Fatty Liver Disease
The liver naturally stores a small amount of fat. When a child’s liver stores too much fat, they have what is called fatty liver disease.
One type of fatty liver disease is simple fatty liver, which usually doesn’t cause any liver damage. The other type is nonalcoholic steatohepatitis, or NASH. With this type, the child’s liver is inflamed, and the liver cells are damaged. If NASH becomes severe, it can lead to scarring, or cirrhosis when the child is an adult.
Fatty liver disease is the most common liver condition in children in the U.S, according to the American Academy of Pediatrics. It’s sometimes called nonalcoholic fatty liver disease (NAFLD) to distinguish it from alcoholic fatty liver disease, which is caused by drinking too much alcohol.
Symptoms
Both simple fatty liver and NASH are unlikely to cause symptoms. With NASH, older children may have symptoms after their liver is damaged and become cirrhotic. These symptoms can include:
Fatigue or tiring easily
Discomfort over the liver, which is on the upper right side of the abdomen
Yellow color of the skin or whites of the eyes (called jaundice), which can indicate cirrhosis
High blood pressure
Both types of fatty liver disease are more likely in children who are overweight or obese. Since untreated fatty liver disease can lead to serious complications, doctors recommend that overweight and obese children between the ages of 9 and 11 be screened for this condition.
Diagnosis
At Orlando Health Children's Arnold Palmer Hospital Center for Digestive Health and Nutrition, your specialist will do a physical exam that includes calculating your child’s body mass index, or BMI. They also will check for an enlarged liver and other signs of fatty liver disease. Since this disease can run in families, your child’s specialist will ask whether any close relatives have been diagnosed with this condition.
The following tests also are used to diagnose fatty liver disease:
Blood tests. These can find increased liver enzyme levels that may indicate fatty liver disease.
Imaging tests. An ultrasound test uses safe, painless sound waves to create images of the liver. Magnetic resonance imaging, or MRI, uses radio waves and magnets to produce these images.
Liver biopsy. The doctor numbs the area and inserts a needle to take a small piece of tissue from the liver, which is then examined in the lab.
Elastography. This newer technique measures the stiffness and elasticity of soft tissue in the liver. It can help diagnose scarring (fibrosis and cirrhosis).
Treatments
If your child is diagnosed with fatty liver disease, your doctor will recommend that they gradually lose weight. Weight loss is the best way to reduce fat in the liver and to avoid inflammation and other complications.
Your team at Orlando Health Children's Arnold Palmer Hospital Center for Digestive Health and Nutrition will coach you on helping your child establish healthy lifestyle habits. Regular exercise and a nutritious diet that’s low in fat and sugary foods can get your child on track for losing weight and reducing fat in their liver.
There are no medications approved for treating fatty liver disease in children. While vitamin E is sometimes used for this condition in adults, you should talk with your doctor before giving it to your child. Also check with your doctor before using any herbal medicines, since some can damage a child’s liver.
Next Steps
A balanced diet is essential for overall health and especially for overcoming fatty liver disease. Your team at Orlando Health Children's Arnold Palmer Hospital Center for Digestive Health and Nutrition includes the only full-time registered pediatric dietitians in Central Florida. We also have several pediatric gastroenterologists who are board certified in obesity care. These experts provide the range of care your child needs to heal along with coaching and confidence-boosting to help your family stay healthy.
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