UH Liver Experts Provide Coordinated Care for Fatty Liver Disease (FLD)

Two Types of Fatty Liver Disease

There are two main types of fatty liver disease. These include:

Alcohol-Associated Fatty Liver Disease

This type of FLD is caused by long-term, heavy alcohol use and is the earliest stage of alcohol- associated liver disease. Untreated, it can progress to severe alcohol-related liver disease, including alcohol-related hepatitis and even alcohol-related cirrhosis.

Nonalcoholic Fatty Liver Disease (NAFLD)

NAFLD is a type of fatty liver disease that occurs in individuals who do not drink or only drink very occasionally. While doctors don’t know the exact cause of nonalcoholic fatty liver disease, obesity and metabolic syndromes are common risk factors. While fatty liver disease is most common in middle age, children and young adults can develop this condition as well. Risk factors for NAFLD include:

• Being overweight or obese
• Having diabetes or prediabetes
• Having high blood fat levels – either triglycerides or LDL “bad” cholesterol
• Having high blood pressure

Collectively, these risk factors can cause metabolic syndrome, a condition which places individuals at higher risk for developing heart disease. If untreated, NAFLD can lead to severe liver inflammation and the more aggressive sub type of non-alcohol hepatitis (NASH). When NASH progresses, it can cause scarring of the liver and even cirrhosis.

Regardless of the type of fatty liver disease (FLD), most people will not experience any symptoms, and symptoms may only manifest when the disease is quite advanced. However, some patients report fatigue and/or abdominal discomfort in the right upper quadrant of the abdomen.

Expert Diagnosis of Fatty Liver Disease

The expert liver specialists at University Hospitals can assess for fatty liver disease (FLD) using blood tests and non-invasive imaging tests that can include MRI and Fibroscan. Sometimes a liver biopsy may be necessary to make a diagnosis of FLD and to determine the severity of liver disease which, can help diagnosis the aggressive form of NASH and cirrhosis.

Treatments for Fatty Liver Disease

The highly-trained multidisciplinary team at University Hospitals will create a holistic approach and treatment plan for patients with FLD, the cornerstone of which will involve intensive lifestyle changes including an improved diet, exercise and eliminating alcohol.

Dietary changes may include eating more of a plant-based diet with more fruits, vegetables and high-fiber plants such as whole grains and legumes. It is also important to reduce your intake of sugar, salt, trans fats, saturated fat and refined carbohydrates.

Specific medications can be discussed with your liver specialist or hepatology provider. In addition, our licensed clinical dietitians can create personalized dietary plans and offer support and nutritional counseling to patients. Some patients may also be referred to our Bariatric Surgery and Nutritional Health center. For patients with alcohol-associated FLD, it is essential for patients to stop consuming alcohol – this is the first and important step for treatment and recovery. UH offers both inpatient and outpatient programs to help patients achieve long term success.

Clinical Trials and Research

In collaboration with the Case Western Reserve University School of Medicine, the UH Digestive Health Institute is involved in ongoing clinical research related to fatty liver disease (FLD). This research provides us with a path forward to develop new technology and innovations to provide our patients with the most advanced, value-based care and improved outcomes. For some patients, participation in a clinical trial may be part of their total treatment plan.