Non-alcoholic fatty liver disease screening: Difference between revisions
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==Overview== | ==Overview== | ||
There is insufficient evidence to recommend routine screening for NAFLD.But it can be argued that at least for high-risk profiles like [[obesity]], [[insulin resistance]] and patients with [[metabolic syndrome]] should be screened for NAFLD. However, at present, there are significant gaps in our knowledge regarding the diagnosis, natural history, and treatment of NAFLD.Sometimes patients with normal liver enzyme levels have NAFLD and NASH and maybe not enough for screening alone but with ultrasound which is sensitive can serve as a screening test. | There is insufficient evidence to recommend routine screening for NAFLD. But it can be argued that at least for high-risk profiles like [[obesity]], [[insulin resistance]] and patients with [[metabolic syndrome]] should be screened for NAFLD. However, at present, there are significant gaps in our knowledge regarding the diagnosis, natural history, and treatment of NAFLD.Sometimes patients with normal liver enzyme levels have NAFLD and NASH and maybe not enough for screening alone but with ultrasound which is sensitive can serve as a screening test. | ||
==Screening== | ==Screening== | ||
* There is insufficient evidence to recommend routine screening for NAFLD. | * There is insufficient evidence to recommend routine screening for NAFLD. But it can be argued that at least for high-risk profiles like [[obesity]], [[insulin resistance]] and patients with [[metabolic syndrome]] should be screened for NAFLD. | ||
* Most of the time NAFLD is accidental finding on routine ultrasound. | * Most of the time NAFLD is accidental finding on routine ultrasound. | ||
* NAFLD usually has no symptoms. So diagnosing the problem often starts after a blood test finds higher-than-normal levels of liver enzymes. A standard blood test could reveal these results.<ref name="urlThe Diagnosis and Management of Non-alcoholic Fatty Liver Disease: Practice Guideline by the American Gastroenterological Association, American Association for the Study of Liver Diseases, and American College of Gastroenterology - Gastroenterology">{{cite web |url=http://www.gastrojournal.org/article/S0016-5085(12)00494-5/fulltext?referrer=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2F#sec8 |title=The Diagnosis and Management of Non-alcoholic Fatty Liver Disease: Practice Guideline by the American Gastroenterological Association, American Association for the Study of Liver Diseases, and American College of Gastroenterology - Gastroenterology |format= |work= |accessdate=}}</ref> | * NAFLD usually has no symptoms. So diagnosing the problem often starts after a blood test finds higher-than-normal levels of liver enzymes. A standard blood test could reveal these results. | ||
* However, at present, there are significant gaps in our knowledge regarding the diagnosis, natural history, and treatment of NAFLD.Sometimes patients with normal liver enzyme levels have NAFLD and NASH and maybe not enough for screening alone but with ultrasound which is sensitive can serve as a screening test. <ref name="urlThe Diagnosis and Management of Non-alcoholic Fatty Liver Disease: Practice Guideline by the American Gastroenterological Association, American Association for the Study of Liver Diseases, and American College of Gastroenterology - Gastroenterology">{{cite web |url=http://www.gastrojournal.org/article/S0016-5085(12)00494-5/fulltext?referrer=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2F#sec8 |title=The Diagnosis and Management of Non-alcoholic Fatty Liver Disease: Practice Guideline by the American Gastroenterological Association, American Association for the Study of Liver Diseases, and American College of Gastroenterology - Gastroenterology |format= |work= |accessdate=}}</ref> | |||
Revision as of 03:19, 18 December 2017
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Non-Alcoholic Fatty Liver Disease Microchapters |
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Differentiating Non-Alcoholic Fatty Liver Disease from other Diseases |
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Diagnosis |
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Treatment |
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Case studies |
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Non-alcoholic fatty liver disease screening On the Web |
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American Roentgen Ray Society Images of Non-alcoholic fatty liver disease screening |
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Directions to Hospitals Treating Non-alcoholic fatty liver disease |
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Risk calculators and risk factors for Non-alcoholic fatty liver disease screening |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vamsikrishna Gunnam M.B.B.S [2]
Overview
There is insufficient evidence to recommend routine screening for NAFLD. But it can be argued that at least for high-risk profiles like obesity, insulin resistance and patients with metabolic syndrome should be screened for NAFLD. However, at present, there are significant gaps in our knowledge regarding the diagnosis, natural history, and treatment of NAFLD.Sometimes patients with normal liver enzyme levels have NAFLD and NASH and maybe not enough for screening alone but with ultrasound which is sensitive can serve as a screening test.
Screening
- There is insufficient evidence to recommend routine screening for NAFLD. But it can be argued that at least for high-risk profiles like obesity, insulin resistance and patients with metabolic syndrome should be screened for NAFLD.
- Most of the time NAFLD is accidental finding on routine ultrasound.
- NAFLD usually has no symptoms. So diagnosing the problem often starts after a blood test finds higher-than-normal levels of liver enzymes. A standard blood test could reveal these results.
- However, at present, there are significant gaps in our knowledge regarding the diagnosis, natural history, and treatment of NAFLD.Sometimes patients with normal liver enzyme levels have NAFLD and NASH and maybe not enough for screening alone but with ultrasound which is sensitive can serve as a screening test. [1]
| Incidental finding of Fatty liver on ultrasound | |||||||||||||||||||||||||||||||||||
| Check for persistently raised LFTs | |||||||||||||||||||||||||||||||||||
| Ask the patient for significant alcohol intake | |||||||||||||||||||||||||||||||||||
| NO | YES | ||||||||||||||||||||||||||||||||||
| Diagnose NAFLD | Consider other alcoholic related diseases | ||||||||||||||||||||||||||||||||||
Monitor severity of the disease
| Offer Enhanced Liver Fibrosis Test (ELF) | |||||||||||||||||||||||
| (>10.51) ELF Positive | (<10.51) ELF Negative | ||||||||||||||||||||||
| Indicating advanced fibrosis and risk of progression to cirrhosis | Typically Benign -- Advanced fibrosis unlikely | ||||||||||||||||||||||
| Refer the patient to Heptologist | |||||||||||||||||||||||
- On negative ELF test offer retest for every 3 years for adults and 2 years for children.