Overview Of A Common Liver Disease Non-Alcoholic Fatty Liver Disease (NAFLD)

Non-Alcoholic Fatty Liver Disease (NAFLD) is a silent epidemic, usually having no clinical symptoms unless the disease is far advanced. The spectrum of the disease ranges from simple deposition of fat in the liver to derangement of LFT and further progression into fibrosis, cirrhosis, HCC, and mortality due to liver dysfunction, major adverse cardiovascular events, or neurological disorders.(Image source: Canva)

Characteristics of NAFLD: 1. Silent Epidemic: NAFLD is often asymptomatic, especially in the early stages. Clinical symptoms typically appear only when the disease has progressed significantly. (Image source: Pinterest/ myteashack)

2. Disease Spectrum: The progression of NAFLD can be described as a spectrum, starting from simple steatotic (fat deposition in the liver) to more severe forms, including: Steatohepatitis (inflammation and damage) Fibrosis (scarring) Cirrhosis (advanced scarring leading to liver dysfunction) Hepatocellular carcinoma (HCC, a type of liver cancer) Mortality due to liver failure, major adverse cardiovascular events (MACE), or neurological disorders. (Image source: Canva)

Diagnosis: The commonest method of diagnosis is “an incidental one.” A fatty liver diagnosis is made on USG or other imaging of the abdomen or by a deranged LFT. Rarely is it diagnosed when the liver decompensates with ascites, jaundice, or variceal bleeding. Once a diagnosis of fatty liver disease is made, we need to quantify the extent of liver dysfunction by imaging and blood tests and document the evidence of fibrosis, which gives a prognostic assessment of the liver disease. (Image source: Canva)

Treatments: The primary line of treatment is to target the deranged metabolic factors (DM, dyslipidemia, and hypothyroidism) along with weight loss or aerobic exercise. The intent of weight loss is to reset the primary event leading to a fatty liver. Target loss by diet and exercise is around 7 percent in 6 months. This amount of weight loss leads to improvements in the biochemical, structural, and histological changes in the liver. Medication like vitamin E, pioglitazone, saroglitazar, and obetocholic acid has an additional role to play in improving liver disease. (Image source: Canva)

Conclusion: NAFLD is a significant health issue with a broad spectrum of disease progression and serious potential complications. Early diagnosis through incidental findings or targeted screenings in at-risk populations, combined with lifestyle modifications and specific medical treatments, can improve outcomes and potentially reverse some of the liver damage. Regular follow-up and monitoring are essential for managing this chronic condition effectively. (Image source: Canva)

Inputs By: Dr. Jayanta Mukherjee, Consultant Gastroenterologist ILS Hospitals, Saltlake (Image source: Canva)