“Non-Alcoholic Fatty Liver Disease (NAFLD) is the most common form of liver disease in children and has more than doubled over the past 20 years.  About 100 million individuals are estimated to have NAFLD.”

The American Liver Foundation

Part II Liver and Disease (Non-Alcoholic Fatty Liver Disease-NAFLD)

A      healthy liver

              A. HEALTHY LIVER  

  B      liver diease 1      

                B. DISEASED LIVER

TREATMENT There are no medical treatments yet for NAFLD. Eating a healthy diet and exercising regularly may help prevent liver damage from starting or reverse it in the early stages.

  • See a doctor who specializes in the liver regularly
  • Talk to your doctor about ways to improve your liver health
  • Lose weight, if you are overweight or obese
  • Lower your cholesterol and triglycerides
  • Control your diabetes
  • Avoid alcohol
  • PREVENTION There are ways to prevent NAFLD:
  • Maintain a healthy weight
  • Eat a healthy diet
  • Exercise regularly
  • Limit alcohol intak
  • Only take medicines that you need and follow dosing recommendations. The more severe form of NAFLD is called non-alcoholic steatohepatitis (NASH). NASH causes the liver to swell and become damaged. NASH tends to develop in people who are overweight or obese, or have diabetes, high cholesterol or high triglycerides. NASH can occur in many.
  •  Causes: NASH:NASH affects 2 to 5 percent of Americans. An additional 10 to 20 percent of Americans have fat in their liver, but no inflammation or liver damage, a condition called “fatty liver.” Although having fat in the liver is not normal, by itself it probably causes little harm or permanent damage. If fat is suspected based on blood test results or scans of the liver, this problem is called nonalcoholic fatty liver disease (NAFLD). If a liver biopsy is performed in this case, it will show that some people have NASH while others have simple fatty liver.
  • Nonalcoholic steatohepatitis or NASH is a common, often “silent” liver disease. It resembles alcoholic liver disease, but occurs in people who drink little or no alcohol. The major feature in NASH is fat in the liver, along with inflammation and damage. Most people with NASH feel well and are not aware that they have a liver problem. Nevertheless, NASH can be severe and can lead to cirrhosis, in which the liver is permanently damaged and scarred and no longer able to work properly.
  • Most people with NASH are between the ages of 40 and 60 years. It is more common in women than in men. NASH often has no symptoms and people can have NASH for years before symptoms occur. NASH is one of the leading causes of cirrhosis in the United States.  Up to 25% of adults with NASH may have cirrhosis.  Know people have NASH even if they do not have one risk factor can get the disease.
  • Both NASH and NAFLD are becoming more common, possibly because of the greater number of Americans with obesity. In the past 10 years, the rate of obesity has doubled in adults and tripled in children. Obesity also contributes to diabetes and high blood cholesterol, which can further complicate the health of someone with NASH. Diabetes and high blood cholesterol are also becoming more common among Americans.
    • Nonalcoholic steatohepatitis (NASH) is fat in the liver, with inflammation and damage.
    • NASH occurs in people who drink little or no alcohol and affects 2 to 5 percent of Americans, especially people who are middle-aged and overweight or obese.
    • NASH can occur in children.
    • People who have NASH may feel well and may not know that they have a liver disease.
    • NASH can lead to cirrhosis, a condition in which the liver is permanently damaged and cannot work properly.
    • Fatigue can occur at any stage of NASH.
    • Weight loss and weakness may begin once the disease is advanced or cirrhosis is present.
    • NASH may be suspected if blood tests show high levels of liver enzymes or if scans show fatty liver.
