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Symptoms and Signs of Fatty Liver Disease (NAFLD, NASH)

Doctor's Notes on Fatty Liver Disease (NAFLD, NASH)

Fatty liver disease refers to the buildup of fat within the liver. This condition is most commonly cause by alcohol abuse, but other conditions can also cause fatty liver (non-alcoholic fatty liver diease or non-alcoholic fatty liver steatohepatitis, NASH). Other conditions that can cause fatty liver include genetic conditions, obesity, and taking certain medications.

Fat in the liver does not cause specific signs and symptoms. However, if inflammation (hepatitis) is present along with the fat deposition, associated symptoms can include loss of appetite, nausea, vomiting, fatigue, jaundice, and abdominal pain. Some cases of fatty liver progress to scarring (cirrhosis) of the liver and resultant liver failure. In this case, symptoms include a distended, fluid-filled abdomen, problems with blood clotting, and confusion.

Medical Author:
Medically Reviewed on 3/11/2019

Fatty Liver Disease (NAFLD, NASH) Symptoms

For the majority of patients, NAFLD is a benign disease and is not associated with any symptoms. It is only when the liver manifests signs of inflammation, either NASH or alcoholic steatohepatitis, that the patient may experience symptoms. As with other types of hepatitis, the initial symptoms are non-specific and include malaise, fatigue, and upper abdominal fullness and discomfort.

If steatohepatitis progresses to cirrhosis, symptoms of liver failure may develop. Symptoms of liver failure include:

Fatty Liver Disease (NAFLD, NASH) 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.

Picture of the Liver the Largest Gland in the Body
Picture of the Liver the Largest Gland in the Body

Hepatitis Surprising Things That Can Damage Your Liver Slideshow

Hepatitis Surprising Things That Can Damage Your Liver Slideshow

Too much sugar isn't just bad for your teeth. It can harm your liver, too. The organ uses one type of sugar, called fructose, to make fat. Too much refined sugar and high-fructose corn syrup causes a fatty buildup that can lead to liver disease. Some studies show that sugar can be as damaging to the liver as alcohol, even if you're not overweight. It's one more reason to limit foods with added sugars, such as soda, pastries, and candy.

REFERENCE:

Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.

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