Prognosis of the Fatty Liver Disease

Non-alcoholic fatty liver disease is very heterogeneous and the exact mechanisms that cause it to appear and promote its progression are not yet known. Studies show it takes an average of about 20 years to go from a simple steatosis phase (fat in the liver) to cirrhosis. Patients with more risk factors (e.g. diabetes, hypertension, dyslipidaemia and obesity) are more likely to develop and get worse with the disease and, above all, to do so more quickly.

The path from steatosis or fatty liver to cirrhosis is silent, without symptoms to warn the patient they have the disease; it is not until cirrhosis and complications appear that the diagnosis is made.

The main complications of cirrhosis are:

• Ascites (accumulation of fluid inside the abdomen).
• Intestinal bleeding due to oesophageal varices: abnormal dilation of the oesophagus veins.
• Hepatic encephalopathy: loss of brain function due to failure of the liver to remove toxins from the blood.
• Kidney failure: malfunction of the kidneys.
• Infections.

All of these carry a high risk of hospital admission, complications and mortality.

Another of the known complications of cirrhosis is the appearance of liver cancer (hepatocarcinoma), which can appear in non-alcoholic fatty liver disease before cirrhosis fully develops. In these final stages of the disease, the only curative treatment is often a liver transplant.

Due to the increased prevalence of the disease in recent years, there has been a worldwide increase in the need for liver transplants for non-alcoholic fatty liver disease.