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Nonalcoholic fatty liver disease


Diagnosis

 
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.