Nonalcoholic Fatty Liver Disease and Metabolic Associated Steatohepatitis (MASH)

A gastroenterologist in blue scrubs is holding a pair of tweezers and pointing at a gallbladder on a plastic anatomical model of the liver

Nonalcoholic fatty liver disease (NAFLD) is a condition in which fat builds up in your liver. As the name implies, alcohol is not a factor in this type of liver disease. There are two types of NAFLD: simple fatty liver and nonalcoholic steatohepatitis (NASH). Simple fatty liver typically does not cause liver damage, but NASH does. NASH is a serious form of the disease that may progress to cirrhosis, liver failure, or liver cancer.

NAFDL is the most common form of chronic liver disease in the US, affecting an estimated 80 to 100 million people. It is most prevalent in those over 40 years old, who are at risk of heart disease due to obesity and type 2 diabetes.

You are more likely to develop NAFLD if you have any of the following risk factors:

  • Overweight or obesity, especially with abdominal fat
  • Insulin resistance (inability to effectively use insulin)
  • Metabolic syndrome, which includes the presence of any three of the following:
    • High blood sugar, which may indicate prediabetes or type 2 diabetes
    • High cholesterol (high levels of LDL, the bad cholesterol, or low levels of HDL, the good cholesterol)
    • High levels of triglycerides (a type of fat) in the blood
    • High blood pressure
    • Large waist size

These combined health problems appear to promote the deposit of fat in the liver. For some people, this excess fat acts as a toxin to liver cells, causing liver inflammation and nonalcoholic steatohepatitis, which may lead to a buildup of scar tissue (fibrosis) in the liver.

Most people with nonalcoholic fatty liver disease or nonalcoholic steatohepatitis do not have any symptoms. For those who do, symptoms may be vague, such as fatigue and pain in the upper right side of the abdomen.

Because NAFLD is asymptomatic, the disease is typically detected when tests are done for other reasons or during routine bloodwork, in which liver enzymes are elevated. If your doctor suspects you have simple fatty liver or NASH, they will conduct blood tests to measure the level of liver enzymes or to check for other health conditions that may increase your liver enzyme levels. Your doctor may also perform an ultrasound, which can show fat in your liver.

Other imaging tests, such as magnetic resonance elastography (MRE) or transient elastography (a type of ultrasound), may be used to assess the stiffness of the liver. If tests indicate that liver damage is present, your doctor may obtain a sample of your liver (biopsy) to determine the extent of scarring.

Gradual weight loss through a combination of a healthy diet and exercise is the only effective treatment for NAFLD. Weight loss can reduce fat in the liver, alleviate inflammation, and help heal any liver damage, or scarring, that has occurred.

Losing 10 percent of your body weight within 12 months is ideal. Reaching this target will decrease liver inflammation. However, losing even 3 to 5 percent of your body weight can reduce the amount of fat in the liver and improve other risk factors, such as metabolic syndrome.

It is best to lose weight gradually over the course of a year. Rapid weight loss by fasting or following a very low-calorie diet can make NAFLD worse. If you need to lose a large amount of weight, weight-loss surgery may be a good solution for you.

If you have NASH that has progressed to cirrhosis or liver failure, you may need a liver transplant.

Treatment for All Stages of Nonalcoholic Fatty Liver Disease in Austin, TX

Nonalcoholic fatty liver disease (NAFLD) can impact your health silently, but early intervention makes all the difference. At Austin Gastroenterology, our dedicated team provides personalized care to help manage NAFLD and protect your liver health. Reach out to us today and explore how we can support you on your path to better health. To schedule an appointment, you can send us a message on Klara or fill out our secure online appointment request form. We proudly serve our community from 18 convenient locations around the greater Austin area.