Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and metabolic dysfunction associated steatohepatitis (MASH)

What is pediatric non-alcoholic fatty liver disease (NAFLD)?

Non-Alcoholic Fatty Liver Disease (NAFLD) is the most common cause of chronic liver disease in children the United States, affecting millions. It is a condition in which fat builds up in the liver, and – if untreated – it can lead to serious liver problems like cirrhosis (scarring of the liver) and cancer during adulthood.

Risk factors

• Pediatric NAFLD is common in the United States, affecting 10% of children.

• Obese children are at the greatest risk for developing fatty liver disease, but having type-2 diabetes or pre-diabetes, insulin resistance, or high cholesterol also increase a child’s risk.

• The disease has been found in adolescents, as well as young children. In some cases, it runs in families.

What is non-alcoholic steatohepatitis (NASH)?

Over time, the extra fat can cause inflammation and scarring of the liver. When that happens, the disease becomes known as non-alcoholic steatohepatitis (NASH). The exact cause of NAFLD and NASH is unknown.

What are the signs and symptoms of pediatric non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH)?

• Fatigue

• Loss of appetite

• Pain in the upper right part of the abdomen

• Weakness

• Weight loss

How is pediatric non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) diagnosed?

There are several tests to diagnose NAFLD and NASH in children. A doctor will go over your child's medical history and perform a physical exam. Doctors usually discover fatty liver disease through abnormal results in routine blood tests or by discovering an enlarged liver during routine examination.

Your healthcare provider may also perform one or more of the following tests:

• Blood tests

• Ultrasound

• CT scan

• MRI

• Liver biopsy

Not every child needs all these tests. Your physician will discuss with you exactly what the next steps are.

How is pediatric non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) treated?

There is no medication for NAFLD, but healthy lifestyle choices can stop the disease and even reverse it.

At Children's Health, helping children overcome NAFLD starts with:

• An accurate diagnosis, enabled by comprehensive blood tests, advanced imaging technology and (if needed) innovative biopsy techniques.

• A team approach that brings together GI specialists, dietitians and a psychologist

Children can stop or reverse NAFLD by eating healthier and exercising more. Our dietitians know how to teach your child how to crave less sugar and choose healthier foods. We can also teach your child which foods will give them the best fuel to succeed at school. Together, we’ll come up with a plan that involves fewer calories, less sugar and less fat – and plenty of physical activity.