Pediatric Non-alcoholic Fatty Liver Disease (NAFLD) and Non-Alcoholic Steatohepatitis (NASH)
What is non-alcoholic fatty liver disease (NAFLD)?
Non-Alcoholic Fatty Liver Disease (NAFLD) is the most common cause of chronic liver disease in children the United States, affecting millions. It is a condition in which fat builds up in the liver, and – if untreated – it can lead to serious liver problems like cirrhosis (scarring of the liver) and cancer during adulthood. Pediatric NAFLD is common in the United States, affecting 10% of children.
What is non-alcoholic steatohepatitis (NASH)?
Over time, the extra fat can cause inflammation and scarring of the liver. When that happens, the disease becomes known as non-alcoholic steatohepatitis (NASH). The exact cause of NAFLD and NASH is unknown.
Who is at risk for non-alcoholic fatty liver disease and non-alcoholic steatohepatitis?
Obese children are at the greatest risk for developing fatty liver disease, but having type-2 diabetes or pre-diabetes, insulin resistance, or high cholesterol also increase a child’s risk. The disease has been found in adolescents, as well as young children. In some cases, it runs in families.
What are the symptoms for non-alcoholic fatty liver disease and non-alcoholic steatohepatitis?
- Loss of appetite
- Pain in the upper right part of the abdomen
- Weight loss
How is non-alcoholic fatty liver disease and non-alcoholic steatohepatitis diagnoses?
There are several tests to diagnose NAFLD and NASH in children. A doctor will go over your child's medical history and perform a physical exam. Doctors usually discover fatty liver disease through abnormal results in routine blood tests or by discovering an enlarged liver during routine examination. Your healthcare provider may also perform one or more of the following tests:
- Blood tests
- Ultrasound: a noninvasive test that uses sound waves to take pictures of your child’s body
- CT scan: a noninvasive test that uses X-rays to create cross-sectional pictures of your child’s body
- MRI: a noninvasive test that uses magnetic fields to produce images of your child’s body
- Liver biopsy: removal of a small amount of tissue from your child’s liver using a needle. The tissue is later examined under a microscope.
Not every child needs all these tests. Your physician will tell you exactly what the next steps are.
How is non-alcoholic fatty liver disease and non-alcoholic steatohepatitis treated?
The progression of your child's NAFLD or NASH will determine the treatment. Your healthcare provider may recommend one or more of the following treatments:
- Lifestyle changes - which may include weight loss, a healthy diet, exercise and controlling diabetes
- Liver transplant
For more information on NAFLD, refer to the following resources:
- American Liver Foundation
- Medscape - Pediatric Nonalcoholic Fatty Liver Disease
- North American Society for Pediatric Gas...