NAFLD
Pediatric Fatty Liver Disease (NAFLD & NASH)
Evaluation of nonalcoholic fatty liver disease in children and teens, with a focus on early detection, metabolic risk, and family-based lifestyle change.
Nonalcoholic fatty liver disease is now the most common chronic liver condition in children, closely tied to insulin resistance, obesity, and metabolic syndrome. Many children have no symptoms at all, and the condition is often discovered incidentally on blood tests or imaging performed for other reasons.
Dr. Mendez evaluates liver enzyme patterns, coordinates fibrosis assessment when indicated, and works with families on practical, sustainable lifestyle changes that address the root metabolic drivers. Early intervention can prevent progression from simple steatosis to steatohepatitis and fibrosis.
Signs and symptoms
- Often asymptomatic, discovered on routine labs or imaging
- Mild right upper quadrant discomfort in some children
- Fatigue that is hard to distinguish from normal childhood energy swings
- Associated features: acanthosis nigricans, central weight gain, or prediabetes
- Family history of type 2 diabetes or metabolic syndrome
How we treat it
- Comprehensive metabolic and liver enzyme panel to characterize disease severity.
- Imaging review (ultrasound or elastography) to assess liver fat and stiffness.
- Evaluation for coexisting metabolic risk factors: prediabetes, dyslipidemia, and hypertension.
- Family-based nutrition and physical activity counseling, tailored to real-world schedules.
- Coordination with pediatric endocrinology when metabolic syndrome is present.
When to call a pediatric GI
- Your child has elevated liver enzymes found on routine blood work.
- An ultrasound noted fatty liver and you want a clear assessment of what this means.
- Your child has obesity, prediabetes, or acanthosis nigricans and you want to screen for liver involvement.
- You need a structured plan to reverse fatty liver through lifestyle change rather than medication.
- A prior doctor mentioned NASH or fibrosis and you want a pediatric GI opinion on next steps.
Frequently asked
Is medication needed to treat NAFLD in children?
There is no FDA-approved medication for pediatric NAFLD. Treatment centers on lifestyle modification: reducing sugar-sweetened beverages, improving diet quality, increasing physical activity, and addressing insulin resistance. We create realistic, family-based plans rather than restrictive diets.
Can NAFLD be reversed?
Yes, especially in early stages. Weight loss of even five to ten percent, combined with improved diet quality and regular activity, can significantly reduce liver fat and inflammation. The key is sustainable change, not crash diets.
Ready to talk it through?
Concierge access means we have the time to listen, evaluate carefully, and stay with your family through every step.