Fatty Liver Disease
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Non-Alcoholic Fatty Liver Disease (NAFLD) and Non-Alcoholic Steatohepatitis (NASH)
What is Fatty Liver Disease?
Just as people get fat, so do livers. Simple fat in the liver is called steatosis. When there is fat and inflammation we add the term ‘hepatitis’ and get steatohepatitis. Therefore, fatty liver disease exists on a spectrum from simple fatty liver (NAFLD) to an inflamed fatty liver (NASH). Standard liver function tests (LFTs) cannot differentiate the two. NAFLD/NASH is the most common liver disorder in industrialized countries.
Presentation of Fatty Liver Disease
Most patients with NAFLD/NASH have no symptoms but some may complain of fatigue, malaise, and intermittent right upper abdominal discomfort or aching. Patients are typically diagnosed with NAFLD in their 40s or later, but given the size of the obesity epidemic, we know there are many younger patients who have still not been screened and likely have fatty liver disease. Patients usually come to medical attention when laboratory testing reveals elevated liver tests or when fat is detected incidentally on abdominal imaging (e.g. ultrasounds, CT scans, or MRIs).
Management of Fatty Liver Disease
In a liver consultation at COMET, our patients receive a thorough history, physical examination, and appropriate laboratory imaging tests. We typically use state-of-the-art medical imaging (MRI, CT, or ultrasound), and are set to use advanced MRI protocols in the appropriate context to try and estimate how much liver scarring is present. In some cases your doctor might recommend a liver biopsy to determine the extent of damage in your liver or to find out if more than one type of injury pattern is present.
UCLA Division of Digestive Diseases