    • NASH is diagnosed by examining a small piece of the liver taken through a needle, a procedure called biopsy.
    • People who have NASH should reduce their weight, eat a balanced diet, engage in physical activity, and avoid alcohol and unnecessary medications.
    • No specific therapies for NASH exist. Experimental therapies being studied include antioxidants and antidiabetes medications.
    • Other Pointers in knowing about the types of liver diseases:
  • Most liver diseases are managed and not cured. The exception is for gallstone disease and some viral infections like Hepatitis A and infectious mononucleosis. All forms of liver disease has the ability to progress to cirrhosis and cause liver failure. Complications associated with cirrhosis and liver failure include an increased risk of bleeding and infection, malnutrition and weight loss, and decreased cognitive function.
  • Depending on the type of cause for liver disease, determines how it is treated. Hep A requires supportive care from others to maintain hydration while the body’s immune system continues to fight off infections. Other diseases may require long-term care to control and minimize consequences of a particular disease. With cirrhosis and end-stage liver disease patients, they are often given medications to control the amount of protein absorbed in the diet. For other cirrhosis patients, they may not be able to metabolize waste products which raises their blood ammonia levels. To help them function, they need to take water pills (diuretics) and start a low sodium diet to minimize water retention. Only when all other options have failed is liver transplantation an option.
  • Symptoms of liver disease range depending on the exact cause for the limited liver function. The general symptoms include a weakness or fatigue, weight loss, nausea, vomiting, fever and a yellow discoloration. If these symptoms are experienced without an explanation, it may be time to consult a medical professional. The time for education is before something like this happens. The survival rate is much higher for the individuals that seek medical attention early on through the act of having the knowledge to make the right decision. By the way the yellow discoloration is what we call Jaundice.
  • Some of the other viruses that cause liver disease are viral infections like Mononucleosis, Adenovirus and Cytomegalovirus. There are also non-viral infections like toxoplasmosis and Rocky Mountain Spotted fever that could lead to liver disease but they are less common.
  • There are other conditions like Hemachromatosis (iron overload), which is a metabolic disorder that leads to abnormally elevated amounts of iron that is stored in the body. It is an inherited disease. Wilson’s disease is another inherited disease but it affects the body’s ability to metabolize copper. Gilbert’s Disease is an abnormality in bilirubin metabolism in the liver and affects up to 7% of the North American population.
  • Most people with NASH are between the ages of 40 and 60 years. It is more common in women than in men. NASH often has no symptoms and people can have NASH for years before symptoms occur. NASH is one of the leading causes of cirrhosis in adults in the United States. Up to 25% of adults with NASH may have cirrhosis. Know people have NASH even if they do not have one risk factor.
  • Due to alcohol abuse acting as the most common cause of liver disease, it is recommended that alcohol consumption is in moderation. It may help minimize the risk of alcohol-related liver disease. Hepatitis B and C contraction can be decreased by minimizing the risk of exposure to another person’s bodily fluids. There is a vaccination available for Hepatitis A and B. There is screening available for Hepatitis C at most clinics or doctors offices. Fatty liver disease is preventable by the promotion of a healthy lifestyle. Those lifestyle choices include a well-balanced diet, weight control, avoiding excess alcohol consumption and routine exercise.


