Fatty Liver Disease
(NAFLD, NASH)

Medical Author:

Benjamin Wedro, MD, FACEP, FAAEM

Benjamin Wedro, MD, FACEP, FAAEM

Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

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Medical Editor:

Bhupinder Anand, MD

• Fatty Liver Overview
• Fatty Liver Causes
• Fatty Liver Symptoms
• When to Seek Medical Care
• Exams and Tests
• Fatty Liver Treatment
• Self-Care at Home
• Medical Treatment
• Medications
• Surgery
• Next Steps
• Follow-up
• Prevention
• Outlook
• Synonyms and Keywords
• Author and Editor

Fatty Liver Overview

Fatty liver disease is characterized by increased accumulation of fat, especially triglycerides, in the liver cells. It is normal for the liver to contain some fat and by itself, this causes no symptoms. In some patients, the excess fat can cause inflammation called steatohepatitis (steato=fat +hepar=liver +itis=inflammation), although there is no relationship between the amount of fat present and the potential for inflammation.

Steatohepatitis can lead to cirrhosis (fibrosis, scarring and hardening of the liver). There is also an association with liver cancer (hepatocellular carcinoma).

Fatty Liver Causes

Fatty liver can be classified as alcohol and nonalcohol related. Alcohol is a direct toxin to the liver and can cause inflammation. Nonalcoholic fatty liver disease (NAFLD) and nonalcoholic related steatohepatitis (NASH) are markedly different illnesses and there are many potential causes that are linked to fat accumulation in the liver.

Some of the causes of fatty liver include:

• Diet: Consumption of excess calories in the diet (the excess caloric intake overwhelms the liver's ability to metabolize fat in a normal fashion, which results in fat accumulation in the liver).
  
  
• Diseases: Fatty liver is also associated with type II diabetes, obesity, and high triglyceride levels in the blood, celiac disease, and Wilson's disease (abnormality of copper metabolism).
  
  
• Medical conditions: Rapid weight loss and malnutrition.
  
  
• Medications: Medications such as tamoxifen (Soltamox), amiodarone injection (Nestorone), amiodarone oral (Cordarone, Pacerone), and methotrexate (Rheumatrex Dose Pack, Trexall) are associated with NAFLD.

There is evidence to suggest the presence of an association between insulin resistance and the development of NAFLD. In this situation, although the body makes adequate insulin, the ability of cells to adequately use that insulin to metabolize glucose is abnormal. The relative excess of glucose is then stored as fat and can accumulate in the liver.