Understanding Fatty Liver Disease

What is Fatty Liver Disease?

Fatty liver disease happens when fat builds up in the liver. It can be caused by alcohol (Alcoholic Fatty Liver Disease) or other factors like obesity and diabetes (Non-Alcoholic Fatty Liver Disease or NAFLD). This leaflet will focus on NAFLD.

Why do I have NAFLD?

NAFLD is often linked to a combination of lifestyle factors and underlying health conditions. The primary reasons you might have NAFLD include being overweight or obese, particularly if the excess weight is carried around your abdomen, which is associated with a higher risk of fat accumulation in the liver.

Conditions like type 2 diabetes, insulin resistance and high cholesterol are also major contributors, as they can disrupt normal fat metabolism and lead to increased fat storage in the liver. Poor dietary habits, such as consuming a diet high in processed foods, sugars, and unhealthy fats, along with a sedentary lifestyle, further exacerbate these risks.

Why is it important?

NAFLD often presents without symptoms in its early stages, making it difficult to detect without specific testing. Although many people with NAFLD do not progress to more severe disease, a significant proportion can develop further complications if untreated. This includes cirrhosis and liver cancer.

There are four major stages of NAFLD:

Simple NAFLD is when fat builds up in the liver without causing significant damage or symptoms, though some people might experience mild fatigue or discomfort. Management involves adopting a healthy diet, regular exercise, and weight loss to reduce liver fat.

Non-alcoholic steatohepatitis involves fat buildup, inflammation, and liver cell damage, and it may cause fatigue or upper right abdominal discomfort, though many have no symptoms. Management includes lifestyle changes such as a healthy diet, exercise, weight loss, and possibly medications as prescribed by your doctor.

Fibrosis occurs when ongoing liver inflammation leads to scar tissue formation, which might not cause obvious symptoms but can gradually impair liver function. Management focuses on continued lifestyle changes and medical treatments to reduce liver damage. Early intervention is key to managing fibrosis effectively.

Cirrhosis is severe liver scarring that impairs its function, with symptoms such as jaundice, severe fatigue, abdominal swelling, and easy bruising. This stage requires close medical management and possibly a liver transplant if liver failure occurs.

What can we do to help as your GP?

To manage NAFLD, we use specific tests to assess the health of your liver. The first test we do is the Fib-4 index, which uses your age and routine blood test results to estimate the amount of scarring in your liver. We typically perform this test when we first diagnose NAFLD or during regular check-ups to monitor your liver health.

If the Fib-4 test suggests that there might be significant scarring or if the results are not clear, we follow up with a special blood test called the ELF test. This test provides a more accurate picture of the liver’s condition by measuring specific markers in your blood that indicate fibrosis. Your ELF score will determine whether we need to refer you to a liver specialist for further investigations.

How can you prevent Fatty Liver Disease?

Maintain a healthy weight through diet and exercise.

Control blood sugar levels if you have diabetes.

Limit alcohol consumption.

One You Haringey provides free local exercise classes, a 12-week weight management course, walking groups and lots of other activities that anybody can sign up to that are beneficial for your physical health. You can self-refer here: https://www.oneyouharingey.org/