alcohol entirely
- Regular exercise
- Dietary modification (reduce refined carbohydrates, sugars, processed foods)