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What Is Nonalcoholic Fatty Liver Disease (NAFLD)?

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Fatty Liver Disease Overview and Risk Factors

Nonalcoholic fatty liver disease (NAFLD) is a disorder in which large amounts of fat build up in the liver. It's like alcoholic liver disease, but NAFLD occurs in people who don't drink a lot of alcohol.

For some people, liver fat causes swelling and scarring — a condition called nonalcoholic steatohepatitis (NASH).

When the liver is swollen, it doesn't work properly.

Left untreated, NASH could lead to cirrhosis of the liver.

Cirrhosis — a serious disease that replaces healthy tissue in the liver with hard scar tissue — can cause:

  • Organ failure
  • Liver cancer
  • Other complications throughout the body

Conditions that increase NASH risk

People who are at high risk for NASH often suffer from one or more of the following:

  • Obesity and overweight
  • Type 2 diabetes
  • High cholesterol
  • Metabolic syndrome

But, NASH can occur in people who do not have any of these risk factors.

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Symptoms and Signs of NAFLD

Some people with NAFLD may have no symptoms at all, even in late stages of the disease.

Others may have nonspecific symptoms and should be aware of warning signs such as:

  • Fatigue
  • Higher levels of liver enzymes
  • Achiness in the upper right abdomen

People with NAFLD who progress to cirrhosis can have symptoms such as:

  • Liver cancer
  • Fluid overload
  • Kidney failure
  • Confusion and cognitive changes
  • Bleeding from the gastrointestinal tract

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Diagnosing NAFLD

At the UPMC Flow Clinic, our liver specialists use state-of-the-art tools to diagnose fatty liver disease.

Diagnostic tools

Imaging scans of the belly, such as ultrasound, CT, or MRI:

  • Detects fatty liver disease

Noninvasive means, such as blood tests:

  • Detects scarring (cirrhosis) in the liver

Tests that assess liver stiffness, such as Fibroscan or MR elastography:

  • Detects scarring (cirrhosis) in the liver

A liver biopsy, in some cases:

  • Detects the degree of liver inflammation and scarring that has already occurred

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Personalized Treatments for Fatty Liver Disease

Treatments for NAFLD and NASH include:

  • Managing or losing weight with diet changes and exercise.
  • Restricting calories and fructose intake.
  • Taking medicine to treat inflammation and NAFLD-associated metabolic disorders.

For people who can't lose weight through diet and exercise alone, doctors might suggest bariatric surgical procedures, such as gastric bypass. This option is only for carefully selected patients.

If there is too much damage from NASH — leading to liver failure — you will need a liver transplant.

Fortunately, the UPMC Liver Transplant Program is one of the oldest and largest transplant programs in the United States.

As part of the Thomas E. Starzl Transplantation Institute, we have decades of experience providing life-saving transplants to people with liver disease.

Make an Appointment for Fatty Liver Disease Care

Contact the UPMC Flow Clinic at 412-647-1170 to make an appointment or learn more.

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