Fatty Liver: What is NAFLD and what are its symptoms and complications?

Fatty Liver Disease is a group of Hepatic Diseases, which is characterized with the buildup of excess fats in the liver.

There are two type of FLDs, Non-alcoholic Fatty Liver Disease and Alcoholic Liver Disease.

Regarding Alcoholic Liver Disease, the manifestations of hepatitis and cirrhosis are brought to the liver due to consumption of alcohol.

Non-Alcoholic Fatty Liver Disease is the excess buildup of fats in liver, not related to the consumption of alcohol. It is a direct manifestation of obesity, diabetes type 2, high serum triglycerides, etc.

NAFLD is of two types:

  • Non-alcoholic Fatty Liver 
  • Non-alcoholic Steatohepatitis – with the additional hepatitis (liver inflammation)



Although initially no signs or symptoms are seen, as the disease may progress, some symptoms that can be seen are:

  • Unexplained Fatigue 
  • Pain in the upper right abdomen 
  • Enlarged Spleen 
  • Abdominal swelling (Ascites) 
  • Yellowing of the skin & eyes (Jaundice) due to excess biliary secretions by the liver.


Some primary causes that can be narrowed down are:

  • High blood sugar (Hyperglycemia) 
  • Type-2 Diabetes 
  • Obesity/Being Overweight 
  • Insulin resistance that can lead to buildup of sugars in the blood. 
  • Presence of high serum triglycerides (Fats)



There are various comorbidities or risk factors that can contribute to:

  • Consumption of Fatty diet 
  • High blood cholesterol 
  • Metabolic syndrome 
  • Hypothyroidism (Thyroid hormone not secreted at the required levels) 
  • PCOS (Polycystic Ovary Syndrome)


  1. As the disease (NAFL) gradually progresses, it develops to NASH, which leads to inflammation of the liver cells (Hepatitis). 
  2. NASH, being an aggressive form has a higher rate of development of Liver Cirrhosis (scarring of the Liver) which slowly progresses to Liver Cancer. 
  3. Further complications can result in comorbidities like high blood pressure, Coronary Artery Disease, Steatorrhea, etc.


  1. Primary diagnosis is on the basis that NAFLD is caused due to factors other than excess alcohol consumption, drug related complication or Hep-C. 
  2. Blood tests are done to rule out possibility of EBV, Hepatitis (A,B or C), autoimmune diseases, etc. 
  3. Imaging, like Ultrasounds, MRI, CT scan are done to diagnose steatosis, which can be linked to NAFLD. 
  4. Liver biopsy is the gold standard method for effectively diagnosing and distinguishing NAFLD (including NAFL and NASH) from other forms of liver disease. 
  5. NAFL can be differentiated from NASH, on the basis that, in the latter, hepatocyte injury and lobular inflammation is existent.


  • Medications like Statins, Pioglitazone & Omega-3 Fatty acid supplements. 
  • Bariatric Surgery for obese person, can reduce and even cure individuals with fatty liver. 
  • NAFLD is a leading cause for Liver Transplant. 
  • Calorie restriction and low fat/lipid consumption is the key to prevention of NAFLD and the related comorbidities. 
  • More consumption of Coffee, in certain scientific studies has shown preventive action on the liver. 
  • Increased physical activity that promotes fat loss and liver health. 
  • Moderate consumption or completely cutting off alcohol consumption and over or unnecessary popping of drugs like aspirin, which are bad for hepatic health.