Non-alcoholic Fatty Liver Disease

WHAT YOU SHOULD KNOW:

• When you have non-alcoholic fatty liver disease (NAFLD), your liver has more fat in it than it should. Your liver is in the upper right side of your abdomen (stomach) and under your lower ribs. It makes a fluid called bile that helps digest (break down) food to turn it into energy. You may have a mild form of NAFLD (simple steatosis) or a severe form called non-alcoholic steatohepatitis (NASH). With NASH, your liver cells may become damaged and inflamed (swollen). You may get very serious liver diseases such as cirrhosis and liver cancer. With NAFLD, you may have swelling or pain on the upper right side of your abdomen. You may have skin darkening, feel more tired than usual, or have extra fat around your waist.
  
  
• The cause of NAFLD is not known. People who have NAFLD are usually overweight and eat too many fatty foods. People who have NAFLD also may have diseases such as diabetes (high blood sugar), hepatitis, or metabolic syndrome. NAFLD is usually diagnosed with blood tests, imaging tests, or a liver biopsy. Weight loss by diet and exercise is a common treatment for NAFLD. With treatment, you may be less likely to have NASH and other liver problems. Your liver may become healthier, less fatty, and may work better than before treatment.

INSTRUCTIONS:

• Take your medicine as directed. Call your primary healthcare provider if you think your medicine is not helping or if you have side effects. Tell him if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.
  
  
• Blood pressure medicine: This is given to lower your blood pressure. A controlled blood pressure helps protect your organs, such as your heart, lungs, brain, and kidneys. Take your blood pressure medicine exactly as directed.
  
  
• Cholesterol medicine: This type of medicine is given to help decrease (lower) the amount of cholesterol (fat) in your blood. Cholesterol medicine works best if you also exercise and eat a healthy diet that is low in certain kinds of fats. Some cholesterol medicines may cause liver problems. You may need to have blood taken for tests while using this medicine.
  
  
• Steroids: Your caregiver may give you steroid medicine to help protect the tissue in your liver. This medicine also may help your liver become healthier. Steroids may have side effects. Be sure you understand why you need steroids. Do not stop taking steroids without your caregiver's okay.
  
  
• Hypoglycemic medicine: This medicine may be given to decrease the amount of sugar in your blood. Hypoglycemic medicine helps your body move the sugar to your cells, where it is needed for energy.
  
  
• Insulin: This medicine may be given to decrease the amount of sugar in your blood. It helps your body move the sugar to your cells, where it is needed for energy.

Ask for information about where and when to go for follow-up visits:

For continuing care, treatments, or home services, ask for more information.

• You will need to see your caregiver for follow-up visits so that he can check your liver. He may test your blood. He also may measure your waist, weigh you, and check your blood pressure. He may give you tests to check for cancer in your liver.
  
  

Diet:

• Your caregiver will ask you to decrease the amount of calories and fat in your diet. Your caregiver may ask you to eat fewer foods that contain saturated fat. Saturated fats include butter, lard, coconut or palm oil, shortening, and some types of margarine. Your caregiver may want you to eat fewer foods that contain carbohydrates (carbs). Carbs are found in breads and starches, dairy products, fruits, vegetables, sugars, and sweets. Do not eat less carbs than your caregiver wants you to eat. Eating too few carbs can make your NAFLD worse.
  
  
• Your caregiver may want you to have more polyunsaturated fats in your diet. Polyunsaturated fats are found in oils such as canola, sunflower, sesame, safflower, and other plant oils. Your caregiver also may want you to have more fiber in your diet. Examples of high fiber foods are fresh fruits and vegetables, whole grain breads, cooked dried beans, and bran cereals.

Exercise:

Exercise makes the heart stronger, lowers blood pressure, and helps keep you healthy. Begin to exercise slowly and do more as you get stronger. Talk with your primary healthcare provider before you start an exercise program.

• Aerobic exercise may help you lose weight and make your muscles stronger. Examples of aerobic exercise include cycling, brisk walking, and jogging. Exercising 3 to 4 times a week may make your liver less fatty. Do not exercise more than your caregiver says is okay.
  
  

Alcohol:

Your caregiver will probably tell you not to drink alcohol. Alcohol can damage your liver, brain, and heart. Drinking alcohol also can make NAFLD worse.

CONTACT A CAREGIVER IF:

• You feel pain in the upper right side of your abdomen.
  
  
• You have swelling in the upper right side of your abdomen.
  
  
• You feel more tired than usual.
  
  
• You bruise or bleed easily.
  
  
• Your skin looks yellow.
  
  
• You have questions or concerns about your condition, treatment, or care.

SEEK CARE IMMEDIATELY IF:

• You feel lightheaded or have fainted (passed out).
  
  
• You have shaking, chills, and a high fever (high body temperature).
  
  
• You have trouble thinking clearly or seem confused.
  
  
• You have trouble breathing.

Learn more about Non-alcoholic Fatty Liver Disease (Aftercare Instructions)