Non-Alcoholic Fatty Liver Disease (NAFLD)

What is it?

Non-alcoholic fatty liver disease (NAFLD) is when too much fat builds up in your liver. It's very common and happens even if you don't drink much alcohol. Your liver is an important organ that helps clean your blood and break down food.

The good news is that this condition can often be improved with healthy changes to your lifestyle.

What are the symptoms?

Most people with NAFLD don't have any symptoms at all. Many people have it without knowing. It's often found by accident when you have blood tests or scans for something else.

Some people might notice:

• Feeling very tired all the time
• Feeling generally unwell
• Pain or discomfort in your tummy, under the right side of your ribs

Who gets it?

NAFLD is very common. You're more likely to get it if you:

• Are overweight, especially if you carry weight around your middle
• Don't eat a healthy diet or don't exercise much
• Have type 2 diabetes
• Have polycystic ovary syndrome (PCOS)
• Have high blood pressure or high cholesterol
• Are over 50 years old

How do doctors find it?

Usually, NAFLD is found when you have blood tests or scans for another reason. If your GP thinks you might have it, they will:

• Ask about your symptoms
• Check your height, weight and waist size
• Ask how much alcohol you drink
• Arrange blood tests
• Sometimes arrange scans of your tummy

The different stages

NAFLD has 4 stages:

1. Fatty liver - Fat builds up but your liver isn't damaged
2. Inflamed liver - The fat has caused swelling in your liver
3. Scarred liver - There's some damage but your liver still works well
4. Severe scarring (cirrhosis) - Serious damage that affects how your liver works

Most people only have stage 1, which doesn't usually cause problems.

What can you do to help yourself?

The best treatment is making healthy changes to your lifestyle:

Do:

• Eat a healthy, balanced diet
• Exercise regularly - aim for 150 minutes each week
• Lose weight if you're overweight

Don't:

• Drink too much alcohol - stick to no more than 14 units per week
• Smoke

These changes can reduce the fat in your liver and help repair damage. They also lower your risk of heart disease, kidney problems, high blood pressure and diabetes.

Medical treatment

If you only have fat in your liver without damage, lifestyle changes are usually all you need. You'll have check-ups once a year and tests every 2-3 years.

If your liver is damaged, you may need to see a liver specialist at hospital. They might give you medicines or, in very severe cases, you might need a liver transplant.

When to speak to your GP

Speak to your GP if:

• You think you might have NAFLD
• You think you have a higher risk of getting it
• You have ongoing tummy pain under your right ribs

Remember, most people with NAFLD can improve their condition with healthy lifestyle changes. Your GP can give you advice and support to help you make these changes.

---

Based on NHS.uk guidance. Written by Dr Krishnan Pasupathi, NHS GP.