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Non-alcoholic Liver Disease

Symptoms

Usually, metabolic dysfunction-associated steatotic liver disease (MASLD) is a silent disease with no signs or symptoms. However, early symptoms may include:

  • Enlarged liver
  • Fatigue
  • Pain in the upper right abdomen

Possible signs and symptoms of non-alcoholic steatohepatitis (NASH) and cirrhosis (advanced scarring) include:

  • Abdominal swelling (ascites)
  • Enlarged blood vessels beneath the skin's surface
  • Enlarged breasts in men
  • Enlarged spleen
  • Red palms
  • Yellowing of the skin and eyes (jaundice)

When to see a doctor?

Make an appointment with your doctor if you are obese, with type 2 diabetes, or have metabolic syndrome and if you have persistent signs and symptoms that cause you concern.

Prevention & Treatment

To prevent the risk of developing non-alcoholic fatty liver disease:

  • Choose a healthy lifestyle with a healthy plant-based diet rich in fruits, vegetables, whole grains, and healthy fats.
  • Exercise. Exercise most days of the week. Get an OK from your doctor first if you haven't been exercising regularly
  • Maintain a healthy weight. If you are overweight or obese, reduce the number of calories you eat each day and get more exercise. If you have a healthy weight, work to maintain it by choosing a healthy diet and exercising.

To treat non-alcoholic fatty liver disease:

Currently, lifestyle changes may ameliorate steatosis (1-3). Several research trials showed that weight loss is the most effective way to reduce liver fat; losing at least 3 to 5 percent of the body weight can reduce fat in the liver. There is evidence that ≥10% weight loss could be associated with a reduction in liver fibrosis.

The Mediterranean diet is another option for the treatment. Mediterranean diet is rich in vegetables, fruits, whole grains, seeds, nuts, legumes, and fish. This diet is rich in monounsaturated fatty acids and polyunsaturated fatty acids as well as fibers and antioxidants and has been shown to reduce hepatic fat and improve hepatic insulin sensitivity even without weight loss.

Physical activity also reduces liver fat and may be promoted in patients who find it difficult to modify their diet and follow dietary recommendations.

Therefore, the combination of calorie restriction as well as dietary patterns associated with physical activity needs to be considered in the treatment of metabolic dysfunction-associated steatotic liver disease (MASLD).

Alcohol-Associated Liver Disease

Symptoms

The symptoms of this liver condition may vary depending on the severity of the liver disease. Early symptoms include:

  • Abdominal pain and tenderness
  • Loss of energy, fatigue
  • Poor appetite and weight loss
  • Nausea
  • Small, red spider-like blood vessels on the skin

If the liver function worsens, the symptoms may include:

  • Stools might be dark, bloody, black, or tarry
  • Frequent nosebleeds or bleeding gums
  • Vomit blood or material that looks like coffee grounds
  • Fluid buildup of the legs (edema) and in the abdomen
  • Yellow color in the skin, mucous membranes, or eyes 
  • Easy bruising and abnormal bleeding
  • Confusion or problems thinking

Alcohol-associated liver disease also affects the brain function and nervous system. Symptoms include:

  • Agitation
  • changing mood
  • confusion
  • numbness, or a tingling sensation in the arms or legs.

Prevention & Treatment

The first treatment line is to stop drinking alcohol altogether.

In the early stages of liver disease, stop drinking will allow the liver to heal itself.

Things that will help you take care of liver disease are:

  • Stop drinking alcohol
  • Eat a healthy diet that is rich in fiber (fruit and vegetables) and low in salt
  • Talk to your provider about taking vitamin supplements, especially B-complex vitamins, and folic acid, which can help reverse malnutrition
  • Get vaccinated for diseases such as influenza, hepatitis A and hepatitis B, and pneumococcal pneumonia

If you cannot stop drinking, you may need an alcohol rehabilitation program or counseling to help you stop drinking.

Support

American Liver Foundation: