Nonalcoholic fatty liver disease (NAFLD) is defined as the presence of excessive fat accumulation in the liver in individuals without significant alcohol consumption or other etiologies of chronic liver disease. It is the most common cause of chronic liver disease in the United States and is rapidly becoming the most common indication for liver transplantation. NAFLD encompasses a broad spectrum of diseases, ranging from simple steatosis or nonalcoholic fatty liver (NAFL), progressing through nonalcoholic steatohepatitis (NASH) and advanced fibrosis, to cirrhosis and end-stage liver disease. Most patients with NAFLD are asymptomatic and are often diagnosed incidentally. They often present with elevated liver enzymes on routine blood work or with incidental findings of hepatic steatosis (HS) on imaging studies performed for other reasons. In this chapter we will discuss the epidemiology, natural history, diagnosis modalities, assessment of disease severity, and the available treatment options for NAFLD.
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