Fatty Liver, NAFLD and NASH

Topics

• What is Fatty Liver?
• Causes of Fatty Liver, NAFLD and NASH
• Who Is At Risk?
• Signs and Symptoms
• Diagnosis
• What is the Treatment?
• Suggested Articles

How is Fatty Liver, NAFLD and NASH Diagnosed?

During an exam a doctor may detect an enlarged liver and signs of cirrhosis like ascites (fluid buildup in the abdominal cavity). An enlarged spleen might also be present but only in people with NASH. There is no single test that can accurately diagnose fatty liver or NASH. A diagnosis of NASH is made only after all other causes of fatty liver and causes of elevated liver enzymes have been excluded.

Blood work can be done to test for any abnormalities. Typically elevations in liver enzymes - whereby the level of ALT elevation is higher than the level of AST - elevation could be an indicator of fatty liver or NASH.

Ultrasounds can also be performed to diagnose fatty liver. However, an ultrasound needs a skilled operator. In addition, the sensitivity of the scan is decreased in people with high amounts of abdominal fat. A CT (computerized tomography) scan could be performed as well and may even measure the degree of fat in the liver, but this determination can be hampered if there are any liver iron deposits. Imaging studies can detect the presence of fat in the liver but not the severity.

Therefore, one can presume a diagnosis of fatty liver or NASH based on signs of insulin resistance, elevated ALT levels for a long duration, signs of fatty liver through imaging and exclusion of other causes of elevated ALT levels and fatty liver.

Only a liver biopsy can definitively diagnose a fatty liver and NASH as well as the amount of fatty deposits, degree of inflammation and extent of damage to the liver.

Signs and Symptoms What is the Treatment?