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Non-Alcoholic Fatty Liver Disease


What is NAFLD?

Non Alcoholic Fatty Liver Disease (NAFLD) occurs when you build up fat in your liver. This can cause inflammation leading to damage.


You might be at higher risk of developing NAFLD if you: 

  • are overweight

  • have type 2 diabetes

  • have high blood pressure

  • have high cholesterol

  • are over the age of 50

  • smoke

A healthy liver should have very little or no fat within.


However, the current estimates are that up to 30% of people in the UK have early stages of NAFLD involving small amounts of fat in their liver.

Early-stage NAFLD doesn’t typically cause harm, but it can predispose to serious liver damage, including cirrhosis.


High levels of fat in your liver can also increase your risk of conditions such as diabetes, coronary disease and strokes.

If detected and controlled from an early stage, it’s possible to prevent NAFLD from worsening thereby reducing the amount of fat in your liver.

The Stages of NAFLD


Non-Alcoholic Fatty Liver Disease develops in 4 stages:

  1. Steatosis - a "simple" fatty liver where there has been a largely harmless build-up of fat in the liver 

  2. non-alcoholic steatohepatitis (NASH)– a more serious form of NAFLD, where the liver has become inflamed; estimated to be present in up to 5% of the UK population

  3. fibrosis – persistent inflammation creates scar tissue around the liver and nearby blood vessels, but the liver is still functioning normally

  4. cirrhosis – the most severe stage where the liver shrinks after years of inflammation, becoming scarred and lumpy. This damage is permanent and can lead to liver failure and liver cancer.

It can take years for fibrosis or cirrhosis to develop. It’s important to make lifestyle changes to prevent the disease from getting worse.


What are the symptoms of NAFLD?

Symptoms of NAFLD in its early stages are rare. This means that you probably wouldn’t know that you have it unless it’s discovered while having tests for something else.

Occasionally, people with more advanced stages of liver disase will experience:

  • a dull, aching pain in the top right of their abdomen tummy 

  • fatigue 

  • unexplained weight loss

  • weakness


If the condition develops into cirrhosis, you can get experience more severe symptoms such as jaundice, where the skin and white of your eyes turn yellow, itchy skin (pruritus), and swelling in your legs, feet or tummy.


How can NAFLD be diagnosed?


NAFLD can be diagnosed during a blood test or by performing an ultrasound of the abdomen.


A Fibroscan will then determine how inflamed the liver is. Dietary and lifestyle interventions can help reverse this inflammation. 


Where can I get a Fibroscan? 


Hartwood Health are delighted to announce their partnership with Professor Aftab Ala, Consultant Gastroenterologist and Hepatologist.


We regularly refer patients to Professor Ala and vice versa, and we look forward to helping more patients learn about the state of their liver and where necessary, make dietary changes to halt their advancement to more serious pathology.

If you would like more information or would like to book an appointment, please contact us.

What is a Fibroscan? 


Fibroscan is a similar technique to ultrasound, known as elastography. It measures stiffness of the liver.


Healthy liver tissue is soft, so if stiffness is detected the scar tissue (fibrosis) may be present. Fibroscan does not diagnose specific liver disease, but it can provide an image of how badly the liver is damaged. It can distinguish normal liver or minimal fibrosis from cirrhotic livers. The Fibroscan results will then be interpreted by a specialist. 


How does Fibroscan work? 

Fibroscan is a small ultrasound device that makes high-frequency sound waves. The sound waves travel into our body and bounce back, creating an image of the inside of the liver.

  • It is a non-invasive procedure as it does not enter the body.

  • It is quick and painless.

  • It is unlikely to have any risks or complications during or after the testing procedure. 


What does a Fibroscan measure? 

Fibroscan measures the current condition of your liver by investigating the extent of any scarring (fibrosis).


To do this, it measures the time it takes for a sound wave to bounce back from within the liver. When a liver is healthy and soft, it will take longer for the sound to travel to the liver and back.

  • Scarred liver makes the sound waves travel faster.

  • Fibroscan can also detect any abnormal buildup of fat in the liver.

What can the results show?

A Fibroscan can show how much scarring (fibrosis) there is in your liver. This will help in planning treatment, should you need any.


Early identification of problems with the liver can reduce the chance of you getting worse, and minimise the risk of more serious problems in the future. 


How long does it take?

A fibroscan is quick, takes just 10 to 20 minutes, and provides you with immediate results. 

How do I prepare for a scan?

  • Do not eat or drink for 3 hours before your Fibroscan.

  • It is ok to take small sips of water (or clear fluid), but do not drink large amounts. 

  • Continue taking any prescribed medicines. 

  • Just before the scan is performed, you will need to be able to lie flat on an examination couch with your arms above your head.

  • There is no need to remove any clothes or jewellery for the scan. You will only need to uncover the right side of your abdomen. The Fibroscan technician will palpate your abdomen to find the right place for the probe to perform the scan. 

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