Non-alcoholic fatty liver disease (NAFLD)

Non-alcoholic fatty liver disease does not usually cause any symptoms.

Many people have it without realising. It's usually found when you have tests for another reason.

Some people have symptoms including:

• feeling very tired
• feeling generally unwell
• liver pain or discomfort, which is felt in your tummy (abdomen) under the right side of your ribs

Non-alcoholic fatty liver disease is very common.

You're more likely to get it if you:

• are overweight, particularly if you have a lot of fat around your stomach and waist
• do not have a healthy diet or are not very physically active
• have type 2 diabetes
• have polycystic ovary syndrome
• have high blood pressure or high cholesterol
• are over 50

• you think you could have non-alcoholic fatty liver disease
• you think you have a higher risk of getting non-alcoholic fatty liver disease

Non-alcoholic fatty liver disease is usually diagnosed after blood tests or scans are done for another reason, and the results show signs of problems with your liver.

If a GP thinks you could have non-alcoholic fatty liver disease, or if tests show signs of liver problems, the GP will ask about your symptoms and check your height, weight and waist measurement. They'll also ask about how much alcohol you drink, to rule out alcohol-related liver disease.

They may arrange more blood tests, and sometimes scans such as an ultrasound scan of your tummy, to:

• confirm if there's a build-up of fat in your liver
• rule out other causes of liver problems
• find out if there's any damage to your liver
• check for other conditions linked to non-alcoholic fatty liver disease, such as kidney problems

Non-alcoholic fatty liver disease has 4 stages.

Most people only have the 1st stage, which does not usually cause any problems. A small number of people will progress to the later stages with more serious liver damage, but lifestyle changes can help prevent this.

If you have non-alcoholic fatty liver disease, healthy lifestyle changes can reduce the build-up of fat in your liver and help repair any damage or stop it getting worse. Your GP can give you advice about this.

These changes will also reduce the risk of some other conditions that are linked to non-alcoholic fatty liver disease, including cardiovascular disease, chronic kidney disease, high blood pressure and type 2 diabetes.

• eat a healthy, balanced diet

• exercise regularly – aim to do at least 150 minutes of exercise a week

• lose weight if you're overweight

• do not drink too much alcohol – keep to the recommended limit of no more than 14 alcohol units a week

• do not smoke

If you have non-alcoholic fatty liver disease, apart from making healthy lifestyle changes you will not need any other treatment unless your condition has progressed and you have damage to your liver.

You should have check-ups as least once a year and tests every 2 to 3 years to monitor your condition.

If you have damage to your liver (fibrosis or cirrhosis), as well as making healthy lifestyle changes you'll need to see a liver specialist in hospital for treatment.

Treatment from a liver specialist may include a medicine called pioglitazone, or vitamin E. In very severe cases you may need a liver transplant.

If you're living with obesity a specialist may recommend treatments to help with weight loss such as medicines or surgery.

If you have non-alcoholic fatty liver disease, you will be supported by your GP or specialists.

There are also national charities that offer support and information about non-alcoholic fatty liver disease.

Liver UK

Information and support for people affected by liver disease.

• Website: liveruk.org
• Helpline: 0800 652 7330
• Liver UK: support groups
• Liver UK: living with a liver condition
• Liver UK: how is MASLD treated?

Non-alcoholic fatty liver disease does not usually cause any symptoms. Some people get tiredness and pain under the right side of the ribs.

You're more likely to get non-alcoholic fatty liver disease if you're overweight, have an unhealthy diet or have conditions such as type 2 diabetes.

Non-alcoholic fatty liver disease has 4 stages, depending on how much damage there is to the liver. Most people only have the 1st stage.

Non-alcoholic fatty liver disease does not always need medical treatment. If you have damage to your liver you may need medicines or other treatments.

You can treat non-alcoholic fatty liver disease or help stop it getting worse by eating a healthy diet, regular exercise and losing weight.