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Fatty liver is common and affects about 20% of the UK population. It may result from alcohol consumption but is also commonly associated with being overweight or obese and having a central weight distribution. Many people with the metabolic syndrome (overweight, high blood pressure and high blood lipids) and diabetes have a fatty liver, which puts them at risk of nflammation and scarring in the liver and eventual cirrhosis. Non-alcoholic steatohepatitis (NASH) describes a fatty liver when there is injury to liver cells and associated inflammation. This condition can lead to scarring (fibrosis) and cirrhosis and is also associated with poor cardiovascular outcomes such as stroke and heart disease. NAFLD is diagnosed with ultrasound or other scans and different liver disorders need to be excluded. The severity of fibrosis can be assessed with Fibroscan, specialist blood tests and sometimes a liver biopsy. Treatment of NAFLD requires a holistic approach in order to optimise general and cardiovascular health as well as the liver disease. Liver specific treatments are becoming available and patients in South London can be referred into clinical trials of emerging therapy.
