Non-alcoholic Fatty Liver Disease
What is fatty liver disease?
When someone is overweight or obese, too much fat can be stored in the liver. This can lead to a disease called Nonalcoholic Fatty Liver Disease, or NAFLD.
In some children and adults, the extra fat in the liver becomes a more severe problem, causing inflammation and scar tissue. When this happens, it is called Nonalcoholic Steatohepatitis, (pronounced stee-at-oh-hep-a-titus), or NASH. Over time, NASH can lead to severe scarring, called cirrhosis (sir-oh-sis). Cirrhosis can lead to liver failure and loss of liver function.
What causes fatty liver disease?
The exact causes of fatty liver disease are not known, but risk factors include:
- Being overweight or obese, especially around the waist
- Diabetes and insulin resistance
- High levels of triglycerides in the blood (fat in the blood)
- Race and ethnicity (Caucasians, Hispanic and Native Americans are at greater risk)
What are the symptoms of fatty liver disease?
- Pain in the right upper part of the belly
- Feeling tired
- Increased levels of liver enzymes in the blood
Because children who have fatty liver disease (NAFLD and/or NASH) may not have any symptoms, your child's doctor will check his/her liver enzyme levels by taking a sample of blood. Normal liver enzyme levels vary with a child's age.
What can cause liver enzymes to be higher than normal?
- Fatty liver or NASH
- Viral infections
- Certain medicines
- Physical activity
- Muscle injury
- Gall stones
Your child's liver doctor may recommend further testing if your child's liver enzymes are very high.
How do you tell if my child has NASH?
The only way to determine if your child has NASH is to perform a liver biopsy. There is no blood test or x-ray that will tell us if a fatty liver has scar tissue, or NASH A liver biopsy is a special test that places a needle through the skin to get a small piece of tissue from the liver. Your child's doctor will look at this tissue to see if there is any scarring. One out of four children with NASH may eventually develop severe liver disease and scarring. Early diagnosis is very important.
What is the treatment for NAFLD and NASH?
Right now, the only way to treat NAFLD and NASH is to have the child lose weight through healthy eating and increased physical activity. Usually the liver disease is reversible if it is in the early stages and no scarring is found. Some medicines are being tested in both adults and children to see if they can help lower the fat levels in the blood or treat insulin resistance. These medicines are usually not recommended for children unless they are involved in a study or under the care of a liver doctor.
Here are some tips to help your child with NAFLD or NASH:
- Encourage your child to follow a healthy portion-controlled diet, with low amounts of saturated fats and refined sugars.
- Avoid large portion sizes and sweetened drinks, like soda. Limit the amount of meals eaten at fast food restaurants, since this food is usually high in fat.
- We encourage you to visit with the dietitian to learn about healthy diet choices for your child and family.
- Increasing physical activity and outdoor play is a great way to help children achieve and keep a healthy weight.
A child with NAFLD or NASH should have Hepatits B and A vaccinations to avoid potential injury to the liver caused by these viral infections.
Call your child's liver doctor if he/she:
- Becomes jaundiced (skin and/or eyes turn yellow or green in color)
- Complains of increased belly pain or swelling of the belly or legs
- Becomes more short of breath with exercise
Rev. 3/08
