And Non-Alcoholic Steatohepatitis
There should be little or no fat
in a healthy liver. For most people, carrying a little fat in
the liver causes no problems. Fatty liver is the name given to a
condition in which you have too much fat in your liver. This is
caused by the build-up of fats called triglycerides. These are
the most common fats in our bodies. They belong to a group of
fatty, waxy substances called lipids that your body needs for
energy and cell growth.
We get triglycerides from our diet
and they are also made in the liver. The liver processes
triglycerides and controls their release. It combines them with
special proteins to form tiny spheres called lipoproteins which
it sends into the bloodstream to circulate among the cells of
your body. When this process is interrupted and the flow of
triglycerides to the liver is increased, their release, or
‘secretion’, from the liver is slowed down. This is what leads
to the build-up of fat in your liver cells.
Until recently fatty liver was
considered rare and relatively harmless. It was not thought to
progress to chronic (long-term) or serious liver disease.
Today it is one of the most common
forms of liver disease and is known to lead to advanced
conditions. In the majority of cases fatty liver does not cause
any harm but for an increasing number of people the effects of
having fat in their liver over a long period may lead to
inflammation causing swelling and tenderness (hepatitis) and
then to scarring (fibrosis).
In some people, this can progress
to a condition known as cirrhosis, which can be life
Clinical knowledge about fatty
liver is still coming together but common risk factors are
obesity, diabetes and drinking too much alcohol. While the
relationship between these factors is not fully known, they can
be considered triggers for progression to other types of liver
If alcohol is the cause of fatty
liver it is called alcoholic liver disease (ALD). This leaflet
is for people worried about fatty liver that is not caused by
alcohol. This is known as non alcoholic fatty liver disease (NAFLD).
What is the difference between
NAFLD and NASH?
Non alcoholic fatty liver disease
(NAFLD) is actually a term for a
wide range of conditions characterised by the build-up of fat in
the liver cells of people who do not drink alcohol excessively.
At one end of this range is simple
fatty liver, or steatosis. This is the stage where fat is first
detected in the liver cells and is generally regarded as benign
Non alcoholic steatohepatitis
(NASH) is a significant development in NAFLD. This is a more
aggressive condition that may cause scarring to the liver and
can progress to cirrhosis. Cirrhosis causes irreversible damage
to the liver and is the most severe stage in NAFLD.
In simple terms it may be easiest
to think of NAFLD as having the following stages:
a form of hepatitis known as non alcoholicsteatohepatitis (NASH)
NAFLD is almost the same as
alcoholic liver disease (ALD) and shares the same stages, with
alcoholic hepatitis occurring in place of steatohepatitis
In practical terms the only
difference between the two conditions – NAFLD and ALD – is that
the latter is caused by drinking too much and the former by all
NAFLD can affect a wide range of
people. In general, the older you are the more chance there is
that you may have the condition. NAFLD is typically seen in
people aged around 50 and more commonly in men than women.
It is hard to be precise about how
many people have some form of NAFLD but it is estimated that one
in five people (20%) in the UK have the earliest stages of NALFD,
People most at risk of NAFLD are
resistance, associated with diabetes
hypertension (high blood pressure)
hyperlipidaemia (too much cholesterol and triglyceride in
certain drugs prescribed for other conditions
have been malnourished, starved or given food
Non alcoholic steatohepatitis
Non alcoholic steatohepatitis
(NASH) is a more advanced form of NAFLD in which there is
inflammation in and around the fatty liver cells. This may cause
swelling of your liver and discomfort or pain around it. If you
place your right hand over the lower right hand side of your
ribs it will cover the area of your liver.
With intense, on-going inflammation a build up of scar tissue
may form in your liver. This process is known as fibrosis, and
can lead to cirrhosis. NASH is now considered to be one of the
main causes of cirrhosis.
Cirrhosis is usually the result of
long-term, continuous damage to the liver. This is where
irregular bumps, known as nodules, replace the smooth liver
tissue and the liver becomes harder. The effect of this,
together with continued scarring from fibrosis, means that the
liver will run out of healthy cells to support normal functions.
This can lead to complete liver failure.
NASH should be distinguished from
acute fatty liver disease, which may occur during pregnancy or
with certain drugs or toxins (poisons). This condition is very
rare and may lead rapidly to liver failure.
