Non-Alcoholic Fatty Liver Disease

Simple Fatty Liver (Steatosis)

This stage represents the initial phase of NAFLD, marked by the accumulation of excess fat in liver cells. Typically, there is no inflammation or damage to the liver cells, and it often remains asymptomatic without complications.

Non-Alcoholic Steatohepatitis (NASH)

If NAFLD progresses, it can lead to non- alcoholic steatohepatitis (NASH), a more serious form of the disease. NASH is characterised by inflammation of the liver, which can damage the liver cells and potentially lead to scarring (fibrosis).

Liver Fibrosis

At this stage, ongoing inflammation causes scar tissue to form in the liver, replacing healthy liver tissue. This process of scarring is called fibrosis. While the liver can still function at this stage, its ability to regenerate and perform vital roles becomes increasingly impaired.

Obesity

Being overweight or obese (with a body mass index of 25-30 or above 30, respectively)

Diabetes

Individuals with type 2 diabetes are more prone to fatty liver disease due to the association with insulin resistance, which can cause excessive fat buildup in the liver

High Blood Sugar

Persistently high blood sugar levels can contribute to fat accumulation in the liver

Elevated Levels of Fats in the Blood

Elevated levels of cholesterol and triglycerides can lead to the buildup of fat in the liver, resulting in fatty liver disease

High Blood Pressure

Hypertension has been associated with a higher risk of developing fatty liver disease

Fatigue

Fatigue is a common symptom of many liver diseases, including NAFLD. Patients may feel constantly tired or weak.

High Blood Pressure

While high blood pressure is also a risk factor for NAFLD, it can also occur due to the disease. This is because NAFLD can contribute to the development of cardiovascular diseases.

Jaundice

Jaundice is characterised by a yellowing of the skin and eyes. This occurs when the damaged liver cannot properly process bilirubin, a by-product of red blood cell breakdown.

Abdominal Distension From Fluid Retention

Also known as ascites, this symptom arises when the liver cannot produce enough protein to hold fluid in the bloodstream, causing fluid to accumulate in the abdomen.

Internal Bleeding From Swollen Blood Vessels (Varices)

In response to liver damage, blood may flow into smaller vessels that cannot handle the increased volume. This can cause the vessels, particularly those in the oesophagus and stomach, to swell and potentially bleed.

Confusion

Hepatic encephalopathy occurs when the liver cannot remove toxins from the blood, causing them to build up in the brain. This leads to confusion and other cognitive problems.

Coma

In severe cases of hepatic encephalopathy, the patient may fall into a coma due to the high levels of toxins in the brain.

Blood Tests

Blood tests can reveal liver function abnormalities and help identify other conditions that may cause similar symptoms. Elevated liver enzymes may suggest liver damage, particularly alanine aminotransferase (ALT) and aspartate aminotransferase (AST).

Imaging Procedures

Imaging tests such as ultrasound for fatty liver, CT scan, or MRI can show fat accumulation in the liver. These non- invasive procedures are often the first step in diagnosing NAFLD.

Liver Biopsy

A liver biopsy involves inserting a needle into the liver to collect a small tissue sample for examination under a microscope. A biopsy can confirm a diagnosis of NAFLD and show the degree of liver damage or inflammation.

Weight Loss

In overweight or obese individuals, losing weight can reduce fat in the liver. This may be achieved through a balanced diet and regular exercise.

Lifestyle/Dietary Modifications

Maintaining a healthy diet rich in fruits, vegetables, whole grains, and healthy fats helps manage NAFLD. It is also advisable to avoid high-calorie meals and saturated fat. Limiting alcohol consumption is also advised.