“Non-alcoholic fatty liver disease (NAFLD) is the build up of extra fat in liver cells that is not caused by alcohol. It is normal for the liver to contain some fat. However, if more than 5% – 10% percent of the liver’s weight is fat, then it is called a fatty liver (steatosis).”

American Liver Foundation

The Liver and NAFLD (Non-Alcoholic Fatty Liver Disease).

liver awareness2

The liver is a large, meaty organ that sits on the right side of the belly. Weighing about 3 pounds, the liver is reddish-brown in color and feels rubbery to the touch. Normally you can’t feel the liver, because it’s protected by the rib cage.

The liver has two large sections, called the right and the left lobes. The gallbladder sits under the liver, along with parts of the pancreas and intestines. The liver and these organs work together to digest, absorb, and process food.

The liver’s main job is to filter the blood coming from the digestive tract, before passing it to the rest of the body. The liver also detoxifies chemicals and metabolizes drugs. As it does so, the liver secretes bile that ends up back in the intestines. The liver also makes proteins important for blood clotting and other functions.

The liver is a vital organ of vertebrates and in some other animals. In the human it is located in the upper right quadrant of the abdomen, below the diaphragm. The liver has a wide range of functions, including detoxification of various metabolites, protein synthesis, and the production of biochemicals necessary for digestion.

The liver is a gland and plays a major role in metabolism with numerous functions in the human body, including regulation of glycogen storage, decomposition of red blood cells, plasma protein synthesis, hormone production, and detoxification.[3] It is an accessory digestive gland and produces bile, an alkaline compound which aids in digestion via the emulsification of lipids. The gallbladder, a small pouch that sits just under the liver, stores bile produced by the liver. The liver’s highly specialized tissue consisting of mostly hepatocytes regulates a wide variety of high-volume biochemical reactions, including the synthesis and breakdown of small and complex molecules, many of which are necessary for normal vital functions Estimates regarding the organ’s total number of functions vary, but textbooks generally cite it being around 500.

Nonalcoholic fatty liver disease is a term used to describe the accumulation of fat in the liver of people who drink little or no alcohol.

Nonalcoholic fatty liver disease is common and, for most people, causes no signs and symptoms and no complications.

But in some people with nonalcoholic fatty liver disease, the fat that accumulates can cause inflammation and scarring in the liver. This more serious form of nonalcoholic fatty liver disease is sometimes called nonalcoholic steatohepatitis.

At its most severe, nonalcoholic fatty liver disease can progress to liver failure.

Much of the American Liver Foundation’s emphasis during October continues to point to the cause and treatment for liver diseases like hepatitis A, B and C; cirrhosis, biliary atresia and liver cancer.

Much of the Foundation’s emphasis during October continues to point to the cause and treatment for liver diseases like hepatitis A, B and C; cirrhosis, biliary atresia and liver cancer.

But the Foundation is also tapping into the heightened awareness during Liver Awareness Month to draw attention to the alarming increase in the incidence of Non-Alcoholic Fatty Liver Disease (NAFLD), which, staggeringly, affects up to 25 percent of people in the United States.

As its name suggests, NAFLD is the buildup of extra fat in the liver that isn’t caused by alcohol. It’s normal for the liver to contain some fat. But if more than 5 to 10 percent of the liver’s weight is fat, then it is called a “fatty liver.”

Most often, NAFLD tends to develop in people who are overweight or obese or have diabetes, high cholesterol or high triglycerides. Sedentary behavior is another major contributing factor to the onset of NAFLD.

For these reasons, concern continues to grow as one in 10 children—that’s seven million children in the United States—is estimated to have fatty livers.

NALFD can become even more serious. It can progress to Non-Alcoholic Steatohepatitis (NASH), which means that along with the fat, there is inflammation and damage to the liver. A swollen liver may cause scarring (cirrhosis) over time and may even lead to liver cancer or liver failure.



“The liver has many functions, including detoxifying of harmful chemicals, breakdown of drugs, filtering of blood, secretion of bile and production of blood-clotting proteins.”


Why the liver is so vital to our human body!

healthy liver

The liver is like our transmission to the human body—it cleans out end products of what enters our body keeping the essentials we need inside. This is what this organ does for us:

Your liver is your very own chemical processing plant. It receives 30% of the blood circulating in your system every minute – performing chemical reactions to remove harmful toxins and distribute and store essential nutrients. This vital process is called ‘metabolism’ and cells in the liver, known as hepatocytes, are put to work to keep your body working at its best. Essentially, your liver loves and cares for you.

