Red flags & when to go in person for Nonalcoholic Fatty Liver Disease (NAFLD) - Education

Audience: pediatric

Nonalcoholic Fatty Liver Disease (NAFLD) is a condition where fat builds up in the liver of children who do not drink alcohol. It is often linked to obesity and can cause liver damage over time if not managed properly. Early stages may not show symptoms, so regular check-ups are important. Telemedicine can help families learn about NAFLD, manage diet and lifestyle changes, and monitor symptoms. However, some signs mean a child should see a healthcare provider in person quickly. These include severe belly pain, yellowing of the skin or eyes, swelling, or sudden changes in behavior. This guide helps parents and caregivers understand when to use telemedicine and when to seek in-person care for children with NAFLD.

Red flags — go in person / ER

• Severe or worsening abdominal pain — seek emergency care immediately.
• Yellowing of the skin or eyes (jaundice) — see a healthcare provider in person promptly.
• Confusion, extreme tiredness, or unusual behavior — urgent medical evaluation needed.

What telemedicine can do

• Providing education about NAFLD and lifestyle changes.
• Reviewing symptoms and general health status.
• Discussing lab results and monitoring plans.
• Supporting adherence to treatment and follow-up schedules.

What telemedicine cannot do

• Evaluating severe or sudden symptoms such as intense pain or jaundice.
• Performing physical exams or diagnostic tests.
• Managing medical emergencies or complications.
• Making definitive diagnoses requiring imaging or biopsy.

What is Nonalcoholic Fatty Liver Disease (NAFLD)?

NAFLD happens when extra fat builds up in the liver cells of children who do not drink alcohol. It is one of the most common liver problems in kids, especially those who are overweight. NAFLD can cause inflammation and damage to the liver if it gets worse. Early on, children might not feel sick, but over time, the liver can become scarred (a condition called fibrosis). Managing NAFLD usually involves healthy eating, physical activity, and regular medical follow-up.

How Telemedicine Can Help with NAFLD

Telemedicine allows families to talk with healthcare providers remotely using video or phone calls. For NAFLD, telemedicine can be used to:

This can save time and make it easier to stay connected with your child's care team. However, some situations require an in-person visit.

When to Seek In-Person Care for NAFLD

Certain signs mean your child should be seen in person as soon as possible:

These symptoms could mean serious liver problems or complications that need urgent evaluation.

Preparing for a Telemedicine Visit

To get the most from a telemedicine visit:

After Your Telemedicine Visit

After the visit, you may be advised to:

Keep notes from the visit and contact your healthcare provider if you have concerns.

How to prepare for your tele-visit

• Write down all symptoms your child is experiencing, including when they started.
• Gather any recent lab test results or medical reports.
• Prepare a list of questions or concerns you want to discuss.
• Ensure your device (phone, tablet, or computer) is charged and connected to the internet.
• Find a quiet, private space for the telemedicine visit where your child can be comfortable.

After your tele-visit

• Follow any lifestyle or dietary recommendations given by the healthcare provider.
• Schedule and complete any recommended lab tests or imaging studies.
• Monitor your child's symptoms daily and note any changes.
• Contact your healthcare provider if new or worsening symptoms occur.
• Plan for in-person visits if advised or if red-flag symptoms develop.

FAQs

What causes NAFLD in children?

NAFLD in children is often linked to excess weight, poor diet, and lack of physical activity. It can also be influenced by genetics and other health conditions like diabetes.

Can NAFLD be reversed?

In many cases, early NAFLD can improve or even reverse with healthy lifestyle changes such as better nutrition and increased physical activity.

How is NAFLD diagnosed?

Doctors usually diagnose NAFLD based on medical history, physical exams, blood tests, and sometimes imaging tests like ultrasound. A liver biopsy is rarely needed in children.

Is telemedicine safe for managing my child's NAFLD?

Telemedicine is a useful tool for education, follow-up, and monitoring stable symptoms. However, it cannot replace in-person exams or urgent care when serious symptoms appear.

What should I do if my child has symptoms like yellow skin or belly swelling?

These are warning signs that require prompt in-person medical evaluation. Contact your healthcare provider or emergency services immediately.

Sources

1. Nonalcoholic Fatty Liver Disease — MedlinePlus, U.S. National Library of Medicine / NIH.
2. Nonalcoholic Fatty Liver Disease (NAFLD) in Children — American Academy of Pediatrics.
3. Nonalcoholic Fatty Liver Disease (NAFLD) — Centers for Disease Control and Prevention (CDC).
4. Nonalcoholic Fatty Liver Disease — Mayo Clinic.

This telemedicine education is for informational purposes only and is not a substitute for professional in-person medical care. If your child has any concerning symptoms or emergencies, seek immediate medical attention.