Fatty Liver Disease

One of the most common liver conditions, and one of the quietest.

Fatty liver disease means excess fat has accumulated in liver cells. In many people it causes no symptoms and no harm. In others, the fat triggers inflammation, and over years that inflammation can scar the liver — a process that runs from mild fibrosis through to cirrhosis. Most people who have it do not know they do. It is often picked up incidentally on an ultrasound ordered for something else, or from mildly abnormal liver enzymes on routine bloodwork.

Who Is at Risk

• Excess weight, particularly around the abdomen
• Type 2 diabetes or insulin resistance
• High cholesterol or triglycerides
• High blood pressure
• Certain medications
• Significant alcohol use, which causes a related but distinct form of the disease

Symptoms

Usually none, which is the point worth understanding. When symptoms do appear, they tend to be vague — fatigue, or a dull discomfort in the upper right abdomen. Symptoms of advanced liver disease, such as swelling in the legs or abdomen, jaundice, or confusion, appear late. This is why evaluation matters before anything feels wrong.

How We Evaluate It

The question that matters is not whether fat is present but whether the liver has been scarred. We assess that with bloodwork, a review of your history and medications, and FibroScan — a painless ten-minute scan that measures both liver stiffness and fat content. It requires no needles and no sedation, you can drive yourself home, and it is available at all three of our offices. In many cases it answers the question that would otherwise have required a liver biopsy.

Because FibroScan is quick and repeatable, it also lets us track whether things are improving over time rather than guessing.

Treatment

The encouraging part is that early fatty liver disease is often reversible. Sustained weight loss is the single most effective treatment, and a modest reduction can meaningfully reduce liver fat. Because that is easier said than done, we offer medically supervised weight management as part of treating the liver rather than treating it as a separate problem. Controlling diabetes, cholesterol, and blood pressure matters, as does reducing or eliminating alcohol. Newer medications for liver-related fibrosis are available for selected patients, and we will tell you if you are one of them.