Signs and Symptoms
You may not have signs and
symptoms of simple fatty liver (steatosis) or nonalcoholic
steatohepatitis (NASH). When symptoms do occur, they are usually
vague and nonspecific and may include:
At a more advanced stage, such as
cirrhosis, nonalcoholic fatty liver disease may cause:
Lack of appetite
Small, red spider veins under
your skin or easy bruising
Yellowing of your skin and eyes
and dark, cola-colored urine
Bleeding from engorged veins in
your esophagus or intestines
Loss of interest in sex
Fluid in your abdominal cavity (ascites)
Itching on your hands and feet
and eventually on your entire body
Swelling of your legs and feet
from retained fluid (edema)
Mental confusion, such as forgetfulness or trouble concentrating
It's unclear what causes
nonalcoholic fatty liver disease. But many researchers believe
that metabolic syndrome — a cluster of disorders that increase
the risk of diabetes, heart disease and stroke — may play an
important role in its development. Symptoms of metabolic
Obesity, particularly around the
waist (abdominal obesity)
High blood pressure
One or more abnormal cholesterol
levels — high levels of triglycerides, a type of blood fat, or
low levels of high-density lipoprotein (HDL) cholesterol, the
so-called "good" cholesterol
Resistance to insulin, a hormone
that helps to regulate the amount of sugar in your blood
Of these, insulin resistance may
be the most important trigger of simple fatty liver (steatosis)
and nonalcoholic steatohepatitis (NASH). Since both conditions
can remain stable for many years, causing little harm,
researchers have proposed that a "second hit" to the liver may
trigger a progression to cirrhosis. Possible triggers include
viral infections, an accumulation of excess iron in the liver (hemochromatosis)
and moderate consumption of alcohol.
It's also unclear exactly how a liver becomes fatty. The fat may
come from other parts of your body, or your liver may absorb an
increased amount of fat from your intestine. Another possible
explanation is that your liver loses its ability to change fat
into a form that can be eliminated. But one thing's certain: The
eating of fatty foods, by itself, won't produce a fatty liver.
Although the cause of nonalcoholic
fatty liver disease is unclear, the condition is associated with
many risk factors. The three most important ones are closely
related to the metabolic syndrome and insulin resistance:
Overweight and obesity.
increases with every pound of excess weight. More than 70
percent of people with nonalcoholic steatohepatitis (NASH) are
obese. Overweight is defined as having a body mass index
between 25 and 30; obesity as having a body mass index of 30
When your body becomes resistant to the effects of insulin or
your pancreas doesn't produce enough insulin to maintain a
normal blood sugar (glucose) level, it can damage many organs
in your body, including the liver. Up to 75 percent of people
with NASH also have diabetes.
As many as
80 percent of people with NASH have elevated cholesterol and
Other risk factors include:
Operations to remove large sections of the small intestine
(small bowel resection), treat obesity (gastric bypass) or
bypass parts of the small intestine (jejunal bypass) often
lead to rapid weight loss. Losing more than one or two pounds
a week, even from dieting, may increase your risk of
nonalcoholic fatty liver disease.
Chronic infection with hepatitis C or B.
Most people with hepatitis C became infected through blood
transfusions received before 1992, the year improved
blood-screening tests became available. Intravenous drug use
with contaminated needles is now the leading risk factor for
hepatitis C. In the United States, hepatitis B is usually
transmitted sexually or through contaminated needles.
Long-term infection with hepatitis C slowly damages the liver,
with cirrhosis developing in 20 percent of people 20 or more
years after infection. The older you are when you're infected
with the hepatitis C virus, the more likely you are to develop
These include oral corticosteroids (prednisone,
hydrocortisone, others), synthetic estrogens (Premarin, Ortho-Est,
others) for menopause, amiodarone (Cordarone, Pacerone) for
heart arrhythmias, tamoxifen (Nolvadex) for breast cancer,
diltiazem (Dilacor XR, Cardizem, others) for high blood
pressure, anti-retroviral drugs such as indinavir (Crixivan)
for infections related to HIV/AIDS, and methotrexate (Rheumatrex,
Folex), an immune-suppressing medication for rheumatoid
arthritis. In rare cases, cirrhosis may result from a severe
reaction to amiodarone or methotrexate.
