Fatty liver disease progresses slowly. Studies indicate it may take upwards of ten years for alcohol-related fatty liver disease to progress to cirrhosis. ¹⁴ This process may not cause symptoms until the later stages. A healthy lifestyle can significantly reduce your risk of fatty liver disease.
It takes upwards of ten years for alcohol-related liver disease to progress from fatty liver through fibrosis to cirrhosis to acute on chronic liver failure. This process is silent and symptom free and can easily be missed in primary care, usually presenting with advanced cirrhosis.
Ultrasound or computed tomography (CT scan) to get a picture of the liver. Liver biopsy (tissue sample) to determine how far advanced liver disease has progressed. FibroScan®, a specialized ultrasound sometimes used instead of a liver biopsy to find out the amount of fat and scar tissue in the liver.
Liver failure can develop slowly or rapidly, depending on the cause and the condition of the liver. Chronic liver failure: The most common type of liver failure is chronic, which can take months or years to develop.
You may live the rest of your natural life without having any complications from it. It becomes more complicated for a small percentage of people when it turns to steatohepatitis (NASH), and especially when NASH progresses to cirrhosis. Research suggests that NAFLD overall may lower life expectancy by four years.
The rate of disease progression is usually slow. About 20% of patients with NAFLD will develop NASH in three to seven years (10), which is considered the potentially progressive form of the disease (11). About 9 to 25% of individuals with NASH develop cirrhosis over a 10 to 20 year period (12).
In typical patients, cases of non-alcoholic fatty liver disease occur around the age of 70, but in recent years, the patient population most impacted by this disease is changing. Fatty liver disease is a condition where the liver develops fatty cells that reduce its function.
The liver can develop new cells, but prolonged alcohol misuse (drinking too much) over many years can reduce its ability to regenerate.
However, the changes over time in the histology of NAFLD and liver fibrosis markers are not well documented. Fibrosis progresses at a speed of 0.07 stages/year in NAFL and 0.14 stages/year in NASH, so NAFL progresses by 1 stage every 14 years and NASH by 1 stage every 7 years (4).
The onset of liver fibrosis is usually insidious, and most of the related morbidity and mortality occur after the development of cirrhosis (16). In the majority of patients, progression to cirrhosis occurs after an interval of 15–20 years.
Symptoms of fatty liver disease
NASH can damage your liver for years or even decades without causing any symptoms. If the disease gets worse, you may experience fatigue, weight loss, abdominal discomfort, weakness and confusion.
It depends! Even short periods of drinking can lead to some form of liver disease, but it typically takes several years for permanent damage to occur.
The liver is very resilient and capable of regenerating itself. Each time your liver filters alcohol, some of the liver cells die. The liver can develop new cells, but prolonged alcohol misuse (drinking too much) over many years can reduce its ability to regenerate.
If you have fatty liver disease, the damage may be reversed if you abstain from alcohol for a period of time (this could be months or years). After this point, it's usually safe to start drinking again if you stick to the NHS guidelines on alcohol units. However, it's important to check with your doctor first.
According to the American Liver Foundation, there are no medical treatments – yet – for non-alcoholic fatty liver disease. So that means that eating a healthy diet and exercising regularly are the best ways to both prevent liver damage from starting or reverse liver disease once it's in the early stages.
Research suggests that losing weight is the single best thing you can do to control or reverse NAFLD. A good goal is to lose 10% of your total body weight, but even a loss of 3% to 5% can improve your liver health.
Most people who have a body mass index (BMI) over 27 have fatty liver disease. People who gain weight in the abdomen are at greater risk than those who gain weight around their hips or shoulders.
The first stage is referred to as simple fatty liver or steatosis; This occurs when the liver cells start to build-up fat, although there is no inflammation or scarring at this stage. There are often no symptoms in this early stage, so many people are unaware they have a fatty liver.
Nonalcoholic fatty liver disease (NAFLD) has widely been considered a manifestation of metabolic syndrome in close relation to obesity [1]. In fact, although obesity is undoubtedly one of the main risk factors for fatty liver, since its first description it is known that it can also occur in lean subjects.
Between 5% and 12% of people with NASH will progress to cirrhosis.
The good news is that fatty liver disease can be reversed—and even cured—if patients take action, including a 10% sustained loss in body weight.