Fatty Liver Disease: The Diagnosis Everyone Ignores
Fatty liver is now found on roughly one in three routine ultrasounds. Most people are told it is 'nothing to worry about' — which is true only if something is done about it.
Read articleFatty liver is the accumulation of fat within liver cells, usually found by chance on an ultrasound done for something else. It is a warning of insulin resistance, and in a proportion of people it progresses to inflammation, scarring and cirrhosis.
Symptoms
Not everyone gets every symptom, and the pattern can differ in older people, in people with diabetes and in children. These are the ones most often reported.
- No symptoms in most people
- Vague discomfort or heaviness in the right upper abdomen
- Tiredness and reduced stamina
- Abnormal liver enzymes found on a routine blood test
- In advanced disease, swelling of the legs or abdomen and yellowing of the eyes
When to see a doctor
Do not wait these out
If any of the following applies, arrange to be seen the same day. For anything sudden or severe, call 9281862028 or come straight to the emergency department at SIMS — it is open 24 hours and does not need an appointment.
- Fatty liver reported on ultrasound, particularly with diabetes, obesity or high triglycerides
- Persistently raised liver enzymes on repeat testing
- Yellow eyes, abdominal swelling or vomiting of blood
- Any liver abnormality in a person who consumes alcohol regularly
Tests that may be advised
Your consultant will order only the investigations that change the plan. Most of the following are available on the SIMS campus, so results usually come back the same visit.
- Ultrasound of the abdomen
- Liver function tests, repeated over time
- Fasting blood sugar, HbA1c and lipid profile
- Hepatitis B and C screening
- Fibroscan or elastography to assess liver stiffness where available
How it is treated
Treatment is decided case by case — by how advanced the problem is, what else you are being treated for, and what you can realistically sustain. Broadly, it involves the following.
- Gradual weight reduction of seven to ten percent, which reverses most early disease
- Complete avoidance of alcohol
- Reducing sugar, sweetened drinks, fried food and refined carbohydrate
- Regular aerobic exercise, which improves the liver even without much weight loss
- Tight control of diabetes and lipids, and periodic monitoring of liver enzymes
This page is general information, not a diagnosis
Fatty Liver can look like several other conditions, and the reverse is equally true. Nothing here can replace an examination, your test results and the judgement of the doctor treating you — and no medicine mentioned by name to a friend or relative should be started on the strength of this page. If you recognise yourself in it, book a consultation with the Medical Gastroenterology department. If a symptom is sudden or severe, call 9281862028.
