About Fatty Liver Disease in Children

Fatty liver disease in children, also known as nonalcoholic steatohepatitis, is a buildup of fat within the liver that can cause inflammation and scarring. This inflammation and scarring can prevent the liver from functioning as it should and may eventually lead to liver failure. With today’s increasing obesity rates in children, it is important to understand what fatty liver disease is, its causes, symptoms, treatments, and how to prevent it.

Symptoms

• Fatty liver is known as a silent killer with few initial symptoms. The symptoms of fatty liver disease are the same in children as in adults. As the disease progresses, you may see:
  Jaundice (yellowing of the eyes and skin)
  Fatigue/lethargy
  Abdominal pain
  Increasing abdominal girth
  Decreased appetite
  Weight loss
  Confusion (secondary to increased blood ammonia)
  Unusual bleeding
  Cirrhosis, which may lead to the need for a liver transplant

Diagnosis

• Your health care provider will diagnose fatty liver disease based on the following:
  Blood tests--usually a child has had a routine blood test for some other issue that has incidentally shown elevated liver enzymes and will need for further testing
  Physical examination and history
  X-rays and ultrasound--shows fat or enlarged liver
  Liver Biopsy (definitive)-- a biopsy needle is inserted into the liver and a sample is taken. Under microscope, the liver sample will show fat with inflammation.

Causes

• Exact causes of fatty liver disease in children are not known, but it is suspected that obesity, insulin resistance and a decrease in antioxidants may play a role. "The most common serious consequence of childhood obesity is fatty liver disease, and more than one million kids have it," said Jeffrey Schwimmer, MD, from Children's Hospital and Health Center and the Weight and Wellness Center, both in San Diego, California. "I think this is an under-recognized disease by pediatricians and the general public. All obese children should be screened."

Treatment

• According to the National Institutes of Health (NIH), the progression of this disease can take years, even decades. The process can stop and, in some cases, reverse on its own without specific therapy.
  There are no specific therapies for pediatric fatty liver. The National Institutes of Health recommends:
  Weight reduction (if obese or overweight)
  Follow a balanced and healthy diet
  Increase physical activity
  Avoid unnecessary medications
  The treatment for advanced liver failure is liver transplantation.

Prevention

• You must be proactive in deterring this disease. Although the causes are not definitive, obesity seems to rank on top. Help your child change his lifestyle by becoming an example. Slowly phase out things like:
  Too much television and video games
  Too many snacks
  Late bedtimes

  Gently phase in:
  Family exercise, like walking
  Healthier diet

  Set goals with your children to help them lead healthier, longer and more productive lives.