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Non-Alcoholic Fatty Liver Disease

What is Non-Alcoholic Fatty Liver Disease?

Non-alcoholic fatty liver disease (NAFLD) refers to a wide spectrum of liver disease ranging from simple fatty liver (steatosis), to nonalcoholic steatohepatitis (NASH), to cirrhosis. All of the stages of NAFLD have in common the accumulation of fat in the liver cells. In NASH, the fat accumulation is associated with varying degrees of inflammation (hepatitis) and scarring of the liver. The term nonalcoholic is used because NAFLD and NASH occur in individuals who do not consume excessive amounts of alcohol. Yet, in many respects, the biopsy of an NAFLD patient is similar to what can be seen in liver disease that is due to excessive intake of alcohol.


The symptoms of NAFLD and NASH are identical. They are non-specific and can occur at any adult age and, in children, usually appear after 10 years of age. Actually, most patients have no symptoms. They may experience occasional, vague right upper-quadrant abdominal pain. It is not an intense, sudden, and severe pain, as might occur with, for example, gallstones. The abdominal pain in NAFLD and NASH is thought to be due to the stretching of the liver covering when the liver enlarges and/or when there is inflammation in the liver.

But symptoms of severe, acute liver failure are not observed in NAFLD or NASH. The symptoms and signs of liver failure include yellowing of the skin, intense fatigue, loss of appetite, nausea, vomiting, and confusion.


  • Blood tests
  • Imaging procedures, including  ultrasound, computerized tomography (CT) scan and magnetic resonance imaging (MRI).
  • Liver tissue testing


No standard treatment exists for nonalcoholic fatty liver disease. Treatment is focused on the risk factors that contribute to liver disease, like obesity.

Non-alcoholic Fatty Liver Disease is treated in the Pediatric Liver Center at Hopkins Children's.