DEAR MAYO CLINIC: Is nonalcoholic fatty liver disease treatable?
ANSWER: Nonalcoholic fatty liver disease (NAFLD) — a condition in which excess fat accumulates in the liver of people who drink little or no alcohol — has become one of the most common liver diseases in the U.S. It’s estimated that the disorder affects up to 20 percent of American adults. Researchers believe this is associated with rising rates of obesity. While some studies have shown a benefit from vitamin E and the prescription medication pioglitazone, the focus is generally on treating the risk factors.
The liver performs many tasks, including processing what you eat and drink into energy and nutrients and filtering harmful substances from your blood. With NAFLD, fat builds up in liver tissue. Some people may experience nonspecific symptoms; however, most individuals with NAFLD experience no symptoms at all.
The buildup of fat in the liver can result in inflammation and scarring (fibrosis). This more serious form of NAFLD — called nonalcoholic steatohepatitis, or NASH — can cause severe liver damage and eventually lead to liver failure or liver cancer in a small percentage of people. Although rare, the scarring can also harden the liver and impair its ability to function properly — a condition known as cirrhosis.
NAFLD may not be discovered until blood tests show an elevation in certain liver enzymes. Additional blood tests may be ordered to rule out other causes of liver disease. To confirm the presence of fat in your liver, doctors often perform an imaging procedure — such as ultrasound, computerized tomography (CT) or magnetic resonance imaging (MRI) — and may also recommend a liver biopsy to examine a sample of tissue for signs of inflammation and scarring.
A number of diseases and conditions can increase the risk of fatty liver disease. These include obesity, high blood cholesterol, and type 2 diabetes. Other risk factors include malnutrition and rapid weight loss. Certain medications, such as corticosteroids, and exposure to some toxins and chemicals also may contribute to fatty liver disease.