What is Fatty Liver Disease

Fatty liver disease occurs when excess fat accumulates in liver cells. It ranges from simple steatosis, known as nonalcoholic fatty liver disease (NAFLD), to a more serious condition called nonalcoholic steatohepatitis (NASH), which includes inflammation and can progress to fibrosis and cirrhosis. Fatty liver disease can also result from heavy alcohol use.

Risk Factors

• Obesity and metabolic syndrome.
• Type 2 diabetes or insulin resistance.
• High cholesterol or high triglycerides.
• Heavy alcohol intake (for alcoholic steatohepatitis).
• Certain medications, rapid weight loss, or malnutrition.

Symptoms

• Many people with fatty liver disease have no symptoms and are diagnosed by abnormal liver tests or imaging.
• When symptoms occur, they may include fatigue and vague right‑upper‑quadrant discomfort.
• In advanced NASH, signs of cirrhosis such as jaundice, ascites, and swelling may develop.

Diagnosis

• Blood tests including liver enzymes and metabolic profile.
• Imaging studies such as ultrasound, CT scan, or MRI to assess liver fat and structure.
• Non‑invasive fibrosis assessments such as transient elastography (FibroScan) to evaluate liver stiffness.
• Liver biopsy may be performed to assess inflammation and fibrosis in selected cases.

Management

• Lifestyle modifications: Weight loss through diet and exercise is the most effective treatment. Even a 5–10% reduction in body weight can improve liver inflammation and fibrosis.
• Controlling metabolic risk factors: Managing diabetes, hypertension, and dyslipidemia is critical.
• Avoiding or limiting alcohol: Essential for alcoholic fatty liver disease and recommended in NAFLD/NASH.
• Medications: No specific drugs are currently approved for NASH, but clinical trials are ongoing. Vitamin E or insulin‑sensitizing agents may be helpful in certain cases.
• Monitoring: Regular follow‑up with liver tests and imaging to detect progression. Patients with advanced fibrosis or cirrhosis may need surveillance for liver cancer.

Our hepatology team offers comprehensive evaluation and management of fatty liver disease, including coordination with nutrition and weight‑loss programs.