Liver disease: NHS Doctor talks about link with alcohol
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Fatty liver disease falls into two categories – alcoholic (AFLD) and non-alcoholic (NAFLD). As the name would suggest, the AFLD describes a buildup of fat in the liver caused by drinking too much alcohol. NAFLD is not associated with excessive alcohol intake but is closely linked to being overweight.
For many people, NAFLD causes no symptoms or problems in the initial stages.
According to health body Penn Medicine, symptoms may show up if NAFLD progresses to non-alcoholic steatohepatitis (NASH).
NASH is a more serious form of the disease that can cause liver failure and liver cancer.
In people with NASH who have liver damage (cirrhosis), symptoms may include:
- Weakness
- Loss of appetite
- Nausea
- Yellow skin and eyes (jaundice)
- Itching
- Fluid buildup and swelling in the legs and abdomen
- Mental confusion
- GI bleeding.
How is NAFLD diagnosed?
According to the NHS, NAFLD is often diagnosed after a blood test called a liver function test produces an abnormal result and other liver conditions, such as hepatitis, are ruled out.
It is worth noting that blood tests do not always pick up NAFLD.
“The condition may also be spotted during an ultrasound scan of your tummy,” explains the NHS.
This is a type of scan where sound waves are used to create an image of the inside of your body.
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Am I at risk?
It is unclear exactly why some people accumulate fat in the liver while others do not.
Similarly, there is limited understanding of why some fatty livers develop inflammation that progresses to cirrhosis (liver damage).
However, chronic disease markers have been associated with an increased risk of NAFLD.
According to the Mayo Clinic, NAFLD and NASH are both linked to the following:
- Overweight or obesity
- Insulin resistance, in which your cells don’t take up sugar in response to the hormone insulin
- High blood sugar (hyperglycaemia), indicating prediabetes or type 2 diabetes
- High levels of fats, particularly triglycerides, in the blood.
“These combined health problems appear to promote the deposit of fat in the liver,” explains the health body.
“For some people, this excess fat acts as a toxin to liver cells, causing liver inflammation and NASH, which may lead to a buildup of scar tissue in the liver.”
A wide range of diseases and conditions can increase your risk of NAFLD, including:
- High cholesterol
- High levels of triglycerides in the blood
- Metabolic syndrome
- Obesity, particularly when fat is concentrated in the abdomen
- Polycystic ovary syndrome
- Sleep apnea
- Type 2 diabetes
- Underactive thyroid (hypothyroidism)
- Underactive pituitary gland (hypopituitarism).
How to treat NAFLD
There is no specific treatment for NAFLD that all doctors agree on.
“However, if your NAFLD is linked to being overweight then you will be advised to make various lifestyle changes including losing weight gradually and taking sensible exercise,” explains the British Liver Trust (BLT).
According to the BLT, there is good evidence that gradual weight loss coupled with increased exercise can reduce the amount of fat in your liver.
“In mild cases of NAFLD doctors may concentrate on treating associated conditions, such as obesity and diabetes, which can cause fat to build up,” notes the health body.
It adds: “They will also treat disorders such as high blood pressure and high cholesterol as these are often associated with NAFLD.”
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