Fatty Liver

The liver is a large organ located on the right side of the abdomen beneath the rib cage. It is essential for digesting food and removing toxins and alcohol from the body. If extra fat builds up inside the liver, it will make it harder for the organ to function. This condition is called fatty liver disease.

There are two key types of this condition:

  • Alcoholic fatty liver disease (ALD), resulting from heavy alcohol consumption; and
  • Non-alcoholic fatty liver disease (NAFLD), which may be genetic but also is more common among people who are overweight, have high cholesterol, and are resistant to insulin or type 2 diabetes, among other factors.

Nonalcoholic fatty liver disease is among the most common forms of chronic liver disease in the U.S., affecting 30% to 40% of the population. Fat deposition can sometimes lead to inflammation called nonalcoholic steatohepatitis (NASH) – which can lead to scarring. If left unchecked this can eventually lead to cirrhosis or end-stage liver disease.

Patients living with fatty liver typically experience few symptoms. That is why it’s important to follow up with a gastroenterologist to evaluate and monitor the amount of damage as well as evaluate for other potential liver conditions.

Because patients rarely experience symptoms, diagnosis usually requires a physical exam, patient history review, and tests. Those tests may include:

  • Blood tests – This test checks the levels of liver enzymes, blood proteins, and other signs of damage. A blood test can also measure blood counts (anemia), identify viral infections such as hepatitis B or C, or find autoimmune liver conditions.
  • Imaging tests are used to view the liver and assess damage and may include:
    • Abdominal ultrasound –a tool sends sound waves that identify hard surfaces and objects.
    • Transient elastography an enhanced ultrasound that measures the stiffness of the liver (fibrosis or scarring).
    • Computerized tomography (CT) scan or MRI (magnetic resonance imaging) – specialized X-rays.
    • MRE (magnetic resonance elastography) – a test that combines imaging and soundwaves to create a visual map to detect tissue hardening.
  • Liver biopsy – A tissue sample may be taken and examined under a microscope to determine the severity, extent, and cause of the damage.
The most effective treatment for fatty liver disease is weight loss. Losing just 3% to 5% of body weight can reduce the amount of fat in the liver and the risk factors associated with it. Those who drink alcohol will need to stop immediately to prevent their liver health from worsening.

Your doctor might also suggest an exercise regime and other lifestyle changes, such as eating more plant-based foods to help reduce cholesterol.

No drug treatments have been approved for fatty liver disease, although some are being tested.

If the disease results in cirrhosis, it can be treated with medications or surgery.

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