These include Wilson's disease, a hereditary condition that
affects copper levels; Weber-Christian disease, which affects
nutrient absorption; and abetalipoproteinemia, a rare
congenital disorder that affects the ability to digest fat.
Inherited metabolic disorders that increase the risk of
cirrhosis include galactosemia, a rare disorder that affects
the way the body metabolizes milk sugar (lactose), and
glycogen storage diseases, which prevent glycogen, the stored
form of glucose, from being formed or released when the body
Screening and Diagnosis
Because early-stage nonalcoholic
fatty liver disease seldom causes signs and symptoms, your
doctor may discover it during a routine medical examination.
Many cases are detected after doctors order liver tests to
monitor people taking cholesterol-lowering drugs.
Before diagnosing nonalcoholic
fatty liver disease, your doctor may order blood tests for other
conditions that cause liver damage, such as hepatitis B and C.
He or she also will inquire about your alcohol consumption
during the past five years. Excess alcohol consumption three
or more drinks a day for men and two or more drinks a day for
women can also cause fatty liver and steatohepatitis.
If your doctor suspects
nonalcoholic fatty liver disease, you're likely to have certain
liver-function blood test.
A damaged liver releases certain enzymes. If the test shows
that these enzymes are mildly elevated, it may be a sign that
you have liver damage.
This noninvasive test uses sound waves to produce a picture of
internal organs, including the liver. Abdominal ultrasound is
painless and usually takes less than 30 minutes. While you lie
on a bed or examining table, a technician applies a conductive
gel to your abdomen and places a hand-held device (transducer)
on the area, moving the transducer along your skin to locate
the liver and adjacent organs. The transducer emits sound
waves that are reflected from your liver and transformed into
a computer-generated image.
Computerized tomography (CT).
This test uses X-rays to produce cross-sectional images of
resonance imaging (MRI).
Instead of X-rays, MRI creates images using a magnetic field
and radio waves. Sometimes a contrast dye also may be used.
The test can take from 15 minutes to an hour. You may find an
MRI scan to be more uncomfortable than a CT scan. That's
because you'll likely be reclining on a stretcher enclosed in
a tube with very little space above you or on either side. The
thumping noise the machine generates is also disturbing to
Although other tests can provide a great deal of information
about the extent and type of liver damage, a biopsy is the
only way to definitively diagnose nonalcoholic fatty liver
disease. In this procedure, a small sample of tissue is
removed from your liver and examined under a microscope. Your
doctor is likely to use a thin cutting needle to obtain the
sample. Needle biopsies are relatively simple procedures
requiring only local anesthesia, but your doctor may choose
not to do one if you have bleeding problems or severe
abdominal swelling (ascites). Risks include bruising, bleeding
difficult to predict the course of nonalcoholic fatty liver
disease in any one person. Most people with simple fatty liver (steatosis)
or nonalcoholic steatohepatitis (NASH) don't develop serious
liver problems. Without treatment, however, these conditions may
lead to cirrhosis and liver failure in some individuals. Some
estimates suggest that as many as one in four people with
nonalcoholic fatty liver disease may develop serious liver
disease within 10 years. In some cases, a liver transplant may
be the only option.
A well-proven Pure herbal
treatment by Dr. Tariq Mehmood Taseer to cure & Has a very high
success rate in treating different causes of viral or non viral
heapatitis/ cirrhosis/fatty liver/jaundice/ Liver cancer/
Wilson's disease/ Portal hypertension/ Primary biliary
cirrhosis/ Obstetric cholestasis/ Haemochromatosis / Gilbert's
Cystic disease/ Budd Chiari/ and other liver problem with well
proven results. Our herbal treatment is a very effective and
100% pure herbal treatment that are especially prepared
according to each patient's age, disease history and other
physical factors. Dosage, duration and price of the treatment
may vary as per the patient profile. Treatment is without any
We are glad to offer you our herbal consultation.
We have a team of qualified Tib-e-Unani experts who are doing
regular practice as consultant Tib-e-Unani experts.
You can go through the profiles of our expert
Tib-e-Unani doctors. Here is brief information about them.
Contact Dr. & Hakeem Tariq
Mehmood Taseer at:
send your complete details and Complaints through E-mail.
We can guide you more
are sure that you will be benefited by our Tib-e-Unani