Liver disease: NHS Doctor talks about link with alcohol
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A healthy liver should contain little or no fat. It is estimated up to one in every three people in the UK has early stages of NAFLD, where there are small amounts of fat in their liver. Early stage NAFLD does not usually cause any harm, but it can lead to serious liver damage, including cirrhosis, if it gets worse.
According to doctor Colin Tidy, clinical editor for Patient, most people with simple fatty liver or non-alcoholic steatohepatitis (NASH) – an advanced form of non-alcoholic fatty liver disease – are asymptomatic.
However, some people with simple fatty liver or NASH have a “nagging persistent pain in the upper right part of the tummy (abdomen), over an enlarged liver,” said doctor Tidy.
You may feel generally tired if you have NASH. As most people do not have symptoms, the diagnosis is often first suspected when an abnormal blood test result occurs.
A small proportion of people with NAFLD develop cirrhosis. Cirrhosis is a condition where normal liver tissue is replaced by a lot of scar tissue (fibrosis).
Those with NAFLD can experience ongoing abdominal pains, with seven percent to 30 percent of people with the condition experiencing worsening effects over time. It progresses through three stages:
Your liver becomes inflamed (swollen), which damages its tissue. This stage is called steatohepatitis.
Scar tissue forms where your liver is damaged. This process is called fibrosis.
Extensive scar tissue replaces healthy tissue. At this point, you have cirrhosis of the liver. The hard scar tissue that replaces healthy liver tissue slows down the liver’s functioning. Eventually, it can block liver function entirely. Cirrhosis can lead to liver failure and liver cancer.
Various medicines have been suggested as possible treatments for NAFLD.
However, there is little research evidence to say that any medicine works very well.
For example, for NASH, no treatment has been proved to stop or reverse the inflammation. Various medicines are being trialled in different studies.
One or more medicines may emerge as treatments in the future.
Most cases of NAFLD are linked to being obese or overweight. There is good evidence that a programme of gradual weight loss and regular exercise can reduce the amount of fat in your liver.
So, if you have simple fatty liver or mild NASH, this may prevent or delay the progression of NAFLD. It may reduce your chance of developing cirrhosis too.
It is estimated that, on average, about two in 100 people with simple fatty liver progress to cirrhosis over 15-20 years.
Furthermore, about 12 in 100 people with NASH progress to cirrhosis over about eight years. Those with NAFLD, or any liver disease may have concerns surrounding the COVID-19 vaccination programme and its effectiveness, particularly if you are immunosuppressed.
The British Liver Trust’s Octave study recently published results on vaccine effectiveness in people with weakened immune systems. Initial findings found that 89 percent of people involved in the trial who were immunocompromised or immunosuppressed generated antibodies following vaccination.
It also found that six in 10 of clinically at-risk patients with certain immunocompromised or immunosuppressed condition, who took part in the trial, produced a strong antibody response but four in 10 had a low, or undetectable, immune response after two doses of the same COVID-19 vaccine.
The liver charity stated: “We know these findings may be particularly concerning for liver patients who are immunocompromised only based on tests of a small number of people covering a number of conditions. However, these initial results will guide clinical practice, including prioritising booster vaccines for immunosuppressed patients to ensure they have better protection through the winter.”
The effectiveness of a booster vaccine in immunosuppressed patients will be examined as part of a new clinical trial, Octave Duo, to find out if it gives a stronger immune response.
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