Once carbs have been broken down into glucose in your gastrointestinal tract, the glucose enters the blood stream and is taken straight to your liver to regulate and maintain healthy levels. Your liver also stores excess glucose in the form of glycogen (inactive glucose) and the liver will fill up with this glycogenl (like a gas tank). When the tank of the liver gets full the excess of the sugar floating in your bloodstream is used by our tissues that need it right than.  The sugar that couldn’t go in the liver is extra glucose that now needs a place to store (if the liver is full) than it gets dumped in our fat tissue next. This is how we get obese. This is the logic of eating small meals not 3 large meals a day. The small meals are utilized mostly where there is no extra floating glucose that needs to be stored anywhere like in our case the fatty tissue. The average American doesn’t realize this with knowing that glycogen (inactive glucose) when needed by our body is ready for converting back into glucose when levels drop between meals which usually occurs during exercise or when you’re fasting; which most of us in America don’t do by overall population. For our liver to do these processes of breakdown of our foods (including medications), to convert active glucose to inactive glucose (glycogen), store glycogen in the liver and to do much more the liver has to be working meaning healthy.

And here’s the really clever thing. Your liver can also convert non-sugars, such as amino acids, into glucose to keep levels healthy. It does some pretty impressive things with fats too.

Every time you eat either through food or protein fluid drinks in place of your food, your liver feeds you. Once food is digested, nutrients enters the blood from the stomach after digestion in that organ takes place including the small intestines, which are taken straight to your liver for processing. Depending on how low or plentiful these nutrients are in your body, the liver cells will either release the goodness of these processed broken down nutrient end products to where it’s needed (regarding our tissues of the body) or store they will be stored away for when your body tissues needs a boost later.

And here’s the really clever thing. Your liver can also convert non-sugars, such as amino acids, into glucose to keep levels healthy. It does some pretty impressive things with fats too.

Your liver is your fat processing factory – it breaks down fat and compounds such as lipoproteins, cholesterol and phospholipids. If fat is in excess, the liver combines fatty acids and glycerol to form a storage molecule and transports it to your body’s storage depots, such as the subcutaneous tissue (tissue just under the skin). Then, at times when energy levels are low, between meals and during exercise, this stored fat is converted back into glycerol and the liver turns the remaining fatty acids into an alternative energy supply. To aid absorption of fat and fat-soluble vitamins and flush out unwanted substances from your body, your liver produces bile. It stores the bile in your gall bladder, where it can be emptied into your intestines when needed.

Proteins are also vital for a healthy body, and your liver takes charge of these too. Once proteins are broken down into amino acids in your intestines, they enter the blood stream and flow direct to the liver. Here, the liver cells (hepatocytes) go to work on removing nitrogen from the proteins which rapidly changes into ammonia – a highly toxic substance. Your liver then acts fast to convert this into urea to be excreted into the urine and eliminated from your body. With excess amino acids, your liver converts them into fat for storage or, if your body needs an energy boost, it will use them to create glucose.

Ending line the liver breaks down our Calories & CHOs, Fats, and Proteins that enter our body.

Our liver watches out for us. When harmful toxins and substances enter your blood stream, your liver acts fast to detoxify and destroy them. Some may simply be a by-product of a normal metabolism, others may be ingested or inhaled substances such as drugs and alcohol. Filtering the blood, your liver removes dead cells and invading bacteria, processes nitrogen and cholesterol and neutralises harmful hormones.

The problem comes when the body liver can’t do this function anymore, meaning it can’t break down or do the processing of out nutrients we eat causing toxins to build up in our body. Soon this break down of the liver with no reversal or without treatment will go into liver failure. Liver failure can put a big hold up in your life but if you can reverse it your smart since you addressed the problem in getting cared for by a doctor. You can even be better than this in being healthy to your body which is you taking PREVENTION in allowing yourself never to deal with this headache.

Liver failure or hepatic insufficiency is the inability of the liver to perform its normal synthetic and metabolic function as part of normal physiology. Two forms are recognized, acute and chronic.

Acute liver failure defined as “the rapid development of hepatocellular dysfunction, specifically coagulopathy and mental status changes (encephalopathy) in a patient without known prior liver disease.”.

Chronic liver failure usually occurs in the context of cirrhosis, itself potentially the result of many possible causes, such as excessive alcohol intake, hepatitis B or C, autoimmune, hereditary and metabolic causes (such as iron or copper overload, Steatohepatitis or non-alcoholic fatty liver disease).

