Paul Coater has never been much of a drinker. The retired Marine figures that in three decades, his drinks maxed out at two beers a year, with a few special occasion celebrations thrown in. “I might have really wahoo-ed it and drank two glasses of wine on New Year’s,” he says.
So he was surprised when he was diagnosed in 2010 with stage-four cirrhosis, the scarring of liver tissue often associated with excessive alcohol consumption. Coater was referred to Matthew Cave, a liver health specialist at the University of Louisville. Cave took Coater on as a patient, but at first it wasn’t necessarily clear to him what could have caused the disease.
Shortly after, reports started coming out about contaminated water at Camp Lejeune, a Marine Corps base in North Carolina where Coater served in the late 1970s. Now, Cave thinks that exposure probably played a role.
While fatty liver disease often results from too much alcohol, it also affects people who don’t drink, and at an increasing rate. A 2016 study estimated 1 in 4 people globally have non-alcoholic fatty liver disease (NAFLD).
