Digestive & Liver Disorders

Nonalcoholic Fatty Liver Disease

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What is non-alcoholic fatty liver disease (NAFLD)?

NAFLD refers to a range of liver disorders associated with too much fat in the liver.

Steatosis is a mild form of fatty liver. In some patients with this condition, inflammation of the liver may occur with hepatitis. Referred to as non-alcoholic steatohepatitis (NASH), this can lead to liver damage (scarring and cirrhosis).

The exact cause of pediatric NAFLD is unknown. It is likely a combination of several factors, including a genetic predisposition and environmental triggers. These lead to insulin resistance and the accumulation of specific fats in the liver. Activation of immune cells and oxidative stress can also cause ongoing damage to this organ.

The risk factors for developing NAFLD include:

  • Obesity
  • Diabetes
  • Insulin Resistance
  • Hyperlipidemia
  • Certain ethnic backgrounds
  • Males are more affected than females
  • Metabolic syndrome

How is NAFLD diagnosed?

Patients with NAFLD, especially those with mild steatosis, rarely have symptoms. However, the condition may be discovered in the following ways:

A mild increase in liver size may be noted on routine physical examination, warranting further testing.

An elevation of liver enzymes may be noted on routine laboratory testing. An abdominal ultrasound may be ordered to evaluate these abnormalities. Steatosis will appear on the ultrasound.

In other individuals, the presence of fat in the liver may show up on an imaging study such as an abdominal ultrasound or CAT scan performed to another condition.

Further testing with a liver biopsy is performed, as needed, to confirm presence of NAFLD and assess the liver for signs of inflammation and scarring. This helps rule out other causes of fat accumulation in the liver (certain medications, viral or autoimmune hepatitis, metabolic disease, and congenital liver disease).

How is NAFLD treated?

Our pediatric gastroenterologists and hepatologists (liver specialists) are the forefront of diagnosing and treating children with NAFLD. We provide a multidisciplinary and comprehensive approach bringing evidence based care to every child with NAFLD. Our treatment approaches include:

  • Weight loss
  • Exercise
  • Low glycemic index diet (more effective than a low fat diet)
  • Antioxidants such as Vitamin E