CHRONIC can be prevented. How important is your health?


“As the liver plays such a critical part in ridding the body of toxins, and extracting and storing nutrients for the body to use, children born with a congenital liver disease usually become ill as young infants.”


The causes of liver diseases!


Liver disease has many causes.


Parasites and viruses can infect the liver, causing inflammation that reduces liver function. The viruses that cause liver damage can be spread through blood or semen, contaminated food or water, or close contact with a person who is infected. The most common types of liver infection are hepatitis viruses, including:

  • Hepatitis A
  • Hepatitis B
  • Hepatitis C

Immune system abnormality

Diseases in which your immune system attacks certain parts of your body (autoimmune) can affect your liver. Examples of autoimmune liver diseases include:

  • Autoimmune hepatitis
  • Primary biliary cirrhosis
  • Primary sclerosing cholangitis


An abnormal gene inherited from one or both of your parents can cause various substances to build up in your liver, resulting in liver damage. Genetic liver diseases include:

  • Hemochromatosis
  • Hyperoxaluria and oxalosis
  • Wilson’s disease
  • Alpha-1 antitrypsin deficiency

Cancer and other growths

Examples include:

  • Liver cancer
  • Bile duct cancer
  • Liver adenoma


Additional, common causes of liver disease include:

  • Chronic alcohol abuse
  • Fat accumulating in the liver (nonalcoholic fatty liver disease)

Risk factors

Factors that may increase your risk of liver disease include:

  • Heavy alcohol use
  • Injecting drugs using shared needles
  • Tattoos or body piercings
  • Blood transfusion before 1992
  • Exposure to other people’s blood and body fluids
  • Unprotected sex
  • Exposure to certain chemicals or toxins
  • Diabetes
  • Obesity


Complications of liver disease vary, depending on the cause of your liver problems. Untreated liver disease may progress to liver failure, a life-threatening condition.


To prevent liver disease:

  • Drink alcohol in moderation. For healthy adults, that means up to one drink a day for women and up to two drinks a day for men. Heavy or high-risk drinking is defined as more than eight drinks a week for women and more than 15 drinks a week for men.
  • Avoid risky behavior. Get help if you use illicit intravenous drugs, and don’t share needles used to inject drugs. Use a condom during sex. If you choose to have tattoos or body piercings, be picky about cleanliness and safety when selecting a shop.
  • Get vaccinated. If you’re at increased risk of contracting hepatitis or if you’ve already been infected with any form of the hepatitis virus, talk to your doctor about getting the hepatitis A and hepatitis B vaccines.
  • Use medications wisely. Take prescription and nonprescription drugs only when needed and only in recommended doses. Don’t mix medications and alcohol. Talk to your doctor before mixing herbal supplements or prescription or nonprescription drugs.
  • Avoid contact with other people’s blood and body fluids. Hepatitis viruses can be spread by accidental needle sticks or improper cleanup of blood or body fluids.
  • Take care with aerosol sprays. Make sure the room is ventilated, and wear a mask when spraying insecticides, fungicides, paint and other toxic chemicals. Always follow the manufacturer’s instructions.
  • Protect your skin. When using insecticides and other toxic chemicals, wear gloves, long sleeves, a hat and a mask.
  • Maintain a healthy weight. Obesity can cause nonalcoholic fatty liver disease.


“The liver is a large, meaty organ that sits on the right side of the belly. Weighing about 3 pounds, the liver is reddish-brown in color and feels rubbery to the touch. Normally you can’t feel the liver, because it’s protected by the rib cage.”


What is the Liver for and What is cirrohosis?




The liver is an organ about the size of a football that sits just under your rib cage on the right side of your abdomen. The liver is essential for digesting food and ridding your body of toxic substances.

Liver disease can be inherited (genetic) or caused by a variety of factors that damage the liver, such as viruses and alcohol use. Obesity is also associated with liver damage.

