Fatty Liver Disease| Diagnosis & Treatment

How is fatty liver disease diagnosed?

A child's doctor will usually make a diagnosis of non-alcoholic fatty liver disease (NAFLD) based on a combination of medical history, physical examination and blood tests. Children who are obese and have higher-than-normal levels of certain liver enzymes on routine blood tests are more likely to have NAFLD.

The doctor may order an ultrasound (a painless, non-invasive imaging technique that uses high-frequency sound) sound to look at the structure of the liver. In addition, the doctor may order a transient elastography (FibroScan) which measures ultrasound waves through the liver to predict liver stiffness/scarring and the amount of liver fat.

In some cases, the doctor may order a needle biopsy to look for signs of fat buildup and scarring in the liver. This will tell whether a child has simple nonalcoholic fatty liver disease (NASH) or non-alcoholic steatohepatitis (NASH).

If a child is diagnosed with NAFLD, doctors will monitor the child’s liver by several means, including periodic:

  • blood tests, to check how well your child’s liver is working
  • ultrasounds
  • transient elastography
  • physical exams

How is fatty liver disease treated?

There is no simple cure for NAFLD. The focus of treatment is to prevent the disease from getting worse. This includes:

  • encouraging healthy eating and weight loss
  • maintaining tight control of blood sugar levels for children with diabetes
  • monitoring the child for complications or progression from NAFLD to more severe NASH

Some early studies suggest that vitamin E, an antioxidant, may have some benefit. However, it should not be seen as a substitute for weight loss, healthy eating and physical activity.

What is the long-term impact of NAFLD in children?

Because NAFLD is a chronic condition, a child with the condition may have to seek regular care for their entire lives.

If NAFLD advances to NASH, the liver may start to scar. Scar tissue can replace the liver’s healthy, soft tissue, causing cirrhosis and preventing the liver from working properly. If not brought under control, cirrhosis can lead to complications including portal hypertension, as well as liver failure or liver cancer and may require liver transplantation. All of these are serious but preventable conditions as long as the buildup of fat in the liver and the process of scarring can be slowed or stopped.