Fatty liver in children: Signs, causes, and treatments

Non-alcoholic fatty liver disease (NAFLD) is the most common childhood liver disease in the United States. Doctors now screen children for NAFLD if they are obese. A child with NAFLD has a higher risk of other health problems, such as diabetes.

Fatty liver occurs when there is an excessive buildup of fat in the liver. Over time, the fatty deposits can irritate the liver and cause scarring, leading to more serious health problems.

This article discusses fatty liver in children, including its signs, causes, risk factors, and treatments. It also explores the dangers and health risks of fatty liver if left untreated.

NAFLD affects 10% of children in the United States, including:

1% of children aged 2–4 years17% of children aged 15–17 years38% of children with obesity

There are two types of fatty liver that can lead to further complications:

Simple fatty liver or non-alcoholic fatty liver

This type of fatty liver occurs when a child has excess fat in the liver, but there is little or no liver inflammation or damage. It usually does not cause further liver damage or complications.

Non-Alcoholic Steatohepatitis (NASH)

This type occurs when the fatty deposits in the liver cause inflammation and liver damage.

About 20-50% of children with NAFLD have the NASH form. However, researchers don’t know why some kids have simple fatty liver disease while others have NASH.

Specialized pediatricians or pediatricians sometimes refer to NAFLD as a silent liver disease because children usually have no symptoms.

Children who do have symptoms may:

feeling tired getting tired easily have an unpleasant feeling over the liver, in the upper right corner of the abdomen

Doctors may suspect NAFLD because of abnormal blood test results, an abdominal ultrasound, or a CT scan ordered for another purpose.

Pediatricians may refer children to other specialist physicians, such as pediatric gastroenterologists. These doctors specialize in health issues related to the digestive system, liver, or diet.

Doctors don’t fully understand why some children develop NAFLD. The Children’s Liver Disease Foundation suggests that genetic factors are involved.

Environmental triggers that enable insulin resistance and fat accumulation in the liver may also contribute to the development of NAFLD.

Most children with NAFLD are in puberty. However, the condition is increasingly common in young children.

The North American Society of Pediatric Gastroenterology, Hepatology and Nutrition recommends screening for the following groups:

obese children aged 9-11 overweight children with additional risk factors, such as: accumulation of fat in the lower body around the abdomen, which is called central adiposity prediabetes younger children with severe obesity or hypopituitarism, where the pituitary gland does not produce hormones siblings and parents of children with NAFLD

Doctors screen children for fatty liver using the alanine aminotransferase (ALT) test.

While ALT and imaging tests can help screen for fatty liver, having a liver biopsy is the only way to diagnose NAFLD, determine its severity, and rule out other conditions that can cause elevated liver enzymes.

A parent or caregiver can consult a pediatrician if they are concerned about their child’s risk of NAFLD.

Doctors recommend early screening to detect fatty liver before it develops into cirrhosis. NAFLD, especially NASH, is the leading cause of chronic liver disease and liver transplants in older children.

Cirrhosis is a late stage irreversible disease in which scar tissue replaces liver tissue and permanently damages the organ. A child may need a liver transplant if cirrhosis leads to liver failure.

NASH-associated cirrhosis can also lead to liver cancer.

A parent or caregiver should see a doctor to get a prompt diagnosis and make sure their child is getting the right treatment.

If a person gets the right treatment early, liver damage can still be reversible. In some cases, the liver can stop or reverse the damage on its own.

Losing excess weight reduces fat and inflammation in the liver.

This weight reduction can help reverse or at least control the progression of the disease.

Currently, drugs are approved to treat fatty liver disease in children. Making certain lifestyle changes can reverse or control fat accumulation in a child’s liver. Including:

exercise regularly and participate in sports activities maintain a moderate weight eat a balanced diet limit portion sizes reduce cholesterol and triglycerides control diabetes consult a nutritionist

Parents or guardians can consult a pediatrician for support and guidance in making the above lifestyle changes.

Recent research suggests that vitamin E supplements can reduce inflammation and cell damage. However, the role of vitamin E in the long-term management of NAFLD is not clear, so further research is required.

Another 2021 study found vitamin E effective in normalizing ALT levels in 38% of children with NASH.

In addition, a 2017 study found that a mixture of docosahexaenoic acid, choline, and vitamin E was effective in reducing severe NASH in children.

Before trying supplements as a treatment, a parent or caregiver should discuss their use with a pediatrician.

Fatty liver disease is when the liver stores excess fat.

The condition may not cause any symptoms in children. However, early screening is vital to diagnose the condition and prevent serious complications, such as cirrhosis.

Current treatments focus on losing weight by following a balanced diet and doing physical activities. These lifestyle changes can reduce fat buildup, inflammation, and scarring in the liver.

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