Over time, damage to the liver results in scarring (cirrhosis), which can lead to liver failure, a life-threatening condition.

What is cirrhosis of the liver?

Cirrhosis is a complication of many liver diseases characterized by abnormal structure and function of the liver. The diseases that lead to cirrhosis do so because they injure and kill liver cells, after which the inflammation and repair that is associated with the dying liver cells causes scar tissue to form. The liver cells that do not die multiply in an attempt to replace the cells that have died. This results in clusters of newly-formed liver cells (regenerative nodules) within the scar tissue. There are many causes of cirrhosis including chemicals (such as alcohol, fat, and certain medications), viruses, toxic metals (such as iron and copper that accumulate in the liver as a result of genetic diseases), and autoimmune liver disease in which the body’s immune system attacks the liver.

Why does cirrhosis cause problems?

The liver is an important organ in the body. It performs many critical functions, two of which are producing substances required by the body, for example, clotting proteins that are necessary in order for blood to clot, and removing toxic substances that can be harmful to the body, for example, drugs. The liver also has an important role in regulating the supply of glucose (sugar) and lipids (fat) that the body uses as fuel. In order to perform these critical functions, the liver cells must be working normally, and they must have a close proximity to the blood because the substances that are added or removed by the liver are transported to and from the liver by the blood.

The relationship of the liver to the blood is unique. Unlike most organs in the body, only a small amount of blood is supplied to the liver by arteries. Most of the liver’s supply of blood comes from the intestinal veins as the blood returns to the heart. The main vein that returns blood from the intestines is called the portal vein. As the portal vein passes through the liver, it breaks up into increasingly smaller and smaller veins. The tiniest veins (called sinusoids because of their unique structure) are in close contact with the liver cells. In fact, the liver cells line up along the length of the sinusoids. This close relationship between the liver cells and blood from the portal vein allows the liver cells to remove and add substances to the blood. Once the blood has passed through the sinusoids, it is collected in increasingly larger and larger veins that ultimately form a single vein, the hepatic vein, which returns the blood to the heart.

In cirrhosis, the relationship between blood and liver cells is destroyed. Even though the liver cells that survive or are newly-formed may be able to produce and remove substances from the blood, they do not have the normal, intimate relationship with the blood, and this interferes with the liver cells’ ability to add or remove substances from the blood. In addition, the scarring within the cirrhotic liver obstructs the flow of blood through the liver and to the liver cells. As a result of the obstruction to the flow of blood through the liver, blood “backs-up” in the portal vein, and the pressure in the portal vein increases, a condition called portal hypertension. Because of the obstruction to flow and high pressures in the portal vein, blood in the portal vein seeks other veins in which to return to the heart, veins with lower pressures that bypass the liver. Unfortunately, the liver is unable to add or remove substances from blood that bypasses it. It is a combination of reduced numbers of liver cells, loss of the normal contact between blood passing through the liver and the liver cells, and blood bypassing the liver that leads to many of the manifestations of cirrhosis.

A second reason for the problems caused by cirrhosis is the disturbed relationship between the liver cells and the channels through which bile flows. Bile is a fluid produced by liver cells that has two important functions: to aid in digestion and to remove and eliminate toxic substances from the body. The bile that is produced by liver cells is secreted into very tiny channels that run between the liver cells that line the sinusoids, called canaliculi. The canaliculi empty into small ducts which then join together to form larger and larger ducts. Ultimately, all of the ducts combine into one duct that enters the small intestine. In this way, bile gets to the intestine where it can help with the digestion of food. At the same time, toxic substances contained in the bile enter the intestine and then are eliminated in the stool. In cirrhosis, the canaliculi are abnormal and the relationship between liver cells and canaliculi is destroyed, just like the relationship between the liver cells and blood in the sinusoids. As a result, the liver is not able to eliminate toxic substances normally, and they can accumulate in the body. To a minor extent, digestion in the intestine also is reduced.