Clinical Dilemmas in Non-Alcoholic Fatty Liver Disease offers hepatologists practical, up-to-date and expert guidance on the most topical dilemmas, difficulties and areas of controversy/difficulty surrounding this ever-increasing area of liver disease they face in daily practice.

Roger Williams and Simon Taylor-Robinson, two of Europe's leading hepatologists, have recruited leading figures from across the world to assist them, resulting in a truly international approach. Each chapter covers a specific area of difficulty, containing clear learning points and providing evidence-based expert guidance on the latest hot topics in clinical management such as:

Is NAFLD different in absence of Metabolic Syndrome?
Are the pros outweighed by the cons of obtaining a liver biopsy?
Is progression to cirrhosis more likely in children with NAFLD?
What are the dangers as well as the true benefits of bariatric surgery?
How is it best to use antifibrotic agents in clinical practice?
Clinical Dilemmas in Non-Alcoholic Fatty Liver Disease provides the answers to the questions and challenges that clinicians face every day in this area. It is essential reading for hepatologists of all levels and researchers in hepatology, as well as all those involved in the care of patients with NAFLD, including gastroenterologists, pathologists and specialist hepatology nurses.

Table of Contents

List of contributors

Preface

Part I Nature of the condition

Chapter 1 Hype or harm from Fatty Liver Disease?
Stephen H Caldwell and Curt Argo

Chapter 2 Worldwide problem.
Geoffrey Farrell and Philip Newsome

Chapter 3 Is insulin resistance the key motive for NAFLD?
Desmond Johnston

Chapter 4 Progression to cirrhosis is more likely in children with NAFLD?
Anil Dhawan

Chapter 5 NAFLD as cause of cryptogenic cirrhosis?
Jay Lefkowitch

Chapter 6 Is NAFLD different in absence of Metabolic Syndrome?
Yusuf Yilmaz

Chapter 7 Occurrence of noncirrhotic HCC in NAFLD
Stephen Harrison and Dawn Torres

Part II Factors in Disease Progression

Chapter 8 Fibrosis progression molecular pathways all important?
Anna-Mae Diehl and Dr Wing-Kin Syn

Chapter 9 Can fatty liver of NAFLD be distinguished from that of Alcoholic Liver Disease?
David Kleiner and Elizabeth Brunt

Chapter 10 Are inflammasomes and intestinal microbiota relevant in disease progression to NASH?
M. Bilal Siddiqui, M. Shadab Siddiqui and Arun Sanyal

Chapter 11 Can genetic influence in Non-Alcoholic Fatty Liver Disease be ignored?
Quentin Anstee

Chapter 12 Is there a mechanistic link between hepatic steatosis and cardiac rather than liver events?
Soo Lim

Part III Diagnosis and Scoring

Chapter 13 Is there a best method for diagnosis of NAFLD?
Vlad Ratziu

Chapter 14 Choice of non-invasive blood tests and FibroScan
Massimo Pinzani and Manolis Tsocatzis

Chapter 15 Are the guidelines - AASLD, IASL, EASL and BSG of help?
Jean-François Dufour

Chapter 16 How to choose from different imaging modalities and screening techniques
Hero Hussain

Chapter 17 Are the pros outweighed by the cons of obtaining a liver biopsy?
Simon Taylor-Robinson and Jeremy Cobbold

Chapter 18 Screening for NAFLD in high risk population
Nader Lessan

Part IV Value of treatment measures

Chapter 19 Balancing calorie restriction, exercise and weight reduction
Nicholas Finer

Chapter 20 Should Physicians be prescribing, or patients self-medicating with Orlistat, Vitamin E, Vitamin D, insulin antagonist, Trental and coffee?
Brent Neuschwander-Tetri and Haripriya Maddur

Chapter 21 Does improvement in hepatic steatosis have a significant favourable effect on the Metabolic Syndrome, including diabetes?
Jukka Westerbacka

Chapter 22 What are the dangers as well as the true benefits of bariatric surgery?
Andrew Jenkinson

Chapter 23 Liver transplantation; what can it offer?
Roger Williams

Part V What does the future hold?

Chapter 24 Molecular antagonists, leptin or other hormones in supplementing environmental factors?
Jeremy Tomlinson

Chapter 25 Use of antifibrotic agents in clinical practice
Jonathan Fallowfield

Chapter 26 Better understanding of early development and material influence?
Jude Oben

Chapter 27 Defining the role of Metabolic Physician
Nicholas Finer