Non-alcoholic fatty liver disease (NAFLD)

The early stages of NAFLD are difficult to detect and are usually discovered when you're being tested for another reason. More advanced stages of NAFLD (e.g. NASH or fibrosis) have symptoms that include:

• a dull or aching pain in the top right of the tummy
• fatigue
• unexplained weight loss
• weakness

If cirrhosis, the most advanced stage of NAFLD, develops, you can get more severe symptoms such as:

• swelling of the legs, ankles and feet (oedema)
• swelling of the abdomen (ascites)
• extreme fatigue (anaemia)
• very rapid heartbeat (tachycardia)
• vomiting blood (haematemesis)
• dark black, tarry faeces (melena)
• periods of confusion (encephalopathy)
• jaundice

If you are suspected of having NAFLD, your consultant may ask questions about your lifestyle, such as any medication or supplements you're taking, your diet, if you exercise and the amount of alcohol you drink. They may also recommend tests to confirm a NAFLD diagnosis, such as:

• Liver function tests (LFT) which measure various enzymes and proteins in the blood that are made or cleared by the liver.
• Imaging tests, like FibroScan which measure the scar tissue (fibrosis) in your liver; or ultrasound, CT or MRI scans that can reveal the extent of fat deposits in your liver.
• A liver biopsy where a tiny piece of your liver is taken for study.

If you have been diagnosed with NAFLD, your consultant will discuss your treatment options with you and help to determine the best approach for you.

There is no specific medication to treat NAFLD, but treatment may be recommended for associated conditions (high blood pressure, diabetes and cholesterol) or complications.

If your NAFLD is linked to being overweight, your consultant may advise that you make various lifestyle changes, including losing weight gradually, eating a healthy and balanced diet and exercising regularly. You may also be advised to stop smoking as this can help reduce your risk of problems such as heart attacks and strokes.