Non-alcoholic fatty liver disease (NAFLD) is a common liver disorder in Australia. It is an accumulation of excess fat in liver cells, taking up 5 to 10 percent of the entire organ. Typically, consuming too much alcohol is a primary cause of fat build-up in the liver, but those with NAFLD may not drink much alcohol at all. Approximately one in three Australians have the disease and according to gastroenterologist, Dr Harmeet Malhi, it is the leading cause of chronic liver disease worldwide. Though it causes no permanent damage, NAFLD can progress to non-alcoholic steatohepatitis (NASH), which can result in cirrhosis (irreversible scarring of the liver) or liver cancer.
NAFLD is asymptomatic, meaning it usually has no physical symptoms. However, you should consult your doctor if you have any of the following risk factors. Doctors may use a variety of factors to diagnose the condition, such as blood tests, an abdominal ultrasound or scan or a liver biopsy.
One of the early fatty liver symptoms is binge eating, either feeling hungry all the time or having an intense craving for sugars. These eating habits only add to the fat that is already accumulating in your liver. “We have to be cognisant of what we’re eating because we are what we eat,” says Dr Rohit Loomba. “And if we consume excess kilojoules, especially kilojoules that are sugar-rich or carbohydrate-rich, over a long period of time, it will have negative consequences.” He recommends keeping a food log of what you eat every day to track your sugar and fat intake. This will help you to see if your eating habits are something you need to watch out for.
People who are overweight are at an increased risk of NAFLD. Since the obesity rate in Australia is on the rise – more than two thirds of the population is overweight or obese – the threat is more prevalent than ever. Dr Loomba cautions that visceral fat (the kind stored in your abdomen that gives you a big gut) is a big concern. “As the body mass index goes up and people go from a BMI of 30 to 35 to 40, the prevalence of non-alcoholic fatty liver disease starts going up,” he says. “We’re finding that the visceral fat correlates well with liver fat especially in middle-aged and younger adults.”
High blood fat levels, either triglycerides or LDL (‘bad’) cholesterol, can signal that there’s too much fat in your liver. “The cholesterol that we measure in the blood is predominantly a product of what is coming out of the liver,” Dr Loomba explains. The liver makes cholesterol on its own and circulates it into your bloodstream, but when we eat foods high in saturated and trans fats, it releases more fat and raises cholesterol levels. Have your doctor check your cholesterol levels often to make sure they’re not one of the fatty liver signs that you need to watch out for.
If you have diabetes, Dr Loomba says getting tested for NAFLD should be a major medical priority. In a 2016 study, he and other researchers tested 100 type 2 diabetics who had no other fatty liver symptoms. All of them received an MRI of their livers. The results showed that 65 per cent of the participants had NAFLD and didn’t even know it.
When German researchers analysed data from more than 3000 individuals, they found that those with NAFLD were three times more likely to have hypertension than those who didn’t have the disease. Monitoring blood pressure and maintaining heart health, in general, is especially important if you have or think you may have liver disease. Cardiovascular problems are the leading cause of death in people who have NAFLD, says Dr Malhi.
Dr Loomba and his colleagues recently conducted a study of 25 families who have a history of NASH cirrhosis. They found that the risk of this advanced stage of NAFLD is 13 times higher if a family member had the disease as well. This is an ongoing study, but other familial research has evidence that some people may be genetically predisposed to this disease as well.
NAFLD doesn’t have any physical symptoms, which makes it virtually impossible to identify without blood tests or a liver biopsy, explains Dr Loomba. However, once it progresses to cirrhosis, you may start to experience common symptoms like fatigue and weakness. Since the effects of cirrhosis are permanent and could lead to cancer, it’s important to visit your doctor right away if you develop these fatty liver symptoms and have any of the previous risk factors.
People with NAFLD sometimes have pain just below the ribs on the right front, but it’s a symptom that doesn’t usually show up unless NASH or cirrhosis have developed. At this point, fluid may gather in the abdomen (called ascites) and can cause pain. If the fluid gets infected, though, you’ll almost definitely experience pain, often with fever and chills, and you need to call your doctor or head to the emergency room. A less severe tummy issue that can result from cirrhosis is a loss of appetite.
This article originally appeared on Reader’s Digest.