Your child’s doctor may suspect NAFLD if your child is overweight or obese and routine blood tests suggest that the levels of certain liver enzymes are higher than normal. The diagnosis can sometimes be confirmed by ultrasound or other imaging techniques, which can show whether and how much fat has built up in the liver. Because certain medications, viral or autoimmune hepatitis, metabolic disease, and congenital liver disease can also cause fat to build up in the liver, it is important to rule these other causes out before diagnosing a child with NAFLD.
Currently the only way to tell the difference between NAFLD and NASH is with a liver biopsy. If the biopsy shows fatty accumulation, inflammation, and scarring, then a diagnosis of NASH can be made.
For details, see Tests.
How do you treat NAFLD?
- Controlling your child’s weight, especially through health eating and regular exercise
- Controlling cholesterol and triglyceride levels
Regular visits to a doctor who specializes in liver disease and conversations with your doctor about liver health are important parts of the treatment process. In addition, if your child has diabetes, tight blood sugar control can also help. Some studies suggest that vitamin E may provide some benefit.
The same recommendations apply to both NAFLD and NASH. Remember, though, that in many cases the goal of treatment for both conditions is management, not cure.
For details, see Treatment & care.
How can NAFLD affect my child in the long term?
If NAFLD advances to NASH, the liver may start to scar. Scar tissue (also called fibrosis) can replace the liver’s healthy, soft tissue, causing cirrhosis and preventing the organ from working properly. If not brought under control, cirrhosis can lead to complications including portal hypertension or hepatopulmonary syndrome, as well as liver failure or liver cancer. 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.
Because NAFLD is a chronic condition, your child may have to seek care for it for the rest of his or her life. The Center for Childhood Liver Disease can help you and your child plan for the eventual transition from pediatric to adult care.
Questions to ask your doctor
If your child has been diagnosed with NAFLD, you and your family will play an essential role in his or her care. It’s important that you share your observations and ideas with your child’s treating physician, and that you have all the information you need to fully understand the treatment team’s explanations and recommendations.
It’s often very helpful to jot down your thoughts and questions ahead of time and bring them with you, along with a notebook, to your child’s appointment. That way, you’ll have all of your questions in front of you when you meet with your child’s treating clinician and can make notes to take home with you.