Non-alcoholic fatty liver disease (NAFLD) clinic
What is NAFLD?
NAFLD is the accumulation of too much fat in the liver. It is closely linked to being overweight as well as conditions such as type 2 diabetes, high blood pressure and high cholesterol levels.
Some people with NAFLD may develop inflammation and scarring of the liver. In a small number of people this can lead to liver cancer or liver failure.
The main treatment for NAFLD is eating a well-balanced diet, being physically active, losing weight if overweight and having good control of metabolic comorbidities such as type 2 diabetes, high blood pressure and high cholesterol. There are also several pharmacological treatments in development which might become available in the next few years.
How are people referred to the NAFLD service?
We have pioneered a referral pathway, according to which people diagnosed with NAFLD have risk stratification by their GP using non-invasive fibrosis tests. These are blood tests that are very good at excluding people who do not have significant liver scarring. People with NAFLD who do not have significant liver scarring can be managed by their GP with lifestyle advice. Those people at risk of liver scarring, are referred to the NAFLD service for further investigations and management.
What do we offer in the NAFLD service?
Clinical care: We offer a multidisciplinary service for patients with consultant-led clinics by Professor Tsochatzis and specialist nurse-led clinics. We also offer dietetic support by a dedicated liver dietitian who provides bespoke consultations for patients in need of dietetic advice. Finally, there is input for associated conditions such as type 2 diabetes and high cholesterol from Dr Atul Goyal, who is a consultant chemical pathologist. Patients might see all specialists on the day of their clinical appointment.
The clinic is supported by specialist multi-disciplinary teams including histopathology, radiology and interventional radiology and is closely linked to the Royal Free Hospital liver transplant service.
The multidisciplinary NAFLD service was recipient of the runner up prize for the service award of the British Society of Gastroenterology in 2021.
Research focus: in addition to specialist clinical care we also offer a portfolio of clinical trials and a rage of research projects exploring the causes, management and outcomes of NAFLD and its impact on patients’ lives. If they wish, patients may be eligible to take part in these studies to contribute to research, to donate samples (such as blood) to a research archive (biobank) and potentially to access novel treatments in clinical trials.
As part of our commitment to education and practice development, the NAFLD service frequently hosts international clinician observers and visiting practicing clinicians from across the globe.
Useful contacts:
Telephone: 020 3758 2000 X33575
Email – administration: rf-tr.hepatologyadmin@nhs.net
Email – clinical nurse specialists (for current patients): rf-tr.hepatologycns@nhs.net
Patient support organisations:
The British Liver Trust is a UK-wide health charity that promotes liver health, campaigns to raise awareness about liver diseases and provides information and support for patients with liver diseases.
Patient resources
1) Information about NAFLD in the British Liver Trust website
2) Guidelines for patients developed by the European Association for the Study of the Liver (EASL).